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Health Systems Dipping Into The Business Of Selling Insurance

By Michelle Andrews November 10, 2015 KFF Health News Original

These plans, which still are a minority in the marketplaces, can help drive consumers to use the system’s hospitals and doctors, but some also offer competitive prices.

Federal Officials Propose Small Rise In Medicare Advantage Rates

February 22, 2016 Morning Briefing

The Centers for Medicare and Medicaid Services has proposed an average 1.35 percent increase in the rate the government pays private Medicare Advantage plans for 2017.

As Medicare Stifles PSA Testing Penalties, It Signals Interest In Reviving The Issue Later

March 29, 2016 Morning Briefing

The Center for Medicare & Medicaid Services says in its statement that it will continue to solicit input “to determine whether a restructured, appropriate-use PSA measure should be developed.” Also, a look at new efforts by the agency to make sure beneficiaries in Medicare Advantage plans can keep their doctors.

Colon Cancer Screening: Five Things To Know

By Julie Appleby June 24, 2016 KFF Health News Original

The U.S Preventive Services Task Force recently expanded the list of approved colorectal cancer screening tests. Here’s a primer on these various tests and how they might be covered now and in the future by health insurance.

Catastrophic Insurance Could Help With Long-Term Care Expenses: Studies

By Michelle Andrews July 1, 2016 KFF Health News Original

Urban Institute researchers examine how such a plan could work and whether it would be better to make payments when people first need care or after they have used up much of their own money instead.

Readers Ask About Concierge Medicine And Medicare; Insulin Costs And The Doughnut Hole

By Michelle Andrews September 8, 2015 KFF Health News Original

KHN consumer columnist Michelle Andrews answers questions about Medicare beneficiaries’ costs associated with doctors who have concierge medicine practices, insulin pumps and respite care.

Medicare Policy Preserves Cigna Bonuses As Insurer Fixes Plan Failures

March 11, 2016 Morning Briefing

Despite sanctions against Cigna for its mismanaged Medicare Advantage plans, a quietly announced revision in Medicare policy will allow the insurer to keep hundreds of millions of dollars in bonus payments. The change by the Centers for Medicare & Medicaid Services drove up both Cigna and Anthem stocks.

CMS Proposal Would Cut Payments To Medicare Advantage Plans Sponsored By Employers

February 23, 2016 Morning Briefing

The proposal would change the bidding process for plans sponsored by employers and unions for retirees. Meanwhile, The Associated Press examines how the Centers for Medicare & Medicaid Services’ favorable assessment of factors affecting rates is playing out with other Medicare Advantage plans. In other marketplace news, a group calls for the creation of long-term care insurance plans similar to Medicare, CVS health says it toned down its prescription drug spending, and the new leader at Zenefits tries to rein in the rambunctious culture at the startup.

Medicaid, Private Insurers Begin To Lift Curbs On Pricey Hepatitis C Drugs

By Judith Graham July 5, 2016 KFF Health News Original

Over the past few months, Massachusetts, Florida, New York, Delaware and Washington have lifted restrictions on the expensive medications, and private insurers around the country are also making the changes.

UnitedHealthcare Sues HHS Over Medicare Advantage Overpayment Rule

February 4, 2016 Morning Briefing

The 41 UnitedHealth Group companies say the regulation will result in underpayment to insurers. In other news, the administration nears its goal for revamping the way Medicare providers are paid.

‘Widespread And Systemic Failures’ Cited In Cigna Medicare Advantage Suspension

January 25, 2016 Morning Briefing

The Centers for Medicare & Medicaid Services said Cigna did not handle complaints and grievances from patients properly. The suspension will not affect those already enrolled.

Feds Urge State Medicaid Programs To Encourage Long-Acting Contraceptives

By Michelle Andrews June 16, 2016 KFF Health News Original

Medicaid spends billions on unintended pregnancies, and federal officials say better use of long-acting contraceptives, such as IUDs, offer advantages for women and are cost-effective.

Despite Payment Cuts, Medicare Advantage Plan Enrollments Rise More Than 50 Percent

February 16, 2016 Morning Briefing

The trend bucks experts who predicted that the private plans would be gutted by the health law measure that cut payments to the private insurance programs. In other Obamacare news, 2016 sign-ups fall short of estimates made in 2010 and delayed tax forms are confusing consumers.

Medicare Turns 50 But Big Challenges Await

By Mary Agnes Carey July 27, 2015 KFF Health News Original

Medicare provides coverage to one in six Americans, and federal officials hope to trim the increasing cost and improve how the program operates.

Aetna-Humana Deal Could Cause Medicare Advantage Costs To Increase: Report

January 22, 2016 Morning Briefing

The Center for American Progress found the proposed purchase of Humana by Aetna could lead to increased premium costs for seniors with these private Medicare plans. Meanwhile, California’s four largest health plans may owe the state an estimated $10 billion in back taxes — depending on the outcome of a pending legal case.

Good News, Bad News In Medicare Trustees Report

By Phil Galewitz July 23, 2015 KFF Health News Original

Trust fund solvent until 2030, but some seniors may see a big spike in Part B premiums.

Medicare Slow To Adopt Telemedicine Due To Cost Concerns

By Phil Galewitz June 23, 2015 KFF Health News Original

Less than 1 percent of beneficiaries use the technology because Congress has put tight restrictions on it.

Medicare Advantage Plans Overcharged By Millions With Diminished Chance Of Getting Caught

December 18, 2015 Morning Briefing

The Center for Public Integrity reports that CMS officials perform only 30 in-depth financial audits to recover overpayments each year, when they have the capacity for 80. Meanwhile, news outlets report on other Medicare developments such as the impact of the budget deal on the program, the continued high out-of-pocket costs for oral cancer medications and 21st Century Oncology Holdings’ $19.75 million settlement of a billing probe.

Are Medicare ACOs Working? Experts Disagree

October 21, 2015 KFF Health News Original

Federal officials reported recently that in 2014 the accountable care organizations saved $411 million, but after the program paid bonuses to the successful groups, Medicare recorded a net loss of $2.6 million. So KHN asked a panel of experts to offer their views about the program.

For Hospitals, Prestige Leads To Profits

By Shefali Luthra May 2, 2016 KFF Health News Original

A new study explores why the most profitable U.S. hospitals are who they are.

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