When Coverage Breaks Down: The Hidden Costs of Insurance Disputes
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When Coverage Breaks Down: The Hidden Costs of Insurance Disputes
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In this episode of The Vitals, we sit down with Dr. Alan Adler to unpack one of the most important issues affecting patients and health systems today: negotiations between hospitals and insurance companies.
As discussions continue between Mount Sinai and Anthem, Dr. Adler explains what is at stake in these conversations, how contract negotiations between major health systems and insurers typically work, and why these agreements can have far-reaching implications for patient access, affordability, and continuity of care.
The conversation also explores the broader economics behind hospital-insurer relationships—how reimbursement rates are determined, what drives negotiating leverage on both sides, and how health systems balance financial sustainability with their commitment to patient care.
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