Health Insurance
The enhanced premium tax credits (EPTCs) help middle-class Americans purchase affordable, comprehensive coverage on the Health Insurance Marketplace. These tax credits are set to expire at the end of 2025, putting millions of families at risk of higher costs and coverage losses.
Absent commercial health insurance companies fulfilling a recent promise to reform their prior authorization (PA) and claims-paying behaviors, what can hospitals and health systems do to combat increasing claim denials and their growing threat to clinical and financial sustainability?
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on hospitals, which found that increased enrollment is not statistically associated, on average, with all-payer hospital margins.
The AHA May 29 submitted a letter to the Centers for Medicare & Medicaid Services responding to a request for information regarding Medicare Advantage data, urging CMS to increase oversight of the program.
Automating health care insurance claims management with AI-powered tech can speed denials resolution - TrailBlazers
An analysis published Sept. 30 by KFF found that Health Insurance Marketplace enrollees who currently benefit from the enhanced premium tax credits would pay more than double their current premium payments if the EPTCs expire at the end of this year.
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure insurance plans adhere to the agencies’ health insurer pledge to reform prior authorization processes.
AHA supports the Administrations role in facilitating the health insurer pledge to reform prior authorization processes announced on June 23.
The Census Bureau reported that the uninsured rate increased nationally to 8.2% in 2024 from 7.9% in 2023 based on data from the American Community Survey.
The Centers for Medicare & Medicaid Services Innovation Center Sept. 2 announced changes to the Achieving Healthcare Efficiency through Accountable Design Model, including a new end date of Dec. 31, 2035.