Medicare & Aging News From KHN — 2013

Kaiser Health News has had a variety of coverage about Medicare, long-term care and other issues affecting seniors’ quality of care and life. Below is a complete list of our 2013 coverage.

See Stories Published In: 2014 | 2012

KHN’s coverage of aging and long-term care issues is produced with support from The SCAN Foundation.

DECEMBER

Medicare Identifies 97 Best And 95 Worst Hospitals For Hip And Knee Replacements
By Jordan Rau, Dec. 17
The new analysis is part of the government’s effort to improve the quality of care.

Table: Hospitals Judged Best And Worst For Hip And Knee Readmissions And Complications
Dec. 17
Medicare has evaluated how often patients undergoing hip and knee surgery were readmitted or suffered a serious complication. These hospitals did much better or worse than average.

Readers Ask: Will Health Law Help Cover My Braces; Should A Retired Couple File Separate Tax Returns To Avoid Penalties?
By Michelle Andrews, Dec. 17
Consumer columnist reminds consumers that details make all the difference.

How Palliative Care Helps: One Iowa Family’s Journey
By Jenny Gold, Dec. 16
‘This is their life. They’re the boss,’ says Dr. Tim Ihrig of the palliative care department at UnityPoint hospital in Fort Dodge, Iowa. ‘It’s an honor to be on this journey.’

A Reader Asks: Can I Opt Out Of My Retiree Plan To Get Subsidized Insurance?
By Michelle Andrews, Dec. 13
The health law treats retirees differently than workers getting insurance through their jobs.

Congress Moves Closer To Changing How Medicare Pays Doctors

Dec. 12

Key House and Senate committees approved legislation Thursday to repeal the Sustainable Growth Rate, the formula officials use to pay doctors who treat Medicare patients. KHN’s Mary Agnes Carey and Politico Pro’s Jennifer Haberkorn discuss.

Medicare Beneficiaries Have Good Access To Doctors, Study Finds
By Mary Agnes Carey, Dec. 10
As key congressional committees consider legislation to repeal Medicare’s physician payment formula, a new study shows that the program’s beneficiaries have generally good access to doctors.

Rehospitalization Rates Fell In First Year Of Medicare Penalties
By Jordan Rau, Dec. 9
During the first eight months of this year, fewer than 18 percent of Medicare patients ended up back in the hospital within a month of discharge, the lowest rate in years, the government reported Friday. This drop occurred during the first year that Medicare financially penalized hospitals for their readmission rates, and the government seized on the decrease as evidence the incentives are having an effect.

Judge’s Medicare Advantage Order Could Have National Impact
By Susan Jaffe, Dec. 6
UnitedHealthcare will appeal a federal judge’s order temporarily blocking the insurer from dropping Connecticut providers, while doctors’ groups in Ohio and New York look at bringing similar lawsuits.

When Palliative Care Is The Best Care
By Anna Gorman, Dec. 3
A growing subspecialty that manages pain and stress for the seriously ill saves money, increases patient satisfaction and lengthens lives.

Medicare Seeks To Curb Spending On Post-Hospital Care
By Jordan Rau, Dec. 1
One out of every six dollars Medicare spent in the traditional fee-for-service program went to nursing and therapy for patients in rehabilitation facilities, nursing homes, long-term care hospitals and in their own homes.

Table: Medicare Spending By State And Category
Dec. 1
One out of every five dollars Medicare spends goes to nursing homes, home health services or other post-acute facilities and services. The spending varies greatly between states: Louisiana spends 31 percent on post-acute services while Hawaii spends 12 percent.

UnitedHealthcare Dropping Hundreds Of Doctors From Medicare Advantage Plans
By Susan Jaffe, Dec. 1
The insurer has been notifying members about the network changes as the Dec. 7 deadline for choosing coverage for next year quickly approaches.

NOVEMBER

In Iowa, Accountable Care Begins To Make A Difference
By Jenny Gold, Nov. 21
The Medicare program created by the Affordable Care Act focuses on smarter, targeted care to save lives and money.

Safety-Net Hospitals Lose More Under Medicare’s Quality-Based Payments
By Jordan Rau, Nov. 19
Medicare’s effort to reward hospitals for quality is leaving many of the nation’s safety-net hospitals poorer, a new analysis finds.

Nearly 1,500 Hospitals Penalized Under Medicare Program Rating Quality
By Jordan Rau, Nov. 14
The hospitals were rated on two-dozen measures, including surveys of patient satisfaction and death rates.

Interactive Chart: Bonuses And Penalties For U.S. Hospitals
Nov. 14
This chart shows the payment adjustments for each hospital and how they compared to the bonuses and penalties from last year.

Strange Pricing Details Can Bedevil Medicare Beneficiaries
By Susan Jaffe, Nov. 13
Pharmacist Gina Upchurch knows all the ins and outs of the Medicare prescription drug benefit and was sure she discovered something very wrong:  using the government’s online plan finder tool to help seniors compare dozens of 2014 drug policies, she noticed that some insurers charge higher prices for a prescription filled every two or three months compared to the same drug bought every month.

OCTOBER

Key Senate, House Committee Chairs Offer Plan To Fix Medicare Doctor Payments
By Mary Agnes Carey, Oct. 31
The proposal would keep physician pay at current levels but offer them incentives for quality improvements.

Tough Medicare Decisions Await Bipartisan Budget Panel
By Mary Agnes Carey, Oct. 18
Lawmakers have until Dec. 13 to reach agreement under legislation ending the shutdown of the government and raising the debt ceiling.

Shutdown Not Hurting Seniors’ Ability To Get Medicare Plan Information
By Susan Jaffe, Oct. 16
Medicare beneficiaries do not have to worry about getting accurate details from the plan finder website during the current open enrollment season, officials said.

Seniors Cautioned To Pay Close Attention To Details As Enrollment Begins In Medicare Plans
By Susan Jaffe, Oct. 15
Costs, coverage details of different Medicare Advantage or prescription drug plans can vary significantly, so beneficiaries should weigh their options and consider switching plans for a better deal.

Some Good News About Saving For Retirement Health Costs
By Ankita Rao, Oct. 10
Saving for health care after retirement is less costly than it was just a few years ago thanks to the slowed growth of health care spending. But that’s just part of the picture.

Costliest 1 Percent Of Patients Account For 21 Percent Of U.S. Health Spending
By Sandra G. Boodman, Oct. 7
Most of these patients have multiple chronic illnesses and all too often they wind up in emergency rooms because they have enormous difficulty navigating the increasingly fragmented, complicated and inflexible health-care system.

SEPTEMBER

Medicare To Delay Enforcement Of New Observation Rule
By Susan Jaffe, Sept. 27
Medicare officials announced Thursday that they will delay enforcement of controversial new rules that define when hospital patients should receive observation care, rather than being admitted, a distinction that makes beneficiaries ineligible for follow-up nursing home coverage.

Video: Health Law Changes, Seniors And Medicare
Mary Agnes Carey, Sept. 27
KHN’s Mary Agnes Carey appeared on PBS Newshour to answer questions from seniors uncertain of how the Affordable Care Act will affect people older Americans and what changes are coming for Medicare recipients.

Federal Judge Throws Out Lawsuit Over Hospital Observation Care
By Susan Jaffe, Sept. 23
A federal court judge in Hartford, Conn., dismissed a lawsuit Monday which was filed against the government by 14 Medicare beneficiaries who were denied nursing home coverage.

FAQ: Seniors On Medicare Don’t Need To Apply To The Health Law Marketplaces
By Mary Agnes Carey, Sept. 23
The online exchanges that open Oct. 1 are not aimed at Medicare beneficiaries, but the 2010 health law does affect seniors in other ways.

States Balk At Terminating Medicaid Contracts Even When There’s Fraud Or Poor Patient Care

By Jenni Bergal, Sept. 15

Officials won’t use “nuclear option” for fear of disrupting services to patients.


Labor Dept. Mandates Minimum Wage, Overtime Pay For Home Health Workers

Susan Jaffe, Sept. 17

The Obama administration had been trying for almost two years to extend overtime and minimum wage protections to the workers. The rule doesn’t take effect until 2015.

Long-Term Care Panel Releases Recommendations But Fails To Offer Plan To Help Pay For Services
Susan Jaffe, Sept. 13
The group tackles wide-ranging list of concerns, but the lack of a financing plan raises strong objections from some members.

A Reader Asks: When I Retire Can My Husband Get Coverage On The Marketplace?
By Michelle Andrews, Sept. 6
Consumer columnist says he likely can, but the bigger question is whether he will qualify for subsidies to help defray costs.

Video: ‘It’s A Fire Sale On The SGR’
Mary Agnes Carey and Emily Ethridge, Sept. 4
With the Congressional Budget Office projecting a reduced cost for a long-term “doc fix,” Congress may seize the opportunity to end the annual adjustments to Medicare reimbursement rates. Mary Agnes Carey and CQ Roll Call’s Emily Ethridge discuss.

FAQ: Hospital Observation Care Can Be Poorly Understood And Costly For Medicare Beneficiaries
By Susan Jaffe, Sept. 4
To patients, observation care often looks just like being admitted. But it can mean they have co-payments for doctors’ fees and each hospital service, must pay for routine drugs for chronic conditions such as diabetes and cannot receive Medicare coverage for follow-up nursing home care.

AUGUST

AMA President Optimistic About A Fix For Medicare’s Doctor Payment Formula
By Mary Agnes Carey, Aug. 29
Debated and despised, the Medicare physician payment formula may finally be on the way out – at least that’s what AMA President Ardis Hoven believes.

No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces
By Susan Jaffe, Aug. 25
Administration officials are planning campaign to convince millions of seniors that they don’t need to sign up for the online exchanges.

FAQ On ACOs: Accountable Care Organizations, Explained
By Jenny Gold, Aug. 23
Accountable care organizations are practically a footnote in the health law, but advocates say they’ll be critical to holding down the cost of care while improving quality.

Moving People Home After Nursing Home Stay Is Complicated
By Martha Bebinger, WBUR, Aug. 16
A program aimed at getting people out of nursing homes and back in their own homes is off to a slow start. Organizers say it’s a challenge to find out which services each person needs, from meals delivered to a whole new apartment.

Talking Scales and Telemedicine: ACO Tools To Keep Patients Out Of The Hospital
By Elizabeth Stawicki, MPR News, Aug. 15
A Minnesota hospital’s care for congestive heart failure patients set the stage for it to become an Accountable Care Organization under the health law.

My Place CT – Connecticut’s Plan For Long-Term Care
By Kelsey Miller, Aug. 7
KHN’s Kelsey Miller talks with the Connecticut Department of Social Services’ Dawn Lambert about Connecticut’s efforts to address residents’ long-term care needs while also minimizing the strain on the state’s Medicaid budget.

Armed With Bigger Fines, Medicare To Punish 2,225 Hospitals For Excess Readmissions
By Jordan Rau, Aug. 2
Penalties will total $227 million, but many hospitals will see their fines go down in October in the second year of the program.

JULY

HHS Inspector General Scrutinizes Medicare Rule For Observation Care
By Susan Jaffe, July 30
The difference between inpatient and observational care status can have a big effect on Medicare beneficiaries — both in terms of the bills they face and the post-hospital options available to them.

IOM Finds Differences In Regional Health Spending Are Linked To Post-Hospital Care And Provider Prices
By Jordan Rau, July 24
Report recommends that Congress use Medicare’s influence to push doctors and other providers to work more closely and share in financial risk for care that is too costly.

Medicare Announces Plans To Accelerate Linking Doctor Pay To Quality
By Jordan Rau, July 22
The government, in a draft rule, says it will double the penalties and bonuses offered some group practices with 100 or more professionals. It also moves up deadlines for practices with 10 professionals.

Hospitals May Soon Be Reaching For The Stars
By Jordan Rau, July 18
Medicare is considering assigning stars or other symbols to hospitals so that patients can compare quality more easily. Hospital groups are wary.

9 Pioneer ACOs Jump Ship After First Year
By Jenny Gold, July 16
Nearly a third of the health systems chosen for the ambitious Pioneer accountable care organization program with Medicare are leaving after the first year of the three-year program. The goal of accountable care is for hospitals and doctors to save money while lowering costs.

Kentucky’s Rush Into Medicaid Managed Care: A Cautionary Tale For Other States
By Jenni Bergal, July 15
Doctors, hospitals, patients and their advocates complained about disruptions in care and payments after Kentucky moved more than half a million people on Medicaid into private plans.

Medicare Advantage Plans Cut Total Cardio Procedures, But Regional Variations Remain
By Jay Hancock, July 9
New versions of managed care are health care’s great cost control hope. Researchers publishing in the latest JAMA tested that idea by counting procedures in one of the biggest managed care programs of all: Medicare Advantage plans for seniors. One finding they expected. The other they didn’t.

A Busy ER Doctor Slows Down To Help Patients Cope With Pain
By Annie Feidt, Alaska Public Radio, July 5
After 20 years as a busy ER doctor, Linda Smith now finds satisfaction guiding patients through treatment for life-threatening illnesses.

Advocates Urge More Government Oversight Of Medicaid Managed Care
By Jenni Bergal, July 5
The health law’s expansion of Medicaid is putting a spotlight on how regulators monitor the performance of privately-run plans.

Lawmakers to NY Docs: Screen All Baby Boomers for Deadly Liver Disease

By Fred Mogul, WNYC, July 3

The New York legislature passed a bill that would make the state the first in the nation requiring doctors to offer the hepatitis C test to anyone born between 1945 and 1965.

Study: Emergency Rooms Take Toll On Older Patients
By Kelsey Miller, July 1
The majority of older patients who go to emergency departments in several nations around the world are likely to start out with complex conditions that deteriorate after their visits, according to a study published in the June 25 issue of Annals of Emergency Medicine.

JUNE

Facing A Tight Deadline, Long-Term Care Panel Holds First Meeting
By Susan Jaffe, June 28
The commission, set up by Congress to offer recommendations on paying for services to help seniors and disabled people, has only a few months left to do its work.

Medicare Enhances Doctor-Rating Website
By Jordan Rau, June 27
Medicare Thursday added new features to its Physician Compare website as it prepares to start including quality data on thousands of doctors.

Hospital Officials Complain To Senate Panel About Medicare Efforts On Observation Care
By Mary Agnes Carey, June 26
Overly aggressive practices of contractors charged with recovering inappropriate Medicare payments are causing headaches for hospitals and patients, hospital executives told the Senate Finance Committee.

Pittsburgh Researchers Look For Ways To Prevent Depression In Seniors
By Judith Graham, June 25
The study is examining whether offering support for older adults with chronic illnesses, pain and cognitive problems can stave off the serious mental health issues.

Getting Help For Depression Is Important
By Judith Graham, June 25
Recommended interventions for seniors include prescription drugs, problem-solving therapy, cognitive behavior therapy, and interpersonal therapy.

Video: The Toll Of Depression
June 25
Retiree Marilyn Franz talks about working to get her life back.

FAQ: Medicare Beneficiaries May See Increased Access To Physical Therapy Or Some Other Services
By Susan Jaffe, June 25
For years, seniors were told that they had to show improvement to keep getting skilled care but a lawsuit has changed that standard.

Panel Tells Congress Medicare Is Unfairly Penalizing Hospitals Serving The Poor
By Jordan Rau, June 14
An important feature of the health law designed to bring down the rate of patient readmissions is backfiring on safety-net hospitals, says a report by a congressional advisory agency.

Study: Brand Name Drugs Drive Up Medicare Spending
By Ankita Rao, June 11
A new study suggests that cash-strapped Medicare has missed an opportunity to save more than $1 billion.

Medicare Data Show Wide Divide In What Hospitals Bill For Outpatient Services
By Jordan Rau, June 3
Medicare released average bill charges for 30 hospital outpatient procedures Monday, showing big differences from hospital to hospital in how much they bill patients for the same service.

PSA Screening: New Round Of Guidelines Emphasizes Importance Of Weighing Harms And Benefits
By Rita Rubin, June 2
Physicians’ and patients’ thoughts on the prostate cancer screening test are changing, with many taking a more cautious approach to the test and what it might mean.

MAY

Slowdown In Medicare Spending Extends Trust Fund
By Mary Agnes Carey, May 31
Slower growth in spending is helping extend the life of Medicare’s hospital trust fund to 2026, two years beyond last year’s estimate, officials say.

Minnesota Ranked Best State For Seniors
By Judith Graham, May 29
Mississippi, Oklahoma are least healthy states for people over 65, according to a United Health Foundation analysis of 34 measures of health.

Immigrants Contribute More To Medicare Than They Take Out, Study Finds
By Jordan Rau, May 29
Immigrant workers are helping buttress Medicare’s finances, say researchers, because they contribute tens of billions of dollars a year more than immigrant retirees use in medical services.

Medicare Spending Variations Mostly Due To Health Differences, Study Concludes
By Jordan Rau, May 28
The finding challenges the notion that billions could be saved by making the health system more efficient.

Senate Confirms Tavenner To Head CMS
Mary Agnes Carey and Jennifer Haberkorn, May 15
KHN’s Mary Agnes Carey talks with Jennifer Haberkorn of Politico Pro about the Senate’s confirmation Wednesday of Marilyn Tavenner to head the Centers for Medicare and Medicaid Services and the challenges she faces.

The Dramatic Difference: What A Hospital Charges Vs. What Medicare Pays
By Annie Feidt, May 13
For the first time, the federal government has publicly shared what hospitals bill Medicare for the 100 most common diagnoses and treatments. The information shows hospitals across the country — and across Alaska — bill dramatically different prices for the same things.

Medicare Lags In Project to Expand Hospice
By Jordan Rau, May 9
The 2010 health law called for an experiment to see if allowing patients to continue to have lifesaving treatments when they join hospice would improve their quality of care and save money.

Boehner Says GOP Will Not Make Nominations For Medicare Cost Control Panel
Mary Agnes Carey, May 9
Note to the Obama administration: Don’t wait by the phone for those GOP nominations to the Independent Payment Advisory Board, a panel created in the health law to make recommendations to Congress on how to control Medicare costs.

Study Models Three Big Changes To Medicare
By Ankita Rao, May 7
A study from the Rand Corporation compared the impact of three proposals that have been discussed by Congress or the White House to curb the costs of the government health care program for seniors and the disabled.

Advocates Head To Court To Overturn Medicare Rules For Observation Care
By Susan Jaffe, May 3
Some hospital stays are not considered in-patient care, but seniors often don’t know that until they find they don’t qualify for full Medicare coverage.

Medicare Seeks To Limit Number Of Seniors Placed In Hospital Observation Care
By Susan Jaffe, May 3
The proposal, part of the annual payment update, would help ease confusion over when beneficiaries are admitted to the hospital – an important criteria that can impact whether Medicare will cover nursing home stays – by setting guidelines.

APRIL

Seniors Get Hung Up In Health Care Scams
By Jenny Gold, April 22
Law enforcement agencies report an increase in phone scams by fraudsters who prey on the public’s confusion over the massive changes taking place in the nation’s health care system — and the thieves often target senior citizens.

Despite Win, UnitedHealth Criticizes Medicare Rates, Eyes Pruning Business
By Jay Hancock, April 19
If the Obama administration expected the biggest health insurance company to give thanks for this month’s decision to reverse cuts to private Medicare plans, it was wrong.

Beginning End Of Life Care At The Dinner Table
By Ankita Rao, April 19
As the founder of “Let’s Have Dinner and Talk About Death,” Michael Hebb urges Americans to engage in a conversation about how they want to die, a conversation that could change the high cost of caring for the terminally ill and grant patients their ultimate requests.

Bipartisan Center Offers Plan To Reduce Health Spending
By Mary Agnes Carey, April 19
Medicare beneficiaries would have access to better coordinated medical care and the current Medicare physician payment formula would be scrapped as part of a health care cost containment plan the Bipartisan Policy Center.

The Medicare Budget Cuts No One Likes
By Mary Agnes Carey, April 18
Just in case the Obama administration didn’t know it already, cutting Medicare is hard to do.

Democratic Lawmakers Seek To Restore Drugmaker Rebates For ‘Dual Eligibles’
By Mary Agnes Carey, April 16
Senate and House lawmakers unveiled legislation that would require brand-name drugmakers to pay rebates to Medicare for drugs used by some of the program’s low-income and disabled beneficiaries.

Questions About Colon Screening Coverage Still Vex Consumers
By Michelle Andrews, April 16
Although the federal government has tried to clarify the preventive care provisions that mandate no out-of-pocket expenses for patients on screening exams, there is still a good bit of confusion.

Auditors: Medicare Could Save Millions By Limiting Advance Payments To Insurers
By Julie Appleby, April 16
Medicare could earn up to $111 million annually if it limited insurers’ ability to retain investment earnings on the billions they are paid through the prescription drug program, according to a government report.

Five Ways The President’s Budget Would Change Medicare 
By Mary Agnes Carey, April 15
President Obama’s 2014 budget plan includes a number of money-saving changes to Medicare, some of which have triggered concern from patient and provider groups

Doctor-Owned Hospitals Prosper Under Health Law
By Jordan Rau, April 12
Even though the 2010 health law stymies their growth, these hospitals are gaining under Medicare’s quality payments programs.

‘Remarkably Friendly’ Hearing For Acting Medicare Chief
Mary Agnes Carey and Jackie Judd, April 9
Marilyn Tavenner, the acting head of the Centers for Medicare & Medicaid Services and President Obama’s nominee to keep the job, found both Democratic and Republican support during a Senate Finance Committee hearing today.

Tavenner Fields Questions on Leaks, Premium Costs, Future Of Medicare
Video excerpts, April 9
House Majority Leader Eric Cantor, R-Va., set the tone for a very-supportive Senate Finance Committee hearing on Marilyn Tavenner’s nomination to head the Centers for Medicare & Medicaid Services.

Death Rates Rise At Geographically Isolated Hospitals, Study Finds
By Jordan Rau, April 2
These critical access hospitals, which are often in rural areas, get paid more generously by Medicare and are exempt from some federal reporting standards. But those exemptions may be hiding quality issues at the facilities.

IG Report Slaps Medicare For Not Recouping More Overpayment For Equipment
By Mary Agnes Carey, April 1
Medicare has made nearly $70 million in overpayments to suppliers of consumers’ medical equipment, and more than half of that money is unlikely to be recovered, according to a new report from the Department of Health and Human Services Inspector General.

MARCH

Maryland’s Tough New Hospital Spending Proposal Seen As ‘Nationally Significant’
By Jay Hancock, March 31
State officials want to limit hospital spending to the growth rate of the state’s economy, a huge challenge for hospitals.

Panel Raises Concerns About Lowering Medicare Pay For High Spending Areas
Jordan Rau, March 22
IOM report suggests that cutting payments in areas that pay more per beneficiary could hit hospitals and doctors who are not providing expensive care.

At Health Law Anniversary, Even Bigger Changes Loom
Video roundtable, March 21
Health policy reporters weigh in on what’s changed since the Affordable Care Act became law three years ago for consumers, businesses, state governments, and what’s next for expanding Medicaid and launching exchanges.

Q&A: I Had To Return To The Hospital; Will They Be Penalized?
Michelle Andrews, March 20
Consumer columnist Michelle Andrews answers a reader question about what triggers Medicare’s penalties for hospitals who readmit patients too frequently.

Group Appointments With Doctors: When Three Isn’t A Crowd
By Michelle Andrews, March 19
More doctors are holding appointments with multiple patients, a trend some say may help ease a forecasted shortage of physicians.

Hospital Ratings Are In The Eye Of The Beholder
By Jordan Rau, March 18
With an expanding number of groups offering a stamp of approval, consumers find a confusing array of quality awards to consider when choosing a hospital.

Hospital Ratings Websites
By Jordan Rau, March 18
This list includes various sources for hospital ratings.

Medicare Revises Readmissions Penalties – Again
By Jordan Rau, March 14
More than 1,200 hospitals are getting good news –- smaller penalties — from a recalculation of how well they are curbing rapid readmissions of patients.

Democrats, Republicans Clash Over Health Care Savings
Mary Agnes Carey and Jackie Judd, March 13
Leaders from both chambers of Congress this week offered competing budget proposals that both look for savings in health spending.

Difference In What Medicare Spends On Cancer Care May Not Affect Survival Rates
By Alvin Tran, March 12
Although Medicare spending for patients with advance cancers varies regionally, a new study suggests that those differences are not related to survival rates.

What’s The Price? Simple Question, Complicated Answer In Medicare
By Martha Bebinger, WBUR, March 8
I wrote to Medicare a while back, asking for a price. I know nothing is simple in the world of health care costs, but I just needed one number, a number Medicare uses all the time, I supposed, to calculate payments to doctors and hospitals.

In Conservative Arizona, Government-Run Health Care That Works
By Sarah Varney, March 7 
Arizona occupies an unusual place in the national landscape: as a model for how a generously-funded, tightly regulated government program can aid vulnerable, low-income patients.

Prostate Screening Tests In Older Men Decline, But Many Still Get Them, Study Finds
By Julie Appleby, March 4
Fewer men over age 75 are being routinely screened for cancer with a prostate-specific antigen (PSA) test following a 2008 recommendation against the tests, researchers said today, but while the numbers have declined, they remain significant.

Panel Calls For ‘Drastic Changes’ In Medicare Doctor Pay
By Jordan Rau, March 4
A panel convened by a major medical group is recommending that Medicare heal its physician payment shortfalls with “drastic changes” in how it reimburses doctors and other providers, rather than seeking more taxpayer money.

Medical Research, FDA And Mental Health Programs Face Budget Bite
Mary Agnes Carey, March 1
Federal funding for Medicaid is untouched but doctors, hospitals and other Medicare providers will see a 2 percent reduction.

Hospital Executive Bracing For Budget Cuts Says ‘We Need To Deal With Medicare’
By Mary Agnes Carey, March 1
David Blom, the president of OhioHealth, talks about the effects of sequestration and the need to find a long-term fiscal remedy.

FEBRUARY

Ways & Means Chairman Hopes To Move Medicare ‘Doc Fix’ Plan
Mary Agnes Carey, Feb. 27
The chairman of the House Ways and Means Committee made clear Tuesday that finding a solution to the vexing issue of setting Medicare physician payment rates is on his to-do list this year.

Key Long-Term-Care Insurer To Raise Women’s Premiums
By Michelle Andrews, Feb. 26
Although the health law seeks to end health plans’ use of gender to set prices, the new rules don’t apply to policies for long-term care.

House Panel Examines Nuts & Bolts Of Changing Traditional Medicare
Mary Agnes Carey and Jackie Judd, Feb. 26
Outside of the heat of election season, a House subcommittee chaired by GOP Rep. Kevin Brady begins examining options for cost savings in traditional Medicare.

3 Hill Panels Examining Changes To Medicare
By Mary Agnes Carey, Feb. 25
There are small signs that Democrats and Republicans are beginning to wrestle with Medicare’s role in deficit reduction.

Plans To Expand Florida Medicaid Welcomed And Feared
By Phil Galewitz, Feb. 24
Doctors, consumer groups cheer expansion, worry that for-profit health plans may cut corners.

Dartmouth Study Questions Widely Used Risk-Adjustment Methods
By Jordan Rau, Feb. 21
A new study challenges the validity of several widely used “risk-adjustment” efforts and suggests that Medicare is overpaying some plans and facilities while underpaying others.

In Arizona, Poorest, Sickest Patients Get Coordinated Care
By Sarah Varney, Feb. 20
Can for-profit health insurance companies be trusted to take care of the nation’s sickest and most expensive patients? Many states, under an effort supported by the Obama administration, are planning to let the companies manage health care for those elderly and disabled people covered by both Medicare and Medicaid.

Pressure Rising To Avoid Federal Spending Cuts That Will Impact Health Programs
By Mary Agnes Carey, Feb. 20
While both Democrats and Republicans say they don’t want billions of dollars in cuts to kick in, there’s no agreement on how to stop them.

San Diego Hospice Will Close As Financial Problems Grow
By Randy Dotinga, Feb. 14
San Diego Hospice, one of the nation’s oldest and busiest, is closing its doors permanently in response to financial problems stemming from an investigation of its practices by Medicare.

President Obama Calls For ‘Modest Reforms’ To Medicare
Mary Agnes Carey and Jackie Judd, Feb. 13
Jackie Judd and KHN’s Mary Agnes Carey examine the health care issues in the State of the Union address — and Sen. Rubio’s Republican response — in this Health on the Hill discussion.

Higher Hospital Readmissions Aren’t Linked To Fewer Deaths, Study Finds
By Jordan Rau, Feb. 12
A new study finds that there’s no major link between hospitals with high readmissions and those with low mortality rates.

FAQ On Medicare Doctor Pay: Why Is It So Hard To Fix?
By Mary Agnes Carey, Feb. 10
A bipartisan House bill and an effort by GOP leaders seek to stop the threats of drastic cuts each year.

Medicaid Transformation Watched Closely In Florida 
By Lynn Hatter, WFSU, Feb. 8
The federal government gave the green light to Florida to put its long-term-care Medicaid patients into managed care. The big question now is: Will it work?

San Diego Hospice Files For Bankruptcy
By Randy Dotinga, Feb. 7
After a federal investigation and the prospect of having to return Medicare reimbursements, the hospice – one of the largest in the country – will seek Chapter 11 protection. A local hospital chain plans to step in to help meet patients’ needs.

Grassley Calls For Senate Consideration Of Tavenner’s Nomination
By Mary Agnes Carey, Feb. 7
President Barack Obama Thursday once again nominated Marilyn Tavenner to head the Centers for Medicare & Medicaid Services, and a key GOP senator said the chamber should consider the nomination.

Kansas’ Great Hope: Managed Care Will Tame Medicaid Costs
By Bryan Thompson, KPR and Jim McLean, KHI News, Feb. 6
Starting this year, the state — hoping to control costs and improve quality — has moved almost all of its Medicaid recipients into managed care plans.

Long-Term Care Protection May Be Toothless
By Michelle Andrews, Feb. 5
But a provision in insurance policies that people rely on to help ensure their coverage will meet their needs decades hence may do nothing of the kind.

Aggressive Care Still The Norm For Dying Seniors
By Alvin Tran, Feb. 5
Although federal data show that fewer Medicare beneficiaries are dying in hospitals, new research suggests that doesn’t mean they’re getting less aggressive care in their final days.

Research Finds Link Between Poor Health And Seniors Switching Out Of Private Medicare Plans
By Jordan Rau, Feb. 4
Some advocates are concerned that the Medicare Advantage plans have incentives to skim off the lowest-maintenance customers and leave the expensive patients to the traditional program.

JANUARY

Fed Economist Steps Into Dispute On Geographic Differences In Health Spending
By Jordan Rau, Jan. 30
A new analysis concludes that things like the prevalence of smoking, obesity and diabetes best explain why Medicare spending in some regions of the country is higher, instead of how medicine is practiced, as other researchers believe.

A Wish List For Medicare
By Mary Agnes Carey, Jan. 30
If you could make one change to Medicare, what would it be? Ask three former directors of the program and you’ll get plenty of ideas.

Kidney Donation Over Age 70? Desperate Patients Saying, ‘Yes, Please’
By Judith Graham, Jan. 28
While most of the nation’s kidney transplant centers don’t have an upper age limit for recipients, more than three-quarters don’t accept the organs from people older than 70. Some doctors and patients are pushing to change that.

Kidney Sharing System May Change To Better Accomodate Older Patients
By Judith Graham, Jan. 28
The United Network for Organ Sharing system for allocating kidneys is considering ranking the ages of donors and potential recipients. Kidneys with the lowest expected survival would be distributed more widely across the country, a move that would help older patients whose life expectancy is limited.

Retiring Medicare Actuary Reflects On The Politics Of Health Care Spending And Why He Almost Quit
By Mary Agnes Carey, Jan. 28
Richard Foster talks about the travails of trying to provide objective information to Congress and the White House.

Long Waits For Consumers When Medicare Is ‘Secondary Payer’
By Michelle Andrews, Jan. 28
A new law sets schedules for providing details about medical claims in cases where a beneficiary suffers a personal injury due to someone else’s negligence.

Long-Term Care Ombudsmen Face Challenges To Independence
By Jenni Bergal, Jan. 27
The advocates for elderly and disabled people living in nursing homes or assisted living centers responded to 204,000 complaints nationwide in 2011.

Americans Want Deficit Addressed Without Medicare Cuts, Poll Finds
By Mary Agnes Carey, Jan. 24
Most Americans want quick action to reduce the deficit, but almost six in 10 oppose cutting Medicare spending to achieve that goal, according to a new poll.

Report: CMS Community Initiatives Could Reduce Health Costs
By Ankita Rao, Jan. 22
A pilot program introduced by the U.S. Centers for Medicare and Medicaid Services to boost quality of care for seniors by developing community approaches to health problems could play a key role in bringing down costs, according to a new report in the Journal of the American Medical Association.

Slowly Dying Patients, An Audit And A Hospice’s Undoing
By Randy Dotinga, Jan. 16
For one San Diego Hospice, the trouble began with a federal audit.

Study: Seniors Look For Star Ratings On Medicare Advantage Plans
By Ankita Rao, Jan. 15
America’s seniors are benefiting from a star rating system that ranks the quality of Medicare Advantage plans, according to a study published in the Journal of the American Medical Association.

A Regional Analysis Of Which Hospitals Got Rewards, Penalties Based On Quality
By Jordan Rau, Jan. 9
In Medicare’s new program that ties about $1 billion in payments to quality of care, hospitals in Fort Wayne, Ind., are faring the best on average while hospitals in Washington, D.C., are doing the worst.

Rural Hospitals Get Relief In Fiscal Cliff Deal
By Phil Galewitz, Jan. 4
It’s not just another New Year’s Day in Wellsville, N.Y., as rural hospitals get financial relief from Congress.

Behind The Fiscal Cliff Deal, A Prolonged Hospital Finance Fight
By Jordan Rau, Jan. 3
Hospitals complain they are bearing the brunt of sustaining payment levels for doctors but the changes in Medicare were a long time coming.

Counting Health Care Changes In The ‘Fiscal Cliff’ Deal
By Mary Agnes Carey and Jennifer Haberkorn, Jan. 2
KHN’s Mary Agnes Carey and Politico Pro’s Jennifer Haberkorn detail the deal struck between President Obama and Congress to avert the so-called “fiscal cliff” and what the compromise means for hospitals and doctors who serve Medicare patients.

‘Doc Fix’ In ‘Fiscal Cliff’ Plan Cuts Medicare Hospital Payments
By Mary Agnes Carey, Jan. 1
Legislation passed by Congress New Year’s Day to avert the dreaded “fiscal cliff” would stop a scheduled payment cut in Medicare physician payments. But hospitals, which have to bear a major part of financing for that “doc fix,” are not happy.

See Stories Published in 2012