Boston Children’s Hospital Creates ‘Living’ Practice Guidelines
Overuse of some medical treatments – and underuse of others, when patients fail to get recommended care — are two factors linked to high medical spending in the United States. But efforts to set “best practice guidelines” have often drawn criticism from physicians and patients as “cookbook medicine” that could limit doctors’ autonomy or restrict […]
Auditors: Medicare Could Save Millions By Limiting Advance Payments To Insurers
Medicare could earn up to $111 million annually if it limited insurers’ ability to retain investment earnings on the billions they are paid through the prescription drug program, according to a government reportout today. That’s because Medicare prepays the private insurers approximately 20 days before the insurers pay their pharmacy bills and does not require them to return […]
Groups Seek To Fast-Track Efforts To Curb Costs, Boost Quality
Five veteran health care leaders representing insurers, hospitals, employers and consumers on Thursday outlined an ambitious set of recommendations aimed at slowing rising costs, focused mainly on changing the way America pays for health care. Many of the ideas draw on existing efforts, such as accelerating Medicare’s efforts to pay for quality rather than just […]
Consumer Groups Fear Patients Could Be Hit With Large Out-Of-Pocket Costs
The Obama administration’s decision to delay the health law provision setting a maximum payment cap for some plans spurs complaints from several dozen organizations.
Insurers’ Efforts To Delay Health Law Compliance Could Affect Premiums, Benefits For Millions
By moving up renewal dates on plans sold directly to consumers, insurers could delay meeting law’s requirements for up to a year.
Walgreens Becomes 1st Retail Chain To Diagnose, Treat Chronic Conditions
Stores in 18 states to use nurse practitioners, physician assistants to expand services to include diagnosis and treatment for chronic conditions such as diabetes and asthma.
Prostate Screening Tests In Older Men Decline, But Many Still Get Them, Study Finds
Fewer men over age 75 are being routinely screened for cancer with a prostate-specific antigen (PSA) test following a 2008 recommendation against the tests, researchers said today, suggesting a less-is-more approach sometimes works. But while the numbers have declined, they remain significant – more than 4 in 10 men in that group still get the […]
Some States Will Rate Health Plans On Quality This Fall
Beginning in October, some states will score health plans on cancer screening rates and flu shot delivery, among other measures, to help consumers make smarter buying decisions.
Feds Outline What Insurers Must Cover, Down To Polyp Removal
The Obama administration on Wednesday released its final rule on essential health benefits, which sets out what benefits insurers must offer starting in 2014. Insurers must cover 10 broad categories of care, including emergency services, maternity care, hospital and doctors’ services, mental health and substance abuse care and prescription drugs. Essential benefit requirements apply mainly to […]
Walmart Health Screening Stations Touted As Part Of ‘Self-Service Revolution’
The kiosks are part of a technology boom targeted at consumers seeking instant health data and cheaper, more convenient care.
California Sets Standard Deductibles, Copays For Insurance Plans
California on Wednesday became the first state to standardize health insurance plans under the federal health law, which regulators say will make shopping for health insurance easier when new online marketplaces begin enrolling customers in the fall. The state has set specific rules governing how much insurers can charge consumers for such things as office visits, […]
Study: One-Third Of Individual Plans Exceed Law’s Out-Of-Pocket Cap
Consumers who buy their own health insurance will see the total amount they could pay out of pocket for medical care capped starting next year, but some will likely pay higher premiums as a result. That’s one conclusion that can be drawn from a new study showing more than one-third of health insurance plans currently offered to […]
Study: Premium Increases To Be Offset By Subsidies, Better Coverage
How the federal health law will affect premiums is among the most asked – and most controversial – questions in the final months before new rules kick in requiring most Americans to carry coverage. A white paper out Wednesday considers how the law will affect premiums for people who buy their own coverage because they […]
State Action Needed To Guarantee Health Law Protections, Says Report
Lawmakers in most states better get busy if they want authority to enforce key provisions of the federal health law that go into effect next year. That’s the takeaway message from a report by the Commonwealth Fund showing that only 11 states and the District of Columbia have passed rules needed to implement the law. […]
Some Families Will Be Ineligible For Insurance Subsidies Under Final Rule
Some families with costly job-based health coverage may be ineligible for federal subsidies to help them buy less expensive coverage through new online insurance markets, under final rules released Wednesday by the IRS. The two rules, published by the Treasury Department here and here, uphold earlier proposals outlining what is considered affordable, employer-sponsored coverage. Under the federal health law, low […]
HMO-Like Plans May Be Poised To Make Comeback In Online Insurance Markets
Insurers bet some consumers will choose cheaper plans that restrict their choice of doctors, despite worries about skimpy care and huge bills for out-of-network providers.
A Guide To Health Insurance Exchanges
The new online marketplaces, to be set up by October, are designed to make it easier to buy insurance. But they’re in the middle of a political fight over the health care law.
Tax Exclusion For Health Benefits Could Be Part Of ‘Fiscal Cliff’ Talks
As the deficit debate continues, some policy wonks think it’s inevitable that negotiators will address a loophole that allows workers to avoid paying taxes on the value of their job-based health insurance. “The No. 1 tax expenditure is employer-provided health insurance,” said G. William Hoagland, a senior vice president at the Bipartisan Policy Center, who […]
Governors Weigh Options On Health Insurance Exchanges
What’s at stake if they build state-based exchanges, partner with the federal government — or let federal regulators run everything?
Health Plans Gear Up To Sell Directly To Consumers
Insurers develop new business strategies as the health law upends old models.
