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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.

How Medicare Drug Plans Hope To Follow Private Sector Lead

By Julie Appleby March 18, 2016 KFF Health News Original

The proposal that Medicare made this month to better control prescription drug costs involves testing strategies used with some success in the private sector.

Tax Credits For Seniors’ Home Modifications Could Save States Medicaid Funding

August 24, 2016 Morning Briefing

Virginia and some other jurisdictions are offering residents tax advantages to help pay to retrofit a home, for example widening doorways to accommodate wheelchairs or adding ramps. Also, a look at how for-profit companies are moving into a Medicare program designed to keep people in their homes.

Research Roundup: The Cadillac Tax; Patient-Centered Care; Medicare Advantage

October 30, 2015 Morning Briefing

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

Some Dialysis Patients Give Medicare Failing Grade On Ambulance Trial

By Lisa Gillespie February 8, 2016 KFF Health News Original

A Medicare trial aimed at averting billing fraud and waste in nonemergency ambulance service in eight states is drawing complaints from patients’ families and ambulance companies.

Medicare Advantage Plan Ratings May Be Adjusted After Fairness Complaints

October 21, 2015 Morning Briefing

Elsewhere, a proposal to stave off a $54-per-month increase in Medicare premiums for some seniors could lead to a budget battle on Capitol Hill.

CMS Releases Star Ratings For 2016 Medicare Advantage Plans

October 9, 2015 Morning Briefing

Almost three out of four beneficiaries are enrolled in medical and drug coverage plans that received at least a four-star quality rating, according to the Centers for Medicare and Medicaid Services. The rankings did show a drop for some companies, especially in regard to prescription drug benefits.

Pa. High Court To Hear Expedited Appeal In UPMC-Highmark Case

September 10, 2015 Morning Briefing

At issue is a Commonwealth Court judge’s order in May that says UPMC must maintain in-network rates until 2019 for people insured by Highmark Medicare Advantage plans. UPMC canceled its Medicare Advantage contract with rival Highmark in April.

GAO Report Says More Medicare Advantage Network Oversight Needed

September 30, 2015 Morning Briefing

In other Medicare news, Part D drug prices are set to rise in 2016, some by a lot. Elsewhere, a new poll finds wide support for Medicare paying for end-of-life conversations, and another report finds nursing homes get much more in Medicare payments than it costs them to provide care.

New Kaiser Permanente Med School Part Of A Growing Trend

By Julie Rovner December 18, 2015 KFF Health News Original

Twenty new schools opened in the past decade; but some doubt whether so many new doctors are needed.

EHealth Sees Once-Thriving Business Decline Due To Health Law Exchanges

By Phil Galewitz June 1, 2015 KFF Health News Original

The nation’s largest online broker lost thousands of customers, but some analysts suggest that if the Supreme Court strikes down subsidies on the federal exchange, some may return to the company.

Obamacare, Private Medicare Plans Must Keep Updated Doctor Directories In 2016

By Susan Jaffe March 9, 2015 KFF Health News Original

New federal rules requiring current information apply to insurers selling plans on healthcare.gov and the private policies that are an alternative to Medicare.

Most Medicare Advantage Plans Will Not Increase Premiums In 2016, HHS Announces

September 22, 2015 Morning Briefing

It is the sixth year of stable prices for these private plans, that seniors can choose as an alternative to traditional Medicare. However, the Chicago Tribune notes that a popular plan in Illinois will increase premiums.

Hospital Closures Rattle Small Towns

By Sarah Varney March 10, 2016 KFF Health News Original

More than 50 shuttered rural hospitals mean a loss of jobs and other commerce for municipalities and uncertain care for residents.

When Your Doctor Leaves Your Health Plan, You Likely Can’t Follow

By Michelle Andrews June 2, 2015 KFF Health News Original

KHN’s consumer columnist answers readers’ questions about options when physicians leave an insurer’s network, the lack of coverage for hearing aids and penalties linked to insurance subsidies.

Having Survived Court Ruling, Insurance Markets Still Face Economic Threats

By Jordan Rau June 25, 2015 KFF Health News Original

Among the challenges for these online exchanges set up by the health law are attracting more customers, keeping consumers’ health costs affordable and quality high, and finding enough financing.

Seniors Switch To Traditional Medicare Plans When More Serious Conditions Hit, Study Shows

October 7, 2015 Morning Briefing

In other Medicare news, the Pennsylvania Supreme Court hears the University of Pittsburgh Medical Center’s appeal regarding in-network rates. Also, open enrollment begins Oct. 15, the GAO wants tougher Medicare Advantage oversight and beneficiaries face hurdles to getting hearing aids.

Auditor Find Issues With Medicare Payments To Nursing Homes, Oversight Of Advantage Plans

October 1, 2015 Morning Briefing

In different reports, the HHS inspector general says Medicare could save billions of dollars by closer monitoring of nursing home services that may not be necessary and questioned if federal officials are making sure that the private Medicare Advantage plans offer adequate networks of doctors and other health care providers.

Pelosi Says Boehner Is Stalling Efforts To Avert Medicare Premium Increase

October 8, 2015 Morning Briefing

The increase for next year could be as much as 50 percent for some beneficiaries. In other Medicare news, Sen. Sherrod Brown reintroduces a bill that would bar Medicare Advantage plans from dropping doctors from their networks during the plan year, and a pilot project designed to save money produces mixed results.

Report Finds Lack Of Competition Among Medicare Advantage Plans

August 25, 2015 Morning Briefing

The study by the Commonwealth Fund finds that in 97 percent of markets a small number of insurers dominate, which could raise concerns about some high-level insurance company mergers. Also in industry news, health analytics company Inovalon is acquiring the consulting firm Avalere Health and two large kidney-care providers plan consolidations.

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