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Improving Health Care Reimbursement

A diverse array of payer guidelines has created new challenges to streamlining processes.

U.S. Health Insurance Impacts on Commercial Providers

There currently is no standard health insurance provided in the United States, nor mandates that require individuals to purchase health insurance (individually or through an employer). Although low-income earners are automatically qualified for Medicaid through the government, most uncovered individuals are not eligible for this option and do not choose to obtain coverage privately due to the high associated costs. The U.S. has struggled for many years to arrive at approaches to a health care reform that would provide access to a cost effective healthcare system and basic medical necessities with little progress. This has created opportunities for the private sector to create tailored coverage plans to fill this gap and take advantage of consumer demand. Insurers are coming up with many different variations in structure, coverage, and pricing of such plans which have continuously grown over time such that the numbers of possibilities are seemingly infinite.