Category: Cost and Quality

These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They’re Failing to Deliver.

Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations — even as it’s sued thousands of patients for unpaid bills.

Biden Administration to Ban Medical Debt From Americans’ Credit Scores

The White House said the Consumer Financial Protection Bureau will develop new regulations that would prevent unpaid medical bills from being counted on credit reports.

Your Exorbitant Medical Bill, Brought to You by the Latest Hospital Merger

After decades of unchecked mergers, health care is the land of giants, with huge medical systems monopolizing care in many cities, states, and even whole regions of the country. This decreases patient choice, impedes innovation, erodes quality of care, and raises prices. And federal regulators have been slow to act.

Sen. Sanders Says Millions of People Can’t Find a Doctor. He’s Mostly Right.

The Vermont senator sees beefing up the primary care workforce as a critical step in expanding Americans’ access to health care.

Be Aware: Someone Could Steal Your Medical Records and Bill You for Their Care

Consumers should know that this type of fraud can happen, whether from a large-scale breach or theft of an individual’s data. The result could be thousands of dollars in medical bills.

Medi-Cal’s Fragmented System Can Make Moving a Nightmare

When Medi-Cal beneficiary Lloyd Tennison moved last year from Contra Costa County to San Joaquin County, he was bumped off his managed care plan without notice before his new coverage took effect. His case highlights a chronic issue in California’s fragmented Medicaid program.

California’s Medicaid Experiment Spends Money to Save Money — And Help the Homeless

Gov. Gavin Newsom’s ambitious experiment in health care is supposed to cut costs as it fills the needs of hard-to-reach people. The program’s start is chaotic and limited, but it shows promise.

A Progress Check on Hospital Price Transparency

Hospitals are facing mixed reviews regarding their efforts to comply with a federal requirement that they post information about prices related to nearly every health care service they provide.

Truly Random Drug Testing: ADHD Patients Face Uneven Urine Screens and, Sometimes, Stigma

Doctors have no national standards on when to order urine tests to check whether adult ADHD patients are properly taking their prescription stimulants. Some patients are subjected to much more frequent testing than others.

Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients

The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has morphed into an unwieldy monster that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New federal rules may not be enough to tame it.