Julie Appleby

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jappleby@kff.org
@Julie_appleby

California Insurance Chief Wants To Bar Anthem From Selling Small Business Coverage

KFF Health News Original

Citing a pattern of “unreasonable rate increases” for small business customers by Anthem Blue Cross, California Insurance Commissioner Dave Jones said Thursday he will recommend that the state’s new online insurance marketplace exclude the firm from selling small business coverage. The move comes amid national debate about the cost of coverage for individuals and small businesses […]

California Law Likely Resulted In Lower Bills, Free Care For Uninsured

KFF Health News Original

A California law limiting how much hospitals can charge the uninsured likely resulted in lower bills for many patients – and free care for most of the state’s poorest uninsured residents, according to a study published today in the journal Health Affairs. While some hospitals around the country have  voluntarily agreed to reduce how much they […]

Final Rule Upholds Increased Rewards, Penalties For Wellness Participation

KFF Health News Original

Employers will be able to increase rewards to workers who participate in wellness programs under final rules released Wednesday by the Obama administration. The final rules, similar to those proposed in November as part of the Affordable Care Act, have raised concerns among advocates who represent people with chronic or severe illnesses, as well as […]

Boston Children’s Hospital Creates ‘Living’ Practice Guidelines

KFF Health News Original

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

KFF Health News Original

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

KFF Health News Original

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 […]

Prostate Screening Tests In Older Men Decline, But Many Still Get Them, Study Finds

KFF Health News Original

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 […]

Feds Outline What Insurers Must Cover, Down To Polyp Removal

KFF Health News Original

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 […]

California Sets Standard Deductibles, Copays For Insurance Plans

KFF Health News Original

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, […]