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Mercy cited "red tape" and Anthem BCBS's inability to keep pace with inflation. Mercy also stated that Anthem reported a 24.12% increase in year-over-year net income and a 24.29% increase in its ...
The policy, which would have covered Anthem's plans in Connecticut, New York and Missouri, was disclosed in recent weeks, with the company's New York unit posting a notice on Dec. 1. The policy ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Most provider markets (especially hospitals) are also highly concentrated—roughly 80%, according to criteria established by the FTC and Department of Justice [137] —so insurers usually have little choice about which providers to include in their networks, and consequently little leverage to control the prices they pay. Large insurers ...
A 2015 study found 14% of privately insured consumers received a medical bill in the past two years from an out-of-network provider in the context of an overall in-network treatment event. Such out-of-network care is not subject to the lower negotiated rates of in-network care, increasing out-of-pocket costs.
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Joseph Robert Swedish (born 1951) is an American healthcare executive and leader. [1] [2] He is a former senior adviser to the board of directors at Anthem, Inc., a Fortune 29 company, and was the CEO of Anthem, Inc. from 2013 to 2017.
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