15 trends from UnitedHealthcare
A surge in high-cost claims was among the trends last year that UnitedHealthcare identified in its employer-sponsored health plans. The dominant healthcare payer’s 2026 Health Trends Report used data from UnitedHealthcare’s self-funded and fully insured plans. The annual report used claims filed from November 2024 to October 2025 and paid through January 2026. Top findings from the…
Nathan Kaufman: Hospital-based anesthesia and radiology operate in a broken financial model
The good ol’ days of hospital-based physicians providing services at no cost in exchange for exclusivity are over, creating significant disruptions. Health systems are facing a growing shortage of anesthesiologists and radiologists, a shortfall that is driven by a broken business model for those types of services. Underpayment for anesthesia and radiology care by Medicare and Medicaid combined with a lack of experience in related revenue cycle management and high…
Rural hospitals face significant payment disparities compared to urban hospitals
Rural hospitals are reimbursed 20% less than urban hospitals, with the gap widening as hospitals become more rural, according to a new analysis of price transparency data from over 5,000 U.S. hospitals.
Four financial challenges EDs face
Flat-to-declining payment rates, increasing Medicaid volumes, downcoding by payers, and increasing costs from waits and boarding have combined to increase financial challenges for hospital emergency departments in recent years.