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
Photo: Paul Sableman via FlickrCentene’s St. Louis-area headquarters.
Policyholders of St. Louis-based Centene allege in a new lawsuit that the health insurer’s narrow network system is overly restrictive and limits access to doctors in 15 states. One policyholder who served as a plaintiff in the suit said she received surprise medical bills for treatment from out-of-network doctors.
In Harvey v. Centene Corp., filed Jan. 11 in U.S. District Court for the Eastern District of Washington State, policyholders Cynthia Harvey of Spokane, Wash., and Steven Milman of Travis County, Texas, said they bought their policies from Centene subsidiary companies. Continue reading
The Advisory Board recently asked this question: Are patient-centered medical homes (PCMHs) living up to the hype? As Tomi Ogundimu and Abby Burns wrote, the concept’s popularity has increased since passage of the Affordable Care Act and a shift to value-based payment for health care providers.
Ogundimu and Burns referenced a recent report from the Patient-Centered Primary Care Collaborative, which found that PCMHs can help improve the quality of care can take time to deliver a return on investment. That means this model may not lower costs right away. Continue reading
Data compiled by the Kaiser Family Foundation show that when the Children’s Health Insurance Program was enacted in 1997, the uninsured rate among children (those individuals under age 18) was 14 percent and that it reached an all-time low of 5 percent last year.
Officials in 12 states may start sending letters to parents this week, alerting families that funding for the Children’s Health Insurance Program is running out, according to reporting by Colby Itkowitz and Sandhya Somashekhar in The Washington Post. In Colorado, letters went out in the mail today.
“Many states have enough money to keep their individual programs afloat for at least a few months, but five could run out in late December if lawmakers do not act,” Itkowitz and Somashekhar wrote. “Others will start to exhaust resources the following month.” Continue reading
In December 2016, Charles Piller (@cpiller), the west coast editor for Stat, reported that a genetic test to identify patients who could be prone to addiction lacked a firm scientific basis.
With an eye-opening headline, “Called ‘hogwash,’ a gene test for addiction risk exploits opioid fears,” the article raised important questions about the Proove Opioid Risk test from Proove Biosciences in Irvine, Calif. Continue reading