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.

Report shows health insurers are failing to comply with mental health parity laws

Source: “Addiction and Mental Health vs. Physical Health: Widening disparities in network use and provider reimbursement,” Milliman, November 2019.In a recent report on the level of parity between care for patients with mental health versus physical health conditions, actuaries from Milliman reported which states (shown in white and light blue) have the highest rates of parity and which states have the lowest rates (darker and deep blue). One of the strengths of the report is that it has data on parity for each state.

A recent report indicates that health insurers are failing to comply with mental health parity laws for people with employer-sponsored health coverage and their families.

In the report, “Addiction and Mental Health vs. Physical Health: Widening disparities in network use and provider reimbursement,” actuaries from the consulting firm Milliman document wide disparities in access to behavioral health care services for employees, family members and retirees with health insurance through an employer.

The report shows that disparities between physical and behavioral health care for both in-network access and provider reimbursement rates are making it harder for Americans to find affordable and available mental health care and addiction treatment. Continue reading

In 2020, employers’ benefit plans will promote more virtual care and focus on high-cost claims

Companies that pay for employer-sponsored health insurance are continually seeking ways to cut health care costs and improve the care delivered to employees, their family members and retirees.

To accomplish these goals in 2020, employers will implement more virtual care, such as telemedicine, and will focus more on high-cost claims, according to a report from National Business Group on Health (NBGH). Continue reading

Maternal deaths among black women focus attention on the need for policy and payment reform

The number of pregnancy-related deaths per 100,000 live births has risen steadily since the CDC started reporting the data in 1987 when the rate was 7.2. In its most recent report, the rate was 16.9.

Source: Centers for Disease Control and PreventionThe number of pregnancy-related deaths per 100,000 live births has risen steadily since the CDC started reporting the data in 1987 when the rate was 7.2. In its most recent report, the rate was 16.9.

For the past several years, health care journalists have correctly focused on the rising rate of pregnancy-related mortality in the United States. Data from the federal Centers for Disease Control and Prevention show that over the past 40 years, the nation’s rate of pregnancy-related deaths has more than doubled.

Although the rate dropped slightly in 2016 to 16.9 per 100,000 live births (from a high of 18 in 2014), the rate was 7.2 per 100,000 in 1987 when the CDC began tracking the data. Continue reading

Globe Spotlight journalist reports on the link between economic inequality and financial toxicity in health care

health-money

Image by Colin Dunn via Flickr

Two of the biggest issues the Democratic candidates are addressing in the presidential race are economic inequality and the need to reform the health insurance system.

In 2016, Liz Kowalczyk, a health care and medical writer for The Boston Globe, rotated onto the paper’s Spotlight team for a project about race to document segregation in the city’s health care system. Soon after beginning that assignment she found an almost ideal source for one of her first articles, a nursing home worker who was diagnosed with stage three breast cancer. Continue reading

As employers attempt to contain health insurance costs, workers and families struggle too

Photo: Pictures of Money via Flickr

One of the largest and most important parts of our health care system is the role employers play in providing health insurance coverage for workers, retirees, and family members. U.S. employers cover 55.1% of Americans who have health insurance, according to a report released by the U.S. Census Bureau.

By providing health insurance for more than half of all Americans, employers pay for the biggest share of health coverage in the United States. Continue reading

Report explains the need for a waste-free formulary for pharmacy benefits

Photo: Marko Javorac via Flickr

A recent study from the Commonwealth Fund and the Pacific Business Group on Health (PBGH) shows that developing a waste-free formulary by cutting the number of high-cost, low-value drugs in employers’ health benefit plans could save employers as much as 24% in pharmacy spending.

Concern about rising prescription drug costs has caused large self-insured employers to develop innovative formularies for the pharmacy benefit plans they provide to employees, their family members and retirees. A formulary is a list of drugs that employers and health plans include in their benefit plans for employees and members. Continue reading