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Federal Appeals Court Denies UnitedHealthcare Request To Throw Out Medicare Advantage Case

February 10, 2014 Morning Briefing

An appeals court upheld an injunction stopping UnitedHealthcare from dropping thousands of Connecticut doctors from their Medicare Advantage network and directed the parties to arbitration. In the meantime, some consumers must re-enroll in the original Medicare program there to keep doctors UnitedHealthcare dropped in New Haven, Conn.

GAO: Most Medicare Advantage Plans Meet Medical Expense Standard

January 24, 2014 Morning Briefing

The federal health law requires the plans to pay out at least 85 percent of their premium dollars on medical expenses or refund the excess revenue to the government.

Methodology: How Value Based Purchasing Payments Are Calculated

By Jordan Rau November 14, 2013 KFF Health News Original

The Kaiser Health News story and data on Medicare’s quality payment programs are based on data from the Centers for Medicare & Medicaid Services (CMS) containing the Hospital Value-Based Purchasing and Readmissions Reduction Program adjustment factors for individual hospitals.

When Cut From Medicare Advantage Plans, Doctors Face Dilemma About Patients

January 27, 2014 Morning Briefing

Doctors are trying to find the best way to tell some of their patients that they have been cut from Medicare advantage plans — cuts they say threaten patient care. In the meantime, Medicare is trying to crack down on habitual overcharging by doctors.

House GOP To Vote On ‘Doc Fix’ Bill That Repeals Health Law Individual Mandate

March 7, 2014 Morning Briefing

The bill could put House Democrats in an awkward spot, but would be a nonstarter in the Democrat-controlled Senate and could kill prospects this year to get rid of the sustainable growth rate formula. Meanwhile, a right-leaning advocacy group unveils a $1 million ad campaign against congressional Democrats over the administration’s proposed reductions in funding to private Medicare Advantage plans.

Medicare Advantage Plans Cut Total Cardio Procedures, But Regional Variations Remain

By Jay Hancock July 9, 2013 KFF Health News Original

Call them bundled payments, medical homes, capitation or accountable care, new versions of managed care (think HMOs in the 1990s) are health care’s great cost control hope. Researchers publishing in the latest JAMA tested that idea by counting procedures in one of the biggest managed care programs of all: Medicare Advantage plans for seniors. One […]

Medicare Seeks To Curb Spending On Post-Hospital Care

By Jordan Rau December 1, 2013 KFF Health News Original

One out of every six dollars Medicare spent in the traditional fee-for-service program went to nursing and therapy for patients in rehabilitation facilities, nursing homes, long-term care hospitals and in their own homes.

What Obamacare Means For You

September 9, 2013 Page

We’re here to help you navigate your way around what the new health law will mean for you, your family and what health care — and insurance — will cost you. New Health Insurance MarketplacesA Very Quick GuideHow The Marketplaces Will WorkVideo Series: Shopping For CoverageTips For New Obamacare Coverage: Stay In Network, Avoid Out-Of-Pocket […]

Health Costs Are Still Tame, Insurer Results Show

By Jay Hancock August 1, 2013 KFF Health News Original

Some give all the credit to Obamacare. Others cite the poor economy or employers forcing workers to bear more of the cost of their medical expenses. Whatever the reason, health-cost increases stayed tame through the first half of the year, insurers say. Thursday’s report from Cigna was the last dispatch on second-quarter financial results from […]

No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces

By Susan Jaffe August 25, 2013 KFF Health News Original

Administration officials are planning campaign to convince millions of seniors that they don’t need to sign up for the online exchanges.

Nearly 1,500 Hospitals Penalized Under Medicare Program Rating Quality

By Jordan Rau November 14, 2013 KFF Health News Original

The hospitals were rated on two-dozen measures, including surveys of patient satisfaction and death rates.

How Proposed Part D Changes Are Playing On Capitol Hill

March 7, 2014 KFF Health News Original

Officials at the Centers for Medicare & Medicaid Services are proposing to remove some drugs from Medicare’s prescription drug plans and limit how many plans insurers can offer. KHN’s Mary Agnes Carey and CQ Roll Call’s Emily Ethridge discuss.

Viewpoints: Stop ‘Bailout’ Of Obamacare; Health Law Not To Blame For All Insurance Woes; ‘Theft’ Of Medicare Advantage Money

January 3, 2014 Morning Briefing

A selection of opinions and editorials from around the country.

Doctors Overlook Lucrative Procedures When Naming Unwise Treatments

By Jordan Rau April 14, 2014 KFF Health News Original

In the “Choosing Wisely” campaign, medical specialty societies have published lists of procedures that doctors and patients should consider skeptically. But some groups overlooked their own dubious, but profitable procedures.

Miami-Area Seniors Get ‘White-Glove’ Treatment From Private Plans

November 26, 2013 Morning Briefing

The Miami Herald reports that seniors in South Florida have benefited from the highly lucrative and super competitive world of privately managed Medicare Advantage plans.

Colorado’s Elusive Goal: A Complete, Useful Health Care Price List

By Eric Whitney February 19, 2014 KFF Health News Original

Making health care prices available to the public is difficult and expensive, and Colorado and several other states are in jeopardy of losing funding for their efforts unless Congress intervenes.

Medicare Overpays Advantage Plans Billions Because Of Billing Errors: Report

June 4, 2014 Morning Briefing

An investigation by the Center for Public Integrity examines how use of a “risk score” that is supposed to help protect the private plans if they have an excess of sicker beneficiaries may have been mishandled.

FAQ: What You Need To Know About The New Online Marketplaces

By Julie Appleby and Mary Agnes Carey September 16, 2013 KFF Health News Original

These marketplaces open Oct. 1 and will allow individuals and small businesses to compare insurance coverage.

Patient Coordination Would Get Boost If Medicare Changes How It Pays Docs

By Tara Kulash, St. Louis Post-Dispatch February 4, 2014 KFF Health News Original

If Congress finally overhauls the way Medicare pays doctors, experts say patients would see new emphasis on coordinated care and preventive services.

Sources and Methodology: A Guide To Medicare’s Readmissions Data And KHN’s Analysis

By Jordan Rau August 2, 2013 KFF Health News Original

Kaiser Health News’ data on hospital readmissions penalties comes from the Centers for Medicare & Medicaid Services.

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