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Viewpoints: Downside Of Privatizing Medicaid; Medicare Advantage Stars And Poor Seniors

August 11, 2015 Morning Briefing

A selection of opinions on health care from around the country.

Texas Whistleblower Says Medicare Advantage Plans Overstate Home Visit Charges

August 12, 2015 Morning Briefing

Also in news related to Medicare, MedPAC argues for tightening dialysis subsidy rules.

Survey: Low-Income Elderly Reject Calif. Managed Care Experiment For Fear Of Change

By Anna Gorman October 27, 2015 KFF Health News Original

About 47 percent opt out of California’s “dual eligibles” program serving Medicare and Medicaid patients, in part because they fear losing their doctors, a survey finds. But once enrolled in the pilot program, most stay.

Insurance Merger Raising Questions In Ill. About Consolidation Of Medicare Advantage Market

July 22, 2015 Morning Briefing

Humana and Aetna are the second- and third-largest Medicare Advantage companies in the state. Also in the news, Novartis reports flat sales in its eye-care business.

Medicaid Insurer Centene To Purchase Health Net

July 6, 2015 Morning Briefing

The deal will allow Centene to expand its Medicaid managed care business and also move into the Medicare Advantage market.

Aetna To Buy Rival Humana As Insurance Market Consolidates

July 6, 2015 Morning Briefing

The merger increases Aetna’s share of Medicare Advantage customers. Meanwhile, Bloomberg reports that Cigna’s tie-up with Anthem could be next.

Only 251 Hospitals Score Five Stars In Medicare’s New Ratings

By Jordan Rau April 16, 2015 KFF Health News Original

The ratings, posted on Medicare’s website Thursday, rank hospitals based on patient reviews.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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