Check The Fine Print: Some Work-Based Health Plans Exclude Outpatient Surgeries
This new generation of so-called “skinny plans” can save employers money, but it’s not yet clear if they will meet regulatory scrutiny.
Whistleblower Doctor Warns About Hospitals Hiring Physicians
Orthopedist Michael Reilly believes the surge of doctors going to work for hospitals is not a healthy trend. He had a firsthand view of what can happen.
7 Questions To Ask Your Employer About Wellness Privacy
Workplace wellness programs have joined doctors, hospitals and your mother in the campaign to get you healthy. Will they treat your data carefully?
Workplace Wellness Programs Put Employee Privacy At Risk
A large variety of information may be collected by wellness programs and shared with others, including businesses eager to make a buck off of it.
Employers Shift More Health Costs To Workers, Survey Finds
Even as premiums for employer-based insurance increased only moderately this year, deductibles rose faster than total spending.
When The Hospital Is Boss, That’s Where Doctors’ Patients Go
Hospital ownership of doctors’ practices “dramatically increases” odds that a doctor will admit patients there instead of another, nearby hospital, researchers say.
Health Law Experiment Failed To Show Savings
An ambitious demonstration to transform clinics into “medical homes” treating patients in the community instead of the hospital didn’t save money. Some blame the test, not the idea.
High Court’s Decision On Same Sex Marriage Expected To Boost Health Coverage Among Gay Couples
By marrying partners with employer health plans, people in same-sex relationships are more likely to gain coverage.
High Court Upholds Health Law Subsidies
The 6-3 ruling stopped a challenge that would have erased subsidies in at least 34 states for individuals and families buying insurance through the federal government’s online marketplace.
How Not To Find Out Your Health Plan Lacks Hospital Benefits
Don’t assume your employer’s health plan offers comprehensive coverage. Marlene Allen did. Then she got hurt.
5 Reasons Feds Are Overhauling Regs On Medicaid Outsourcing
Management of the joint state-federal program for low-income people has changed dramatically, and federal officials are seeking to make sure it meets the needs of enrollees.
Patient Finds Shopping For Low-Priced CT Scan Doesn’t Pay Off
Despite efforts to keep costs down, Douglas White gets a bill nearly three times what he expected.
‘Milestone’ Rules Would Limit Profits, Score Quality For Private Medicaid Plans
The Centers for Medicare & Medicaid Services proposal, which includes provisions related to network adequacy and quality standards, would be the biggest regulatory change to Medicaid managed care in more than a decade.
Radical Approach To Huge Hospital Bills: Set Your Own Price
A small consulting firm is disrupting hospitals’ business as usual by encouraging employers to pay much less than what hospitals bill — based on its analysis of what is reasonable.
An Obamacare Payment Reform Success Story – One Health System, Two Procedures
As part of an experiment run by the Centers for Medicare and Medicaid Innovation, doctors, nurses and managers at Baptist Health System in San Antonio joined forces to cut costs for hip and knee replacements, getting patients on their feet sooner, saving taxpayers money and increasing their own earnings.
Medicaid’s Tension: Getting Corporate Giants To Do Right By The Needy
Tennessee’s TennCare program awaits federal rules to limit insurer profits and set stricter standards for quality and doctor networks — the biggest rules change for Medicaid managed care in a decade.
High-Deductible Plans Bring Lower Costs Now, But Will They Bring Pricey Problems?
Companies that introduced these plans experienced overall savings in the first three years, according to a new study.
Attention, Shoppers: Prices For 70 Health Care Procedures Now Online!
Guroo.org shows the average local cost of 70 common diagnoses and medical tests in most states. That’s the real cost — not “charges” that often get marked down — based on a giant database of what insurance companies actually pay.
Obama Administration Disallows Plans Without Hospital Coverage
Large-employer plans without inpatient benefits were seen as a health law loophole that trapped workers in inadequate insurance. Now, the Obama administration has blocked them.
Mixed Results For Obamacare Tests In Primary-Care Innovation
Early reports show two major medical-home experiments run by the health law’s Center for Medicare & Medicaid Innovation reduced hospitalizations in some cases but are still working to cut overall costs.