Category: Medicare

Under New Cost-Cutting Medicare Rule, Same Surgery, Same Place, Different Bill

A Trump administration Medicare rule will push some hospital patients into a Catch-22: The government says several hundred procedures no longer need to be done in a hospital, but it did not approve them to be performed elsewhere. So patients will still need to use a hospital while not officially admitted — and may be charged more out-of-pocket for the care.

Is it time to consider social determinants of health in Medicare payments?

Eta was a 76-year-old woman with a recent heart attack in and out of the hospital over the last several months. Her course had been complicated by social determinants of health, in that she lacked reliable transportation for necessary follow-up, had un…

Analysis: Spending on Health Care Would Drop by an Estimated $352 Billion in 2021 if Private Insurance Used Medicare Rates to Reimburse Hospitals and Other Health Care Providers

Total health care spending for people with private health insurance would be an estimated $352 billion lower in 2021 if private insurers used Medicare rates to pay hospitals and other health care providers, rather than the substantially higher rates th…

Limiting Private Insurance Reimbursement to Medicare Rates Would Reduce Health Spending by About $350 Billion in 2021

This analysis estimates the total annual reduction in health care spending by employers and privately insured individuals that would result from having private insurers reimburse hospitals and other health care providers at Medicare rates. In total, we…

Countless Homebound Patients Still Wait for Covid Vaccine Despite Seniors’ Priority

Health organizations have begun sending doctors and nurses to apartment buildings and private homes to vaccinate homebound seniors, but the efforts are slow and spotty.

Montana’s Health Policy MVP Takes Her Playbook on the Road

Marilyn Bartlett, credited with saving Montana’s state employee health plan millions of dollars, is a busy consultant now, as states, counties and big businesses try to use her playbook to bring down hospital costs.

4 Vital Health Issues — Not Tied to Covid — That Congress Addressed in Massive Spending Bill

Lawmakers answered pleas from strained health facilities in rural areas, agreed to cover the cost of training more new doctors, sought to strengthen efforts to equalize mental health coverage with that of physical medicine and instructed the federal government to collect data that could be used to rein in high medical bills.

Trump’s Pardons Included Health Care Execs Behind Massive Frauds

Those walking away free were facing years in prison for crimes of “unbounded greed.”

After a Decade of Lobbying, ALS Patients Gain Faster Access to Disability Payments

In late December, then-President Donald Trump signed a law that eliminates — only for people with Lou Gehrig’s disease — the required five-month waiting period before benefits begin under the Social Security Disability Insurance program. Gaining SSDI also gives these patients immediate Medicare health coverage.

One Ambulance Ride Leads to Another When Packed Hospitals Cannot Handle Non-Covid Patients

A Kansas woman thought she’d find help at her local emergency room. What she found instead was a packed hospital and an ambulance ride to someplace else.