Category Archives: Insurance

Time to track how the pandemic is hurting health care provider finances

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: How health costs might change with COVID-19, Peterson KFF Health System Tracker, April 15, 2020.Elective procedures and routine (non-emergency) care represent 52% of what large employers pay for hospital care, according to the Peterson KFF Health System Tracker.

While the death of more than 120,000 Americans related to the novel coronavirus is the most important story, the economic impact of the pandemic on hospitals and physicians is another significant story to cover.

Not only are providers paying higher prices for equipment and supplies, but they also lost income when stay-at-home orders put a hold on elective surgeries and nonessential physician visits.

Mark Taylor recently wrote about the devastating financial effects the virus has had on hospitals in an article for MarketWatch, noting that, “The coronavirus is devastating U.S. hospitals, which will lose $200 billion in revenue by the end of June.” Continue reading

Despite violation records, nursing homes seek liability waivers during pandemic

Joseph Burns Liz Seegert

About Joseph Burns and Liz Seegert

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. Liz Seegert (@lseegert), based in New York City, is AHCJ’s topic leader on aging.

NursingHomeLiability

Photo: Elvert Barnes via Flickr

Despite a recent GAO report detailing persistent infection control violations at nursing homes throughout the United States, many states are waiving liability for these facilities during the COVID-19 pandemic.

To date, at least 20 states have issued executive orders or enacted legislation temporarily absolving long-term care and assisted living facilities unless “gross negligence” or “willful misconduct” can be proven. Continue reading

In the midst of a pandemic, employers begin to negotiate insurance coverage for next year

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: Rachel via Flickr

Every year, all employers negotiate with health insurers over what they’ll pay in insurance premiums for the coming year. And many employers also negotiate with hospitals, health systems and physician groups over what they’ll pay in direct-contracting arrangements that bypass traditional insurance contracts.

In both negotiations, the employers will be seeking better care and lower costs, as they do each year. Continue reading

Webcast to explore the high cost of failing to cover the uninsured during pandemic

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.

Clinical lab scientist Nancy Leonard prepares samples to be tested for COVID-19. She wears a face shield and gloves for protection because she is handling material that may contain the virus and will transfer patient samples into smaller tubes for testing.

Photo: Sarah Pack, Medical University of South Carolina

Leaving anyone uninsured during this viral pandemic increases the risk of spreading the disease.  A warning report on Monday from the Urban Institute projects that an estimated 25 million to 43 million Americans may lose their employer-sponsored health insurance coverage in the coming months due to the economic effects of the new coronavirus.

In “How the COVID-19 Recession Could Affect Health Insurance Coverage,” UI senior fellow Bowen Garrett and research associate Anuj Gangopadhyaya base their estimate on the possibility that the unemployment rate could reach as high as 20%. The report was produced with support from the Robert Wood Johnson Foundation. Continue reading

Reporter explores impact of medical credit cards on dental debt

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Manuela-Tobias

Manuela Tobias

Dental patients in need of costly procedures may turn to medical credit cards to pay for the services. But these cards, which often include deferred-interest provisions, can pose risks.

If consumers do not fully understand the terms or fall behind on payments, they can end up facing inflated bills and crippling dental debts, as Fresno Bee reporter Manuela Tobias explained in a recent investigative piece. Continue reading

Scrutiny of hospital charges likely to intensify in wake of pandemic

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.

hospital-roomAs the nation’s hospitals strain to keep up with the demand to care for COVID-19 patients, it seems almost unfair to ask how much all of this treatment will cost. Still, we know that the costs will be high, both for the care itself and for what health insurers, employers and consumers will end up paying.

In a recent report, the health insurance marketplace Covered California projected that the one-year costs of testing and treatment related to COVID-19 could range from $34 billion to $251 billion. These new costs could cause health insurance premiums for individuals and employers to rise by 40% or more next year in the absence of federal action, the report said, adding that insurance premiums would increase because insurers would want to recoup any losses from the pandemic this year and plan for any future losses they might incur next year. Continue reading