Articles related to INSURANCE

Hospital ownership of health insurance plans increased from 18.3% in 2018 to 27.2% in 2023, with higher adoption among academic institutions. Effects on care, physician incentives, and costs remain uncertain.

Retina practices are adjusting after Good Days funding limitations reduced copay support for some patients requiring chronic anti-VEGF therapy. Medicare Advantage patients appear especially exposed to affordability pressure.

“By design, this system of pleading makes it relatively easy for plaintiffs to subject defendants to discovery, even for claims that are likely to fail.” — U.S. Supreme Court opinion

“Prior authorization began as a reasonable mechanism for controlling costs, but over the decades, I have been practicing it has ballooned into a massive administrative burden that far too often leads to care delays and unnecessary agony and harm.” – René Bravo, MD, President of the California Medical Association (CMA)

“The goal is to advance scientific rigor, cultural inclusivity, and adaptability while ensuring that the DSM remains useful to clinicians and remains a trusted, relevant tool for understanding and treating mental disorders.” – Marketa M. Wills, MD, MBA

“When 60% of ‘not medically necessary’ denials are reversed…we’re seeing algorithmic denial for delay’s sake.” — Anthony J. Paravati, MD, Kettering Health