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The Collapse Of A Hospital Empire — And Towns Left In The Wreckage

By Barbara Feder Ostrov and Lauren Weber Photos by Heidi de Marco August 20, 2019 KFF Health News Original

Jorge A. Perez and his management company, EmpowerHMS, helped run an empire of rural hospitals. Now, in a staggering implosion, 12 of them have entered bankruptcy and eight have closed their doors, leaving hundreds of residents without jobs and their communities without lifesaving emergency medical care. So, what happened?

Medicare Insurance Options ‘Complicated’ For 300,000 Minnesotans Seeking New Coverage

November 16, 2018 Morning Briefing

Traditional Medicare or Medicare Advantage? As open enrollment gets under way across the nation, many Minnesota residents are especially hard pressed to decide which insurance is better for them because their current plan is being eliminated in many parts of the state. Enrollment is down compared to last year. In other news, advocates for older citizens in North Carolina are trying to help them sort through the differences.

A Few Pointers To Help Save Money And Avoid The Strain Of Medicare Enrollment

By Susan Jaffe October 17, 2017 KFF Health News Original

Most beneficiaries have from Oct. 15 to Dec. 7 to decide on drug coverage and whether to switch from traditional Medicare to a Medicare Advantage plan.

Nueva estrategia: hospitales internan a pacientes… en sus propias casas

By Michelle Andrews March 6, 2018 KFF Health News Original

Un enfoque común en Australia, Gran Bretaña y Canadá comienza a cobrar fuerza en el país: internar en sus propios hogares a los pacientes que no tienen condiciones de cuidado crítico.

One Of Nation’s Largest Dialysis Providers Agrees To $270M Settlement Over Medicare Advantage Fraud

October 2, 2018 Morning Briefing

The settlement cites improper medical coding by HealthCare Partners from early 2007 through the end of 2014. According to the settlement, the company, which is part of giant dialysis company DaVita Inc., submitted “unsupported” diagnostic codes that allowed the health plans to receive higher payments than they were due.

White House Revising Controversial Proposal On Birth Control Coverage

October 31, 2018 Morning Briefing

The Affordable Care Act requires health plans to provide preventive care at no charge, and the Obama administration included contraception services in that category. The Trump administration says employers should be allowed to opt out if they have religious or moral objections. Other administration news includes efforts to claw back overpayments to Medicare Advantage plans and the defense of the president’s plan on drug pricing.

Health Startup Oscar Gets Vote Of Confidence To The Tune Of $375 Million From Google’s Parent Company

August 15, 2018 Morning Briefing

Oscar’s focus is on health plans and helping consumers pick out the right coverage for them. The company announced that the investment will help it expand into Medicare Advantage space in the coming years.

Justice Department Asks Court To Order Anthem Testimony In Medicare Billing Case

August 22, 2018 Morning Briefing

The request is part of an investigation into Medicare Advantage risk-adjustment payments. Also in the news, a study finds that Medicare could save $925 million if generic drugs were substituted for 29 expensive combination prescriptions.

Hospitals Lure Diabetes Patients With Self-Care Courses, But Costs Can Weigh Heavily

By Julie Appleby April 26, 2018 KFF Health News Original

Self-management classes can help the tens of millions of Americans now diagnosed with Type 2 diabetes. But the education can come with a high price tag.

Administration To ‘Unleash’ Medicare Advantage Plans’ Bargaining Power On Some Drug Prices

August 8, 2018 Morning Briefing

As a negotiation tool, Medicare Advantage plans will now be able to require patients getting drugs in a doctor’s office or the hospital to try lower-cost medicines before moving up to more expensive ones in a process called step therapy. Insurers already had this option in Part D drug plans — which cover prescriptions such as those purchased by beneficiaries at pharmacies. But the option is now being expanded.

Utah Voters Approved Medicaid Expansion, But State Lawmakers Are Balking

By Erik Neumann, KUER February 8, 2019 KFF Health News Original

Political fights over health care continue to flare. In Utah, angry voters say lawmakers are disregarding their wishes by trying to limit the scope of a ballot referendum that expanded Medicaid.

Telemedicina: guía para entender las citas médicas a distancia

By Steven Findlay May 9, 2018 KFF Health News Original

Algunos consideran que es la atención primaria del futuro. Otros temen que la telemedicina lesione el vínculo médico-paciente. Lo cierto es que las citas virtuales crecen día a día.

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.

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.

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