The Business of Healthcare

Historically speaking, health plan transparency in the United States has been sorely lacking. The Transparency in Coverage Final Rule requires insurers and health plans to disclose negotiated rates with in-network providers and allowed amounts for out-of-network providers — here’s what it means for employers.

A perfect storm of deferred care, rising costs, and record-breaking inflation is going to hit every employer in 2023. While funnel clouds can be incredibly destructive, they’re also somewhat fragile. Here's how to apply mitigating pressures and save your team from the worst of this economic turmoil.

When I worked for an insurance carrier, we had an acronym we used to describe the doctor groups that were most likely to generate surprise medical bills. Insurance companies and others that work with hospitals need to pay special attention to these ERAPH providers.

With nurse turnover and burnout in nurses both on the rise, travel nurses are helping fill staffing shortages in hospitals. While it’s an arguably necessary solution given the state of care, outsize travel nurse pay is creating more problems than the approach solves.

When medical bills go unpaid, those low payment rates have ripple effects that eventually circle back to employers in the form of higher insurance premiums. Here’s what employers can do about it.

Why is healthcare so expensive in the U.S.? Many folks assume soaring prescription prices and expensive medical services are behind the rising costs of healthcare, but the actual answer might surprise you. Read on to learn more about healthcare costs.