Cost and Quality

"Cost and Quality" Main

Latest Morning Briefing Stories

The Colonoscopies Were Free. But the ‘Surgical Trays’ Came With $600 Price Tags.

KFF Health News Original

Health providers may bill however they choose — including in ways that could leave patients with unexpected bills for “free” care. Routine preventive care saddled an Illinois couple with his-and-her bills for “surgical trays.”

Mammography AI Can Cost Patients Extra. Is It Worth It?

KFF Health News Original

Artificial intelligence software to aid radiologists in detecting problems or diagnosing cancer has been moving rapidly into clinical use, where it shows great promise. But it’s a turnoff for some patients asked to pay out-of-pocket for technology that’s not quite ready for prime time.

Why Do We Pay For so Much Worthless Health Care?

KFF Health News Original

Medical advances are expensive. Take Wegovy, the wildly successful obesity drug that we learned last week may also reduce the risk of heart disease. If just 10 percent of Medicare beneficiaries start taking the drug, taxpayers could be on the hook for nearly $27 billion a year.  So how can the country afford the latest […]

Compensation Is Key to Fixing Primary Care Shortage

KFF Health News Original

Many proposals have been floated about how to address the nation’s primary care problem. They range from training slots to medical school debt forgiveness but often sidestep comprehensive payment reform.

Biden Administration’s Limit on Drug Industry Middlemen Backfires, Pharmacists Say

KFF Health News Original

A rule taking effect Jan. 1 was intended to stop one set of abuses by pharmacy benefit managers, or PBMs, but some pharmacists say it’s enabling these price brokers to simply do new things unfairly.

These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They’re Failing to Deliver.

KFF Health News Original

Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations — even as it’s sued thousands of patients for unpaid bills.

Your Exorbitant Medical Bill, Brought to You by the Latest Hospital Merger

KFF Health News Original

After decades of unchecked mergers, health care is the land of giants, with huge medical systems monopolizing care in many cities, states, and even whole regions of the country. This decreases patient choice, impedes innovation, erodes quality of care, and raises prices. And federal regulators have been slow to act.

Medi-Cal’s Fragmented System Can Make Moving a Nightmare

KFF Health News Original

When Medi-Cal beneficiary Lloyd Tennison moved last year from Contra Costa County to San Joaquin County, he was bumped off his managed care plan without notice before his new coverage took effect. His case highlights a chronic issue in California’s fragmented Medicaid program.

A Progress Check on Hospital Price Transparency

KFF Health News Original

Hospitals are facing mixed reviews regarding their efforts to comply with a federal requirement that they post information about prices related to nearly every health care service they provide.

Truly Random Drug Testing: ADHD Patients Face Uneven Urine Screens and, Sometimes, Stigma

KFF Health News Original

Doctors have no national standards on when to order urine tests to check whether adult ADHD patients are properly taking their prescription stimulants. Some patients are subjected to much more frequent testing than others.

Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients

KFF Health News Original

The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has become a confusing maze that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New rules may not be enough to solve the problems.

Pacientes negros visten elegante y hablan distinto para evitar prejuicios cuando van al médico

KFF Health News Original

Estos comportamientos se recogen en una encuesta con 3,325 participantes como parte de un estudio cuyo objetivo fue llamar la atención sobre el esfuerzo que deben realizar los pacientes negros para obtener una atención médica de calidad.