Tag Archives: costs

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

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: 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

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: 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

Who gets the value in value-based 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: Pictures of Money via Flickr

Last year on this blog, I asked a rhetorical question: Is value-based care a fad? I did not expect to get an answer. But in June I hosted a webcast on this topic and learned that value-based care is not a fad and that what health insurers and health care administrators call value-based care rarely delivers any actual value to patients or consumers.

Instead, when health insurers, physicians, and hospital and health system executives use the term “value-based care,” they most often mean value-based payment. Continue reading

ProPublica wants to give you tips on hospital billing practices

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.

Health journalists across the country have been reading ProPublica’s accounts of the lengths to which hospitals pursue low-income patients for payment.

Earlier this year, ProPublica revealed that Methodist Le Bonheur Healthcare in Memphis, Tenn., had filed thousands of lawsuits against patients, including its own employees.

In the latest dispatch about medical debt, ProPublica reports that “thousands of people are jailed each year for failing to appear in court for unpaid bills,” citing a court in Coffeyville, Kan., “where the judge has no law degree, debt collectors get a cut of the bail, and Americans are watching their lives — and liberty — disappear in the pursuit of medical debt collection.”

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Comprehensive approach addresses needs of one city’s poorest seniors

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Millions of older adults struggle to make ends meet. They’re often faced with nearly impossible choices — food or medication; rent or a doctor visit. Some 9.2% of older adults were considered poor in 2017, according to the official poverty rate.

That’s an income of less than $11,756 per year to meet basic costs for food, housing, health care and transportation. Using a more realistic Supplemental Poverty Measure, even more older adults are considered poor, according to the Kaiser Family Foundation. Continue reading

When reporting on efforts to reduce drug prices, be skeptical and follow the money

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.

The Trump administration has been talking tough on drug prices for many months and, of course, pharmaceutical companies and other organizations have pushed back because they mostly oppose controls on the free market for prescription drugs.

For health care journalists covering these proposals, it’s essential to remain skeptical of any group that offers support or opposition and, as always, follow the money. Continue reading