Two large health insurers are trying their hand at a different profession – the practice of medicine. Aetna and Cigna have announced that they may unilaterally “downcode” some types of care – and pay ...

From denials and payer plans for unilateral downcoding to 340B legal battles, the most-read stories of 2025 reveal a revenue cycle under pressure, and the strategies leaders are using to stay afloat.

Several insurers are automatically downcoding -- and, therefore, paying less for -- claims for non-procedural office visits, a practice that provider groups said is unfair and may be anticompetitive.

Over the last few years, the business of emergency medicine has fundamentally shifted. Providers have weathered national crises—from the opioid crisis to the COVID-19 pandemic—while also managing a ...

Subscribe to The St. Louis American‘s free weekly newsletter for critical stories, community voices, and insights that matter. Sign up An initiative by insurance companies to reduce high-cost doctor ...

Insurer Aetna is pulling back on a downcoding policy for inpatient Medicare Advantage claims after at least one prominent hospital group criticized the original policy. In a notice posted to its ...

Veterans Day has been observed in one form or another since 1919, when then-President Woodrow Wilson commemorated the first anniversary of the World War I armistice. "To us in America, the reflections ...

Pope Leo XIV warned Monday that artificial intelligence could exacerbate “antihuman ideologies” in medicine as Catholic doctors and moral theologians raise alarms about the future of AI in health care ...

Dr. Peter Hahn, a cardiac electrophysiologist, works on his computer at Advanced Vein Associates in Uncasville on Sept. 15, 2025. Hahn is concerned that a new reimbursement policy announced by Aetna ...

For many communities, especially in rural and underserved areas, emergency departments (EDs) are the only available point of access for timely healthcare. Most emergency departments are legally ...