Buying health insurance: A handbook

(Posted August 2019; updates planned) How do you buy health insurance? We are frequently asked to help people buy health insurance. Our specialty is the cost of health care, not buying insurance. We don’t do individual consultations on what insurance to buy. We’re not really qualified for that, and also people must be certified and […]

The six-figure cost of being transgender, in medical care and surgery: Business Insider

Filed Under: Costs, Patients

The six-figure cost of being transgender, in medical care and surgery: Business Insider

“In the past six years, Claire, an IT infrastructure engineer living in New York, has spent thousands of dollars on medical care that most Americans never have to think about. There was hormone therapy, hair removal, and what’s known as ‘bottom surgery,’” Benji Jones writes at Business Insider “And that was just the start of […]

Could we be at the edge of health care’s tipping point? Care And Cost

Could we be at the edge of health care’s tipping point? Care And Cost

“Health care wonks play a game where they wonder whether health care really is changing in ways that are palpably better for everyone,” Brian Klepper writes over at careandcost.com and the Valid Points Newsletter. “Everyone, that is, except for the senior executives of the drug and device firms, electronic health record companies, major health plans […]

Medical coding and billing: The inside story of how the sausage is made

Medical coding and billing: The inside story of how the sausage is made

Medical coding and billing seems impenetrable — those strings of numbers on  a bill that purport to show what was done, and what was spent. Sometimes it looks as if chimpanzees are typing in random strings of numbers. The bills and explanations arrive months if not years after the event. The numbers are unfamiliar. Memories […]

Claims denials and appeals in ACA marketplace plans: Kaiser Family Foundation

Claims denials and appeals in ACA marketplace plans: Kaiser Family Foundation

“In this report, we analyze transparency data released by the Centers for Medicare and Medicaid Services (CMS) to examine claims denials and appeals among issuers offering individual market coverage on healthcare.gov from 2015-2017,” Karen Pollitz, Cynthia Cox and Rachel Fehr write for the Kaiser Family Foundation, in a startling analysis of federal data that reveals […]

A behind-the-scenes look at how contracts are made in health care

Filed Under: Costs, Health plans, Patients

A behind-the-scenes look at how contracts are made in health care

“An Open Letter to My Patients Who Have Insurance Coverage Through EMI” is the headline of the blog post, by Randy G. Delcore, M.D., medical director, Cedar Orthopaedic Surgery Specialty Clinic, on the  Cedar Orthopaedic Surgery Center web site, describing to patients the end of a contract with an insurer. The blog post ends with […]

Patients want to shop for care, but have a hard time finding good tools: NPR

Filed Under: Costs, Health plans, Patients

Summary: “Kate and Scott Savett were trying to be responsible when they needed some medical care… Scott, 43, is a chemist and designs software for labs; Kate, 37, works in life insurance,” wrote Elana Gordon, at our partner WHYY public radio in Philadelphia, a bit ago. “They buy their health insurance through Scott’s job, and […]

What your doctor wishes you knew about insurance: Guest post

Filed Under: Costs, Health plans, Patients

What your doctor wishes you knew about insurance: Guest post

Guest post by Dina D. Strachan, M.D. If one were to survey the public, it is not obvious whether being sick would rank as more frustrating than dealing with health insurance —- especially in these times of health reform and uncertainty. Doctors also sometimes find dealing with health insurance difficult —- especially when their patients […]