National Healthcare Spending in the U.S. Was Nearly $5 Trillion (with a “T”) in 2023 – New...
Health Populi December 18, 2024
Increasing denials, prior authorizations driving providers to drop health plans
DOTmed March 13, 2024
Cumbersome prior authorization policies and the rising number of denials that result from an inability to meet these requirements has taken a toll on health system operating margins and pushed many to either drop or consider ending their affiliation with health plans, resulting in higher out-of-pocket costs and limiting access to care for patients.
In a new report published by the Healthcare Financial Management Association (HFMA) and health strategy and market research company Eliciting Insights, HFMA Health System CFO Pain Points 2024: Margin Challenges & Opportunities for Vendors, 90% of health systems say denials are the top challenge for their revenue cycle teams and 82% of chief financial officers say that denials have only gone up significantly since pre-pandemic levels.
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