Medicare

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Seniors Face Higher Drug Costs As Coinsurance Becomes More Common

2:50pm March 18, 2016

by Michelle Andrews

How coinsurance hurts: If a drug costs $200, a patient may owe 20 percent of the cost, or $40, instead of a flat copayment of $20. The higher the cost of the drug, the bigger the coinsurance bite.

Drug-Company Payments Mirror Doctors' Brand-Name Prescribing

9:51am March 17, 2016

An analysis of Medicare data shows that the more money a doctor gets from pharmaceutical companies, the more likely he or she is to prescribe brand-name medications. And that influences cost.

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Medicare wants to experiment with tying the prices it pays for medication to effectiveness.

Medicare To Experiment With Tying Drug Costs to Effectiveness

9:39am March 16, 2016

by Julie Appleby

The goal is to rein in drug price increases while increasing the chance that patients will get the medication that works best for them. It's an idea that's getting increasing private-sector traction.

Health & Safety

For Divorced Couples, Separate Plans OK To Repay Health Law Tax Credits

5:00am March 15, 2016

by Michelle Andrews

The Internal Revenue Service will evenly divvy up the amount divorced or legally separated spouses owe if they have to repay an insurance tax credit — unless they agree to a different arrangement.

Erbitux is used to treat cancers that start in the head and neck and tumors there that spread from other parts of the body. Because its effectiveness varies, should the price also?

Medicare Looks To Cut Drug Costs By Changing How It Pays Doctors

2:55pm March 09, 2016

by Alison Kodjak

The agency plans to reduce the incentive for doctors to use the most expensive drugs and link prices to patient outcomes, perhaps paying less when patients have to be admitted to a hospital.

The care an older patient receives often doesn't match what the person wants.

Health Care For Seniors Often Goes Beyond Their Desires

4:53pm March 08, 2016

by Michelle Andrews

Research from the Dartmouth Atlas Project identifies care that older people receive that doesn't match clinical guidelines or, often, patients' own preferences.

A federal whistleblower suit unsealed in late February alleges that Humana knew about billing fraud involving Medicare Advantage patients and didn't stop it.

Health & Safety

Florida Doctor Says False Diagnoses Inflate Bills, Could Harm Patients

7:28pm March 04, 2016

by Fred Schulte

A whistleblower suit against Humana Inc. alleges the insurer turned a blind eye to billing fraud involving Medicare patients. People were diagnosed with more serious ailments than they actually had.

States can't compel self-insured employers to provide claims data for analytical purposes, the Supreme Court held.

Health & Safety

Supreme Court Strikes At States' Efforts On Health Care Transparency

8:49am March 02, 2016

by Charles Ornstein

The U.S. Supreme Court ruled that states can't require many large employers to submit health care claims to a massive database. The decision means Medicare data will remain the go-to source for now.

Ratings on patient satisfaction and quality of care often don't match.

Conflicting Ratings For Home Health Agencies Can Be Puzzling

5:33pm February 23, 2016

by Jordan Rau

Medicare compiles ratings of agencies' quality and of patients' perceptions. But the stars assigned by the government often don't align.

Sen. Bernie Sanders, a 2016 Democratic presidential candidate, has proposed a health care policy he calls "Medicare for All." But some left-leaning economists say the plan doesn't pencil out.

Sanders' Health Plan Renews Debate On Universal Coverage

1:08pm February 23, 2016

by Alison Kodjak

Left-leaning economists and Democratic analysts are sparring over Sanders' proposal of health care for all, paid for by the government. Some who like his aspiration say the numbers don't add up.

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