The Becker Hospital Review article noted: “Looking to appeal to consumers with lower premium prices, some health insurers selling policies through the Patient Protection and Affordable Care Act health insurance exchanges have turned to narrow provider networks.”
“Here are six key things to know about narrow provider networks. Read more
The New York Times article noted “In a 2013 paper, Dr. Harlan Krumholz, a professor of medicine and public health at Yale School of Medicine, described a syndrome that emerges in the days and weeks after a hospital stay: ‘Physiologic systems are impaired, reserves are depleted, and the body cannot effectively avoid or mitigate health threats.’ He called this period of vulnerability ‘post-hospital syndrome.’”
“The syndrome was identified as a result of new Medicare rules that hold hospitals responsible for re-admissions within 30 days after discharge. When health systems began studying patients who returned to the hospital soon after discharge, two critical facts emerged. First, the problem is common and widespread, occurring after nearly one in five hospitalizations of patients on Medicare. Second, and even more surprising, the majority of cases represent an illness distinct from the initial hospitalization.” Read more
The Huffington Post article noted : “Let’s be honest: No one goes to the hospital to relax. Getting there, whether for a medical emergency or a scheduled appointment, is overwhelming — especially when you’re worried about a loved one. And once you arrive, the situation only seems to feel more tense.”
“If you happen to end up in the hospital (either with a loved one or for yourself), these tips will help you feel calm and in control. Below are seven things you should know before making a hospital visit. Read more
The Kaiser Health News article noted “As soon as Deb Emerson, a former high school teacher from Oroville, Calif., bought a health plan in January through the state’s insurance exchange, she felt overwhelmed.”
“She couldn’t figure out what was covered and what wasn’t. Why weren’t her anti-depressant medications included? Why did she have to pay $60 to see a doctor? The insurance jargon – deductible, co-pay, premium, co-insurance – was like a foreign language. What did it mean?”
The Forbes article noted “If you didn’t know it, the key intent of Affordable Care Act is to shift medical care from fee-for-service to fee-for-quality.”
“For too long, hospitals have gorged on referrals into their systems and walk-ins to their emergency rooms. But besides electronic medical records—a low hanging fruit–hospitals are hailed widely as being inefficient and sloppy. But the game changes when hospitals start getting paid for how many people they heal, not how many people they process. Think: outcomes not transactions.”
The Kaiser Health News article noted “Consumer advocacy group Public Citizen… called on 20 hospital systems to stop partnering with companies that offer low-cost screenings for heart disease and stroke risk, saying the promotions are ‘unethical’ and the exams are more likely to do harm than good.”
“In recent years, more hospitals have paired with firms offering such testing packages, partly to build community goodwill and referrals. Hospitals say residents benefit from the testing packages, which can cost less than $150, because some will discover they are at higher risk for heart problems or stroke early enough to take steps to reduce their risks.”
Q. My 24-year-old daughter was covered under her father’s health insurance, which is a grandfathered plan. She started working and was offered coverage through her employer. My husband’s employer said she had to sign up for her employer’s insurance and could not stay on his policy. Is that true?
The New York Times article noted: “Calling 911 can cause particular problems … Emergency medical personnel want orders … Nothing else has been shown to be effective.”
“Health care professionals, ethicists and advocates continually urge older people to document their preferences about end-of-life medical decisions, and a growing proportion do. A recent large national study, tracking more than 6,000 people over age 60 who died between 2000 and 2010, found that the proportion with advance directives climbed to 72 percent from 47 percent.”
The Connecticut Mirror article noted : “Many patients now have insurance plans that require them to pay a portion of their medical bills. But finding out what their care will cost remains difficult.”
“Because her family’s health insurance plan has a $10,000 deductible, Sue Haynie tries to watch what they spend on medical care and figure out what it will cost ahead of time. But that’s easier said than done, she’s found. There was the time her daughter needed to see a doctor about a lingering sore throat. Haynie wondered how she’d know the cost of any tests the doctor performed, so she asked her insurer, Aetna. Haynie said the representative suggested two options: Ask the doctor’s office to call Aetna and find out, or leave the appointment after finding out what tests the doctor recommends, price out the tests, and — if she decided they’re worth it — go back for another appointment to have the tests done. Haynie chose the first option, so when her daughter went to the appointment, she asked the office staff to call Aetna. But Haynie said she was told they didn’t have time to do so, and that if Haynie wouldn’t pay the bill, her daughter could be pulled out of the visit.”
The Connecticut Mirror article noted: “Want to know how much a medical procedure is going to cost? Experts say it’s not easy. But if you try, there are some things that you should know.”
“Here are few places to look, based on the recommendations of Connecticut and national experts.”
Ask your insurance company. But be sure you have the right information first.
- Ask your health care provider.
- For an estimate, look at online tools like FAIR Health and Health Care Blue Book.
- Another approach: Know the worst-case scenario.
- Know the limits of price information.