Hospitals are facing challenges due to burdensome policies from commercial insurers, leading to cash flow issues and patient safety concerns. Rising costs in healthcare are exacerbated by excessive payer requirements, such as prior authorizations and increased denial rates. This results in high costs associated with appealing denials and delays in payments. Hospital executives are calling for stricter regulations to streamline the prior authorization process and increase transparency. Denials are increasing, particularly for Medicare Advantage plans, leading hospitals to drop these contracts. Insurers’ roadblocks delay patient care and result in increased costs, highlighting the need for regulatory reform and accountability.
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Payers Are Putting Profit Over Patients with Denials and Prior Auth Policies, Hospitals Say
