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Patients Suffer When Health Care Behemoths Quarrel Over Contracts

By Barbara Feder Ostrov February 1, 2019 KFF Health News Original

The latest example is Sutter Health and Anthem Blue Cross, whose failure to seal a deal is causing Anthem members to worry they may not have access to one of the dominant hospital chains in Northern California. Across the U.S., the stakes in such contract fights have risen, as health systems and insurers battle to increase their market share.

Judge Strikes Down ACA Putting Law In Legal Peril — Again

By Julie Rovner December 14, 2018 KFF Health News Original

The case is not expected to have an immediate effect on coverage for people who buy plans on the federal health law marketplaces because the case is likely to go to the Supreme Court — the third time that the justices will decide the fate of the landmark health law.

CMS Wants To Experiment With Alternative Pay Model For Medicare Advantage Plans

July 3, 2018 Morning Briefing

The agency is also considering paying home health agencies for remote patient monitoring.

Todo lo que debes saber sobre la nueva tarjeta de Medicare… ¡para evitar fraudes!

By Judith Graham March 15, 2018 KFF Health News Original

A partir de abril, el programa de salud federal para adultos mayores comenzará a enviar nuevas tarjetas que ya no contendrán el número de seguro social del beneficiario.

CDC Opioid Guidelines For Providers That Sparked Concern At The Time May Have Helped Cut Prescription Rates

September 14, 2018 Morning Briefing

Chronic pain patients worried the guidelines would impede their access to needed medication. Two years later the rules have seemed to make a dent in overall prescription practices, though some caution that it’s hard to attribute the decrease to any one thing. Meanwhile, lawmakers ask CMS to include substance disorder patients in the Medicare Advantage value-based insurance design model.

Trump Administration Salutes Parade Of Generic Drug Approvals, But Hundreds Aren’t For Sale

By Sydney Lupkin and Jay Hancock February 7, 2019 KFF Health News Original

President Donald Trump and FDA officials have pointed to a surge in generic drug approvals, but a data analysis indicates almost half haven’t reached the market.

Must-Reads Of The Week From Brianna Labuskes

By Brianna Labuskes November 30, 2018 KFF Health News Original

Newsletter editor Brianna Labuskes wades through hundreds of health articles from the week so you don’t have to.

Whistleblowers: United Healthcare Hid Complaints About Medicare Advantage

By Fred Schulte July 28, 2017 KFF Health News Original

A Wisconsin lawsuit alleges United Healthcare downplayed abusive sales tactics to avoid losing government bonuses.

Buyers Of Short-Term Health Plans: Wise Or Shortsighted?

By Anna Gorman November 20, 2018 KFF Health News Original

Policyholders reason that their health is good — for now — and they don’t see the need for costly comprehensive coverage. Detractors say the plans undermine the Affordable Care Act, and agents advise reading the fine print. “You basically have to be in perfect health,” says one.

Medicare’s Power To Negotiate Drug Prices Will Harm Patients With Chronic Illnesses, Advocates Warn

August 9, 2018 Morning Briefing

Medicare Advantage’s negotiating tool — requiring patients to try lower-cost treatments before the more expensive ones — is derided as a “fail first” process to those who oppose the strategy. “Consumers may have to go through one or more drugs before they can get a particular treatment they really need,” said Ellen Albritton, a senior policy analyst at Families USA. Meanwhile, there are already signals that implementing the new rules is going to be complicated.

The Doctors Want In: Democratic Docs Talk Health Care On The Campaign Trail

By Shefali Luthra August 27, 2018 KFF Health News Original

Among candidates running for Congress in upcoming elections are a smattering of left-leaning physicians who present a stark contrast to the predominantly Republican physicians currently in office.

Must-Reads Of The Week From Brianna Labuskes

By Brianna Labuskes October 12, 2018 KFF Health News Original

Newsletter editor Brianna Labuskes wades through hundreds of health articles from the week so you don’t have to.

UnitedHealth Doctored Medicare Records, Overbilled U.S. By $1 Billion, Feds Claim

By Fred Schulte May 17, 2017 KFF Health News Original

The company, which is the nation’s largest Medicare Advantage operator, denies wrongdoing and argues that the Justice Department “fundamentally misunderstands” how Medicare Advantage works.

Medicare Eases Readmission Penalties Against Safety-Net Hospitals

By Jordan Rau September 26, 2018 KFF Health News Original

Penalties will total $566 million for all hospitals. But many that serve a large share of low-income patients will lose less money than they did in previous years.

Community Hospitals Link Arms With Prestigious Facilities To Raise Their Profiles

By Sandra G. Boodman January 29, 2019 KFF Health News Original

A growing number of community hospitals are forming alliances with some of the nation’s biggest and most prestigious institutions. But for prospective patients, it can be hard to assess what these relationships actually mean.

Must-Reads Of The Week From Brianna Labuskes

By Brianna Labuskes October 5, 2018 KFF Health News Original

Newsletter editor Brianna Labuskes wades through hundreds of health articles from the week so you don’t have to.

As Seniors Get Sicker, They’re More Likely To Drop Medicare Advantage Plans

By Fred Schulte July 6, 2017 KFF Health News Original

Medicare Advantage plans offer good value and aim to keep patients healthy but sicker people are far more likely to quit because they can’t get the care they need.

Measure To Cap Dialysis Profits Pummeled After Record Spending By Industry

By Ana B. Ibarra and Anna Gorman November 8, 2018 KFF Health News Original

The dialysis industry raised nearly $111 million in a successful bid to defeat the measure, which also was opposed by hospitals and doctors. The union that sponsored the measure collected about one-sixth that amount.

Fraud And Billing Mistakes Cost Medicare — And Taxpayers — Tens Of Billions Last Year

By Fred Schulte July 19, 2017 KFF Health News Original

At a hearing Wednesday, federal health officials pointed to billing errors, fraud and overcharges that led Medicare to overpay by staggering sums.

As 2020 Candidates Go Big And Bold On Health Ideas, Voters Say They Just Want Someone To Bring Costs Down

June 24, 2019 Morning Briefing

Many of the candidates are pushing “Medicare for All” or some variation of expanded government-supported health care. While many voters see the plans as aspirational, for now, they simply want to pay less for their health care. That disconnect between what politicians are preaching and what voters are worried about could be detrimental to Democrats, who polls show currently hold an advantage over Republicans when it comes to the issue of health care. Meanwhile, media organizations help you navigate the candidates’ stances on health.

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