‘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.”
Medicare
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Medicare Takes Aim At Boomerang Hospitalizations Of Nursing Home Patients
One in 5 Medicare patients who leave the hospital for a nursing home end up back in the hospital. To discourage this, the Centers for Medicare & Medicaid Services will soon give bonuses and penalties to facilities based on their rehospitalization rates.
By Jordan Rau -
Look-Up: Compare Nursing Homes’ Track Records On Boomerang Hospitalizations
Use this tool to see how skilled nursing homes in the U.S. performed on two metrics of quality.
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Podcast: KHN’s ‘What The Health?’ Health Care Politics, Midterm Edition
In this episode of KHN’s “What the Health?” Julie Rovner of Kaiser Health News, Alice Ollstein of Talking Points Memo, Stephanie Armour of The Wall Street Journal and Rebecca Adams of CQ Roll Call discuss how Medicare, Medicaid and the fate of the Affordable Care Act are playing out in the politics of the coming midterm elections. Plus, Rovner interviews Matt Eyles, president and CEO of America’s Health Insurance Plans.
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Medicare Financial Outlook Worsens
The Medicare board of trustees said the program's hospital insurance trust fund could run out of money by 2026, three years earlier than previously forecast.
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A Hospital ER Charges An ‘After-Hours’ Fee. Who Has To Pay It?
Tacking on an after-hours surcharge to an emergency department bill strikes some consumers as unfair, since the facilities are open 24 hours a day.
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Looking For Lower Medicare Drug Costs? Ask Your Pharmacist For The Cash Price.
Sometimes a drug plan’s copayment is higher than the cash price, and under a little-known federal rule, pharmacists have to tell Medicare beneficiaries that — but only if they ask.
By Susan Jaffe -
Pfizer Settles Kickback Case Related To Copay Assistance For $24M
The drugmaker agreed to a settlement with the Justice Department over allegations that it funneled copay assistance money through a foundation to Medicare patients.
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Drugmakers Blamed For Blocking Generics Have Jacked Up Prices And Cost U.S. Billions
The Trump administration is shaming brand-name drugmakers who refuse to sell samples so generics can be made from their products.
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When Is Insurance Not Really Insurance? When You Need Pricey Dental Care.
Even under a decent plan, you’ll have to dig deep in your pocket for crowns, bridges and implants. The mouth isn’t covered by insurance the same way as the rest of the body, and this division has deep roots in history and tradition.
By David Tuller -
Podcast: KHN’s ‘What The Health?’ Much Ado About Drug Prices
In this episode of KHN’s “What the Health?” Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Anna Edney of Bloomberg News and Rebecca Adams of CQ Roll Call discuss President Donald Trump’s proposals to control prescription drug prices and the efforts to sell the plan to lawmakers and the public. Also, Rovner interviews emeritus law professor Timothy Jost about the state of the Affordable Care Act.
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Lack Of Insurance Exposes Blind Spots In Vision Care
As many as 16 million people in the United States have undiagnosed or uncorrected vision problems that could be fixed with eyeglasses, contact lenses or surgery.
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Trump Vows (Again) To Lower Drug Prices But Skeptics Doubt Much Will Change
President Donald Trump’s much-awaited speech about slashing drug costs was long on rhetoric but short on specifics that will reduce prices.
By Sarah Jane Tribble and Liz Szabo -
Hoping To See Your Doctor Via Telemedicine? Here’s A Quick Guide.
All private health plans, Medicare, state Medicaid programs and the VA now cover some e-visits — albeit with restrictions.
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Medicare Beneficiaries Feel The Pinch When They Can’t Use Drug Coupons
Federal law prohibits them from using the coupons drugmakers offer to help patients cover their share of a medicine’s cost.
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‘Pharma Bro’ Shkreli Is In Prison, But Daraprim’s Price Is Still High
The saga of Martin Shkreli and Turing Pharmaceuticals focused a lot of attention on prescription drug prices, but no reversal of the exponential price increases for the lifesaving drug Daraprim resulted. The story offers an object lesson into the interworkings of the pharmaceutical market.
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Best Reads Of The Week From Brianna Labuskes
Newsletter editor Brianna Labuskes, who reads everything on health care to compile our daily Morning Briefing, offers the best and most provocative stories for the weekend.
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Dissecting The Rhetoric Vs. Reality Of Trump’s Tough Talk On Drug Prices
President Donald Trump’s upcoming speech on drug prices comes after months of public comments and debate about tackling the issue.
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Podcast: KHN’s ‘What The Health?’ Nothing In Health Care Ever Goes Away
In this episode of KHN’s “What the Health?” Sarah Jane Tribble of Kaiser Health News, Joanne Kenen of Politico, Margot Sanger-Katz of The New York Times and Paige Winfield Cunningham of The Washington Post examine how even after Republicans failed to repeal and replace the Affordable Care Act, the health care debate continues to roil politics. They discuss how Republicans in Congress have shifted their ACA messaging and how the Democrats are looking to Medicare expansion. They also discuss state efforts to expand Medicaid and drug pricing. And they spend a moment talking about Congress’ push to do something about the opioid crisis.
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New Medicare Perk For Diabetes Prevention Stumbles At Rollout
On April 1, Medicare launched a major initiative — a diabetes prevention program for seniors and people with serious disabilities— that is available in only a few cities.