Latest news with #AmericanHealthcare
Fast Company
a day ago
- Health
- Fast Company
Value-based care: How good ideas get crushed
Remember when value-based care was going to revolutionize American healthcare? A decade later, we're still waiting while costs keep climbing. What happened? Simple—the healthcare industrial complex did what it always does: absorbed innovative ideas and neutralized them. Healthcare innovation follows a predictable pattern. A promising new model emerges, gains traction, then gets swallowed by the system, transforming from disruptor to just another profit center for middlemen. THE TRAP Value-based care has an elegant premise: pay providers for patient outcomes, not service volume. Better care, at a price aligned with value—what's not to love? Yet, instead of replacing fee-for-service arrangements, value-based programs were simply added alongside existing arrangements. Since the majority of patients remained under fee-for-service arrangements, value-based protocols resulted in creating even more administrative complexity, not less. In fact, after years of value-based experiments, health spending continues to rise faster than inflation. In 2023, the average annual premium for employer-sponsored family health coverage reached $23,968, according to the Kaiser Family Foundation. In 2024, it climbed to $25,572. That's a year-over-year increase of 7%. Meanwhile, the share that members are responsible for paying through deductibles, co-pays, and other out-of-pocket costs has grown at a similar pace. WHY MODELS THAT BYPASS THE SYSTEM SUCCEED This country is home to some amazing doctors and nurses, but they are trapped in a broken system that forces them to spend time checking boxes for 'quality metrics' rather than caring for patients. And here's the fascinating part—healthcare innovations that completely circumvent traditional payment models are thriving. Take direct primary care, which is booming because it eliminates the middleman entirely. Providers charge transparent monthly subscription fees directly to patients or employers, cutting out insurance companies altogether. In 2023, 9% of doctors surveyed by the American Academy of Family Physicians reported using a direct primary care model, with an additional 2% reporting they were in the process of transitioning. This represents a staggering increase from the 2% of physicians who reported they operated a DPC model the prior year. According to a 2023 study published in Health Affairs, administrative waste comprises between 7.5% and 15% of total U.S. healthcare spending, equivalent to $285 billion to $570 billion annually. Research shows the U.S. spends $1,055 per capita on healthcare administrative costs, more than triple what the next highest nation (Germany) spends. This money isn't going to better care; it's being absorbed by middlemen. If you're writing massive monthly checks to insurance companies, here are three actions to take right now: 1. Demand complete data transparency. Your company's healthcare data belongs to you. Period. Make raw claims data non-negotiable in your next carrier contract. Perform a healthcare spending audit—you'll be shocked at how little reaches actual care providers. 2. Build direct provider relationships. Identify high-volume providers used by your employees and reach out about direct contracting. Start with a pilot for specific services like imaging, lab work, or primary care. 3. Consider alternative payment models. Look into alternatives like employer–direct contracting, payment clearing platforms, HSAs with smart routing, point-of-sale payments, or direct primary care. Even partial implementation of these models can save 15%-20% while improving care access. BREAKING THE CYCLE The healthcare industry is brilliant at absorbing potentially disruptive innovations. It's why hospital systems now own 'disruptive' urgent care centers, and insurance giants have purchased 'innovative' telehealth platforms. But direct payment models succeed by operating outside this absorption cycle entirely. They're structurally resistant to being co-opted because they fundamentally change how money flows. As employers, we need to stop waiting for the system to fix itself. By demanding transparency, building direct provider relationships, and implementing streamlined payment models, we can create the healthcare system our employees deserve—one that delivers better care at lower costs without the bloated bureaucracy.
CBS News
5 days ago
- Business
- CBS News
How to qualify for medical debt forgiveness
If you're struggling to pay off your medical bills, debt forgiveness could be an option to pursue. SengMedical debt has become one of the most common and overwhelming forms of debt in the U.S., and for good reason. The rising cost of healthcare has made even the most routine care unaffordable for the average person, and all it takes is a short hospital stay or emergency room visit to end up with medical bills in the thousands or tens of thousands. And, things like high deductibles, surprise billing and out-of-network charges can add up fast, even if you have insurance. But if you don't have insurance at all, the bills can be staggering. What makes medical debt particularly frustrating is that it often feels unavoidable. Unlike a credit card balance or a personal loan, which you might voluntarily take on or use to bridge the gaps in your salary and expenses, medical debt is typically the result of an unexpected illness, accident or necessary treatment. And when you're dealing with a health crisis, figuring out how to pay the bill is usually the last thing on your mind, at least until the debt collectors start calling about your overdue medical bills and it becomes impossible to ignore. That's where medical debt forgiveness can come into play. While full forgiveness isn't guaranteed or always easy to get, there are legitimate ways to reduce or eliminate what you owe. So, if you're hoping to erase some or all of your medical debt, you'll want to know about qualifying for forgiveness — and what to do if that's not an option. Find out how to start the debt relief process today. How to qualify for medical debt forgiveness The first thing to understand is that medical debt forgiveness can take a few different forms. Unlike student loans or tax bills, there's no single federal program that wipes out healthcare-related debt. But there are hospital- and provider-based programs, nonprofit resources and settlement strategies that can lead to partial or full forgiveness. Here's how to approach these options: Start with hospital financial assistance programs. Many nonprofit hospitals are required to offer charity care or income-based relief under the law. So, if your medical debt is tied to a nonprofit hospital and your income falls under a certain threshold you might qualify for full or partial forgiveness. The catch? You usually have to ask. Hospitals don't always publicize these programs, and some require you to apply within a certain timeframe after receiving care. Look into debt settlement as an option. If you don't qualify for assistance through a hospital or charity, negotiating with the billing department or a third-party debt collector can sometimes lead to partial forgiveness. With medical debt, creditors are often more willing to settle for less than the full balance, especially if the debt is old or has been sold to a collection agency. You can negotiate this on your own, or work with a debt relief company that specializes in unsecured debt. Just keep in mind that there may be fees involved, and any settled debt could be taxed as income if the forgiven amount is over $600. Watch your insurance and billing statements carefully. Sometimes what looks like medical debt may actually be the result of incorrect billing or insurance denials. If you see errors, appeal them. Getting a charge corrected or resubmitted to your insurer could make the balance go away entirely and save you the trouble of needing forgiveness in the first place. Chat with a debt relief expert about the options available to you now. What to do if you don't qualify for medical debt forgiveness If you've explored the forgiveness options above and still come up empty, you may still have some options. Taking the steps below, for example, may help you manage your medical debt burden: Set up a payment plan. Most hospitals and clinics will let you pay off your balance in small monthly installments without tacking on much (or any) interest. This isn't medical debt forgiveness, but it can make the debt much easier to handle and prevent it from going to collections. Explore debt settlement more seriously. Settling your debt for less than you owe comes with some downsides, but it can be a realistic way to cut down the balance. So, if you were hesitant to pursue this route due to the tax and fee implications but are out of options, you may want to revisit the possibility of settling your debt. Prioritize the debt correctly. Unlike credit card debt, medical debt generally doesn't accrue interest or late fees in the same way, and newer changes to credit reporting rules mean that paid medical debts no longer appear on your credit report. Use that to your advantage and focus on higher-interest debts first, while staying in communication with the provider to avoid collections. The bottom line Medical debt forgiveness isn't always easy to come by, but it's more accessible than many people realize. From hospital assistance programs to debt settlement, there are real ways to reduce or erase what you owe, especially if you're proactive about asking for help. And even if forgiveness isn't an option, affordable payment plans and strategic debt management can make the load lighter. The most important step is to take action quickly, though, as there's real power in negotiating, asking questions and exploring every available path to relief.
Yahoo
24-05-2025
- Business
- Yahoo
Nano-X Imaging First Quarter 2025 Earnings: Misses Expectations
Revenue: US$2.82m (up 10% from 1Q 2024). Net loss: US$13.2m (loss widened by 8.2% from 1Q 2024). US$0.21 loss per share. AI is about to change healthcare. These 20 stocks are working on everything from early diagnostics to drug discovery. The best part - they are all under $10bn in marketcap - there is still time to get in early. All figures shown in the chart above are for the trailing 12 month (TTM) period Revenue missed analyst estimates by 29%. Earnings per share (EPS) also missed analyst estimates by 9.1%. Looking ahead, revenue is forecast to grow 51% p.a. on average during the next 3 years, compared to a 6.7% growth forecast for the Healthcare industry in the US. Performance of the American Healthcare industry. The company's shares are down 8.4% from a week ago. You still need to take note of risks, for example - Nano-X Imaging has 1 warning sign we think you should be aware of. Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email editorial-team (at) article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
19-05-2025
- Business
- Yahoo
Doximity Full Year 2025 Earnings: EPS Beats Expectations
Revenue: US$570.4m (up 20% from FY 2024). Net income: US$223.2m (up 51% from FY 2024). Profit margin: 39% (up from 31% in FY 2024). The increase in margin was driven by higher revenue. EPS: US$1.20 (up from US$0.78 in FY 2024). We check all companies for important risks. See what we found for Doximity in our free report. All figures shown in the chart above are for the trailing 12 month (TTM) period Revenue was in line with analyst estimates. Earnings per share (EPS) surpassed analyst estimates by 10%. Looking ahead, revenue is forecast to grow 9.3% p.a. on average during the next 3 years, compared to a 9.7% growth forecast for the Healthcare Services industry in the US. Performance of the American Healthcare Services industry. The company's shares are down 11% from a week ago. While earnings are important, another area to consider is the balance sheet. We have a graphic representation of Doximity's balance sheet and an in-depth analysis of the company's financial position. Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email editorial-team (at) article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.
Yahoo
17-05-2025
- Business
- Yahoo
SBC Medical Group Holdings First Quarter 2025 Earnings: EPS: US$0.21 (vs US$2.36 in 1Q 2024)
Revenue: US$47.3m (down 14% from 1Q 2024). Net income: US$21.5m (up 15% from 1Q 2024). Profit margin: 45% (up from 34% in 1Q 2024). The increase in margin was driven by lower expenses. EPS: US$0.21. Our free stock report includes 2 warning signs investors should be aware of before investing in SBC Medical Group Holdings. Read for free now. All figures shown in the chart above are for the trailing 12 month (TTM) period Looking ahead, revenue is forecast to grow 6.3% p.a. on average during the next 2 years, compared to a 6.8% growth forecast for the Healthcare industry in the US. Performance of the American Healthcare industry. The company's shares are up 2.1% from a week ago. You should learn about the 2 warning signs we've spotted with SBC Medical Group Holdings (including 1 which is potentially serious). Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email editorial-team (at) article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.
