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UrduNot everyone who qualifies for health insurance signs up for it. Consider Medicaid, the national health insurance plan for low-income people. Across the U.S., about 14 percent of eligible adults and 7 percent of eligible children are not enrolled in Med
Tag: Health Insurance
Big Win for Patients: Aetna Drops Prior Authorization for Most Cataract Surgeries
After a year of sustained advocacy from the ophthalmology community, Aetna announced this week that it will no longer require pre-approval for cataract surgeries starting July 1, 2022.
Analysis: California Malpractice Cap on Noneconomic Losses Associated with 16% More Adverse Events
A new analysis suggests California’s cap on noneconomic losses in malpractice cases has fallen far behind present-day values, and may even be associated with an increase in malpractice cases over the past five decades.
UCLA-led Evaluation Shows Improved Outcomes for Medi-Cal Patients Under a Demonstration Program for Public Hospitals
An evaluation led by Dr. Nadereh Pourat, UCLA Fielding School of Public Health professor of health policy and management, found a decreased use of emergency department visits and hospitalizations and slower growth in estimated Medi-Cal payments found in public hospitals compared with other hospitals
Postpartum insurance loss decreased during COVID-19 pandemic, study finds
It’s been the case for decades — high numbers of U.S. women who give birth lose or face changes to their health insurance afterward.
Senate Introduces Bill to Provide Full Chiropractic Coverage in Medicare
The U.S. Senate has introduced a bill, S. 4042, to modernize Medicare coverage and better meet the needs of today’s seniors by increasing access to services provided by doctors of chiropractic.
Prior authorization costs radiation oncology clinics more than $40 million each year, study estimates
The time required to secure prior authorization approvals for radiation therapy treatments equates to a financial impact of more than $40 million annually for academic medical centers, according to a new study. Findings will be presented today at the American Society for Radiation Oncology (ASTRO) Annual Meeting.
Barriers to Voting in Elections Linked to Increased Odds of Being Uninsured
Groups commonly targeted by voting restriction laws—those with low incomes, who are racial minorities, and who are young—are also less likely to be insured in states with more voting restrictions, according to a study by researchers at Columbia University Mailman School of Public Health and University of Alberta School of Public Health, Edmonton, Canada.
ACR Co-Authors Amicus Brief in Support of North Dakota Regulating PBM Industry
The Alliance for Transparent & Affordable Prescriptions (ATAP), the Community Oncology Alliance (COA), and American Pharmacies filed an amicus brief with the 8th Circuit Court of Appeals in support of North Dakota’s efforts to regulate practices of pharmacy benefit managers (PBMs).
Statement: American Academy of Ophthalmology and ASCRS Urge Aetna to Reverse Disruptive New Policy on Cataract Surgery
Aetna, the country’s third-largest provider of health insurance and services, is requiring pre-approval for all cataract surgeries starting July 1, 2021.
AMA Passes ACR-Led Resolution Opposing Paying Patients to Switch Treatments
The American Medical Association (AMA) House of Delegates passed a resolution developed by the American College of Rheumatology (ACR) to oppose insurance companies providing financial incentives for patients to switch from their prescribed treatment to a payer-preferred treatment.
Though ‘unsurprising,’ U.S. Supreme Court decision on Affordable Care Act a relief for many
The United States Supreme Court’s decision to uphold the Affordable Care Act, also known as Obamacare, should not come as a total surprise despite the conservative efforts to invalidate the law, according to West Virginia University policy and legal experts.…
Law, health economics experts available to comment on U.S. Supreme Court decision to uphold the ACA
This morning, the U.S. Supreme Court ruled 7-2 that the red states and two individuals who challenged the Affordable Care Act do not have legal standing to dispute the constitutionality of the law’s individual mandate to buy health insurance and…
Endocrine Society celebrates Supreme Court decision to uphold the Affordable Care Act
The Endocrine Society today praised the U.S. Supreme Court’s decision to uphold the Affordable Care Act, which makes health care accessible to millions of individuals nationwide, including those with hormone health conditions such as diabetes, osteoporosis, thyroid conditions, and breast and prostate cancer.
American Society of Anesthesiologists Makes Recommendations to Biden Admin.: Implement ‘No Surprises Act’ Equitably Without Improper Advantage to Health Insurers
Today, the American Society of Anesthesiologists (ASA) requested the Biden administration include a series of recommendations in its regulations to implement the “No Surprises Act,” the new federal surprise medical bill law, that will be implemented on January 1, 2022. ASA’s recommendations aim to ensure that the law is implemented fairly and equitably without improper benefit to health insurance companies.
Newly Published Comparison of Global Health Insurance Systems Demonstrates U.S. Weaknesses
A landmark work that details the strengths and weaknesses of the U.S. health insurance system, including how it lags behind those of other wealthy countries in measures that include mortality from both preventable and treatable causes, has been published.
Even small bills for health insurance may cause healthy low-income people to drop coverage
Twenty dollars a month might not seem like a lot to pay for health insurance. But for people getting by on $15,000 a year, it’s enough to make some drop their coverage – especially if they’re healthy. That could keep them from getting preventive or timely care, and could leave their insurance company with a sicker pool of patients than before.
Rush Health Partners with Oswego School District 308
Rush University System for Health entered into an agreement with Oswego Community Unit School District 308 to provide employees in the district’s health plan with discounted rates for medical services. The district plans to cover most out-of-pocket expenses (co-pays and deductibles) for care received at Rush.
Health Policy Researchers Propose Filling Health Care Coverage Gap to Help ‘Near Poor’
“Near-poor” Americans – people just above the federal poverty level but still well below the average U.S. income – who rely on Medicare for health insurance face high medical bills and may forgo essential health care, according to new research.
UCLA Expert Available for Comment on Surge in ACA Enrollment
Gerald Kominski, UCLA Fielding School of Public Health professor of health policy and management, is available for expert comment on the surge in enrollment in the Affordable Care Act program. Dr. Kominski is a Professor of Health Policy and Management and Senior…
As insurers end grace period for COVID-19 hospital costs, study estimates potential bills
Hospital care for COVID-19 has been free to most patients, but insurance companies may be ending that. A study of flu-related hospital bills suggests a coronavirus hospital stay could now cost patients $1,000 out of their own pocket, on average.
Magnitude and Effects of “Sludge” in Benefits Administration: How Health Insurance Hassles Burden Workers and Cost Employers
Administrative burdens may have substantial direct and indirect costs for employers and employees, making them important research topics. In this research, Stanford Graduate School of Business Thomas D. Dee II Professor of Organizational Behavior Jeffrey Pfeffer, along with Dan Witters,…
ACA Applauds Signing of Competitive Health Insurance Reform Act
ACA applauds Congress for passing legislation that will promote fair competition in health insurance markets with the removal of a 75-year-old exemption that allowed these companies to avoid federal antitrust laws.
Medicaid Expansion Increased Early Cancer Detection, New Study Finds
States where Medicaid was expanded under the Affordable Care Act have seen a measurable increase in the early detection of cancer and reduced late-stage cancer incidence, according to the results of a new study published in the current issue of the American Journal of Preventive Medicine.
What’s at stake in the Supreme Court’s ACA case? A quick explainer
Though the election and pandemic have eclipsed it in the news, there’s another event unfolding that could affect nearly all Americans: a Supreme Court case that will decide the future of the Affordable Care Act. A health policy researcher explains what would happen if it’s overturned.
Rutgers health policy expert available to discuss upcoming Supreme Court decision on ACA
Joel. C. Cantor, director of the Rutgers Center for State Health Policy, is available to discuss the upcoming U.S. Supreme Court decision on whether the Affordable Care Act, or a portion of the law, is unconstitutional, and what it could…
Eleven Provider and Patient Organizations Join the American College of Rheumatology to Oppose UnitedHealthcare Copay Accumulator Initiative
Eleven provider and patient organizations have joined the American College of Rheumatology (ACR) to petition UnitedHealthcare (UHC) to cancel plans to implement a proposed copay accumulator initiative that would require physicians to share details about their patients’ usage of copay assistance programs. The initiative would prevent funds from assistance programs from being applied towards patients’ annual deductible and out-of-pocket maximums. The groups warn that this would jeopardize patient access to medically necessary therapies by increasing the financial burden of care and lead to an increase in treatment abandonment.
With Affordable Care Act’s future in the balance, U-M holds 10th anniversary discussion with national experts
A free online event featuring health policy experts will explore the past, present and future of the Affordable Care Act
University Hospitals launches new web-based hospital price estimator tool
University Hospitals has launched a new hospital price estimator tool which provides patients with information about their estimated out-of-pocket costs for the most shoppable common services and procedures.
Many medical “rainy day” accounts aren’t getting opened or filled, study finds
One-third of the people who could benefit from a special type of savings account to cushion the blow of their health plan deductible aren’t doing so, according to a new study. And even among people who do open a health savings account (HSA), half haven’t put any money into it in the past year.
Big Opportunity for Telemedicine Emerges from COVID-19 Crisis
Phillip Phan, the Alonzo and Virginia Decker Professor of Strategy and Entrepreneurship at the Johns Hopkins Carey Business School, discusses promising developments in the field of telemedicine – developments that, ironically, may have been sped up by the onset of the coronavirus pandemic.
Mind the gap: Even the richest Americans lag the English on health, study finds
A new study shows that middle-aged people living in the U.S. today have worse health than their English counterparts – and that the difference in health between rich and poor is much larger on the American side of the Atlantic.
COVID-19 Care is (Mostly) Free to Patients. Should Other Vital Care Be Too?
This spring health insurance companies, large employers, and state and federal governments, pivoted rapidly to make COVID-19 tests, treatments and even future vaccines free, or nearly free, for the people covered by their plans. A team that has worked for years to make the same true for other types of care says this is a crucial time to expand that effort.
A Brave New Virtual World of Work
The COVID-19 pandemic has ushered in remote work on an unprecedented scale. Elizabeth Lyons, an assistant professor of management at UC San Diego’s School of Global Policy and Strategy, predicts this sudden transition to virtual will create a “new normal” in the world of work.
ASA Urges Secretary Azar to Implement a Moratorium on Health Insurer Contract Cancellations and Reinstatement of Cancelled Physician Contracts
Health insurance companies around the country are using aggressive negotiating tactics to terminate physician contracts, forcing physicians out of network with little or no notice and increasing the likelihood that patients will receive surprise medical bills. The American Society of Anesthesiologists (ASA) has implored Alex M. Azar II, secretary of the U.S. Department of Health and Human Services (HHS), to press insurers to reinstate terminated contracts and to implement a moratorium on cancellations and terminations during this national health emergency.
Sky-high surprise bills from air ambulance flights possible for many patients
When an emergency dispatcher calls for a helicopter to fly a critically ill patient to a hospital, they don’t have time to check whether they take the patient’s insurance. But after those patients land, 72% of them could face a potential “surprise bill” because their ambulance provider isn’t “in network” with their insurance, a new study of people with private insurance finds. So could 79% of those transported via ground ambulance.
ACA has helped protect low-income patients from catastrophic spending for surgery
n the years after 2014, when the Affordable Care Act’s health insurance marketplaces were established, low-income patients who underwent a surgical procedure saved an average of $601 in out-of-pocket spending and $968 in premium spending per year, compared to before the marketplaces existed. Those low-income patients also had a 35% lower chance of having catastrophic levels of household medical spending.
However, for middle-income patients, spending levels were about the same before and after the marketplaces began.
Affordable Care Act helped make health insurance access more equal, but racial and ethnic gaps remain
As the Affordable Care Act turns 10, a new study shows it has narrowed racial and ethnic gaps in access to health insurance – but definitely not eliminated them.
Both the percentage of people 19-64 who lacked health insurance, and the size of the health insurance gap between white, African-American and Hispanic Americans, shrank. From 2013 to 2017, the gap between blacks and whites narrowed 45%, and the difference between Hispanics and whites narrowed 35%.
ASA Survey Shows Health Insurers Abruptly Terminating Physician Contracts, Dramatically Cutting Payment Rates Forcing Physicians Out of Network
A new national survey from the American Society of Anesthesiologists (ASA) finds physician anesthesiologists are being forced out of network as insurance companies terminate their contracts, often with little or no notice.
Seven Medical Societies Join the ACR to Oppose Insurer Policy Limiting Access to In-Office Treatments
Providers are concerned the mandate adds an additional layer of red tape that will delay patient care, reduce the ability of providers to ensure therapies have been properly handled and safely stored, inflate patient out-of-pocket costs, and result in an increase of drug waste.
1 in 5 operations may lead to surprise bills, even when surgeon & hospital are in-network
As if recovering from surgery wasn’t hard enough, a new study shows that one in five operations could result in an unwelcome surprise: a bill for hundreds or thousands of dollars that the patient didn’t know they might owe.
On average, that potential surprise bill added up to $2,011. That’s on top of the nearly $1,800 the average privately insured patient would already owe after it paid for most of the costs of their operation.
Middle-Aged Adults Worried About Health Insurance Costs Now, Uncertain for Future
Health insurance costs weigh heavily on the minds of many middle-aged adults, and many are worried for what they’ll face in retirement or if federal health policies change, according to a new study. More than a quarter of people in their 50s and early 60s lack confidence that they’ll be able to afford health insurance in the next year, and the number goes up to nearly half when they look ahead to retirement.
Large Proportion of Reproductive-Age Women Live in Counties Where Catholic Hospitals Hold High Market Share
Nearly 2 of every 5 women of reproductive age in the U.S. live in counties where Catholic hospitals have a high market share, according to a new analysis. Catholic hospitals do not provide certain reproductive health options.
WHEN CAREGIVERS NEED CARE
People who regularly care for or assist a family member or friend with a health problem or disability are more likely to neglect their own health, particularly by not having insurance or putting off necessary health services due to cost, according to a study published by the American Psychological Association.
Decline in Late Stage Cancer Diagnoses After Health Reform Law
Advanced stage cancer diagnoses declined following health insurance expansion in Massachusetts, likely due to increased access to screening and diagnostic services that identified cancers earlier, according to new research.
Out-of-network costs soar for non-emergency hospitalizations
The out-of-pocket financial burden for insured working Americans is substantial and growing – especially when it comes to out-of-network, non-emergency hospital care, a new study has found. Researchers at The Ohio State University analyzed claims from more than 22 million enrollees in private insurance plans and found that out-of-pocket costs for non-emergency out-of-network hospital care nearly doubled in five years.
Rural-Urban Flip: How Changing ACA Rules Affected Health Insurance Premium Costs
People in rural areas of the U.S. who receive subsidies to buy health insurance in the Health Insurance Marketplaces pay less in premiums than their counterparts in urban areas, a flip that occurred in 2018 and has been widening since, according to a new analysis.
New Health Insurance Benefit at U-M Led to Increased Rates of IVF
In a new research letter appearing in JAMA detailing a first-of-its-kind study, the team compared the use of IVF among university employees before and after the addition of the insurance coverage benefit.