Live Insurance News

The Impact of AI on Medicare Advantage Claims Denials

November 14, 2024November 13, 2024 Angela Linders

A Growing Concern for Healthcare Providers In recent years, the integration of artificial intelligence (AI) in the healthcare sector has sparked significant debate, especially concerning its role in Medicare Advantage claims denials. As hospitals face mounting administrative burdens, the use of AI by insurance companies has been scrutinized for potentially prioritizing cost-saving measures over patient care. The Rise of AI in Insurance Between 2019 and 2022, insurance companies like UnitedHealthcare, Humana, and CVS began increasingly employing AI tools to automate the prior authorization process. These technologies, while designed to streamline…

The High Cost of Health: Who Gets Weight Loss Prescriptions?

August 8, 2024August 8, 2024 Angela Linders

Disparities in Weight Loss Prescriptions The disparity in access to medications like Wegovy, Rybelsus, and Ozempic highlights a significant issue within the U.S. healthcare system. Despite the increasing medical applications of these drugs, which include managing diabetes and potentially preventing heart disease and stroke, many insurers remain reluctant to cover them for weight loss. Medicare, for example, is legally barred from covering weight-loss drugs unless the patient presents serious health risks. This limitation leaves over two-fifths of American adults who are obese but otherwise healthy without coverage options. Federal spending…

The Rising Tide of Uninsured Americans and the Looming Threat of ACA Subsidies Ending in 2026

August 7, 2024August 6, 2024 Live Insurance News

Uninsured Americans Rise to 27.1 Million in Early 2024, CDC Reports The latest figures from the Centers for Disease Control and Prevention (CDC) are sounding alarms across the healthcare landscape. More than 8% of Americans were uninsured during the first months of 2024, a significant uptick from the record-low uninsured rates observed in the wake of the COVID-19 pandemic. According to the CDC’s National Health Interview Survey, an estimated 27.1 million Americans of all ages lacked health insurance by March 2024. This marks an increase of 3.4 million uninsured individuals…

Health insurance exchanges open their doors today despite gov. shutdown!

October 1, 2013October 1, 2013 Julie Campbell

Health insurance exchanges - American healthcare reforms

After all of the controversy and planning for the central element of the Affordable Care Act, the day has arrived. Following considerable controversy and attempts to put a stop to the healthcare reforms, the most public-facing portion of the Patient Protection and Affordable Care Act, President Obama’s crown jewel, has now arrived for Americans in the form of health insurance exchanges that are opening their doors for enrollment in every state across the country. Regardless of the government shutdown, Obama has announced that millions of Americans can begin shopping for…

Healthcare reforms in China simplify process for patients, not providers

July 31, 2013July 29, 2013 H. Cutner

Hospitals are finding that this new system is not working out as well for them as for the people using them. According to the latest data that has been issued by analysts, while the Chinese government has intentions to lower the bills, and its healthcare reforms have been applauded by the industry, it is lacking in details that are needed to correct the hospital finance shortfalls. The government has made the effort to reduce the size of medical bills central to its massive overhaul. The central government has made its…

Healthcare study identifies possible savings of $2 trillion over 10 years

January 11, 2013April 30, 2013

The researchers are now calling for a new spending target that may be highly effective. According to a study that was just released on Thursday, the United States would be able to save $2 trillion from its spending on the healthcare system over the next 10 years if the federal government would help to influence the rapidly increasing costs in both the public and private sectors, so that they would more effectively align with economic growth. The study was conducted by the Commonwealth Fund, a nonpartisan group. In the report…

As people lose their health insurance, the number of emergency room visits skyrocket

October 22, 2011May 7, 2013

New figures about hospital use have shown that there has been a sharp increase in the number of visits to emergency rooms, and that – according to physicians – the rising numbers are the result of an intensifying demand for improvements and services that would permit emergency departments to provide patients with faster treatment. Early estimates from the U.S. Centers for Disease Control and Prevention have shown that in 2009, the number of emergency room visits increased by nearly 10 percent, which was the most significant rise in visits since…