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ICD-10 Delay Derails More Than IT for Health Insurers
With the delay in ICD-10, many insurers now have to slow down a mammoth IT project and, potentially more disruptive, make adjustments to a whole slew of programs and contracts.
With the delay in ICD-10, many insurers now have to slow down a mammoth IT project and, potentially more disruptive, make adjustments to a whole slew of programs and contracts.
While most payers’ ICD-10 conversions are generally ahead of organizations in other healthcare sectors, this “very late breaking change in the deadline is like throwing a great big wrench into a very complicated process that’s well underway,” as Jordan Battani, CSC’s managing director for emerging health practices, put it.
On an industry-wide level, as America’s Health Insurance Plans sees it, the delay is bound to “cause undue confusion and administrative challenges,” leaving payers and providers in “a stalled transition between two different coding systems.”
Read the full story here: http://bit.ly/1k0Rby7
Source: Healthcare Payer News
AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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ACA Network Regulatory Filings Are Inaccurate, Poorly Match Provider Directories
September 16th 2025A secret shopper survey (N = 8306) in Pennsylvania’s Affordable Care Act (ACA) Marketplace found inconsistencies between carrier regulatory filings and provider directories, frequent inaccuracies in regulatory filings, and challenges in securing timely appointments.
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ACA Dependent Coverage Extension and Young Adults’ Substance-Associated ED Visits
September 15th 2025This study examines the impact of the Affordable Care Act (ACA) on substance-associated emergency department (ED) visits among young adults, revealing reduced alcohol-associated visits but unchanged opioid-associated visits.
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