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Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage

Bart Klion, 95, and his wife, Barbara, faced a tough choice in January: The upstate New York couple learned that this year they could keep either their private, Medicare Advantage insurance plan — or their doctors at Saratoga Hospital. The Albany Medical Center system, which includes their hospital, is leaving the Klions’ Humana plan — […]

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Value-based payment flaws

While CMS has a target of getting 100% of Medicare beneficiaries into value-based payment (VBP) programs–such as accountable care organizations–by the end of the decade, implementing VBP in practice will be challenging. An editorial by Navathe et al. (2024) in Health Affairs provides some key considerations.

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Insurer “Delay and Deny” Practices Continue to Threaten Patients’ Timely Access to Gastrointestinal Care – It’s Time for Reform

When a patient is struggling with gastrointestinal (GI) health issues, such as rectal bleeding, inflammatory bowel disease (IBD), or the possibility of colorectal cancer, they must immediately seek medical care. Receiving a timely colonoscopy or endoscopy is essential to developing an individually tailored treatment plan to help the patient recover.

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Provider Strategy reports on market developments and insights related to the healthcare provider workforce. Our publication is committed to improving the healthcare professional workforce, utilization of providers, and ultimately supporting thought leadership in workforce innovation.

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