How much does Nucala cost? Or how to argue a bill

Filed Under: Costs, Health plans, Patients

How much does Nucala cost? Or how to argue a bill

A friend writes: “Tufts Medicare Preferred on numerous occasions failed to give me cost and alternative information related to Nucala (asthma) injections that I needed to make a reasonable decision. After three injections, I received a bill for my first injection copay of $576.74 indicating a total of $1730.22. I had had no previous indication […]

Politics, lobying, hospital behavior and health care spending: NBER study

Politics, lobying, hospital behavior and health care spending: NBER study

“When trying to pass sweeping legislation, congressional leaders can attract votes by adding targeted provisions that steer money toward the districts of reluctant legislators,” Zack Cooper, Amanda E. Kowalski, Eleanor N. Powell and Jennifer Wu write in a National Bureau of Economic research paper in August 2017 examining the link between legislative politics, hospital behavior, […]

Medicare Beneficiaries’ High Out-of-Pocket Costs: The Commonwealth Fund

Medicare Beneficiaries’ High Out-of-Pocket Costs: The Commonwealth Fund

“More than a quarter of Medicare beneficiaries spent 20 percent or more of income on health care in 2016. Policymakers should consider how proposals to reform Medicare would affect those with poor health or low income,” a Commonwealth Fund analysis finds. “Abstract: Fifty-six million people — 17 percent of the U.S. population — rely on […]

Mayo to favor privately insured over Medicaid patients: The Star Tribune

Summary: “Mayo Clinic’s chief executive made a startling announcement in a recent speech to employees: The Rochester-based health system will give preference to patients with private insurance over those with lower-paying Medicaid or Medicare coverage, if they seek care at the same time and have comparable conditions,” writes Jeremy Olson at The Minneapolis Star-Tribune. “The […]

A doctor’s view on payments: Cherry-picking and lemon-dropping

Guest post summary: “The dirty little secret of current medical payment changes is doctors and hospitals now have a financial incentive to not provide care for some patients, those who put the providers at higher risk of financial penalties. We call this phenomenon cherry-picking and lemon dropping,” writes Mary O’Connor, M.D., Yale School of Medicine and Yale-New Haven Hospital, […]

A Medicare practice wastes money and infuriates doctors: KevinMD

Summary: “In the last decade, the federal government has undertaken considerable steps to control the way doctors care for their patients,” Andrew Lam writes over at KevinMD, in a doctor’s eye view of quality measurements. “Its goal is to improve healthcare quality and lower costs, but the very regulation tasked with achieving this has created […]

The history of our health care system, and the road not taken

Summary: “It’s that time of year again. Insurance companies that participate in the Affordable Care Act’s state health exchanges are signaling that prices will rise dramatically this fall,” Christy Ford Chapin writes over at The Conversation, in a thorough, thoughtful examination of how our health care system came to be — including an explanation of […]

Big-name hospitals fail to get 5 stars in new Medicare ratings: Kaiser

Filed Under: Costs, Patients, Providers

Summary: “The federal government released its first overall hospital quality rating on Wednesday, slapping average or below average scores on many of the nation’s best-known hospitals while awarding top scores to dozens of unheralded ones,” Jordan Rau writes over at Kaiser Health News. “The Centers for Medicare and Medicaid Services rated 3,617 hospitals on a […]

At small rural hospitals, paying more for worse treatment: WSJ

Summary: “Small rural hospitals called critical-access hospitals have in recent years been performing more and more inpatient orthopedic surgeries, even as their overall stays decline, a Journal analysis of Medicare billing records shows,” Christopher Weaver, Anna Wilde Mathews and Tom McGinty write in The Wall Street Journal. “Inpatient joint-replacement surgeries covered by Medicare rose 42.6% […]

Medicare Advantage vs. Medicare: My mom’s story, by Wendell Potter

Filed Under: Costs

Summary: “The odds are pretty high … that Mom would not still be counted among the living had she not switched from an MA plan to traditional Medicare,” Wendell Potter writes in a piece titled “Why Mom went back to traditional Medicare” for He describes his mother’s experience, and concludes: “Only in original Medicare […]