A Massachusetts health care cost watchdog agency helped block plans of the state’s largest hospital system to expand into the suburbs. Now, other states are looking at whether Massachusetts’ decade-old model of controlling health costs is worth emulating.
CMS chief Chiquita Brooks-LaSure says the agency reserves its power to quickly institute new regulations for “absolute emergencies.” On staffing, nursing home residents might need to wait years to see any real change.
Mass General Brigham’s $2.3 billion expansion plan is raising state officials’ concerns that it will reduce competition and raise the price of care in Massachusetts. It also signals a national shift from a focus on hospital mergers and purchases of physician practices — which boost the cost of care — to individual hospitals’ expansions to gain a bigger share of the market.
En parte porque las políticas sobre el acceso y los costos de Medigap cambian dependiendo del estado, o por la información confusa, muchos beneficiarios no eligen lo que más les conviene.
TV ads and mailings targeting seniors tout Medicare Advantage plans this time of year, but millions choosing traditional Medicare make a costly and difficult decision about Medigap coverage, which gets much less attention.
Medicare has proposed revamping its payment rules to get more people into a diabetes prevention plan that helps them eat better, exercise more and maintain a healthier lifestyle. Out of an estimated 16 million Medicare beneficiaries whose excess weight and other risk factors make them eligible, only 3,600 have participated since 2018.
Policies mandating company approval before talking publicly about conditions in hospitals have been a source of conflict over the past year, as physicians, nurses and other health workers have been disciplined for speaking or posting about what they view as dangerous covid-19 safety precautions. The appeals court’s decision could mean that hospitals — and other employers — will need to revise their policies.
The agency is to decide by June 7 whether to greenlight Biogen’s drug aducanumab, despite a near-unanimous rejection of the product by an FDA advisory committee of outside experts in November. Some scientists at the agency have endorsed the drug, though.
Responsible for 34% of the nation’s covid death toll, nursing homes and long-term care facilities get slammed by their investors and are told to change.
A misguided federal program called the Unapproved Drugs Initiative, which put the FDA’s stamp of approval on old drugs, led to higher prices. It’s scrapped. So now what?
Many state Medicaid programs pay out-of-state providers much less than in-state facilities, often making it hard for families with medically complex children to get the care they seek.
A Texas federal judge, who previously ruled the Affordable Care Act unconstitutional, has signaled his openness to ending the law’s popular coverage requirement for preventive services.
One group of maternal health experts in 2016 urged doctors to give all women heparin shots after C-sections, barring specific medical risks for individual patients. But many physicians disagree, questioning whether wide use of the drug is effective, worth the cost and safe, since it carries the risk of bleeding.
The measures would impose taxes on increases in the price of drugs that don’t reflect improved clinical value and set the rates paid by state-run and commercial health plans to a benchmark based on prices in Canada.
The wealthy corporation that owns Chicago’s Mercy Hospital says it must close the hospital because it’s losing money. A government board says no. The corporation still has the upper hand.
While many private insurers cap what members pay in health costs, Medicare does not. Democrats and Republicans in Congress have proposed annual limits ranging from $2,000 to $3,100. But there’s disagreement about how to pay for that cost cap.
A provision the Trump administration tucked into its final rule on health plan price transparency requires telling consumers what they will pay out-of-pocket for drugs and showing them what the plan paid.
President Donald Trump wants to send seniors $200 apiece. Beyond the legal and logistical problems, health care experts point out it does little to help someone with even typical prescription costs.
Poor information-sharing between hospitals and public health agencies has hurt the response to the pandemic. Some health care systems and IT companies are making inroads, but an overhaul would cost billions.
Virginia Mason Health System and CHI Franciscan announced plans in July to merge 12 hospitals and more than 250 other treatment sites in the Puget Sound region and the Yakima area. Some patient advocacy groups warn the proposal would jeopardize access to needed services, such as emergency termination of pregnancies, contraception and physician aid in dying.