Cost and Quality

"Cost and Quality" Main

Latest Morning Briefing Stories

The Eye-Popping Price Tags On Life-Saving Air Ambulance Rides Are Spiking Despite States’ Efforts To Rein In Costs

KHN Morning Briefing

Sixty-nine percent of the 20,700 air ambulance transports–which cost up to $40,600–taken in 2017 by privately insured patients were out of network, meaning that the costs may not be fully covered, a Government Accountability Office report finds. And it will only get worse: Companies have hiked their prices by 60 percent, despite states’ efforts to put controls in place. In other health care costs news: the price tag on treating sepsis, surprise medical bills, and what the U.S. is spending on health care.

University Of Illinois At Chicago Acknowledged Failure To Catch Warnings Signs Over Child Psychiatrist Who Violated Research Protocols

KHN Morning Briefing

According to new documents, the University of Illinois at Chicago Institutional Review Board, the committee responsible for protecting research subjects, improperly fast-tracked approval of Dr. Mani Pavuluri’s clinical trial, didn’t catch serious omissions from the consent forms parents had to sign and allowed children to enroll in the study even though they weren’t eligible. Still, UIC officials have continued to blame only Pavuluri, and have downplayed the institution’s role in the research.

When Drug Costs Get Too High, Patients Are Skipping Doses Or Just Not Taking Medication

KHN Morning Briefing

Experts are worried this behavior could be extremely dangerous for the patients. “We have lots of treatments where if you don’t take them exactly as prescribed, you might be doing more harm than good,” said Stacie Dusetzina, a health policy researcher at Vanderbilt University. Other ways patients are trying to control costs are by asking for cheaper drugs from doctors or seeking out alternative therapies. Meanwhile, Ohio’s attorney general is suing UnitedHealth’s OptumRx unit alleging it overcharged the state for prescription drugs.

Software Tool To Determine Which Veterans Are Eligible For Private Care So Flawed That It Could Derail System

KHN Morning Briefing

A review conducted by the U.S. Digital Service, an elite group of software developers and designers employed by the White House, recommended that the VA should scrap the eligibility tool and start over. The report predicted that the tool would generate errors or run slowly or crash, and that these glitches would lengthen each appointment by five to 10 minutes.

‘Now We Have To Reach The Hard-To-Reach’: Gaps In Access To Treatment, Testing Stymie Progress Against HIV

KHN Morning Briefing

A new CDC report finds that an estimated 15 percent of people with HIV don’t know they have the virus, and that population accounted for 38 percent of all new infection, according to the study. The CDC said the data prove the effort to end HIV in the U.S. needs to focus on quickly diagnosing those who have it, treating them as soon as possible and protecting people who are at risk of getting it. But that goal isn’t easy in places where deep stigma still exists around the virus.

As House Dems Assemble Budget, A Health Care Reckoning Is On The Horizon Between Centrists And Progressives

KHN Morning Briefing

Where to move forward with health care has become a sharply dividing issue with the Democrats. Moderates want to make improvements to the health law, while the left-wing is charging full-tilt toward “Medicare for All.” With their budget, Democrats will signal what their health care priorities are, and the road to decide that will likely be far from smooth.

Insurance Giant UnitedHealthcare Will Require All New Employer-Sponsored Health Plans To Pass Drug Discounts To Consumers

KHN Morning Briefing

Pharmacy benefit managers typically negotiate rebates from pharmaceutical companies to help offset the high initial prices set for many drugs. But those discounts rarely flow directly to consumers. The rebate system has come under intense scrutiny as of late as lawmakers take aim at high drug prices and pharma companies point the blame elsewhere. Meanwhile, the Senate Finance Committee plans to call executives from five pharmacy benefit managers–the middlemen who operate within the rebate system–to testify in front of Congress next month.

Following Allegations Of Abuse And Lax Supervision, Four Shelters For Immigrant Children In Chicago To Close

KHN Morning Briefing

The decision, announced by the operators of Heartland Human Care Services, comes as another agency, Maryville Academy, plans to open two additional shelters, including one as early as next month. Heartland officials plan to move children out of its four shelters in Des Plaines between now and the end of May. Meanwhile, the Pentagon is reviewing military bases as possible locations to hold up to 5,000 immigrant children.

Top Indian Health Service Official Pledges To Address Flaws That Allowed Doctor Who Sexually Abused Children To Continue Practicing

KHN Morning Briefing

Rear Adm. Michael Weahkee reassured lawmakers on the Senate Committee on Indian Affairs that he was taking steps to find and fix breadowns in the agency that allowed Stanley Patrick Weber to continue seeing IHS patients for years after he was accused of sexual abuse. Weahkee added that recent scrutiny of the agency and new efforts to encourage employees have unearthed other possible cases.

Hospitals, Health Industry Question Trump Administration’s Legal Authority To Require Price Transparency

KHN Morning Briefing

The Trump administration is considering requiring hospitals and insurers to reveal the true costs of medical services, which have always been tightly held, confidential secrets by the parties involved. The industry says the administration lacks the authority to mandate such disclosures, while also pointing out that they wouldn’t do much to help consumers.

Trump’s Budget Contains $291 Million Funding Boost For Domestic HIV Goals, But Also Cuts Global Aid To Fight Epidemic

KHN Morning Briefing

While experts called the increased domestic spending for HIV “quite significant,” they said any progress will be undermined by the deep cuts that were proposed to the health law and Medicaid in other parts of the budget. Meanwhile, critics used the dichotomy between slashing global aid while increasing funding domestically as an example of the administration’s contradicting messages when it comes to fighting the epidemic.

Inside Trump’s $4.75 Trillion Budget: Inflated Economic Expectations, Sharp Cuts To Safety Net Programs, Red Meat For His Base

KHN Morning Briefing

President Donald Trump released his $4.75 trillion budget, which included a big increase in military spending and deep cuts to other domestic spending. The presidential budget is all but dead-on-arrival on Capitol Hill and can be viewed more as a symbolic roadmap for priorities than a realistic spending plan. House Speaker Nancy Pelosi called Trump’s cuts “cruel and shortsighted … a roadmap to a sicker, weaker America,” while other Democrats were also quick to condemn the proposal.

The Cost Of Not Getting Vaccinated For Tetanus: 57 Days In The Hospital And $800,000 In Medical Bills

KHN Morning Briefing

The harrowing tale of an unvaccinated 6-year-old boy who got a cut on his head and later developed tetanus was detailed in a new report last week. The experience highlights just how costly and dangerous the old disease that doctors thought was under control can be. “I honestly never thought I would see this disease in the United States,” said Dr. Judith A. Guzman-Cottrill, a pediatric infectious disease specialist at Oregon Health & Science University, who helped care for the boy and was the lead author of the article.