In Montana, a tough negotiator proved employers don’t have to pay so much for health care: ProPublica

Jeanne Pinder August 20, 2019

In Montana, a tough negotiator proved employers don’t have to pay so much for health care: ProPublica

“Marilyn Bartlett took a deep breath, drew herself up to her full 5 feet and a smidge, and told the handful of Montana officials that she had a radical strategy to bail out the state’s foundering benefit plan for its 30,000 employees and their families,” Marshall Allen writes over at ProPublica. “The officials were listening. […]

Price estimates at the doctor’s office: Yes, it can be true

Jeanne Pinder August 12, 2019

Price estimates at the doctor’s office: Yes, it can be true

Epic, the giant electronic medical records company, is offering a price estimate button that doctors can use in the office. Kristin Cain, a reproductive endocrinologist in North Dakota, posted this on Twitter: “EPIC has a button I just discovered: Patient Estimate. After you place an order, it estimates the out of pocket cost. Except if […]

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Opinion | Democrats are having the wrong health care debate: The New York Times

Jeanne Pinder August 3, 2019

Opinion | Democrats are having the wrong health care debate: The New York Times

“As this week’s Democratic debates made clear, the party is divided on how to improve health care for Americans,” Ezekiel J. Emanuel wrote over at The New York Times. “Bernie Sanders, Elizabeth Warren and others are for a single-payer Medicare for All system. Joe Biden, Pete Buttigieg, Amy Klobuchar and others want an incremental approach […]

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Moral injury and burnout in medicine, a year of lessons learned: STAT

Jeanne Pinder July 28, 2019

Moral injury and burnout in medicine, a year of lessons learned: STAT

“When we began exploring the concept of moral injury to explain the deep distress that U.S. health care professionals feel today, it was something of a thought experiment aimed at erasing the preconceived notions of what was driving the disillusionment of so many of our colleagues in a field they had worked so hard to […]

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Individual insurance market performance in early 2019: The Henry J. Kaiser Family Foundation

Jeanne Pinder July 7, 2019

“The early years of the Affordable Care Act (ACA) exchanges and broader ACA-compliant individual market were marked by volatility. Markets in some parts of the country have remained fragile, with little competition, an insufficient number of healthy enrollees to balance those who are sick, and high premiums as a result,” Rachel Fehr, Cynthia Cox and […]

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So, Trump says he wants health cost transparency. What’s up with that?

Jeanne Pinder July 3, 2019

So, Trump says he wants health cost transparency. What’s up with that?

So the Trump Administration issued an executive order on June 24, 2019, saying that it would set in place a process to make health prices available to consumers. Historically, of course, the prices people will pay to the doctor or hospital have been shrouded in secrecy — characterized as “trade secrets” by the hospitals, insurers […]

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Behind the scenes at a health insurer: How the money is made, or why the Medical Loss Ratio matters

Jeanne Pinder

Behind the scenes at a health insurer: How the money is made, or why the Medical Loss Ratio matters

A contributor to one of my online communities, Scott Haas, wrote this to the group the other day in the context of what happens behind the scenes in health insurance. His note primarily concerns the Medical Loss Ratio formula and the way it was changed by the Affordable Care Act — and the role of […]

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How much U.S. households with employer insurance spend on premiums and out-of-pocket costs: Commonwealth Fund

Jeanne Pinder July 1, 2019

How much U.S. households with employer insurance spend on premiums and out-of-pocket costs: Commonwealth Fund

“In the years since the Affordable Care Act (ACA) took effect, public debate over the cost and quality of insurance has focused primarily on health plans sold through the marketplaces established by the law,” Susan L. Hayes, Sara R. Collins, and David C. Radley write for the Commonwealth Fund. “There has been less attention on […]

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Ghost networks of psychiatrists hinder patients’ access to care: STAT

Jeanne Pinder June 23, 2019

Ghost networks of psychiatrists hinder patients’ access to care: STAT

“When I started my training in psychiatry, a senior doctor told me I should have a therapist of my own,” Jack Turban writes over at Stat, about seeking in-network and affordable psychiatric care. “He explained that it’s essential to understand myself so I can better understand my patients. That made sense, so I started calling […]

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‘I always price out any labs or tests, even prescriptions’: How people shop for health care

Jeanne Pinder June 21, 2019

‘I always price out any labs or tests, even prescriptions’: How people shop for health care

“I always price out any labs or tests, even prescriptions before hand the price variations are wild, I then choose the lowest’” — she commented on a Facebook post on my TED talk. I queried her: “Thanks for this! This is my TED talk. I’d like to write about your experience for my blog. Can […]

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Category: Health reform