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Republican Gov. Brian Kemp’s Georgia Pathways to Coverage program has seen anemic enrollment while chalking up millions in start-up costs — largely in technology and consulting fees. Critics say the money’s being wasted on a costly and ineffective alternative to Obamacare’s Medicaid expansion.
Drugmakers offer copay assistance programs to patients, but insurers are tapping into those funds, not counting the amounts toward patient deductibles. That leads to unexpected charges. But the practice is under growing scrutiny.
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of “qualifying life events.” But insurers’ contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
Health care wasn’t expected to be a major theme for this year’s elections. But as President Joe Biden and former President Donald Trump secured their respective party nominations this week, the future of both Medicare and the Affordable Care Act appears to be up for debate. Meanwhile, the cyberattack of the UnitedHealth Group subsidiary Change Healthcare continues to do damage to the companies’ finances with no quick end in sight. Margot Sanger-Katz of The New York Times, Anna Edney of Bloomberg News, and Joanne Kenen of Johns Hopkins University and Politico Magazine join KFF Health News’ Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Kelly Henning of Bloomberg Philanthropies about a new, four-part documentary series on the history of public health, “The Invisible Shield.” Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too.
New Social Security Commissioner Martin O’Malley is promising to change how the agency reclaims billions of dollars it wrongly pays to beneficiaries, saying the existing process is “cruel-hearted and mindless.”
For-profit groups own more than 70% of U.S. nursing homes. Industry leaders and researchers wonder whether corporations and investors can succeed where not-for-profit organizations have struggled. Or, will quality of care suffer in the name of making money?
Framed in the rhetoric of choice, Tennessee’s new law governing childhood vaccinations is among more than a dozen recently passed or pending nationwide that set parental freedom against community and children’s health.
A pill form of an effective drug for postpartum depression hit the market in December, but most insurers do not yet have a policy on when or whether they will pay for it. The hurdles to obtain its predecessor medication have advocates worried.
The historically troubled White House Medical Unit is just one part of a government health system that gives VIP care to top officials, military officers, military retirees, and families. Pentagon investigators say some were prioritized over rank-and-file soldiers.
The cyberattack on a unit of UnitedHealth Group’s Optum division is the worst on the health care industry in U.S. history, hospitals say. Providers struggling to get paid for care say the response by the insurer and the Biden administration has been inadequate.
A recent report finds half of America’s rural hospitals are losing money, and many are struggling to stay open. Researchers and advocates worry the hospitals’ financial spiral will have immediate and long-term health effects on their communities.
A mathematical model designed to direct spending of opioid settlement funds is at the center of a debate over whether to invest in technology to guide long-term decisions or focus on the immediate needs of people in addiction.
A recently unsealed lawsuit alleges Aledade Inc. developed billing software that boosted revenues by making patients appear sicker than they were.
A new California law allows trained physician assistants, also called physician associates, to perform first-trimester abortions without the presence of a supervising doctor. The legislation is part of a broader effort by the state to expand access to abortion care, especially in rural areas. Some doctor groups are wary.
California has supported expanded use of medications in the fight against opioid use disorder and overdose deaths. But hospitals and addiction treatment advocates say the state needs to secure ongoing funding if it wants more behavioral health workers to guide patients into long-term treatment.
The Consumer Financial Protection Bureau, created after the Great Recession of 2007-09, has increasingly started policing the health care system.
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