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Slow Progress On Efforts To Pay Docs, Hospitals For ‘Value,’ Not Volume

By Russ Mitchell March 26, 2013 KFF Health News Original

Consortium of large employers says that only 10.9 percent of employers’ health spending is based on value-based payment.

Feds Outline What Insurers Must Cover, Down To Polyp Removal

By Julie Appleby February 20, 2013 KFF Health News Original

The Obama administration on Wednesday released its final rule on essential health benefits, which sets out what benefits insurers must offer starting in 2014. Insurers must cover 10 broad categories of care, including emergency services, maternity care, hospital and doctors’ services, mental health and substance abuse care and prescription drugs. Essential benefit requirements apply mainly to […]

Hospital Consolidation Dance Heats Up In NYC

By Jenny Gold February 28, 2013 KFF Health News Original

The health care game of musical chairs is picking up speed in New York City, one of the most competitive markets in the country. The Mount Sinai Medical Center and Continuum Health Partners announced Thursday that their boards of trustees have reached a tentative agreement on a possible merger. The announcement comes less than nine months after Continuum, which […]

Out-Of Network Care Is Expensive But A Couple Of New Options Help

By Michelle Andrews April 16, 2012 KFF Health News Original

Seeking care from hospitals and doctors who haven’t agreed to negotiated rates with your insurer is costly but consumers can get help from a new database on pricing. The health law is also easing some out-of-network emergency expenses.

Survey: Employers Expect 7 Percent Growth In Cost Of Health Benefits

By Matthew Fleming August 6, 2012 KFF Health News Original

As employers brace to absorb cost increases in employee health benefits, many are also experimenting with new ways to control these expenses, according to a new survey from the National Business Group on Health, a non-profit association of 342 large employers. The survey’s findings, which were released today, are based on the responses of 82 […]

Shingles Vaccinations Not Covered For Some Medicare Beneficiaries

By Michelle Andrews September 10, 2012 KFF Health News Original

Answers to readers’ questions about how seniors can qualify for coverage for the inoculations, whether parents are required to keep young adults on their plan and getting pregnancy care for dependents.

Health Insurers See Big Opportunities In Health Law’s Medicaid Expansion

By Phil Galewitz March 8, 2013 KFF Health News Original

Medicaid managed care plans prepare for as many as 10 million new members in 2014– and billions in additional revenue.

Despite Incentives, Doctors’ Offices Lag On Digital Records

By Eric Whitney, Colorado Public Radio January 22, 2013 KFF Health News Original

A recent study found that the health care industry isn’t benefiting from computer networks that have transformed other fields. But the federal coordinator for health IT says there has been a lot of progress that will result in better care and cost savings in the future.

Hospitals Crack Down On Tirades By Angry Doctors

By Sandra G. Boodman March 5, 2013 KFF Health News Original

For many years, hospitals were reluctant to address physicians who berated nurses, threw scalpels or demeaned co-workers. But increasingly such actions bring discipline.

Florida Gets Green Light For Medicaid Managed Care

By Jim Saunders, News Servce of Florida February 5, 2013 KFF Health News Original

Medicaid-eligible seniors who need long-term care likely will start enrolling later this year in HMOs and another type of health plan known as a “provider service network.” The long-term care changes are the first phase of a controversial proposal to shift Medicaid beneficiaries statewide into managed care.

Olympians Face Unique Health Insurance Options

By Christian Torres July 26, 2012 KFF Health News Original

U.S. Olympic athletes have a number of health insurance options, including the U.S. Olympic Committee’s Elite Athlete Insurance Program.

Consumer Tips: Going Out Of Network

February 8, 2012 KFF Health News Original

Most health insurance plans allow you to visit an out-of-network doctor or hospital, though it is very likely to cost you more. KHN’s Julie Appleby says you may want to use an online calculator to figure out how much more it will cost you and suggests questions you may want to ask your insurer before you decide what to do.

Q&A: Why Did I Receive A Bill From An Out-Of-Network Radiologist?

March 4, 2012 KFF Health News Original

Michelle Andrews answers a question from a reader who received a bill from an out-of-network radiologist after a routine mammogram at an in-network hospital. The reader asks: What can we citizens do to ensure our rights?

Huge Experiment Aims To Save On Care For Poorest, Sickest Patients

By Sarah Varney and Mary Agnes Carey December 5, 2012 KFF Health News Original

An effort in California to move Medicaid patients into managed care has national significance as federal officials roll out a similar but larger program for as many as 2 million people who qualify for both Medicaid and Medicare.

State Roundup: Texas Insurance Regulator Pulls Out-Of-Network Notice Rules

August 21, 2012 Morning Briefing

A selection of health policy news from Texas, California, Massachusetts, Georgia and Oregon.

As ‘Bodega Clinicas’ Fill Void, Officials Are Torn on Embracing Them

By Sarah Varney January 12, 2013 KFF Health News Original

The storefront doctor’s offices serve a vast number of uninsured Latino residents, in a kind of parallel, cash-only health system. But officials have little information on the quality of health care the clinicas provide, and whether they might be able to help fill persistent and profound gaps in Los Angeles’ strained safety net.

Consumers Hit By Higher Out-of-Network Medical Costs

By Julie Appleby February 8, 2012 KFF Health News Original

Insurers switch to new way to calculate reimbursement that shifts more of the expenses onto patients.

Stuart Altman’s Huge Challenge: Bring Down Mass. Health Costs

By Martha Bebinger, WBUR November 18, 2012 KFF Health News Original

The health economist and former presidential adviser is leading a board overseeing the state’s cost-control law.

Health Plans Gear Up To Sell Directly To Consumers

By Julie Appleby December 3, 2012 KFF Health News Original

Insurers develop new business strategies as the health law upends old models.

Today’s Headlines – July 5, 2012

By Lexie Verdon July 5, 2012 KFF Health News Original

Good morning! Hope you had a great holiday. Here are your headlines: Politico: Romney Shifts, Says Mandate’s A Tax Directly contradicting his senior adviser, Eric Fehrnstrom, presumptive GOP presidential nominee Mitt Romney told CBS that the Affordable Care Act’s individual mandate is “a tax.” Earlier this week, Fehrnstrom said in a TV appearance that Romney […]

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