Latest KFF Health News Stories
As Insurers Struggle With GLP-1 Drug Costs, Some Seek To Wean Patients Off
Conventional wisdom says GLP-1 drugs must be taken indefinitely to maintain weight loss. But a growing number of researchers, payers, and providers are challenging that consensus and exploring whether — and how — to taper patients off expensive GLP-1 drugs.
Cuando los pacientes quedan atrapados en medio de las peleas entre aseguradoras y hospitales
El 18% de los hospitales no federales experimentaron al menos un caso documentado de enfrentamiento público con una aseguradora entre junio de 2021 y mayo de 2025. Lo sufren los pacientes.
When Hospitals and Insurers Fight, Patients Get Caught in the Middle
About 90,000 people spent months in limbo as central Missouri’s major, and often only, provider fought over insurance contracts. Patients getting caught in the crossfire of disputes has become a familiar complication, as about 8% of hospitals have left an insurer network since 2021. Trump administration policies could accelerate the trend.
Insurers and Customers Brace for Double Whammy to Obamacare Premiums
Consumers face both rising premiums and falling subsidies next year in Obamacare plans, with insurers seeking increases to cover not only rising costs but also some policy changes advanced by President Donald Trump and the GOP.
5 Takeaways From Health Insurers’ New Pledge To Improve Prior Authorization
Dozens of health insurance companies pledged on Monday to improve prior authorization, a process often used to deny care. The announcement comes months after the killing of UnitedHealthcare executive Brian Thompson, whose death in December sparked widespread criticism about insurance denials.
Their Physical Therapy Coverage Ran Out Before They Could Walk Again
Health plans limit physical or occupational therapy sessions to as few as 20 a year, no matter the patient’s infirmities. The limits persist despite federal rules banning insurers from setting annual dollar limits on the care they will provide.
Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits
Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that […]
The Medicare Advantage Influence Machine
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
Cuando tu cobertura de salud dentro de la red… simplemente se esfuma
los contratos de las aseguradoras con médicos, hospitales y farmacéuticas (o sus intermediarios, los llamados administradores de beneficios farmacéuticos) pueden cambiar abruptamente de la noche a la mañana.
How Your In-Network Health Coverage Can Vanish Before You Know It
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of “qualifying life events.” But insurers’ contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
The Colonoscopies Were Free. But the ‘Surgical Trays’ Came With $600 Price Tags.
Health providers may bill however they choose — including in ways that could leave patients with unexpected bills for “free” care. Routine preventive care saddled an Illinois couple with his-and-her bills for “surgical trays.”
When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill
For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.
Out for Blood? For Routine Lab Work, the Hospital Billed Her $2,400
Convenient as it may be, beware of getting your blood drawn at a hospital. The cost could be much higher than at an independent lab, and your insurance might not cover it all.
Quick Genetic Test Offers Hope for Sick, Undiagnosed Kids. But Few Insurers Offer to Pay.
A new, rapid genetic test shows promise in increasing diagnoses and improving treatment for some children with rare genetic conditions. Many insurers won’t cover it, but Florida’s Medicaid program is among those that see benefits — and, potentially, savings.
Pruebas genéticas rápidas a bebés pueden salvar vidas, pero muchas aseguradoras no las cubren
Que Medicaid cubra la prueba puede expandir significativamente el acceso para los bebés; el programa de salud federal gerenciado por los estados que asegura a las familias de bajos ingresos y que cubre a más del 40% de los niños en su primer año de vida.
Journalists Discuss Abortion Lawsuits and the Pros and Cons of Health Care Sharing Plans
KFF Health News and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.
Patients Squeezed in Fight Over Who Gets to Bill for Pricey Infusion Drugs
To drive down costs, insurers are bypassing hospital system pharmacies and delivering high-priced infusion drugs, including some used in chemotherapy, via third-party pharmacies. Smarting from losing out on billing for those drugs, hospitals and clinics are trying to convince states to limit this practice, known as “white bagging.”
At Least 1.7M Americans Use Health Sharing Arrangements, Despite Lack of Protections
A new report boosts the estimated number of people enrolled in plans whose members — usually brought together by shared religious beliefs — pay one another’s health costs.
Health Care Coalition Jockeys Over Medi-Cal Spending, Eyes Ballot Initiative
California Healthline has learned that a coalition of doctors, hospitals, insurers, and community clinics want to lock in a tax on health insurance companies to draw in extra Medicaid funding. It also wants to make the tax permanent.
La decisión podría afectar los exámenes de detección sin copago y servicios preventivos similares que la mayoría de los estadounidenses con seguro tienen como parte de sus planes de salud.
