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Big Gaps in Care and Even Bigger Medical Debts

The movies, Dallas Buyers Club, Last Holiday, Sicko, The Rainmaker, John Q and Breaking Bad all point to one thing in common: The ugly side of the American Healthcare System.  The United States spent about 16% of the total GDP on healthcare from 1980-2019, when compared with the UK, Australia, New Zealand and Canada. All, but […]

Imbalance in COVID-19 Patients Emerge Through Medicare Claims Data

According to a recently published study by the Centers for Disease Control and Prevention (CDC), there were substantial disparities in Medicare fee-for-service beneficiary spending. The study revealed that non-White race and ethnicity, rural residency, and male sex were linked to higher spending on medical grounds. Researchers took the data of 2020 administrative claims from CMS […]

Physician Practices Demand More from Provider Relief Fund

Future distributions of Provider Relief Fund should prioritize allocation to physician practices struggling with the financial consequences of the unprecedented COVID-19 pandemic, rather than just hospitals, physician groups are urging lawmakers. Where is the Focus? Physicians practicing outside of the hospital systems in the country have already invested thousands of dollars in infrastructure to support […]

The Price Transparency Rule & Non-Compliance of Major Hospitals

Around two-thirds of the largest hospitals in the US are yet to fully comply with the new price transparency rule, with most of the hospitals missing payer-specific charges. The new price transparency rule went into effect on January 1, 2021. Where the Hospitals are Lacking? According to recent research, nearly two-thirds of the 100 largest […]

Reimbursement at Medicare Rates Might Cut Healthcare Spending by $352B

Lowering and matching the rates of private payer reimbursement to that of Medicare might reduce the steadily rising healthcare spending. However, it might also slash the revenue of hospitals and other providers. According to a new analysis, the overall healthcare spending of the country can be lowered by around $352B in 2021 if the private […]

Few Conditions Compelling Employer Healthcare Spending

Five common conditions, consisting of several chronic ones, drive employer healthcare spending and might be able to impact the payer’s overall spending. ASTHMA It is one of the leading factors of employer healthcare spending. The instance of asthma was around 31 percent higher in women. While income levels did not pose to be a differentiating […]

The New Year Comes Bearing Gift: Transparency in Hospital Prices

A new federal healthcare rule will require hospitals to publicly post prices for every service they offer. Not only that, but they also need to break down those prices by component and procedures. What it means… The Transparency in Coverage rule helps patients choose where to go for healthcare, with the matter of price under […]