Payers Are Putting Profit Over Patients with Denials and Prior Auth Policies, Hospitals Say

MedCity News October 6, 2024
Katie Adams

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.

Hospitals have never had a warm and fuzzy relationship with insurers — and it doesn’t seem like their bond will be getting stronger any time soon, according to a recent report from the American Hospital Association.

The AHA’s report stated that hospitals are facing increasingly burdensome policies from commercial insurers. This is causing major problems for hospitals, most notably in the areas of cash flow and patient safety.

The effects of rising...

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