- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Health Insurers Highlight Excessive Out-of-Network Charges
Some California physicians providing out-of-network medical care bill patients at rates far beyond what Medicare allows, a new report from a health insurance trade group shows.The national survey released Friday by America's Health Insurance Plans is part of the industry's effort to show that some medical providers are overcharging consumers and unnecessarily raising healthcare costs. Some critics fault insurers for all too often paying these excessive charges for out-of-network care and then passing along those increased costs in the form of higher premiums for employers and consumers.
In California, the report shows, a pathologist billed $8,100 for a tissue exam in 2011, compared with the Medicare fee of $128.46. Another California doctor billed $30,000 for a gallbladder removal using a laparoscope while the Medicare rate was $778.16, according the industry group.
Read the full story: http://lat.ms/WZ25ZT
Source: Los Angeles Times
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
The Impact of Nurse Practitioner Attribution in Medicare Shared Savings ACOs
December 5th 2023Allowing nurse practitioners to serve as attribution-eligible providers for Medicare Shared Savings Program accountable care organizations leads to no change in hierarchical condition category risk scores and modest growth in attributed beneficiaries.
Read More
Insufficient Data, Disparities Plague Lung Cancer Risk Factor Documentation
September 24th 2023On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.
Listen
What We’re Reading: ChatGPT in Health Care; Menthol Ban Meeting; Health System Cyberattack Impact
November 30th 2023ChatGPT is changing health care while also raising questions about artificial intelligence's promises and limitations; 24 Biden officials met with the National Organization of Black Law Enforcement Executives to discuss the FDA’s proposal to ban menthol cigarettes; a recent hospital cyberattack shows how the vulnerability of health care systems can put patients at risk.
Read More
Untangling Medical Debt From Credit Scores: Effects So Far and Next Steps
November 29th 2023After recent policy changes removing most medical debts from credit reports, Americans are seeing their credit scores increase, but experts warn of the need to monitor billing and collection practices for unintended consequences.
Read More
