Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
As more seniors opt for Medicare Advantage, a few small insurers have begun offering plans that provide culturally targeted benefits for cohorts including Asian Americans, Latinos, and LGBTQ+ people. The approach, policy researchers say, has potential and perils.
Medicare Advantage, the private-sector alternative to original Medicare, now enrolls nearly half of all Medicare beneficiaries. But it remains controversial because — while most of its subscribers like the extra benefits many plans provide — the program frequently costs the federal government more than if those seniors remained in the fully public program. That controversy […]
On Jan. 20, 2023, the Biden Administration announced it will end the public health emergency (and national emergency) declarations on May 11, 2023. This policy watch provides an overview of how health care coverage and access will and won’t change when…
The public health emergency in effect since the start of the covid-19 pandemic will end on May 11, the Biden administration announced this week. The end of the so-called PHE will bring about a raft of policy changes affecting patients, health care providers, and states. But Republicans in Congress, along with some Democrats, have been […]
In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.
KHN has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
Facing rare scrutiny from federal auditors, some Medicare Advantage health plans failed to produce any records to justify their payments, government records show. The audits revealed millions of dollars in overcharges to Medicare over three years.
The lawsuit was filed three years ago to learn about vast overcharges by the popular health plans that are detailed in audits the government refused to release to the public.
The Biden administration has decided to try to fix the so-called “family glitch” in the Affordable Care Act without an act of Congress. The provision has prevented workers’ families from getting subsidized coverage if an employer offer is unaffordable. Meanwhile, Medicare’s open enrollment period begins Oct. 15, and private Medicare Advantage plans are poised to cover more than half of Medicare’s 65 million enrollees. Margot Sanger-Katz of The New York Times, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these topics and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read.
