Category Archives: Right to know

AHCJ webcast to examine drug prices, other cost challenges

Susan Heavey

About Susan Heavey

Susan Heavey, (@susanheavey) a Washington, D.C.-based journalist, is AHCJ’s topic leader on social determinants of health and curates related material at healthjournalism.org. She welcomes questions and suggestions on resources and tip sheets at determinants@healthjournalism.org.

Photo" Phillip Bradshaw via Flickr

Photo” Phillip Bradshaw via Flickr

Mylan’s price hike for its EpiPen allergy medication fueled an Internet storm this week, with consumers and U.S. legislators expressing outrage over its decision to raise the price about 400% since 2007 to as much as $500 or more. The backlash appeared tied in part to timing as U.S. children head back to school, with parents of those needing EpiPens to treat allergic reactions coming to grips with the hefty price tag.

The incident brought echoes of another drug price hike – the 2015 increase by Turing Pharmaceutical’s malaria and HIV medicine Darapim, another move that brought scrutiny by the House Oversight and Government Reform Committee of the company’s chief executive officer. Continue reading

Incremental progress seen in price transparency, but report may rate A+ among journalists

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.

Source: Report Card on State Price Transparency Laws — July 2016, Health Care Incentives Improvement Institute, Sandy Hook, Conn., and Catalyst for Payment Reform, San Francisco.Here’s how price transparency should work for a woman with a silver-level insurance plan in one state. Assume this consumer could go to any hospital and would choose based on the cost of care, meaning her out-of-pocket costs (deductible plus co-insurance). She could pay $5,079 at the highest-priced facility or $3,531 at the lowest-priced hospital. The difference between the two is $1,548.

Source: Report Card on State Price Transparency Laws — July 2016Here’s how price transparency should work for a woman with a silver-level insurance plan in one state. Assume this consumer could go to any hospital and would choose based on the cost of care, meaning her out-of-pocket costs (deductible plus co-insurance). She could pay $5,079 at the highest-priced facility or $3,531 at the lowest-priced hospital. The difference between the two is $1,548.

Progress toward widespread price transparency comes slowly, according to the latest annual report from the Health Care Incentives Improvement Institute (HCI3) and the Catalyst for Payment Reform (CPR). In the “Report Card on State Price Transparency Laws – July 2016,” issued on Tuesday, the authors, Suzanne Delbanco, CPR’s executive director, and François de Brantes, HCI3’s executive director, explained what states are doing to give consumers the information they need to shop for care based on price.

As in past years, most states are doing poorly: 43 states earned an F grade for failing to meet even minimum standards. Last year, 45 states got an F. Continue reading

HIPAA experts: No need to request a waiver after Orlando shooting

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.

emergency-roomSince Sunday’s horrific shooting in Orlando that killed 49 people and injured 53 patrons at the Pulse night club, journalists have been asking whether the Health Insurance Portability and Accountability Act of 1996 (HIPAA) limits what hospital administrators can say about a patient’s condition.

One source of confusion was a statement made by Orlando Mayor Buddy Dyer after the June 12 attack. Continue reading

Survey of AHCJ members finds biggest access problems at federal level

Felice J. Freyer

About Felice J. Freyer

Felice J. Freyer is a member of AHCJ's board of directors, serving as vice chair of the organization's Right to Know Committee. She is a medical writer for The Providence (R.I.) Journal.

Source: AHCJ member survey, 2016

Source: AHCJ member survey, 2016

Health journalists seeking information from government agencies often encounter obstacles, especially at the federal level, according to AHCJ’s recent survey. The biggest roadblocks involve delays, bureaucracy, scripted replies, and barriers to interviews, survey respondents said.

Three-quarters said it is difficult to get the information they need from the federal government, and two-thirds reported difficulty getting adequate responses from state government. Continue reading

GAO confirms Center for Public Integrity’s findings on Medicare Advantage overspending

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.

Fred Schulte

In a report last week, the U.S. Government Accountability Office confirmed what Fred Schulte and other journalists at the Center for Public Integrity (CPI) have been reporting on the Medicare Advantage program for two years.

In the report, “Medicare Advantage Fundamental Improvements Needed in CMS’ Effort to Recover Substantial Amounts of Improper Payments,” the GAO showed that CMS estimated that it improperly paid $14.1 billion in 2013 to insurers running Medicare Advantage plans. Continue reading