Category: Cost and Quality

This Doctor Thought She Could Navigate US Health Care. Then Her Autistic Son Needed Help.

Dr. Mai Pham left her corporate career to spark change in a system that is failing millions of Americans with autism and other intellectual and developmental disabilities.

What Are Taxpayers Spending for Those ‘Free’ Covid Tests? The Government Won’t Say.

Inquiries lead from one federal office to the next, with no clear answers. At one Army Contracting Command, a protocol office employee says that “voicemail has been down for months.” And the email address listed for fielding media inquiries? “The army stopped using the email address about eight years ago.”

Skirmish Between Biden and Red States Over Medicaid Leaves Enrollees in the Balance

The Biden administration is getting rid of several policies implemented by Trump-era appointees that restricted enrollment. Federal officials now say states can no longer charge premiums to low-income residents enrolled in Medicaid and have ruled out work requirements.

‘Somebody Is Gonna Die’: Medi-Cal Patients Struggle to Fill Prescriptions

Problems with California’s new Medicaid prescription drug program are preventing thousands of patients from getting their medications, including some life-saving ones. State officials say they’re working on fixes.

Federal Investigation Into Spine Surgeries Uses Mob Laws to Target Health Care Fraud

Investigators allege a Texas company that arranges spine surgery and other medical care for people injured in car crashes accepted bribes in violation of 1960s-era racketeering law.

Health Care Paradox: Medicare Penalizes Dozens of Hospitals It Also Gives Five Stars

Among the 764 hospitals hit with a 1% reduction in Medicare payments this year for having high numbers of patient infections and avoidable complications are more than three dozen that Medicare also ranks as among the best in the country.

Mental Health Therapists Seek Exemption From Part of Law to Ban Surprise Billing

Some practitioners object to the way upfront cost estimates are designed, saying they could affect access to care and are burdensome. Other experts disagree.

‘An Arm and a Leg’: Know Your ‘No Surprises’ Rights

The No Surprises Act protects patients from surprise out-of-network bills. But there are caveats. For instance, these protections apply only to care in a hospital. This episode breaks it all down.

Faxes and Snail Mail: Will Pandemic-Era Flaws Unleash Improved Health Technology?

The covid-19 pandemic exposed how state and local governments’ severely outdated technology can hinder unemployment benefits, food stamps, Medicaid, vaccine registrations, and the flow of other critical information. Now, with hefty federal pandemic relief and unexpected tax windfalls, states may finally have the chance to revamp their information technology for health care and social services. But can they?

Resistance to a Boston Hospital’s Expansion Centers on Rising Prices

Mass General Brigham’s $2.3 billion expansion plan is raising state officials’ concerns that it will reduce competition and raise the price of care in Massachusetts. It also signals a national shift from a focus on hospital mergers and purchases of physician practices — which boost the cost of care — to individual hospitals’ expansions to gain a bigger share of the market.