When Credit Scores Become Casualties Of Health Care
The complexity of health insurance coverage rules, along with market trends that leave consumers open to more out-of-pocket costs, lead to mounting medical debt for consumers.
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Laws Shield Hospitals From Families Who Believe Loved Ones Contracted Covid as Patients
Families who believe their loved ones contracted covid-19 while hospitalized are finding they have little recourse following a wave of liability shield legislation pushed by business interests.
By Lauren Weber and Christina Jewett -
Jaw Surgery Takes a $27,119 Bite out of One Man’s Budget
A Seattle patient discovers the hard way that you can still hit a lifetime limit for certain types of care. And health plans can vary a lot from one job to the next, even if the insurer is the same.
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Democrats’ Plans to Expand Medicare Benefits May Pinch Advantage Plans’ Funding
As lawmakers weigh new spending provisions to cover dental, hearing and vision services for Medicare beneficiaries, a group supporting Medicare Advantage plans is airing commercials that raise concerns about the funding for those private plans.
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Telemedicine Abortions Offer Cheaper Options but May Also Undermine Critical Clinics
A change in FDA rules during the pandemic has let women receive the drugs needed for a medical abortion by mail after a telemedicine appointment. While some abortion rights advocates hail the move, others note that these services, which are often cheaper than going to a clinic, could siphon away patients needed to keep those brick-and-mortar facilities operating.
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‘Holy Cow’ Moment Changes How Montana’s State Health Plan Does Business
Other states are watching to see if controlling how much hospitals get paid can continue to hold down costs in “Big Sky Country.”
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Major Insurers Running Billions of Dollars Behind on Payments to Hospitals and Doctors
Patients are caught in the middle as insurers clamp down on paying for treatments or force prior authorizations for care.
By Jay Hancock -
Analysis: A Procedure That Cost $1,775 in New York Was $350 in Maryland. Here’s Why.
The state’s unique health system controls what hospitals can charge for services.
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Pharmacies Face Extra Audit Burdens That Threaten Their Existence
Pharmacy benefit managers have curtailed in-person audits of pharmacy claims during the pandemic, switching to virtual audits done by computer. That has markedly increased the number of claims they can review — and the chances for payment denials — squeezing pharmacies and bringing in more cash for the benefit companies.
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Restoring a Sense of Belonging: The Unsung Importance of Casual Relationships for Older Adults
Relationships with people you know only superficially can help develop a sense of belonging and provide motivation to engage in activities. Research has found that older adults who have a broad array of “weak” as well as “close” ties enjoy better physical and psychological well-being and live longer than people with less diverse social networks.
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California Set to Spend Billions on Curing Homelessness and Caring for ‘Whole Body’ Politic
California is embarking on a five-year experiment to infuse its health insurance program for low-income people with billions of dollars in nonmedical services spanning housing, food delivery and addiction care. Gov. Gavin Newsom said the goal is to improve care for the program’s sickest and costliest members and save money, but will it work?
By Angela Hart -
The ER Charged Him $6,500 for Six Stitches. No Wonder His Critically Ill Wife Avoided the ER.
With few options for health care in their rural community, a Tennessee couple’s experience with one outrageous bill could have led to a deadly decision the next time they needed help.
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Mattresses and Mold Removal: Medi-Cal to Offer Unconventional Treatments to Asthma Patients
In January, California’s Medicaid program will begin offering nontraditional services —such as ridding homes of roaches, replacing mattresses and installing air purifiers — to some low-income asthma patients. But the rollout could be chaotic, with insurance companies struggling to identify groups that can deliver the services.
By Angela Hart -
Mission and Money Clash in Nonprofit Hospitals’ Venture Capital Ambitions
Nonprofit hospitals of all sizes have been trying their luck as venture capitalists, saying their investments improve care through the creation of new medical devices, health software and other innovations. But the gamble at times has been harder to pull off than expected.
By Jordan Rau -
A Colorado Town Is About as Vaccinated as It Can Get. Covid Still Isn’t Over There.
San Juan County, Colorado, is one of the most vaccinated counties in the U.S. Leaders across the country continue to expound on the vaccine as the path forward in the pandemic. But San Juan’s experience the past few weeks with its first covid hospitalizations shows that, even with an extremely vaccinated population, masks are still necessary.
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Hospitals Confront Climate Change as Patients Sick From Floods and Fires Crowd ERs
Patients sickened in heat waves, flooding and wildfire have raised awareness of climate change’s impact on health. Now, some hospitals are building solar panels and cutting waste to reduce their own carbon footprints, with support from a new office at the U.S. Department of Health and Human Services. But the industry is moving slowly.
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Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans
The plans are designed for people who don’t get dental coverage through their jobs and can’t afford an individual plan. For about $300 to $400 a year, patients receive certain preventive services at no charge and other procedures at a discount.
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How Low Can They Go? Rural Hospitals Weigh Keeping Obstetric Units When Births Decline
Many small hospitals have shuttered their labor and delivery units as births decline. For those who resist the trend, some studies suggest that hospitals with low deliveries are more likely to see complications for patients. Doctors and public health experts say there is no magic number to determine when it is best to close an obstetrics unit.
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A Hospital Charged $722.50 to Push Medicine Through an IV. Twice.
A college student never got an answer for what caused her intense pain, but she did get a bill that totaled $18,736 for an ER visit. She and her mom, a nurse practitioner, fought to understand all the charges.
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‘Time’s Up’: Covered California Takes Aim At Hospital C-Section Rates
Starting in less than two years, if state hospitals haven't met targets for safety and quality, they'll risk being excluded from the "in-network" designation of health plans sold on the state's insurance exchange.