Prior authorization is a utilization management process used by some health insurance companies for determining if the patient’s health policy covers a prescribed services, like procedures, tests, or medications, before services are rendered. While intended to control healthcare costs, prior authorizations can be a significant burden on healthcare providers and can delay patient care.
No Surprises Act (NSA) protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.
Top At-Risk Conditions and utilization spikes that healthcare leaders and stakeholders across the industry must prepare to proactively address in the upcoming year highlight the recently released, 2023 State of Health – In The Aftermath Report. The report also presents predictive findings and explores the top contributing factors of many utilization increases.
National Survey on Drug Use and Health Released by the U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA), which shows how people living in America reported about their experience with mental health conditions, substance use, and pursuit of treatment in 2021.
The roles and responsibilities now require stretching medical directors’ skills into contract negotiations, group dynamics, organizational development, team management, and many areas not covered in a traditional medical curriculea.
Physician burnout can contribute to patients' own burnout as they navigate their care, wrote Aisling Carroll, an ovarian cancer survivor and freelance writer, in an op-ed for STAT.
U.S. News & World Report released its Best Hospitals rankings for 2019-20 on July 30.
In 2015, cancer deaths cost the U.S. $94 billion in lost earnings, according to a study published in JAMA Oncology.
Increasing amounts of in-basket messages generated by the EHR is correlated to higher levels of burnout symptoms among physicians, according to a study published in Health Affairs.
More than eight and 10 Americans see insurers as the largest contributor to surprise medical bills, according to a recent poll.