Budgeting
Some extremely low QPAs bear little to no resemblance to the actual in-network rates in a given geographic area.
The majority of bad debt now is associated with patients with insurance, contributing to the net revenue challenge for hospitals.
Results of the HealthEdge survey show the pace of change has led to shifting priorities for health plan leaders.
This comes despite a rapid decline in COVID-19 hospitalizations following the winter surge, with the challenges expected to be widespread.
A $37.2 million net loss in Q1 spurred the decision to resize the organization, which CEO Vijay Kotte said "was not made lightly."
Expenses in June were generally down from May but remain extremely elevated from prepandemic levels.
The dip was driven largely by a decline in healthcare price growth relative to economy-wide inflation.
One of the main factors influencing revenue was admissions at its acute care facilities, which were not as high as anticipated.
Key factors include an evolving payer mix, spurred by MA plans, and shifts in sites of care, driven by virtual care and home-based services.
Enrollment would increase by 4.8 million, but it would also increase federal deficits by $246.9 billion over a nine-year span.