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For those of us deluged with analyses and opinions from the left and the right over replacements for the Affordable Care Act – the actuarial cavalry has arrived.
The American Academy of Actuaries has released three papers analyzing long-time conservative ideas about health reform. These alternatives – high-risk pools, selling insurance across state lines, and association health plans (AHPs) – are playing a high-profile role in the debate over ACA “repeal and replace.” Continue reading
A 2011 lawsuit unsealed last week reveals the inner workings of the nation’s largest health insurer, UnitedHealth Group. In the lawsuit, lawyers for the plaintiff allege that UnitedHealth evaluated certain employees on how well they raised risk adjustment scores.
The lawyers contend the practice was part of a scheme to increase payments from the federal Centers for Medicare & Medicaid Services by submitting false statements about the level of illness among Medicare Advantage patients. Continue reading
Millions of Americans face challenges in finding oral health care services. Creative efforts are underway to tackle the problem.
Some of the more exciting initiatives aim to broaden access by delivering dental care in community and primary care settings rather than traditional dental offices. In a recent feature for Modern Healthcare, quality and safety beat reporter Elizabeth Whitman looked at some of these approaches. Continue reading
As the legal drama continues to unfold over the Trump administration’s efforts to enforce travel restrictions on people from seven Muslim-majority countries, it is clear that doctors and patients here and overseas are adversely affected.
Caught in last month’s initial chaos were patients seeking medical treatment in the United States, as well physicians practicing or hoping to practice here, ProPublica’s Marshall Allen writes. The impact is expected to be particularly tough for communities already challenged in attracting medical talent, ranging from isolated, rural towns to struggling cities. Continue reading
In this era of “alternative facts,” everyone should read Sue Halpern’s piece, “They Have, Right Now, Another You,” published in the New York Review of Books in late December.
The piece, along with several recent studies on the accuracy of electronic health records, adds to the growing question over what types of data we can trust. And more important, how can we know the difference between bad and good data. Continue reading