How a Duty To Spend Wisely on Worker Benefits Could Loosen PBMs’ Grip on Drug Prices
As criticism of pharmacy benefit managers heats up, fear of lawsuits is driving some big employers to drop the “Big Three” PBMs — or force them to change.
Health Care Costs
361 - 380 of 1,851 Results
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News Analysis
Rage Has Long Shadowed American Health Care. It’s Rarely Produced Big Change.
The outpouring of anger at health insurers following the killing of UnitedHealthcare CEO Brian Thompson continues a cycle of rage that dates back decades.
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Native American Patients Are Sent to Collections for Debts the Government Owes
Federal law says Native Americans aren’t liable for medical bills the Indian Health Service promises to pay. Some are billed anyway as a result of backlogs or mistakes from the agency, financial middlemen, or health systems.
By Katheryn Houghton and Arielle Zionts -
Perspective
Removing a Splinter? Treating a Wart? If a Doctor Does It, It Can Be Billed as Surgery
Minor interventions are increasingly being rebranded and billed as surgery, for profit. This means a neurologist spending 40 minutes with a patient to tease out a diagnosis can be paid less for that time than a dermatologist spending a few seconds squirting a dollop of liquid nitrogen onto the skin.
A Killing Touches Off Backlash Against Health Insurers
Episode 376The shocking shooting death of UnitedHealthcare’s chief executive in Midtown Manhattan prompted a public outcry about the problems with the nation’s health care system, as stories of delayed and denied care filled social media. Meanwhile, President-elect Donald Trump continues to avoid providing specifics about his plans for the Affordable Care Act and other health issues. Alice Miranda Ollstein of Politico, Sandhya Raman of CQ Roll Call, and Rachel Cohrs Zhang of Stat join 鶹Ů Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Francis Collins, who was the director of the National Institutes of Health and a science adviser to President Joe Biden.
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New Lessons in the Fight for Charity Care
Season 12, Episode 8Host Dan Weissmann checks back in on the fight for hospital charity care, with lessons from Dollar For and a savvy listener.
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9 States Poised To End Coverage for Millions if Trump Cuts Medicaid Funding
About 3.7 million people are at immediate risk of losing health coverage should the federal government cut funding for Medicaid expansions, as some allies of President-elect Donald Trump have proposed. Coverage could be at risk in the 40 states that have expanded Medicaid.
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With Trump on the Way, Advocates Look to States To Pick Up Medical Debt Fight
Patient and consumer advocates fear a new Trump administration will scale back federal efforts to expand financial protections for patients and shield them from debt.
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Who Gets Obesity Drugs Covered by Insurance? In North Carolina, It Helps If You’re on Medicaid
GLP-1 agonist medications such as Ozempic accounted for 10% of the North Carolina state employee health plan’s prescription drug spending, so the state is no longer covering them for weight loss alone. Still, it did decide to cover them for Medicaid patients’ weight loss. A look inside the state’s coverage calculus.
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A Toddler Got a Nasal Swab Test but Left Before Seeing a Doctor. The Bill Was $445.
A mom in Peoria, Illinois, took her 3-year-old to the ER one evening last December. While they were waiting to be seen, the toddler seemed better, so they left without seeing a doctor. Then the bill came.
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Florida’s Deloitte-Run Computer System Cut Off New Moms Entitled to Medicaid
Florida discovered a glitch in its Deloitte-run Medicaid eligibility system. The problem, alleged in court testimony, led to new mothers wrongly losing their insurance coverage.
By Daniel Chang and Samantha Liss -
Indiana Hospitals Pull Merger Application After Pushback Over Monopoly Concerns
Two Indiana hospital rivals withdrew their application to merge after facing pushback from the Federal Trade Commission and the public.
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Journalists Reflect on Trump Picks, Racism and Public Health, and Unnecessary Dental Implants
鶹Ů Health News staff made the rounds on national and local media in the last two weeks to discuss topical stories. Here’s a collection of their appearances.
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Florida Gov. DeSantis’ Canadian Drug Import Plan Goes Nowhere After FDA Approval
Florida sued the FDA over what it said was a “reckless delay” in approving its drug importation plan. Now, nearly a year after the FDA gave the state the green light, the program has yet to begin.
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California Sets 15% Target for Primary Care Spending Over Next Decade
The state Office of Health Care Affordability has set a goal for insurers to direct 15% of their spending to primary care by 2034, part of a push to expand preventive care services. Health plans say it’s unclear how the policy will mesh with the state’s overarching goal to slow spending growth.
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Washington Power Has Shifted. Here’s How the ACA May Shift, Too.
With a new Trump administration poised to move into the White House and Republicans set to control both chambers of Congress, party leaders are making a to-do list for the Affordable Care Act.
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Listen: A Tussle With a Rattlesnake Can Take a Bite Out of Your Wallet
Listen to 鶹Ů Health News' Jackie Fortiér recount how a backyard snakebite led to a harrowing hospitalization — and big bills — for a San Diego family.
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FTC, Indiana Residents Pressure State To Block Hospital Merger
Hundreds of people and the Federal Trade Commission weighed in on a proposed hospital merger in Terre Haute, Indiana, with most arguing that the creation of a monopoly would increase costs and worsen patient care.