Becker's Payer Issues | Payer News

A stroke alert sounds and the neurologist is in clinic across town. Someone starts making calls. Someone else describes the patient over the phone. The clock that costs an estimated 1.9 million brain cells a minute keeps running. There is…

Efforts to transform prior authorization are at a critical crossroads: Will government mandates result in just compliance or catalyze national migration to FHIR-based electronic prior authorization (ePA)? The answer to this question cannot be found in the specifics of the…

Payer contracting has become a top strategic priority for health systems, but many teams still run it on spreadsheets, disconnected systems and knowledge that lives in a few people’s heads. The pressure is mounting from both payers and providers, and…

Picture the morning huddle where someone asks where a patient stands and three people check three different places to answer. One opens a spreadsheet, one checks a whiteboard and one calls the coordinator who happens to know. Nobody is wrong,…

Health system margins have struggled throughout 2026, and the pressure shows no sign of easing. Rising costs and demographic shifts away from traditional profit centers now collide with newer threats: OBBBA-driven coverage reductions, rising payer denials, the accelerated outpatient shift…

Monday morning is when the cost of inconsistent patient access surfaces — unmet demand, backed-up calls, stretched staff and provider capacity that patients cannot reach. For specialty practices, access is no longer just an operational headache; it’s a growth lever.…