RiseHealth Compass’ Post

Addressing payer disparities in healthcare requires a multifaceted approach that expands insurance coverage, improves affordability, and promotes equitable reimbursement practices. By prioritizing policies delivering access and affordability for underrepresented groups and women, we can strive towards a future where everyone has equitable access to high quality healthcare services and achieves optimal health outcomes. #risehealthcompass #payer #healthinsurance #healthcare #hopeforAmericans

Millions of Americans Still Uninsured or Underinsured Despite ACA Gains - HIT Consultant Despite the Affordable Care Act's successes, millions of Americans remain uninsured or underinsured, as highlighted by a recent Commonwealth Fund report. Key findings reveal that 66% of underinsured adults have employer-based coverage, yet many face high out-of-pocket costs, leading to skipped care and significant medical debt. The report calls for urgent policy actions, including extending tax credits, addressing medical debt, and expanding Medicaid, to enhance healthcare affordability and accessibility. As healthcare IT professionals, we must advocate for solutions that bridge these coverage gaps and improve patient outcomes. #HealthcareIT #AffordableCareAct #HealthInsurance #PolicyChange #PatientAccess #MedicalDebt #HealthEquity ai.mediformatica.com #health #insurance #report #debt #healthcare #medical #acce #healthinsurance #policy #provide #affordablecare #affordablecareact #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/4eIb12g)

Last week, our team focused on the patient. This week we shift our attention to the Payers. The Payers, including health insurance companies, businesses, organizations, and individuals, play a pivotal role in financing and facilitating access to healthcare services. However, disparities in insurance coverage, affordability, and reimbursement practices perpetuate healthcare access and outcomes inequities. Access to adequate health insurance coverage remains a significant determinant of healthcare access and utilization. According to recent data from the U.S. Census Bureau racial and ethnic minorities, low-income individuals, and undocumented immigrants are more likely to be uninsured or underinsured compared to their white counterparts, leading to barriers in accessing essential healthcare services, preventive care, and chronic disease management. Policies promoting equitable reimbursement rates and payment policies among payers are crucial for ensuring healthcare providers' fair compensation and incentivizing care delivery to underserved communities. Advocacy efforts to address Medicaid reimbursement disparities, particularly in primary care and mental health services, can help increase provider participation and improve access to care for Medicaid beneficiaries. #risehealthcompass #healthequity #payer #healthcare #access #bettyricelegacy #healthtech #risehealthcompass #health

𝐓𝐡𝐞 𝐀𝐟𝐟𝐨𝐫𝐝𝐚𝐛𝐥𝐞 𝐂𝐚𝐫𝐞 𝐀𝐜𝐭 𝐇𝐚𝐬 𝐑𝐞𝐝𝐮𝐜𝐞𝐝 𝐑𝐚𝐜𝐢𝐚𝐥 𝐇𝐞𝐚𝐥𝐭𝐡 𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞 𝐂𝐨𝐯𝐞𝐫𝐚𝐠𝐞 𝐃𝐢𝐬𝐩𝐚𝐫𝐢𝐭𝐢𝐞𝐬. The Affordable Care Act (ACA), signed into law in 2010, has significantly reduced health insurance coverage disparities among Black and brown communities in the United States. Recent reports from the U.S. Department of Health and Human Services (HHS) highlight the dramatic improvements in insurance rates for Black, Hispanic, Asian, and Native American populations between 2010 and 2022. 𝐊𝐞𝐲 𝐑𝐞𝐩𝐨𝐫𝐭 𝐅𝐢𝐧𝐝𝐢𝐧𝐠𝐬 𝐈𝐧𝐜𝐥𝐮𝐝𝐞: ✅ The uninsured rate among Black Americans decreased from 21% to 11% ✅ Hispanic Americans saw an uninsured reduction from 33% to 18% ✅ Asian Americans' uninsured rate fell from 17% to just over 6% ✅ Native Americans experienced a drop in uninsured from 32% to 20% The ACA and the ability to more broadly access health insurance has narrowed the coverage gap in American. We need to remain vigilant in our efforts to advance health equity so as not to step backward. The success of the ACA in improving coverage rates for Black and brown populations shows that well-designed policies can address and eliminate longstanding inequities in our healthcare system. As the debate over healthcare reform continues, policymakers must consider the impact of these gains and work to ensure that all Americans, regardless of race or ethnicity, have access to affordable, quality health insurance. Partner with KC Health Collaborative to help ensure our fight to advance health equity is sustained. All Kansas Citians deserve quality healthcare. Let’s get to work. - Follow KC Health Collaborative to stay up-to-date about our efforts to advance health equity in the Kansas City region and beyond. #aca #healthinsurance #healthinsurancecoverage #healthequity #kansascity

🔍 Did you know? #DYK According to Heard's second annual report on the #financialstatus of #privatepractice, around 3 in 4 private practice mental health professionals accepted some form of insurance in 2023. 💡 This insight sheds light on the evolving landscape of #mentalhealth care accessibility. 📊 Heard, a platform offering financial tools for therapy practices, conducted a comprehensive survey of 2,268 #therapists across all 50 states for its report. Among the key findings, approximately 50% of surveyed therapists accepted Aetna insurance, marking it as the most widely accepted payer. 💰 Interestingly, the report highlighted that the CVS Health subsidiary #paid the #highest average #reimbursement rate for therapy sessions, according to the providers surveyed. This underscores the crucial role insurance companies play in #supportingmentalhealth care providers AND their clients. Aetna, a CVS Health Company Acceptance rate: 50% Average reimbursement: $141 Cigna Healthcare Acceptance rate: 43% Average reimbursement: $106 #BlueCrossBlueShield Acceptance rate: 42% Average reimbursement: $122 Anthem Blue Cross and Blue Shield Acceptance rate: 29% Average reimbursement: $125 #Oxford (UnitedHealthcare) Acceptance rate: 25% Average reimbursement: $113 Oscar Health Acceptance rate: 25% Average reimbursement: $111 UnitedHealthcare Acceptance rate: 14% Average reimbursement: $114 Humana Acceptance rate: 11% Average reimbursement: $96 Kaiser Permanente Acceptance rate: 11% Average reimbursement: $101 courtesy of Becker's Healthcare 🌟 Advocacy for mental health care accessibility is paramount. By understanding the financial dynamics within the industry, we can advocate for policies and initiatives that ensure equitable access to mental health services for all individuals. #MentalHealthAwareness #InsuranceCoverage #HealthEquity #Parity #MajorPayers #AccesstoCare

The legislative session focused on insurance reform, maternal health, rate increases | Lawmakers signed off on sweeping changes to the insurance industry, boosted support for maternal health, increased provider rates, and did more during the recently concluded spring session. [Health News Illinois}  The package includes $182 million pledged by Pritzker earlier this spring to provide healthcare and other services to asylum seekers in the Chicago region. And it allocates $440 million to two programs that provide Medicaid-like coverage for some undocumented adults. An additional $100 million will be brought in from a federal emergency services match, as well as $50 million from drug rebate payments and $40 million from managed care organization taxes. We share some of the news report on Maternal Health and Behavioral Health here as it is closely aligned with IOMC's mission. Visit the page> https://lnkd.in/gSw_gp4G Visit the Health News Illinois website for the full news report> https://lnkd.in/eBTK5xE #statefunding #budget #maternalhealth #behavioralhealth #publichealth #socialchange #populationhealth #communityhealth #healthequity

We need to expand coverage further. The ACA increased insurance coverage significantly without corresponding increases in costs, largely due to the demographic of newly insured individuals being healthier, as well as the presence of cost-control measures within the ACA itself. However, high-deductible health plans are causing financial strain, particularly on lower-income individuals, limiting access to necessary care. "Our central takeaway is that we can expand access to care for low-income people without breaking the bank. We favor two main improvements: 1) Complete the Medicaid expansion journey in the recalcitrant states, and 2) make marketplace plans more generous and attractive to the lower-income but non-poor uninsured by increasing their actuarial value, especially with lower deductibles." #Medicaidexpansion #uninsured #AffordableCare

Health insurers are taking a tumble as the final Medicare Advantage rates have disappointed, according to Bloomberg. This decision could set up a high-stakes election year gamble for the Biden administration, as seniors may see cutbacks in their health plans right before Election Day. Stay tuned for more updates on this developing story. #healthcare #medicare #insurance #election2022

Americans should be able to trust their local hospitals. What many don’t realize is that these hospitals are often owned by large corporations who are only focused on making more money.   These corporations even use aggressive tactics like threatening to stop treating patients during negotiations to get higher payments from insurers. This tactic, described in a recent Third Way report, is streamlined because many hospital markets lack competition due to consolidation.   In a competitive healthcare market, insurers can choose from many hospitals and doctors to provide affordable care. However, in consolidated markets found in most American communities, hospitals have more power in negotiations. This leaves insurers with little choice but to accept higher costs or risk their patients losing access to care.   This problem worsened during the COVID-19 pandemic, when 70,000 Houston residents lost access to St. Luke’s Health. This problem affects the 178 million Americans, like our members, who rely on employer-provided health insurance, leading to higher costs that hurt wages and consumer prices.   To address these issues, Third Way proposed banning unfair contracting practices nationwide, so patients can access affordable, high-quality care. Some states have already taken steps in the right direction, and federal lawmakers are now considering similar legislation like the Healthy Competition for Better Care Act. It’s crucial for Congress to act to ensure fair healthcare practices and protect patients and employers from escalating costs. https://lnkd.in/eFUffQNn #hospitalprices #hospitalcosts #healthcare #benefits #healthbenefits #employersponsored #medicaldebt #debt #fairprice #hospitals #BetterCareAct

The Commonwealth Fund's latest report and scorecard make the usual sobering and depressing reading 🙁 Patients and their carers have to navigate a "nightmarish maze" of bureaucracy and red tape and it is only getting more complex ❗️ The US lags in affordability, and access and the collection of barriers continue to expand (denials, prior authorization appeals and the like) 😳 Even if you have health insurance the navigation and more worry the "fight" necessary to obtain medically prescribed care is debilitating - and that's atop being sick, oftentimes severely so 🤔 Perhaps one bright spot is the positive notes around preventative and screening services 🙏 Solutions to this require a total rethink of the approach and demand that the competing interests work to find mutually acceptable approaches to remove unnecessary burdens and eliminate waste. Cease the never-ending cycle of fighting change and disruption that inevitably impacts long-standing revenue streams and focus on the patient #HealthcareReform #PatientCare #BureaucracyInHealthcare #HealthInsurance #HealthcareAccess #AffordabilityCrisis #USHealthcare #MedicalBarriers #PriorAuthorization #HealthcareSolutions #PreventativeCare #ScreeningServices #HealthcareInnovation #PatientFirst #HealthcareDisruption #HealthcareWaste https://lnkd.in/eriWST_r