High deductibles cut care across the board — the needed with the wasteful
When a large firm moved everyone to a high-deductible plan, spending fell about 12-14%. The catch: people cut valuable and low-value care alike, and barely shopped on price.
Three companies you've never chosen decide much of what your drugs cost
Pharmacy benefit managers sit between you, your insurer and the pharmacy. The three largest process nearly 80% of US prescriptions, and a federal regulator says the structure can raise costs.
The same operation at one hospital can cost thousands more on another plan
Since 2021, hospitals must post the rates they negotiate with each insurer. The data confirms the same procedure at the same hospital varies widely by which insurer is paying.
Prior authorization delays care. A federal audit shows some denials are wrong.
Physician surveys report delays and abandoned treatment; those are self-reported. A harder number: a federal audit found 13% of Medicare Advantage denials met Medicare's own coverage rules.
ACA marketplace enrollment fell 13% this year. HHS says most of the drop was overdue
A new administration analysis estimates 2.9 million people were removed from ACA exchange plans as improperly or fraudulently enrolled — and that 2.6 million more remain.
One more hot day a week means more ER visits. Medicare Advantage members pay most.
An analysis of insurance claims from 2016 to 2023 found extreme heat consistently drove up emergency department use and cost across commercial, Medicaid, and Medicare Advantage plans.
Two Senate health bills died at 51-48. The enhanced ACA subsidies expire in twelve days
Neither the Democratic extension nor the Republican alternative cleared the 60-vote threshold. KFF puts the average out-of-pocket premium increase at 114%.
Only 12% of 102,564 Korean sleep apnea patients stayed on PAP therapy
A national insurance-claims analysis found long-term adherence far below what trial populations suggest, despite universal coverage and strict usage monitoring. The monitoring may be part of the problem.