Author Archives: Joseph Burns

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Albany reporter fills in the holes that state report left out

Photo: Norman Mosjos via Flickr

How often has this happened to you? Over the transom comes a report you believe will be the basis for a section-front story or maybe warrant page one. Many times, you’re right. You read the report, collect the highlights, conduct a few interviews, and fire off the story on deadline.

However, occasionally what you thought might be a solid report leaves important questions unanswered. Continue reading

Cincinnati journalists spotlight how the heroin epidemic has put a generation at risk

Photo: Nadja Robot via Flickr

On Monday, analysis from the Congressional Budget Office showed that 24 million more Americans would become uninsured over 10 years if the U.S. House Republican’s bill to replace the Affordable Care Act (ACA) becomes law. Coverage of the CBO report overshadowed other news last week that the proposed American Health Care Act also would slash insurance coverage for those who are addicted to opioids and other drugs, according to reporting in USA Today and the Cincinnati Enquirer.

Deirdre Shesgreen and Terry DeMio on March 9 reported the bill would freeze the ACA’s Medicaid expansion provisions and limit federal payments to the states for all beneficiaries. That would result in a disproportionately adverse effect on patients coping with mental illness and addiction, they wrote. Continue reading

Close eye on SEC filings uncovers DOJ targeting of another Medicare Advantage insurer

Bob Herman

We reported last month that the U.S. Department of Justice was investigating the risk-adjustment practices of UnitedHealth Group and WellMed Medical Management. At the time, a question remained about whether the DOJ would look into the risk-adjustment or claims-coding activities of other health insurers.

Turns out that Bob Herman, the health care business reporter for Axios, already had the answer. Continue reading

Lawsuit may indicate change in government’s pursuit of insurance fraud

Photo: Urban Bohemian via Flickr

Photo: Urban Bohemian via Flickr

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

New reports show uninsured rate continued to drop in 2016

Source: NCHS, National Health Interview Survey, 2010-2016, Family Care component, released February 2017.Data from the National Center for Health Statistics shows the rate of growth of high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs) since 2010. A CDHP is an HDHP with a tax-advantaged health savings account.

Source: NCHS, National Health Interview Survey, 2010-2016, Family Care component, released February 2017.Data from the National Center for Health Statistics shows the rate of growth of high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs) since 2010. A CDHP is an HDHP with a tax-advantaged health savings account. (Click to enlarge.)

A report released today by the National Center for Health Statistics indicates that the uninsured rate among Americans of all ages was 8.8 percent in the third quarter of 2016.

The report shows that in the first nine months of last year, 28.2 million Americans remained uninsured, and this number was 20.4 million fewer than those uninsured in 2010, the year Congress passed the Affordable Care Act (ACA). Continue reading