Three Changes Consumers Can Expect In Next Year’s Obamacare Coverage
The Department of Health and Human Services issues new rules designed to simplify health coverage consumers buy through Healthcare.gov.
Medicare To Test New Payment Approaches For Some Prescription Medications
Regulators unveiled a two-part plan that will change payments and test ways in which the Medicare Part B program can change the incentives that some policy experts say encourage doctors to choose higher-cost medications.
Using Data To Help Home Health Workers Manage Patients’ Conditions
A market is emerging for products that enlist data and technology to identify patients who might be at risk for hospitalization or readmission.
Women Increasingly Having Outpatient Mastectomies, New Federal Data Show
Agency For Healthcare Research and Quality data show that more women with breast cancer are opting for mastectomies over less-invasive options, and more are having the procedure in outpatient facilities where they don’t spend even one night in the hospital.
Insurer’s Approval Of Genetic Testing For Some Cancers Raises Questions
The decision by Independence Blue Cross of Pennsylvania to pay for whole genome sequencing for some cancer patients adds to the debate about how to handle these expensive tests.
Health Plans’ Coverage Of Some Drugs Can Be A Source Of Consumer Confusion
Some medicines, particularly intravenous treatments, are not listed in plans’ pharmacy benefit section and, therefore, it’s difficult to confirm coverage specifics.
Cigna CEO David Cordani: ACA Marketplace Is Still In ‘Version 1.0’
In a recent interview, Cordani discussed the evolution of exchange health plans as well the proposed merger between Cigna and Anthem.
2016 PPO Plans Remove Out-Of-Network Cost Limits, A Costly Trap For Consumers
A trend among this year’s marketplace plans leaves some consumers responsible for potentially unlimited out-of-network health care bills, even though they chose plans in which they thought they had some financial protections.
As HMOs Dominate, Alternatives Become More Expensive
A KHN analysis finds a sharp difference in premium prices between plans that offer out-of-network care and those that do not.
UnitedHealth Warns Of Marketplace Exit – Start Of A Trend Or Push For White House Action?
Some analysts and health policy experts view the move as an effort to compel the Obama administration to make changes.
Cancer Meds Often Bring Big Out-Of-Pocket Costs For Patients, Report Finds
The advocacy arm of the American Cancer Society said Wednesday that federal and state governments should move to restrict insurers from charging patients a percentage of the cost of their prescription drugs.
‘Do The Math’ When Shopping For A Health Plan This Open Enrollment Season
Because of the complexity of insurance available through healthcare.gov and state exchanges, and the broad variation in how prescription drugs are covered, experts encourage consumers to compare options to figure out which one best fits their needs.
Feds Issue Proposed Rule On Health Information Collected By Workplace Wellness Programs
This proposal allows these workplace wellness programs to set financial incentives for participation as high as 30 percent of the cost of family coverage. A separate draft rule pegs this amount to the cost of employee-only coverage.
UnitedHealthcare Expands Effort To Rein In Rising Costs Of Cancer Treatment
As part of an effort to pinpoint what’s driving up health expenditures, the insurer is broadening a pilot program to include about 500 more oncologists, bringing the total to 650 physicians in seven states.
No Ready-Made Rx For Rising Drug Costs
Lawmakers, insurers and others have floated proposals to combat the spike in prescription drug prices, but will any of them gain traction?
The clinics have agreed to disclose more fully which health insurance plans consider them “in network.”
Leslie Michelson’s Checklist For Avoiding Diagnostic Errors – The KHN Conversation
Michelson, who runs a Los Angeles-based company that helps patients research their medical options and has written a book about how to avoid bad care, offers advice on how to navigate the health care system.
Express Scripts To Cover Pricey New Cholesterol Drugs
To control costs, the nation’s largest pharmacy benefits manager has in place strict rules on which patients will be eligible.
Workplace Wellness Programs: Early Alarm For Workers’ Health Or A Recipe For Over-Testing?
Some experts worry that these programs encourage health screening that doesn’t necessarily comply with medical guidelines and is helping to drive up health care costs.
Privacy Advocates Urge Stronger Protection Of Employee Health Data
Existing laws designed to control what doctors and hospitals do with your information need to be expanded to employers’ wellness programs, say advocates.
