What's the difference if you get hurt at a Bruce Springsteen concert or a performance of "Die Fledermaus"? To your wrenched back, not much. But to the folks who process your medical records, it's a distinction worth noting. The difference between an injury at a music hall and one at an opera house is one of many thousands of details that will be parsed by a new health care classification system that begins in the U.S. on Oct. 1 — a deadline that presses on every health care provider and insurer in the nation.
Partners HealthCare does not hold back in the response it plans to file today with the state's Health Policy Commission (HPC). The commission issued a report last month that marked a rare effort to crimp Partners' dominance in the Massachusetts market. The commission said that if Partners adds South Shore Hospital in Weymouth to its growing network, costs will increase around $23-26 million a year. Wrong, says Partners, in an 89-page rebuttal that includes dozens of letters and testimonials from South Shore area leaders who support the merger. The commission should withdraw its finding, concludes Partners, and not send the proposed merger to the state attorney general for further regulatory review.
Finding someone to care for an ill or aged relative at home can be challenging. Sorting through the options can be time-consuming, and the need to find help may arise during a crisis, when decisions must be made quickly. Hoping to help consumers make those choices — and to help themselves stand out in a competitive field — some home health agencies are seeking voluntary accreditation by independent organizations. "This market is crowded," said Margherita C. Labson, executive director of the home care program at the Joint Commission, one of the major health care accreditation organizations. "These companies had no credible way of distinguishing themselves as better than others in the marketplace."
Consumer-run health insurance cooperatives, which were included in the Affordable Care Act to stimulate competition and lower prices, have been stymied by the insurance industry and a lack of publicity, industry and health care experts say. The consumer-operated and run insurance companies, called co-ops, are often funded by government loans. Cooperatives can sell their policies through the state and federal health insurance exchanges where Americans can buy coverage. The co-ops have been created by consumer groups, doctors, membership associations — such as for small businesses — and other non-profit organizations with the idea that they will vote on a board made up of the co-op's enrollees in the first year.
Despite highly touted improvements to Healthcare.gov's functionality, the site many Americans are using to sign up health coverage under the Affordable Care Act still has crucial cybersecurity weaknesses, experts testified on Capitol Hill Thursday. Witnesses said that nothing has changed since security failings were first brought to light shortly after the website's glitch-plagued launch back in October. "Healthcare.gov is not secure today," said David Kennedy, head of the computer security firm TrustedSec LLC, one of a several security experts to testify before the House Science, Space and Technology Committee on Thursday.
When Alva Alvarez gets sick, she buys over-the-counter medicine from the grocery and takes as much as she can until she feels better. The mother of five resorts to this because she can't afford a visit to the doctor to figure out what's ailing her. Although scenarios like this are supposed to disappear as millions of Americans become newly insured under the national healthcare law, Alvarez's situation isn't likely to improve and could get worse. The San Bernardino resident represents the biggest — and mostly invisible — group of people left out of the Affordable Care Act: immigrants in the country illegally. Concerned by this, state Sen. Ricardo Lara (D-Bell Gardens) proposed Jan. 10 that such immigrants be allowed to get health insurance through a program such as Medi-Cal.