Category Archives: Insurance

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

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.

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

Lawsuit alleges Centene’s narrow networks led to surprise medical bills

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.

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

Tennessee provides possible preview of health insurance markets

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

photophone02 via Wikimedia

President Trump says he wants to encourage the formation of “association health plans” that would better enable small employers to band together to purchase more affordable health insurance in the large-group market. On Jan. 4, the Department of Labor published for public comment a proposed rule for such entities, also known as small business health plans.

What will these health plans, which typically would organize under the umbrella of a trade group or other association, look like? Continue reading

Full access to the Wiley Online Library added as member benefit

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ’s social media efforts and edits and manages production of association guides, programs and newsletters.

The Association of Health Care Journalists has announced an enhanced partnership with global research and learning company John Wiley and Sons to provide professional journalists with access to the full collection of journals published on Wiley Online Library.

Wiley publishes on behalf of many of the world’s leading organizations dedicated to advancing health science. AHCJ members will be able to access 6 million articles from more than 1,500 journals, including Cochrane Library, Cancer, the Journal of the American Heart Association, and more.

See more …

Missouri journalist gives tips on writing about patient-centered medical homes

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.

Photo: Ann Fisher via Flickr

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