Value in Health Publication Summary

Denials are no longer a slow leak in the revenue cycle—they’re a fast-moving, rule-shifting game controlled by payers, and hospitals that don’t model denial patterns in real time end up budgeting around losses they could have prevented. PayerWatch’s four-digit, client-verified ROI in 2024 shows what happens when a hospital stops reacting claim by…

Health insurers love to advertise themselves as guardians of care, but the real story often begins when a patient’s life no longer fits neatly into a spreadsheet. In oncology especially, “coverage” isn’t a bureaucratic checkbox—it’s the fragile bridge between a treatment that finally works and a relapse that can undo years of grit…

In “Fighting for Coverage,” a patient describes a double war: the physical fight to stay alive and the bureaucratic fight to prove to an insurer that her life is worth the cost. Her account spotlights a core tension in the U.S. system—coverage decisions are increasingly shaped by prior authorizations and desk-based reviewers who…