An Arm and a Leg: A Wild Health Insurance Hustle

When a New York couple purchased a health insurance plan from a telemarketer, they thought it covered everything they wanted: doctor visits, tests, and medicine. But then came the unexpected bills for thousands of dollars, forcing them to skip crucial medical care.  In their series “Health Care Hustlers,” Bloomberg reporters Zachary Mider and Zeke Faux…

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The Promise and Peril of Price Transparency Under Trump’s New Executive Order

President Donald Trump’s latest executive order aims to strengthen enforcement for CMS’ price transparency requirements. Some experts think greater price transparency could reduce healthcare costs by fostering more competition, while others are concerned about the potential effects on hospital-payer negotiations, as well as the practicality of enforcing these requirements. The post The Promise and Peril…

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KFF Analysis Finds Physician Networks in ACA Marketplace Plans Vary Widely, and Enrollees Typically Pay More in Premiums to Access Broader Networks

A KFF analysis of physician networks in the Affordable Care Act’s Marketplace plans finds wide variations in the share of local practicing physicians who participate, with the least costly plans generally having a smaller share of physicians than more expensive plans. The analysis examines the breadth of physician networks listed in Marketplace plan directories in…More

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Why aren’t alternative payment models working?

Out of more than 50 alternative payment models (APM) that CMS has implemented only six have shown statistically significant cost savings and only four of these met the requirements to be expanded in duration and scope. That is not my opinion, CMS itself states this. We all want higher quality at lower cost; so the…

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