Large hospital systems often complain about Medicare Advantage (MA) plans. Just last year some large hospital systems reported dropping or threatened to drop major MA plans run by health insurers. One complaint is low reimbursement, but arguably a more irritating business practices by MA plans is excessive prior authorization and slow payments. Breaking up with an MA plan runs the risk of shutting out thousands of potential patients. A strategy more large hospital systems are exploring is establishing their own MA plans.
Author: Devon Herrick
Obamacare Proponents Leery of Lower Price Health Plans… and Competition
The Kaiser Family Foundation is reporting on the loss of ACA enhanced subsidies and the problems many families face keeping coverage. The article, As Insurance Prices Rise, Families Puzzle Over Options is a series of anecdotes about families who face unaffordable “Affordable Care Act” health plans. Something that is missing in the debate is why ACA plans are so unaffordable. Hint: it is due to all the mandated benefits and costly insurance regulations.
Congress Should Not Force Medicare to Reimburse New Technology without Evidence of Value
For the past several years Congress has been debating a version of Ensuring Patient Access to Critical Breakthrough Products Act. The goal is to force Medicare to reimburse new medical device products that the U.S. Food and Drug Administration (FDA) claims are breakthrough devices, without letting Medicare determine whether these new devices have any value.
Should Medical Care Be a Consumer Good?
Republicans wisely want to inject more consumerism into the medical marketplace. Health savings accounts, high-deductible health plans, direct primary care, price transparency are all attempts to encourage patients to act more like consumers. Democrats, by contrast, seemingly want to remove every shred of consumer sovereignty from health care. Not to cast aspersions, but it is true. Obamacare is but one example.