Hospital claim denial rates have hit new highs, with a 20% increase in those rates over the past five years, suggesting that better claims-denial management-processes are necessary, finds a new survey ...

Employers are becoming more interested in switching to a pharmacy benefit manager they perceive as being more transparent than the “big three,” according to new data published by the National Alliance ...

This story has been updated with comment from AHIP. Medicare Advantage Organizations overturned 95% of appealed prior authorization denials for skilled nursing facility admission in favor of enrollees ...

Optum and Change Healthcare officially merged today. Change filed a report with the Securities and Exchange Commission today in connection with the closing, in accordance with the January 5 merger ...

High utilization and claim costs, chronic conditions and the growing use of GLP-1 therapies continue to drive spending and ...

New York Life completed its $6.3 billion acquisition of Cigna's group life, accident and disability insurance business, the company announced last week. As a part of the deal, New York Life and Cigna ...

The organizations have also raised concerns about changes to practice expenses, same-day services and remote monitoring, ...

Nearly half those paying off medical bills owe at least $2,000, according to the results of a Commonwealth Fund survey.

OBBBA requirements will make it harder for those 19 to 24 to retain coverage because of their changing circumstances, ...

The watchdog found that most of the high-risk diagnosis codes it sampled were not supported by enrollees' medical records.

Two health systems will evaluate the system that gives guidance on emerging bottlenecks up to 72 hours in advance.

The nationwide rollout of the risk-based survey process follows a pilot conducted across 22 states. CMS estimates that about ...