KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Marketplace News: U.S. Overpaying Nursing Homes

News outlets cover various aspects of the costs of coverage, including in Medicare, high-deductible plans and also in the average employee plan.

The Wall Street Journal: Nursing Homes Said To Overbill U.S.
Hundreds of nursing homes overcharge Medicare every year for so-called skilled services, adding $1.5 billion in annual costs to the program, according to a federal report to be released Tuesday. About one-fourth of Medicare bills from facilities examined in the report were incorrect. The majority of these claims involved so-called upcoding, where a nursing home or other provider inflates the cost of its bill to Medicare (Burton, 11/12).

USA Today: New Long-Term Care Insurance Policies Offer More Options
As Americans are living longer they are facing the staggering cost of nursing homes and assisted-living care. ... Long-term-care insurance is one way to prepare for the growing expenses, but the industry is undergoing changes and the products are confusing and costly. ... the industry is shrinking, prices are rising and carriers are limiting their coverage. Since 2010, five key insurance carriers have exited the market (Dugas, 11/12).

CQ HealthBeat: Employee Health Plan Deductibles On The Rise
As employers move to shift more and more health care costs to their workers, deductibles have been growing to the point that it is commonplace for an employee to be enrolled in a plan with a $1,000 or higher up front out-of-pocket payment, according to a new snapshot report issued Monday by the Kaiser Family Foundation. Based on the 2012 Kaiser/HRET Employer Health Benefit Survey, the percent of workers with health insurance who have a general deducible for single coverage has risen from 52 percent in 2006 to 72 percent in 2012 (11/12). (KHN is an editorially independent program of the foundation.)

Kaiser Health News: High Deductible Plans Offer Low Premiums But Steep Risks
In general, the higher a health plan's deductible, the lower the premium. ... "People get caught all the time," says Martin Rosen, co-founder of Health Advocate, a company that helps consumers resolve medical billing problems and provides support for health-care decisions. ... In a high-deductible plan, preventive care is typically not subject to the deductible. But all other care, including prescription drugs and emergency care, may be (Andrews, 11/12).

The Wall Street Journal: More Sticks, Carrots In Health Care Plans
Benefits-enrollment season is here, offering workers a glimpse of their health coverage for next year. For many, the picture will be familiar: higher costs and more incentives to improve their health. Underlying the details is a longer-term trend in health benefits. For many years, U.S. companies have been seeking to shift more responsibility onto employees. ... Next year, workers will see limited effects of the federal health care overhaul (Mathews, 11/11).

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