“You wake up feeling gross – stuffy and full of aches. A quick Google search of your symptoms confirms that yes, you probably have a cold and not the plague. But what if you were directed to a site that had a legitimate sounding name but wasn’t really accurate at all?
It sounds like a problem from the ancient days of the Internet. Since then people have learned that .gov leads to bona fide government sites, but .com could be anyone selling you anything.
How do you feel about .health? A new slew of web domains is coming down the pike, like “.health,” “.doctor,” and “.clinic.” They’re not required to have any medical credentials. That’s deeply worrying to some public health advocates.”
“When Fabrizio Mancinelli applied for health insurance through California’s online marketplace nine months ago, he ran into a frustrating snag.
An Italian composer and self-described computer geek, Mancinelli said he was surprised to find there wasn’t a clear way to upload a copy of his O-1 visa. The document, which grants temporary residency status to people with extraordinary talents in the sciences and arts, was part of his proof to the government to that he was eligible for coverage.
So, the 35 year-old Sherman Oaks resident wrote in his application that he’d be happy to send along any further documentation.
Months went by without word from the state. Then last week he came home from vacation to find a notice telling him he was at risk of losing the Anthem Blue Cross plan he’d purchased.”
“The Affordable Care Act changed the rules on how health insurance plans dealt with pre-existing conditions, outlawing the practice of turning away patients with expensive conditions or charging them a drastically higher cost for coverage. But an editorial alleges some health insurance companies operating on the new marketplaces created by Obamacare may have found a loophole that allows them to discourage sick patients from enrolling in a specific plan.
The change has to do with how drugs are categorized in health systems. From the editorial published online at the American Journal of Managed Care:
“For many years, most insurers had formularies that consisted of only three tiers: Tier 1 was for generic drugs (lowest copay), Tier 2 was for branded drugs that were designated “preferred” (higher co- pay), and Tier 3 was for “nonpreferred” branded drugs (highest copay). Generic drugs were automatically placed in Tier 1, thereby ensuring that patients had access to medically appropriate therapies at the lowest possible cost. In these three-tier plans, all generic drugs were de facto “preferred.” Now, however, a number of insurers have split their all-generics tier into a bottom tier consisting of “preferred” generics, and a second tier consisting of “non-preferred” generics, paralleling the similar split that one typically finds with branded products. Copays for generic drugs in the “non-preferred” tier are characteristically much higher than those for drugs in the first tier.””
“After a long list of Obamacare failures in Alaska, one physician is shutting down his decades-old practice, charging that the health-care law and other federal programs are “unsustainable” for practicing doctors.
Dr. William Wennen, a plastic surgeon, is closing his Fairbanks practice after 38 years of working in the state. Dr. Wennen blames federal health insurance programs, citing Obamacare, Medicaid and Medicare, for shutting down his practice.”
“New survey data show that companies are passing on to their employees additional costs they have incurred as a result of the Affordable Care Act, according to a management professor at the University of South Carolina’s Moore School of Business.
And that means employees who get their health insurance through work are bearing the cost of subsidizing people newly covered under President Obama’s healthcare reform law, said Professor Patrick M. Wright.”
“RALEIGH — A sizable number of North Carolina residents are learning they are no longer eligible for Obamacare, and some health policy premiums could jump 60 percent within two years, an insurance official says.
Rufus Langley, an Apex insurance agent and state leader of the North Carolina Association of Health Underwriters, said Coventry Health Care of the Carolinas CEO Tracy Baker recently told his group that substantially higher consumer costs are anticipated.
“He can see in 2016 this thing shooting up anywhere from 30 to 60 percent in costs” as delayed taxes start to kick in this year and next year, and medical care costs still rising, Langley said Monday at a Raleigh panel discussion.”
“With just one week left before the launch of the controversial Open Payments database – which will reveal how much money doctors receive from drug and device makers – three of the biggest industry trade groups are complaining they have not had an opportunity to review important background information about relationships with physicians.
And the trade groups – the Pharmaceutical Research and Manufacturers of America, BIO and AdvaMed – are reiterating concerns expressed last month that the Centers for Medicare and Medicaid Services has still not explained why one-third of the payment information submitted by drug and device makers, as well as group purchasing organizations, was removed from the database.”
“When the Patient Protection and Affordable Care Act (ACA) was initially passed and being implemented, there were several questions regarding the future of high-deductible health plans, including whether they would continue to exist. The primary issue was a debate on whether health insurance should be designed to prevent severe financial harm due to medical bills or eliminate nearly all financial barriers to obtaining any medical care deemed necessary by a provider. CDHPs put that decisionmaking and often the financial consequences more squarely in the mind of the consumer. They also reduce the monthly premium, potentially making insurance more affordable. Many more plans than initially expected to be made available on the health insurance exchanges in 2013–2014 were CDHPs.”
“Nearly five years after passage, the Affordable Care Act (ACA) and a companion electronic health records (EHR) program have run a startup tab of more than $73 billion, the Bloomberg Government analysis finds.
Part of that total is the cost of healthcare.gov, the flawed website and related enrollment system intended to expand U.S. health insurance coverage.
BGOV’s analysis shows that costs for both healthcare.gov and the broader reform effort are far greater than anything publicly discussed. They’re also substantially greater than what the Congressional Budget Office (CBO) initially estimated health reform would cost by this point, although not what the agency’s more recent piecemeal estimates suggest.”
“The 2010 federal healthcare law experimented with a number of ways to limit healthcare costs, but the real impetus to hold down spending has come from those who pay for coverage — most notably large employers and governments — and from doctors, hospitals and insurers seeking more sustainable business models. A good illustration is the HMO established recently by Anthem Blue Cross and several top Southern California hospitals, which will reward healthcare providers if they cut waste while improving patients’ results. It’s a welcome development, although the industry will have to go even further to rid itself of the perverse incentives that drive up costs.”