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Research Roundup: Medicaid Churning; Addiction Coverage; Medicare Advantage Enrollment

July 10, 2015 Morning Briefing

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

Aetna’s Bid To Buy Humana Driven By Market Forces

July 8, 2015 Morning Briefing

The plan highlights the company’s efforts to exploit business opportunities related to the expansion of coverage under the Affordable Care Act and the rush of baby boomers to Medicare Advantage plans.

From Cost Of Visit To Staff Compassion, Yelp Hospital Ratings Go Beyond ‘Gold Standard’ Survey

April 6, 2016 Morning Briefing

Yelp reviewers offer information on 12 criteria not used by Medicare in assessing hospitals. Meanwhile, in information security news, MedStar hackers took advantage of a system flaw that hospitals had been warned about since 2007 while attacks on three California hospitals expose additional vulnerabilities.

California To Revamp Addiction Treatment For Medicaid Recipients

By Anna Gorman December 10, 2015 KFF Health News Original

Through what’s known as a drug waiver, state officials will have new spending flexibility as they try to improve outcomes and reduce social and financial costs of people with substance abuse disorders.

More Scrutiny Coming For Medicare Advantage, Obamacare

By Fred Schulte, The Center For Public Integrity November 3, 2014 KFF Health News Original

Federal officials are planning a wide range of audits into billing and government spending on managed health care in the new fiscal year, ranging from private Medicare Advantage groups that treat millions of elderly to health plans rapidly expanding under the Affordable Care Act.

The Lowdown On Open Enrollment For Medicare Advantage And Part D

October 28, 2014 KFF Health News Original

Kaiser Health News’ Julie Rovner hosted a webinar Tuesday to provide background to reporters covering Medicare Advantage and Part D issues through open enrollment and beyond.

Rural Hospitals Team Up To Survive

By Michael Ollove, Stateline August 19, 2015 KFF Health News Original

Dozens of rural hospitals have closed in recent years, prompting others to form alliances.

Most Californians On Insurance Exchange Are Sticking With Last Year’s Plan

By Jenny Gold January 29, 2015 KFF Health News Original

In California, the vast majority of people renewing health insurance coverage in the state’s exchange did not switch health plans, and instead are sticking with the one they selected last year.

State Highlights: Mass. Eligibility Review Results In Removal Of Thousands From Medicaid Program; Medicare Advantage Developments In Colo., N.C.

July 22, 2015 Morning Briefing

Health care stories are reported from Massachusetts, Colorado, North Carolina, California, Minnesota, South Carolina and Kansas.

How One Home Health Agency Earned Five Stars

By Michael Tomsic, WFAE September 18, 2015 KFF Health News Original

In North Carolina, Brookdale Home Health Charlotte was one of just two agencies out of the state’s 172 to earn the maximum five stars from the federal government.

What To Know About Medicare’s Enrollment Period

By Mary Agnes Carey and Julie Rovner November 13, 2014 KFF Health News Original

Though not a part of the health law’s open enrollment period, Medicare’s enrollment period runs during some of the same time period. Changes to Medicare advantage and the so-called Medicare prescription drug “doughnut hole” are taking center stage.

Humana Explores Possible Sale As Health Insurance Marketplace Changes

June 1, 2015 Morning Briefing

News outlets report that Humana’s presence in Medicare Advantage program makes it a prime target for acquisition. And, as reports emerged about its possible sale, the insurer’s stock soared.

DaVita To Pay $450M Settlement For False Claims, While Probed About Coding

June 25, 2015 Morning Briefing

The largest U.S. supplier of dialysis services agreed to the settlement to resolve claims that it knowingly created unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients, and then billed the federal government. It is also being investigated for how the company codes for Medicare Advantage patients.

A Third Of Ga. Pediatricians Join Together To Form Network To Improve Care

By Andy Miller, Georgia Health News September 1, 2015 KFF Health News Original

The new physician-led network will allow pediatricians to improve care for Georgia children by sharing best practice standards and expand their billing options for insurance, advocates say.

Humana Enters ‘Quiet Period’ Amid Sale Rumors

June 9, 2015 Morning Briefing

The publicly traded Medicare Advantage coverage provider announced the move in an SEC filing. The company refused to comment on merger speculation, which increased when Humana also pulled out of a large health care conference.

Feds Paid Too Much For Nearly Half Of UnitedHealth’s Medicare Advantage Patients, Audit Says

June 17, 2015 Morning Briefing

Three years of confidential negotiations between the insurer and the federal government were recently released in an audit. Elsewhere, N.J. Sen. Robert Menendez loses his bid to move his trial over corruption charges from his home state to Washington, D.C.

GOP Chairmen Offer Alternative To Health Law

By Mary Agnes Carey February 5, 2015 KFF Health News Original

Sens. Orrin Hatch and Richard Burr join with Rep. Fred Upton to renew a proposal to repeal the health law but preserve some tax credits for insurance and cuts to some Medicare providers.

HHS Pledges To Quicken Pace Toward Quality-Based Medicare Payments

By Jordan Rau January 26, 2015 KFF Health News Original

As part of their effort to improve quality while cutting costs, federal officials announced Monday that they want programs such as accountable care organizations and bundled care to account for 50 percent of traditional Medicare spending by the end of 2018.

Bets On Health Care Paying Off For Investors

June 3, 2015 Morning Briefing

Despite high prices, shares of health care companies continue to soar. Elsewhere, an investor wins an arbitration award against UBS, the feds crack down on Medicare Advantage fraud and health insurer Anthem is offering workers free college tuition to entice new employees.

Growth In U.S. Health Spending In 2013 Is Lowest Since 1960

By Mary Agnes Carey December 3, 2014 KFF Health News Original

The report credits slower growth in spending for private health insurance, Medicare, hospitals, physicians and clinical services.

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