Worried consumers have cited that they think their health care premium costs are on the rise, but recent analyses show the price of insurance is going to vary widely – primarily depending on where people live, but also depending on medical providers, the number of insurance companies and how many people ultimately choose to enroll. Saturday kicks off the second open enrollment season under the Affordable Care Act, a period during which Americans can buy health insurance through federal or state websites, commonly called exchanges or marketplaces. The websites give people the opportunity to compare plans at different levels of care and allow them to qualify for tax subsidies on insurance that they could not afford otherwise.
The future of Truman Medical Centers, a two-hospital safety-net system here, depends on the state legislature—and no one understands that better than its new chief executive, Charlie Shields. Mr. Shields, a genial 55-year-old, spent 20 years as a Republican lawmaker, ending up as the leader of the Missouri Senate before term limits forced him to step down. In 2010, he became chief operating officer of one of Truman's hospitals, and in July he succeeded longtime Truman CEO John W. Bluford III. Now Mr. Shields, whose office décor includes a collection of elephant statues, must press the legislature's current Republican leaders to accept the Affordable Care Act's expansion of Medicaid, the federal-state insurance for low-income people. [Subscription Required]
Doctors are testing seniors for drugs such as heroin, cocaine and "angel dust" at soaring rates, and Medicare is paying the bill. It is a roundabout result of the war on pain-pill addiction. Medical guidelines encourage doctors who treat pain to test their patients, to make sure they are neither abusing pills nor failing to take them, possibly to sell them. Now, some pain doctors are making more from testing than from treating. Spending on the tests took off after Medicare cracked down on what appeared to be abusive billing for simple urine tests. Some doctors moved on to high-tech testing methods, for which billing wasn't limited. [Subscription Required]
The evidence has been piling up that properly done CT scans can help doctors find tiny lung tumors in longtime smokers while the cancer can still be treated effectively. Now Medicare is proposing to pay for annual scans for beneficiaries at a high risk for lung cancer. To qualify, patients would have to first meet with a doctor to talk through the pros and cons of scans, which involve a low-dose of radiation. Patients would have to be: • Between the ages 55 and 74; • Have no symptoms of lung disease; • Have smoked the equivalent of 30 pack-years (or a pack a day for 30 years); • And be a current smoker or have given it up in the past 15 years.
The 2011 merger of the two remaining hospitals in Troy, N.Y., had many potential benefits —and one huge hurdle. Samaritan was secular, committed to providing the widest possible spectrum of reproductive and maternity care to its Albany-area patients. St. Mary's was Catholic, limiting or banning many reproductive options— and any merger partner had to abide by the same rules. It took several years of negotiations among three different health systems, much back-and-forth with women's advocates, and the sign-off of the local bishop. But in the end, the parties struck a deal that all of them could live with. The centerpiece was the brand-new Burdett Care Center, housed on Samaritan's second floor.
Bert Fish Medical Center's overseers have chosen to negotiate exclusively with Florida Hospital, paving the way for a merger they say is vital to keeping the public hospital competitive. The Southeast Volusia Hospital District Board of Commissioners voted 4-2 on Monday night to begin exclusive negotiations with Florida Hospital, a not-for-profit provider, as opposed to Daytona Beach-based Halifax Health and Titusville-based Parrish Medical Center. Now, Bert Fish and Florida Hospital will begin ironing out the final details of a transaction, said Daryl Tol, a regional CEO over Florida Hospital's Volusia-Flagler market. That process could take months.