Becker's Payer Issues | Payer News

Health systems face rising case complexity, thin specialty coverage and operating margins too tight to absorb preventable revenue loss. Denials and misclassified patient status quietly drain dollars that smaller systems can least afford to lose. A nonprofit health system serving…

Physicians in value-based contracts are doing two jobs at once: delivering care and proving it. Risk adjustment, quality reporting and payer-specific documentation all land on the same clinicians already spending 5.3 hours in the EHR for every eight hours of…

Getting a payer file is easy. Trusting it is not. In a late-2025 survey of 56 hospital and health system C-suite leaders, 87% said claims data matters to value-based care. Only 35% were confident it was accurate. Just 11% called…

When a health system sells its ambulatory laboratory operations, it collects a one-time payment and gives up the recurring revenue that testing would have earned for years. Many leaders underestimate how profitable ambulatory testing is, then watch the lost margin…

Your health system already earned the revenue, and now it’s sitting in a fax queue, in a denial nobody had time to appeal, and in an authorization that’s been pending for three weeks. See how health systems are clearing those…

Naples Comprehensive Health was managing roughly 40 travel nurses across four staffing agencies, each with its own systems, rate structures and communication processes. Recruiters contacted every agency individually, forwarded resumes, coordinated interviews, tracked compliance documents and reconciled invoices from multiple…

Health systems rely heavily on medical equipment that moves throughout hospitals with patients and clinicians. These devices play a role at many stages of the patient care journey and represent a significant investment of capital and operating resources. Yet many…