Hospitals: Payers are putting profit over patients

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Top Story Payers Are Putting Profit Over Patients with Denials and Prior Auth Policies, Hospitals Say Hospitals are facing increasingly burdensome policies from commercial insurers, leading to problems with cash flow and patient safety. Hospital executives think federal regulators need to enact stricter policies that require payers to operate on faster timelines, as well as provide more transparency into their reasons for denying claims. Sponsored Embracing Biosimilars to Lower Costs & Foster Innovation Presented by Express Scripts - Evernorth PBMs like Express Scripts are embracing biosimilar competition to provide cost savings today and access to innovative medicines in the future. Read more about our longstanding commitment to driving cost savings. Learn more.

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The Digital Renaissance in Health Plan Ops: What Technologies Should Insurers Deploy? With rising expectations from every stakeholder in the insurance ecosystem, the ability to quickly process data, automate key processes, and rapidly build and iterate on digitally supported health plans will be essential. To stay afloat, health plan providers need experienced partners who can implement strategic technology with powerful outcomes, as the landscape evolves. WebMD Ignite Launches New Solution to Improve Health Plan Care Management Programs WebMD Ignite recently introduced Coach, a solution that supports health plans' care management programs. It includes educational resources for members and reporting on member engagement. J&J Backs Down From 340B Rebates, But Maintains They're 'Legally Permissible' Per Statute Johnson & Johnson stopped short of implementing its proposal to alter the way two drugs are paid for under the 340B drug discount program, but the drugmaker made it clear it still wants changes. In other recent regulatory news, we have drug approvals, clinical holds, and one product withdrawal. Rural Healthcare Needs More Than Just Telehealth People working the most vital occupations, like farmers and ranchers, call the most remote areas in this country home. Their health shouldn't suffer due to their choice of employment.

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MedCity Moves Podcast: Recent Hires, Layoffs & an Interview with Dr. Jayne Morgan, VP of Medical Affairs at Hello Heart In this month's episode, Senior Reporter Katie Adams explored some of the executive moves, exits and layoffs that recently occurred in the healthcare sector. She also interviewed Dr. Jayne Morgan, who recently became vice president of medical affairs at Hello Heart. Listen Now

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