Don’t assume your employer’s health plan offers comprehensive coverage. Marlene Allen did. Then she got hurt.
Management of the joint state-federal program for low-income people has changed dramatically, and federal officials are seeking to make sure it meets the needs of enrollees.
Despite efforts to keep costs down, Douglas White gets a bill nearly three times what he expected.
The Centers for Medicare & Medicaid Services proposal, which includes provisions related to network adequacy and quality standards, would be the biggest regulatory change to Medicaid managed care in more than a decade.
A small consulting firm is disrupting hospitals’ business as usual by encouraging employers to pay much less than what hospitals bill — based on its analysis of what is reasonable.
As part of an experiment run by the Centers for Medicare and Medicaid Innovation, doctors, nurses and managers at Baptist Health System in San Antonio joined forces to cut costs for hip and knee replacements, getting patients on their feet sooner, saving taxpayers money and increasing their own earnings.
Tennessee’s TennCare program awaits federal rules to limit insurer profits and set stricter standards for quality and doctor networks — the biggest rules change for Medicaid managed care in a decade.
Companies that introduced these plans experienced overall savings in the first three years, according to a new study.
Guroo.org shows the average local cost of 70 common diagnoses and medical tests in most states. That’s the real cost — not “charges” that often get marked down — based on a giant database of what insurance companies actually pay.
Large-employer plans without inpatient benefits were seen as a health law loophole that trapped workers in inadequate insurance. Now, the Obama administration has blocked them.
Early reports show two major medical-home experiments run by the health law’s Center for Medicare & Medicaid Innovation reduced hospitalizations in some cases but are still working to cut overall costs.
Results so far show community agencies haven’t made a big difference in keeping seniors from making return hospital trips. But administration officials say the program has plenty of potential.
Some 2.5 million patients are involved in federally funded tests to control costs and reduce injuries, but data on most programs still aren’t available.
The federal government has invested $15 million in a North Carolina experiment that gives community pharmacists a new role in patient care.
Small employers are canceling medical plans and leaving workers to buy insurance through the law’s online marketplaces — sometimes to everyone’s benefit.
Surging contracts related to the Affordable Care Act have helped make the Department of Health and Human Services a fount of revenue for private business.
The Affordable Care Act and related programs have helped make the Department of Health and Human Services the No. 3 federal agency for outsourcing work to private business, after the Pentagon and the Energy Department.
Paying high-risk employees to buy exchange plans is declared illegal.
The new proposed rule would bar such plans that had once qualified under a federal calculator.
Consumers who get health insurance through their employers need to pay close attention this year to their enrollment materials.