Posts All of our commentary in one spot. You can also browse by topics or search. 410 posts in this category Posts pagination Newer 1 … 34 35 36 37 38 … 41 Older Sutter Medicare Advantage Pays $90 million Due to False Data September 1, 2021 Summary: Sutter Health (California) is paying $90 million to settle allegations that it submitted false diagnoses to increase payments to its Medicare Advantage plans. This type of gaming and fraud permeates the private insurance-run Medicare Advantage program. Let’s return to a social insurance model – traditional Medicare, without the privates. Then extend it to everyone. […] More market fiddling, that’s the answer! August 30, 2021 Summary: In a JAMA opinion piece, two physicians with homes in the business world propose payment innovations for our multi-payer health care system. Are these proven strategies? Of course not. Do they betray a blind faith in the magic of the marketplace? Sure do. Setting the Stage for the Next 10 Years of Health Care […] Learning from Costa Rica August 28, 2021 Summary: Atul Gawande writes a compelling New Yorker report of how Costa Rica melded medicine and public health to greatly reduce disease and lengthen life. If the U.S. is to learn from this inspiring example, we’ll need universal coverage with no cost barriers, robust health data, and strong primary care. Single payer will help pave […] HJM Reader Feedback Survey August 27, 2021 Dear HJM Reader: We want your feedback! Health Justice Monitor started in late May as the successor to Don McCanne’s quote of the day. It’s time to see how we’re doing. Please complete this quick (9 questions, 5 minutes) survey to help us improve HJM. Many thanks, Jim Kahn and the HJM team PHARMA Distorts Public Opinion on Drug Price Negotiation August 25, 2021 Summary: The pharmaceuticals trade association ran a big ad claiming that Americans oppose negotiations on drug prices. It is dishonest: only after hearing pharma’s scare tactics do most Americans become opposed. It’s time for drug price negotiations in Medicare. Axios VitalsAugust 24, 2021 MESSAGE FROM PHARMA KFF Health Tracking Poll – May 2021: Prescription Drug […] Price Chaos at US Hospitals August 24, 2021 Summary: The New York Times found huge price variations reported by hospitals across private insurers, generally far above Medicare prices. This causes inefficiencies, inequities, and financial distress for patients. These problems would be eliminated with a single set of negotiated prices. Hospitals and Insurers Didn’t Want You to See These Prices. Here’s Why.New York TimesAug 23, […] The Financialization of “Non-Profit” Health Systems August 23, 2021 Health Systems With Largest Private Equity Investments.Modern HealthcareMay 3, 2021 Largest Health System Investors in Hedge FundsModern HealthcareMay 3, 2021 Both charts are behind a paywall. From the Charts: Health System Private Equity Investments Hedge Fund Investments Kaiser Health Plan $10.180 bil. $2.820 bil. Mayo Clinic $3.869 bil. $3.421 bil. Cleveland Clinic $2.061 bil. $3.335 […] ACOs Fail to Save Medicare Money, Even With Do Overs August 19, 2021 Promise vs. Practice: the Actual Financial Performance of Accountable Care OrganizationsJournal of General Internal MedicineAugust 13, 2021By James G. Kahn and Kip Sullivan We collect and compare financial performance data from all four CMS ACO programs from 2005 to 2018, examining net CMS cost.…We found that overall, ACO programs roughly broke even from the CMS […] Two Decades Into the Quality Improvement Era, Health Care Quality is Falling August 18, 2021 Trends in Diabetes Treatment and Control in U.S. Adults, 1999–2018New England Journal of MedicineJune 10, 2021By Fang M et al.METHODS We conducted a cross-sectional analysis of data from adults with diabetes in the United States participating in the National Health and Nutrition Examination Survey (NHANES) to assess national trends in diabetes treatment and risk-factor control […] Prior Authorization: Less Care, More Illness, Higher Profits August 17, 2021 Aetna creates new obstacle to care for seniors, highlighting need for prior authorization reformCalifornia Medical AssociationAugust 10, 2021 One of the nation’s largest health insurance companies has created new bureaucratic hurdles for patients that could prevent many from receiving cataract surgery – part of a trend of insurance companies creating new “prior authorization” requirements that […] Posts pagination Newer 1 … 34 35 36 37 38 … 41 Older
