4 Months After Cyberattack, VA Grapples With Paying Providers
June 26, 2024
Morning Briefing
The attack hit a third-party company that manages some processes for the Department of Veterans Affairs. Officials say they’re still working to clear a backlog of payments to pharmacies and other providers. Also in the news: AI use by Medicare Advantage insurers.
4.2% Medicare Pay Raise Coming To Nursing Homes In Fiscal 2025
August 1, 2024
Morning Briefing
The rate is higher than the 4.1% the Centers for Medicare and Medicaid Services proposed in March. Also in the news: Humana predicts losing a few hundred thousand Medicare Advantage members next year; Google is not renewing its contract with Amazon One Medical for staff care; and more.
Spotlight Falls On ‘Two-Midnight Rule’ For Medicare Patient Hospital Stays
May 16, 2024
Morning Briefing
Modern Healthcare reports on how providers and Medicare Advantage companies are reacting to the new policy that allows more patient visits to be categorized as higher-cost inpatient care. Separately, reports explain how Blackstone Equity Healthcare is lowering costs.
CMS: Medicare Advantage Premiums To Slightly Rise Next Year
September 27, 2023
Morning Briefing
The Centers for Medicare and Medicaid Services estimates that Medicare Advantage plan premiums will increase from $0.64 per month on average in 2024. Separately, GAO says that CMS does not have useful data on private equity investments in the nursing home industry.
UnitedHealth Doctors Got Diagnoses Checklists To Boost Medicare Payouts
January 2, 2025
Morning Briefing
The Wall Street Journal reports how UnitedHealth provided lists of potential, often obscure diagnoses to its doctors and forced them to weigh in on them for each Medicare Advantage patient, in order to capitalize on the government system that pays private insurers based on how sick doctors say a patient is.
Cigna To Sell Its Medicare Business To Health Care Service Corp.
February 1, 2024
Morning Briefing
Cigna is shedding its troubled Medicare Advantage, Medigap, and Medicare part D plans that cover 3.6 million people. The business will be sold to Health Care Service Corp., a Blue Cross Blue Shield insurer.
Cyberattack Insurance In The Spotlight After UnitedHealth Hack
March 21, 2024
Morning Briefing
Meanwhile, UnitedHealth Group said its Change Healthcare subsidiary’s systems for handling medical claims were back online, about a month after the attack. Also in the news: Medicare Advantage, hospital staff shortages, and more.
Senate Finance Panel Grills Medicare Advantage Brokers Over Incentives
October 19, 2023
Morning Briefing
The Senate Finance Committee held a hearing Wednesday, questioning national insurance brokers about their practice in guiding Medicare Advantage enrollees through choosing among many plan options. Financial incentives and privacy were among the issues discussed.
Trump Chooses Dr. Mehmet Oz To Run Medicare And Medicaid Agency
November 20, 2024
Morning Briefing
A former cardiothoracic surgeon and professor at Columbia University, Dr. Oz is better known to the public as a TV personality and has no experience running a government agency. If confirmed as the CMS administrator, he would be influential in major policies around how states run their Medicaid programs and regulations on Medicare Advantage private plans.
Health Care Providers Indirectly Hit By Medicare Advantage Star Rating Slips
November 21, 2023
Morning Briefing
The argument runs thus: Declining ratings prompt insurers to seek cost savings that then impact health providers. Separately, worries emerge that new nursing home ownership transparency rules may lead to private equity exits. Also in the news: cybersecurity, ADHD drugs, and more.
La inscripción de Medicare es temporada abierta para estafadores
By Susan Jaffe
November 11, 2021
KFF Health News Original
Funcionarios federales dicen que están aumentando las quejas de personas mayores engañadas para que compren pólizas sin su consentimiento, o atraídas por información cuestionable, que pueden no cubrir sus medicamentos ni incluir a sus médicos.
Humana Shares Plummet After Feds Slash Rating
October 3, 2024
Morning Briefing
Humana’s stock took a tumble after the provider admitted to the SEC that only about 1 in 4 of its members were signed up to Medicare Advantage plans rated four stars or more. Meanwhile, CMS is making it harder in 2025 for insurers to get top marks, due to changes in the way stars are calculated.
Regulations Take Aim At Misleading Medicare Ads As Enrollment Opens
October 17, 2023
Morning Briefing
New Biden administration rules crafted to combat deceptive Medicare marketing tactics face their first big test this enrollment season. Other open enrollment news relates to coinsurance changes, Medicare Advantage, and more.
Study: Hospitals Charge Commercial Insurance Double That Of Medicare Advantage Plans
August 10, 2023
Morning Briefing
An analysis of published hospital pricing and insurer payment data finds that commercial insurance payers were charged more than 2 times that of Medicare Advantage. The gap was even larger for surgical procedures.
Even Well-Intended Laws Can’t Protect Us From Inaccurate Provider Directories
By Bernard J. Wolfson
July 26, 2022
KFF Health News Original
State and federal laws require health plans to offer accurate lists of participating doctors and facilities, but consumers still struggle to get timely appointments with providers.
KFF Health News' 'What the Health?': The Open Enrollment Mixing Bowl
October 19, 2023
Podcast
Open enrollment for Medicare beneficiaries with private health plans began Oct. 15, to be followed Nov. 1 by open enrollment for Affordable Care Act plans. The selection for both is large — often too large to be navigated easily alone. And people who choose incorrectly can end up with unaffordable medical bills. Meanwhile, those on both sides of the abortion issue are looking to Ohio’s November ballot measure on abortion to see whether anti-abortion forces can break their losing streak in statewide ballot questions since the overturn of Roe v. Wade in 2022.
Cardiologists Suggest Health Records Should Note Gender Identity
January 26, 2024
Morning Briefing
Since little is known about unique health challenges LGBTQ+ people face, Stat says, researchers are pushing for health systems to record patients’ sexual orientation and gender identity and expression to boost data collection. Also in the news: Medicare Advantage data transparency issues.
Comienzan a estar disponibles audífonos de venta libre desde $199
By Phil Galewitz
October 17, 2022
KFF Health News Original
Los audífonos de venta libre cuestan menos en parte porque no incluyen los servicios de un experto para una evaluación auditiva, ajuste y afinación del dispositivo. En cambio, los nuevos dispositivos deben ser configurados por los propios consumidores.
Morning Briefing for Monday, April 3, 2023
April 3, 2023
Morning Briefing
Preventive care appeal, Medicare Advantage cuts, a Medicare fund warning, “kraken” covid variant, mental health, and more are in the news.
KHN’s ‘What the Health?’: Leaked Abortion Opinion Rocks Washington’s World
May 5, 2022
KFF Health News Original
The unprecedented early leak of a Supreme Court draft opinion that would overturn the landmark abortion-rights ruling Roe v. Wade has heated the national abortion debate to boiling. Meanwhile, the FDA, after years of consideration, moves to ban menthol flavors in cigarettes and cigars. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Shefali Luthra of the 19th, and Jessie Hellmann of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more. Plus, Rovner interviews KHN’s Paula Andalo, who wrote the latest KHN-NPR “Bill of the Month” episode about a family whose medical debt drove them to seek care south of the border.
