Consumer

Teach someone to fish, the saying goes, and they'll eat for a lifetime. Teach a nurse to become more involved in helping people heal, and patients could enjoy a longer life. That's the philosophy behind training nurses to mentor other nurses, says Sheila Davis, chief nursing officer and chief of Ebola response for Partners in Health, the worldwide nonprofit organization.

Docs Face Pay Cuts, Patients May Pay The Price

Jan 6, 2015
Kaiser Health News

Andy Pasternak, a family doctor in Reno, Nev., has seen more than 100 new Medicaid patients this year after the state expanded the insurance program under the Affordable Care Act.

But he won’t be taking any new ones after Dec. 31. That’s when the law’s two-year pay raise for primary care doctors like him who see Medicaid patients expires, resulting in fee reductions of 43 percent on average across the country, according to the nonpartisan Urban Institute.

When your kid's ear is throbbing at 2 a.m., you might want to grab the car keys and head to the emergency room. But now you can pick up your iPhone instead.

A startup called CellScope has built a little ear probe that you clip on top of your iPhone camera. The footage streams into an app where you can view the inside the ear.

Associated Press

Governors across the political spectrum are hitting a roadblock in their bids to expand Medicaid with federal funds: Republican legislators who adamantly oppose "Obamacare."

While some of these governors themselves have criticized the president's health care law in general, they've come to see one component — Medicaid expansion — as too generous to reject. But they're battling conservative lawmakers who say it's better to turn down billions of federal dollars than to expand Medicaid under the 2010 law.

Arkansas became the first Southern state to expand its Medicaid program in a way that many Republicans found acceptable. The state bought private insurance for low-income people instead of adding them to the rolls of the Medicaid system, which GOP lawmakers considered bloated and inefficient.

Now Arkansas could be on the brink of another distinction: becoming the first to abandon its Medicaid expansion after giving coverage to thousands of people.

Years of efforts to reduce the racial disparities in health care have so far failed to eliminate them. But progress is being made in the western United States, due largely to efforts by managed care plans to identify patients who were missing out on management of chronic diseases like diabetes and heart disease.

While management of blood pressure, cholesterol and blood sugar improved nationwide, African-Americans still "substantially" trailed whites everywhere except the western U.S., an area from the Rocky Mountains to the Pacific as well as Alaska and Hawaii.

Businesses See Alternatives, Drop Coverage

Dec 16, 2014

For two decades Atlanta restaurant owner Jim Dunn offered a group health plan to his managers and helped pay for it. That ended Dec. 1, after the Affordable Care Act made him an offer he couldn’t refuse.

Health-law subsidies for workers to buy their own coverage combined with years of rising costs in the company plan made dropping the plan an obvious – though not easy – choice.

Following the lead of other Republican governors, Tennessee's Gov. Bill Haslam is moving to expand Medicaid in his state, using federal funds from the Affordable Care Act. Haslam announced the plan Monday morning; it'll be debated by the legislature next month.

From Nashville, Bobby Allyn of member station WPLN reports:

Alabama’s largest insurer now offers spousal coverage to legally married gay couples in order to comply with a federal rule that insurance companies must treat married couples the same regardless of sexual orientation.

A spokeswoman for Blue Cross Blue Shield of Alabama said the company began offering same-sex spousal coverage for underwritten plans in early 2014, “in response to the Centers for Medicare and Medicaid Services’ regulations that prohibit health insurers from discriminating in health plan coverage on the basis of sexual orientation.”

Nearly 20 percent of U.S. consumers — 42.9 million people — have unpaid medical debts, according to a new report by the Consumer Financial Protection Bureau.

The findings suggest that many Americans are being trapped by debt because they are confused by the notices they get from hospitals and insurance companies about the cost of treatment. As a result, millions of Americans may be surprised to find they are stuck with lower credit scores, making it harder for them to borrow to buy a home or an automobile.

Primary care doctors caring for low-income patients will face steep fee cuts next year as a temporary program in President Barack Obama’s health care law expires. That could squeeze access just when millions of new patients are gaining Medicaid coverage.

If you get health insurance at work, chances are you have some sort of wellness plan, too. But so far there's no real evidence as to whether these plans actually improve the health of employees.

One thing we do know is that wellness is particularly popular with employers right now, as they seek ways to slow the rise of health spending. These initiatives can range from urging workers to use the stairs to requiring comprehensive health screenings.

Job-Based Coverage Confusion May Lead to Lost Subsidies

Dec 9, 2014

Confusion about whether some types of job-based coverage disqualify consumers from signing up for subsidized insurance through the health law’s marketplaces may lead some people to buy skimpier employer plans instead.

In recent weeks, some assisters who help consumers find coverage say people are being told by their employers that their bare-bones plans – which, for example, may cover preventive benefits only — meet “minimum essential coverage” requirements. That’s the type of coverage most people must have to satisfy the health law’s requirement that they have health insurance.

Study Finds Elder-to-Elder Mistreatment

Dec 8, 2014

In a given four-week period, nearly one in five nursing home residents reported being involved in some form of elder-to-elder mistreatment. Those are the findings of a first of its kind study released last month from Cornell University.

Through direct observation and surveys with more than 2,000 nursing home residents and staff members, researchers categorized several types of elder-to-elder mistreatment ranging from verbal or physical abuse, to unwanted sexual overtures, to invading another resident’s personal space or belongings.

It's one of the worst fears we have for our parents or for ourselves: that we, or they, will end up in a nursing home, drugged into a stupor. And that fear is not entirely unreasonable. Almost 300,000 nursing home residents are currently receiving antipsychotic drugs, usually to suppress the anxiety or aggression that can go with Alzheimer's disease and other dementia. You can check NPR's interactive database to see the history of antipsychotic drug usage at nursing homes in your area and how they compare to national and state averages. In Florida, the average is 21.7 percent.

Millions of Medicare Advantage customers are fast approaching a deadline for a task they’d rather avoid: Researching and then settling on coverage plans for 2015.

The annual enrollment window for the privately run versions of the government’s Medicare program for the elderly and disabled people closes on Sunday. This is the main opportunity most customers have each year to adjust their health coverage, and it may be worth paying extra attention to the details.

U.S. Health Spending Growth Lowest Since 1960

Dec 4, 2014

National health spending grew 3.6 percent in 2013, the lowest annual increase since the Centers for Medicare and Medicaid Services (CMS) began tracking the statistic in 1960, officials said Wednesday.

Spending slowed for private health insurance, Medicare, hospitals, physicians and clinical services and out-of-pocket spending by consumers.  However, it accelerated for Medicaid and for prescription drugs, according to the report, published online by the journal Health Affairs.

Women's reproductive rights are once again before the U.S. Supreme Court on Wednesday. Only this time, pregnancy discrimination is the issue and pro-life and pro-choice groups are on the same side, opposed by business groups.

If Subsidies Struck Down, ACA Could Unravel

Dec 2, 2014

Exactly what would happen to the Affordable Care Act if the Supreme Court invalidates tax credits in the three dozen states where the federal government runs the program?

Legal scholars say a decision like that would deal a potentially lethal blow to the law because it would undermine the government-run insurance marketplaces that are its backbone, as well as the mandate requiring most Americans to carry coverage.

New ACO Rules Would Delay Penalties 3 Years

Dec 2, 2014

Health care systems experimenting with a new way of being paid by Medicare would have three extra years before they could be punished for poor performance, the federal government proposed Monday.

Hep C Drugs Behind National Spending Jump

Nov 20, 2014

After several years of modest increases, American spending on medications is projected to shoot up by 12 percent this year, pushing the nation’s drug bill to between $375 billion and $385 billion, according to a report by the IMS Institute for Healthcare Informatics.

Several factors are driving the spending spike, including the introduction of expensive new hepatitis C drugs and fewer drug patent expirations than in previous years, the report found. Such expirations typically lead to savings as cheaper generics replace brand-name drugs.

Few Obese Seniors Using Medicare Benefit

Nov 20, 2014
Associated Press

Three years ago, the Obama administration offered hope to millions of overweight seniors when it announced Medicare would offer free weight-loss counseling.

Officials estimated that about 30 percent of seniors are obese and therefore eligible for counseling services, which studies have shown improve the odds of significant weight loss.

Many of the 7 million consumers who got insurance under President Barack Obama's health care law will see their premiums rise next year unless they switch to another plan, independent analysts said as the government released details Friday.

The Health and Human Services department released a massive computer file of 2015 premiums one day ahead of the start of open enrollment. Those numbers will take time to fully analyze.

NPR — along with seven public radio stations around the country — is chronicling the lives of America's troops where they live. We're calling the project "Back at Base." This is the latest in the ongoing series.

"There's been more advancement in the field of prosthetics since 1945 than there has been in the entire automobile industry," says Mark Vukov, a clinical education manager at College Park Industries, a manufacturer of prosthetic feet.

Jeffrey Craig Hopper is a probate attorney and Little League coach in Austin, Texas, so he knows all about following the rules. Still, accidents happen. Last June on the Little League field, an errant baseball smashed into his face.

His wife, Jennifer, remembers rushing to the field.

"His eye was swollen shut enough that we weren't sure if he could see," she says.

Consumer Guide: SCOTUS Action on ACA Subsidies

Nov 10, 2014

The Supreme Court on Friday agreed to hear a case on a subject that’s important to millions of people who receive subsidies to help purchase coverage under the health-care law. Friday’s decision follows earlier action in July when two U.S. appeals courts issued conflicting rulings on the issue.  KHN’s Mary Agnes Carey answers some frequently asked questions about those court decisions and how they impact consumers.

Q: What did the Supreme Court do?

Electronic medical records were supposed to usher in the future of medicine.

Prescriptions would be beamed to the pharmacy. A doctor could call up patients' medical histories anywhere, anytime. Nurses and doctors could easily find patients' old lab results or last X-rays to see what how they're doing. The computer system could warn doctors about dangerous drug combinations before it was too late.

Debt collection is the top consumer complaint in the nation, and hounding about medical debt accounts for a large number of those complaints, the Palm Beach Post reports. 

Consumers with medical bills say they're being badgered with information that’s inaccurate or being resolved with insurers, according to the survey by the Consumer Financial Protection Bureau. 

Hospitals Taking Cues From Hospitality

Nov 5, 2014

Two years ago, Inova Health System recruited a top executive who was not a physician, had never worked in hospital administration and barely knew the difference between Medicare and Medicaid.

What Paul Westbrook specialized in was customer service. His background is in the hotel business – Marriott and The Ritz-Carlton, to be precise.

Federal officials are planning a wide range of audits into billing and government spending on managed health care in the new fiscal year, ranging from private Medicare Advantage groups that treat millions of elderly to health plans rapidly expanding under the Affordable Care Act.

The Health and Human Services Office of Inspector General, which investigates Medicare and Medicaid waste, fraud and abuse, said it would conduct "various reviews" of Medicare Advantage billing practices with an eye toward curbing overcharges. Results are due next year.

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