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A 10 percent bump in pay, a health law provision that sunsets at the end of the year, was designed to help balance the reimbursement levels between primary care providers and specialists.
Researchers at the University of Pennsylvania found that Medicaid turned down requests for new expensive drugs to treat hepatitis C 46 percent of the time, while private insurers barred them 10 percent and Medicare 5 percent.
Aetna is rolling out a special gold-level plan for 2016 that is aimed at providing better care for people with diabetes in the hopes of keeping them healthier—and their costs down. But it’s not clear the plans are a good buy.
Only 16 percent of the popular plans cover all 10 of the most common drug regimens and charge less than $100 a month in consumer cost sharing, according to a report by Avalere Health.
These plans, which still are a minority in the marketplaces, can help drive consumers to use the system’s hospitals and doctors, but some also offer competitive prices.
Two studies analyze the decline in PPO plans that provide some coverage when patients seek care from doctors, hospitals and other providers that are not on the plan’s network.
KHN’s consumer columnist answers readers’ questions about high deductible plans, out of network benefits and increases in premium costs.
Insurance generally covers routine costs patients encounter in a clinical trial, but the patients can still be responsible for co-payments and other expenses, such as lost wages and travel.
Enrollment for healthcare.gov plans for 2016 begins Sunday and consumers should carefully check their options to see what their costs will be, how much of a subsidy they qualify for and whether their doctors and hospitals are in the plan’s network.
The American Cancer Society now recommends that women begin annual mammogram screenings at age 45 instead of age 40, and that providers reduce the frequency of screening to every two years after age 54.
For beneficiaries, staying in their current plans could prove costly so advocates urge them to check out the alternatives.
The research shows 77 percent of those with dementia receive routine help with household tasks or personal care such as bathing and dressing. Only 20 percent of the 33 million people without dementia received similar help.
The new law, signed by President Barack Obama last week, eases some of the requirements for employers with 51 to 100 workers and counterintuitively may help bolster coverage.
Researchers report that prices for a dozen procedures and tests were 8 to 26 percent higher in counties with the highest level of physicians concentrated in large group practices.
KHN consumer columnist Michelle Andrews answers readers’ questions about trying to get a better return on a health savings account, the Cadillac tax’s impact on a marketplace plan and finding insurance for a grandchild.
Dental care is the health service that people most frequently avoid because of cost, researchers at the Urban Institute found.
Although the government is responsible for providing health services to people in jail, prisoners are still often expected to pay for the treatment.
The new law is only the second in the country that allows women to get a year’s prescription at one time.
Dr. Eric Topol says smartphones and other technology allow patients to monitor and control their chronic health issues.
As the fall enrollment window begins for job-based insurance, workers may see a number of changes in provisions such as wellness programs, dependents’ coverage and specialty drug spending.
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