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.

Pittsburgh reporter uncovers how for-profit hospitals differ from nonprofits in how they provide charity care

When reviewing just about any hospital bill today, it’s difficult to imagine that hospitals were founded to provide care for the poor. “Hospitals in the United States emerged from institutions, notably almshouses, that provided care and custody for the ailing poor,” says America’s Essential Hospitals, an association of hospitals and health systems dedicated to providing high-quality care for all, including the vulnerable. “Rooted in this tradition of charity, the public hospital traces its ancestry to the development of cities and community efforts to shelter and care for the chronically ill, deprived, and disabled.” Continue reading

Reporters dig into pharmacy benefit concerns following merger announcements

Photo: Thomas Hawk via Flickr

The proposed combination of one of the nation’s largest health insurers, Cigna Corp., and the nation’s largest pharmacy benefits manager (PBM), Express Scripts Holdings Company, is unlikely to benefit consumers much, if at all. But to their credit, health care journalists are digging into how consumers might benefit from the deal.

These questions are important, given that the Cigna-Express Scripts deal follows an announcement three months earlier that CVS Health would pay $69 billion for Aetna Inc., another major health insurers, in a deal “that could reshape the health industry,” as the New York Times reported. Pharmacy retailer CVS Health also owns a PBM, CVS/Caremark. Continue reading

#AHCJ18 panel to examine impact of hospital consolidations on costs

Last year, there were 115 hospital and health system mergers and acquisitions – the highest number recorded in recent history, according to a report from Kaufman, Hall & Associates, a management consulting company that tracks M&A deals in health care.

The number and size of these transactions are transforming the health care system, the company said: “The implications reach far beyond the unprecedented number of individual transactions. Organizational size and scale have mattered for decades – but today, they are proving to be imperatives.” Continue reading

Physicians say Anthem policy on ‘unneeded’ ER visits puts patients at risk

Photo: Taber Andrew Bain via Flickr

Emergency medicine physicians contend that Anthem’s policy regarding payment for emergency room visits in some of its markets has been putting patients’ lives at risk.

In six states so far, Anthem has a policy to deny coverage for emergency room visits that it later determines were not emergencies. Continue reading

Mergers may transform health care as insurers encourage moving patients into lower cost sites of care

Photo: Mike Mozart via Flickr

For decades, those who pay for health care have urged providers to move patients out of hospitals into lower cost settings such as home care and doctors’ offices.

That trend is accelerating today as seen in recent mergers involving insurers, pharmacies and providers. Continue reading