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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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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