How to read a bill or explanation of benefits: Know the tricks

Filed Under: Costs, Health plans, Patients

How to read a bill or explanation of benefits: Know the tricks

The insurance company’s “explanation of benefits” explains nothing. In fact it often confuses matters more. Also: People believe their insurance companies are paying more than they really are, because quite often the explanation of benefits leads to that conclusion. When I founded this company, in fact, a major impetus was the fact that no one […]

Watching change happen in real time: How people use our data

Filed Under: Costs, Patients, Providers

Watching change happen in real time: How people use our data

We got to watch a community member learn how to shop for health care in real time the other day, when our partners over at NOLA.com I The Times-Picayune were doing a Facebook Live. She came in in the comments, saying, “I pay my insurance over $500 a month. My out of pocket after my […]

The myth of drug expiration dates: ProPublica

Filed Under: Costs, Health plans, Patients

The myth of drug expiration dates: ProPublica

“The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing,” Marshall Allen writes at ProPublica. “Most were 30 to 40 years past their expiration dates — possibly toxic, probably worthless. But to Lee Cantrell, who helps […]

Top secret no longer: What insurers pay, and what it means for you

Filed Under: Costs, Health plans, Patients

Top secret no longer: What insurers pay, and what it means for you

One of the biggest secrets in health care is the rates that insurance companies pay providers. One insurer might pay one provider $2,400 for an MRI and a different provider $400 — in the same locale and for the same MRI. But we rarely see documentation of that, because the rates are kept secret. So […]

Pharmacies morph into primary-care health destinations: HealthPopuli.com

Filed Under: Costs, Health plans, Patients

Pharmacies morph into primary-care health destinations: HealthPopuli.com

“The business and mission of pharmacies are being re-shaped by several major market forces, most impactful being uncertain health reform prospects at the Federal level — especially for Medicaid, which is a major payor for prescription drugs,” Jane Sarasohn-Kahn writes over at Health Populi. “Medicaid covered 14% of retail prescriptions dispensed in 2016, according to QuintilesIMS; […]

One company behind those surprise emergency room bills: The New York Times

Filed Under: Costs, Health plans, Patients

One company behind those surprise emergency room bills: The New York Times

“Early last year, executives at a small hospital an hour north of Spokane, Wash., started using a company called EmCare to staff and run their emergency room. The hospital had been struggling to find doctors to work in its E.R., and turning to EmCare was something hundreds of other hospitals across the country had done,” […]

California singles out docs with higher patient death rates: Kaiser Health News

Filed Under: Costs, Patients, Providers

California singles out docs with higher patient death rates: Kaiser Health News

“Michael Koumjian, a heart surgeon for nearly three decades, said he considered treating the sickest patients a badge of honor. The San Diego doctor was frequently called upon to operate on those who had multiple illnesses or who’d undergone CPR before arriving at the hospital,” Anna Gorman wrote recently for Kaiser Health News. “Recently, however, […]