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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
Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending
August 19th 2025Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.
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Roflumilast Cream 0.05% Durable, Safe for Younger Pediatric Patients
August 15th 2025The INTEGUMENT-OLE study is an open-label extension analysis that followed a primary investigation from the phase 3 INTEGUMENT-PED trial, which investigated the efficacy and safety of once-daily roflumilast cream 0.05% for atopic dermatitis in children aged 2 to 5 years.
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