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Patients Caught In Middle Of Fight Between Health Care Behemoths

By Steven Findlay April 25, 2019 KFF Health News Original

A legal battle in Pennsylvania is testing the boundaries of health care competition and government action to oversee and regulate it.

KHN Sues To Get Medicare Advantage Audits Released

September 27, 2019 Morning Briefing

The news service is seeking copies of 90 government audits of Medicare Advantage health plans conducted for 2011, 2012 and 2013 but never made public. News on Medicare Advantage comes from Florida as well.

La revancha del debate Biden-Harris destaca diferencias en los planes de salud

By Emmarie Huetteman July 31, 2019 KFF Health News Original

Hay casi tantas versiones de “Medicare para Todos” como candidatos demócratas, y cada uno piensa que su plan es el camino para asegurar a todos los estadounidenses.

Dialysis Industry Spends Millions, Emerges as Power Player in California Politics

By Samantha Young December 10, 2020 KFF Health News Original

Over the past four years, the dialysis industry has spent $233 million on both political offense and defense in California. Most of it went toward protecting its revenues against ballot initiatives, but the industry also strategically worked the corridors of the state Capitol.

Trumpeted New Medicare Advantage Benefits Will Be Hard For Seniors To Find

By Susan Jaffe November 9, 2018 KFF Health News Original

Federal officials are hailing the introduction of services such as transportation to medical appointments, home-delivered meals and installation of wheelchair ramps as a way to keep beneficiaries healthy and avoid costly hospitalizations. But not many plans are offering the services in 2019.

Making Smarter Decisions About Where To Recover After Hospitalization

By Judith Graham April 11, 2019 KFF Health News Original

Older adults — and their families — often find it challenging and stressful to find the best facility. And they often end up in the wrong spot, new research shows.

New Dental Treatment Helps Fill Cavities and Insurance Gaps for Seniors

By Michelle Crouch September 15, 2020 KFF Health News Original

A new treatment for tooth decay is cheaper, quicker and less painful than getting a filling. Originally touted as a solution for kids, silver diamine fluoride is poised to become a game changer for treating cavities in older adults or those with disabilities that make oral care difficult.

Wealthy Hospital Taps Craft Breweries For Aid To Buy Masks, Gloves

By Phil Galewitz June 16, 2020 KFF Health News Original

Although the federal government has poured billions of dollars into hospitals to defray their losses from the coronavirus outbreak, new streams of fundraising have emerged — including health worker-themed beer that adds “a drop in the bucket.”

Bundled Payments Fall Short Of Expectations In Cutting Spending, Improving Quality

January 7, 2020 Morning Briefing

The federal government, hospitals and physicians have been gravitating toward bundled payments, but new studies challenge the belief that they help achieve cost savings. Meanwhile, CMS is proposing changes to Medicare Advantage payments for 2021, including an increase in the percentage of patient “encounter data” used to calculate payments.

Inspector General’s Report Raises Red Flags Over Billions In Medicare Advantage Payments To Private Insurers

December 13, 2019 Morning Briefing

An Inspector General report suggests that private insurers are combing through patients’ files and adding on conditions like diabetes to make the patient looks sicker than they were to get more money from the government. A spokeswoman for America’s Health Insurance Plans said the report is based on a type of data with well-documented challenges, and noted that the watchdog didn’t review medical records for the analysis.

Medicare Advantage Paying For A New Air Conditioner? Plans Starting To Embrace Flexibility In Offered Benefits

October 7, 2019 Morning Briefing

The federal government has encouraged Medicare Advantage plans to offer perks that address the social and environmental factors associated with improved health.

Medicare Advantage Plans Shift Their Financial Risk To Doctors

By Phil Galewitz October 8, 2018 KFF Health News Original

Some private Medicare Advantage plans are offering large physician-management companies more money upfront and control of their patients’ care, but the doctors are responsible for staying within the budget.

New Medicare Advantage Plans Offer Many New Supplemental Options That Regular Medicare Doesn’t

September 26, 2019 Morning Briefing

About a third of people opt for Medicare Advantage plans, and during the upcoming enrollment period they will now see options for things that will help them prevent illness, like carpet shampooing. But Medicare Advantage can still restrict access to doctors and hospitals. In news on Medicaid, the CMS acting director Calder Lynch identifies ways to control spending.

KHN’s ‘What The Health?’: The Labor Pains Of ‘Medicare For All’

February 20, 2020 KFF Health News Original

Organized labor is divided over whether to support “Medicare for All.” Meanwhile, many of the Democratic presidential candidates seem unable to use the health issue to their advantage. Rebecca Adams of CQ Roll Call, Jennifer Haberkorn of the Los Angeles Times and Alice Miranda Ollstein of Politico join KHN’s Julie Rovner to discuss this and more. Also, for extra credit, the panelists offer their favorite health policy stories of the week they think you should read, too.

Pandemic Forced Insurers To Pay For In-Home Treatments. Will They Disappear?

By Julie Appleby June 23, 2020 KFF Health News Original

With stay-at-home orders in place, hospitals experimented with delivering many treatments to patients where they lived. They were a success. As society reopens, the return of old payment practices may prevent the adoption of this new, efficient model of care.

Research Roundup: Marketplace Enrollment, Medicare Advantage And Surprise Bills

September 27, 2019 Morning Briefing

Each week, KHN compiles a selection of recently released health policy studies and briefs.

How Obamacare, Medicare And ‘Medicare For All’ Muddy The Campaign Trail

By Shefali Luthra May 13, 2019 KFF Health News Original

A talking point used by House Speaker Nancy Pelosi refers to all three of these distinct concepts in a way that could magnify public misperceptions.

Medicare Advantage Riding High As New Insurers Flock To Sell To Seniors

By Phil Galewitz October 15, 2018 KFF Health News Original

The private health plans that are an alternative to government-run Medicare continue to grow despite the Affordable Care Act’s cuts of billions of dollars in funding.

Feds Join Lawsuit Alleging Sutter Health Padded Revenue With False Patient Data

By Samantha Young December 14, 2018 KFF Health News Original

The whistleblower complaint says that Sutter, one of the largest health systems in the U.S., exaggerated how sick certain Medicare patients were in order to collect higher payments from the government-funded program.

Trump Expected To Unveil Today Initiative To Expand Medicare Advantage Plans

October 3, 2019 Morning Briefing

The president reportedly will sign an executive order that the White House hopes will be a potent way to compare Republican views about enhancing health care with the “Medicare for All” proposals endorsed by some Democratic presidential candidates.

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