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What We're Reading: Health Insurance Coverage and Unecessary Procedures
What we're reading on October 12, 2015: health insurance marketplaces may have challenges keeping customers they already have, but in California, consumers leaving the state insurance exchange are gaining coverage elsewhere, and the government is increasingly pursuing cases of potentially unnecessary procedures.
Insurance Dropouts Present a Challenge for Health Law
Health insurance marketplaces getting ready for the next open enrollment period, which starts November 1, will have the added challenge of keeping customers they already have, reports New York Times. The last open enrollment period ended in February and by the end of June there had been a drop of about 15% in the total number of people enrolled in the federal and state marketplaces.
Read more: http://nyti.ms/1PpQvob
Cincinnati Hospital to Pay $4.1 Million to Settle Claims for Unnecessary Surgeries
The government is increasingly pursuing cases of potentially unnecessary procedures, reports Modern Healthcare. A hospital in Cincinnati will pay $4.1 million to settle government allegations that the hospital was billing Medicare and Medicaid for unnecessary spine surgeries.
Read more: http://bit.ly/1Ms6Fwd
Consumers Dropping Covered California Plans Gain Insurance Elsewhere
The vast majority (85%) of individuals who have dropped their health insurance coverage through Covered California, the state’s health insurance exchange, gain insurance elsewhere. Nearly half of those who do are opting for employer-based coverage, while others are turning to Medi-Cal and private coverage, FierceHealthPayer reports.
Read more: http://bit.ly/1Lm8FFz
Medicaid Budget Survey Highlights Postpandemic Challenges and Priorities
October 24th 2024The Medicaid budget survey for fiscal years 2024 and 2025 revealed state predictions are expecting a decline in Medicaid enrollment and an increase in spending next year due to the end of pandemic-era policies and federal funding.
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Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
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Sarcoma Care: Biomarker Advancements Shape the Future
October 24th 2024At the regional Institute for Value-Based Medicine® event in Boston, Vinayak Venkataraman, MD, medical oncologist at Dana-Farber Cancer Institute and Harvard Medical School, was a panelist for the discussion, “Recent Advancements in Identifying Predictive Biomarkers for Sarcomas."
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Sustaining Compassionate Trauma Care Across Communities
September 30th 2024September is National Recovery Month, and we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In our final episode, we speak with Lyndra Bills, MD, and Shari Hutchison, MS.
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