Content tagged with 'Medicare/Medicaid' | back to all topics
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A Patient's Perspective on the High Cost of Cancer Drugs
PREPARED PATIENT BLOG | October 21, 2014 | Andrew Schorr
Many cancer therapies now cost over $100,000 a year. Obviously, this expenditure is not sustainable for the majority of patients. At age 64, I am approaching Medicare coverage. Will I have the 20 percent co-pay to shoulder? As more people survive cancer and remain on ongoing medicines, the U.S. has to have a fair and open discussion about the cost of these medicines...
Shopping for a Medicare Advantage Plan — Once Again!
PREPARED PATIENT BLOG | October 15, 2014 | Trudy Lieberman
I have just done something I said I would never do: shop for a Medicare Advantage plan to cover my gaps in Medicare. The usual flyers and brochures from sellers of Medicare Advantage plans began to arrive in the mail with their enticing sales pitches, and one nearly fooled me. Short of having a Medicare representative on the phone, you're stuck in an information swamp. No wonder studies show that beneficiaries are not eager to shop around even if they can get a new policy with a smaller monthly premium...
Home Health, Palliative Care, Hospice: What's the Difference and Who Needs Them?
PREPARED PATIENT BLOG | October 6, 2014 | Janet Bollig
I recently spoke with a gentleman with a significant illness whose main goal is to stay home. He decided to utilize our skilled home health services and home medical equipment. Over time, he transitioned into our palliative care program and currently is in our hospice program. Here is information on what these services are and who may benefit from them...
Expanding Medicaid Increases Rural Health Care Access and Use
HBNS STORY | October 2, 2014
A new study in Health Services Research reveals that expanding Medicaid to cover more adults boosts health care access and use in rural populations.
The Harm to Patients From Two-Tiered Generic Drugs
PREPARED PATIENT BLOG | September 24, 2014 | Trudy Lieberman
As we head into health insurance enrollment season, which opens in November, consumers/patients will face yet another challenge in selecting the best health plan...
Another Strategy in the Health Care Reimbursement Game
PREPARED PATIENT BLOG | September 17, 2014 | Trudy Lieberman
American health care has become a gigantic game board with players of all sorts strategizing to win. Winning, of course, means getting more money from payers...
Seeing the Government's Star Ratings Is One Thing, Believing Them Is Another
PREPARED PATIENT BLOG | September 9, 2014 | Trudy Lieberman
Just a few years ago it seemed that advocates for health care transparency had scored a big victory. The Centers for Medicare and Medicaid Services (CMS) announced that they would rate nursing homes by awarding five stars to the best and fewer stars to lower-quality facilities. It turns out, though, that five-star nursing homes may not be delivering five-star quality...
Seniors Face Barriers to Critical Dental Care
HBNS STORY | August 26, 2014
Poor oral health can have a negative impact on seniors’ overall health and well-being, but for many, there are significant barriers to visiting a dentist, finds a new report in the American Journal of Health Behavior.
An Advantage for Medicare Patients or Just for Health Plans?
PREPARED PATIENT BLOG | August 20, 2014 | Trudy Lieberman
That the government overpays sellers of Medicare Advantage plans is well known in Beltway circles, even if much of the public remains unaware…
Self-Reported Health Information Predicts High-Need Medicaid Patients
HBNS STORY | August 19, 2014
Just three types of simple self-reported health measures can predict which Medicaid-eligible adults are more likely to access intensive and costly health services over the next year, a new study in Health Services Research suggests.
Medicare Changes Lower Hospital Use
HBNS STORY | August 5, 2014
A recent study in Health Services Research based on 15 years of hospital data suggests that cuts in Medicare prices under the Affordable Care Act may slow the growth in overall hospital spending.
Patient-Centered Medical Homes Reduce Costs
HBNS STORY | July 31, 2014
As the number of patient centered medical homes has increased, a new report in the journal Health Services Research finds the model offers a promising option to reduce health care costs and utilization of some health care services.
What's Wrong With Health Insurance Policies That Cover Less?
PREPARED PATIENT BLOG | July 9, 2014 | Trudy Lieberman
Insurance companies and a group of senators headed by Alaska Democrat Mark Begich think they have a great idea for getting more young people to sign up for health insurance...
Stop the War on the Emergency Room (Fix the System Failure)
PREPARED PATIENT BLOG | July 8, 2014 | Nick Dawson
The ED is convenient, it's open 24 hours, it does not require an appointment. So when the stomach bug or kitchen accident gets the best of you at 9:00 pm, and your doctor's office is closed, where are you going to go? And, yet, we still chide people – via reporting, casual comments and the communication of health systems – for using the ED for "non-emergent" needs. What I'd like to see is more hospitals flinging open the doors of their EDs and saying, "We'll take you, any time, for any reason, and you won't wait long or pay an arm and a leg"...
Seamless Health Insurance Coverage Still Illusory
PREPARED PATIENT BLOG | June 30, 2014 | Trudy Lieberman
For ages we've all known that the U.S. health insurance system works splendidly for those who have good employer-provided coverage, slide smoothly into Medicare when the time comes and seldom get sick. But evidence is beginning to trickle in that this seamless pathway for some people who've signed up for Obamacare insurance may be more illusory than real...
Beware Those 'Average' Premium Increases – or Decreases!
PREPARED PATIENT BLOG | June 24, 2014 | Trudy Lieberman
Never before have I seen such intense interest from the press about health insurance rates, normally considered a snoozer of a story. For the public, this may be a good thing. If the stories are done well, consumers might learn something about the mix of factors that go into determining the premiums they will pay. But in the last couple of weeks, some stories have been downright misleading...
Pushing Back Against the High Price of Prescriptions
PREPARED PATIENT BLOG | June 17, 2014 | Trudy Lieberman
Are we finally doing something about the high prices of prescription drugs? Maybe. At the end of May, the Washington-based National Coalition on Health Care launched "Sustainable Rx Pricing," a campaign to "spark a national dialogue" about the high cost of drugs. Will it work?
A Doctor's Strategies Helped Mom Pay for Meds
PREPARED PATIENT BLOG | May 19, 2014 | Narine Wandrey
Bewildered, panicked and disheartened, I watched my mother's eyes dart back and forth as she read the pharmacy's prescription cash price list, knowing she could not possibly afford her monthly medicines. We drove home, not saying a word, but I knew she was deeply distraught. When we arrived, she began cutting each tiny elliptical or rounded tablet into halves and quarters...
Insurers Reap Rewards of Medicare Advantage Plans
PREPARED PATIENT BLOG | April 22, 2014 | Trudy Lieberman
A couple weeks ago, the Obama administration handed sellers of Medicare Advantage plans an increase in government payments for next year. While this may seem like a good thing for the 16 million beneficiaries who have MA plans, it may not be good for Medicare as a whole.
Community Demographics Linked to Hospital Readmissions
HBNS STORY | April 10, 2014
Nearly 60 percent of the variation in hospital readmission rates appears to be associated with a hospital’s geographic location, finds a new study in Health Services Research.
On Each Other's Team: What We Can Learn by Listening to Older Adults
PREPARED PATIENT BLOG | April 10, 2014 | Chris Langston
If there is a population in which we have the biggest opportunity to see improvements in both cost and quality of care outcomes, it is older Americans. The debate on how best to deliver effective primary care has gone on a long time, sometimes frustratingly so, but it has almost never included a crucial constituency: older adults. The John A. Hartford Foundation is pleased to help change that...
The Medicaid Gap Hits Home
PREPARED PATIENT BLOG | April 8, 2014 | Trudy Lieberman
A few days before the recent deadline for Obamacare sign-ups, I visited with one of the exchange navigators in Colorado, a state that expanded its Medicaid program and is working hard to enroll uninsured residents. This visit got me thinking of the millions of other people who live in states where they can't get access to Obamacare because they are too poor and yet are also not eligible for Medicaid...
A Phone Call from a Pharmacist Can Reduce Some Hospital Admissions
HBNS STORY | April 10, 2014
Pharmacist-patient telephone consultations appear to reduce hospitalizations in patients who are least at risk, finds a new study in Health Services Research.
Costs Complicated Dad's Cancer Care
PREPARED PATIENT BLOG | March 31, 2014 | Laura Sander
"I walked in a person, and out a cancer patient," my dad said as we filed home. Crossing this threshold, we found ourselves on the other side of medicine – the side on the exam table or gurney, as opposed to the one standing over it. In time, it became clear we were running out of money...
Online Ratings Don't Help Patients Compare Hospitals
HBNS STORY | March 18, 2014
Despite having access to online ratings, patients can’t distinguish the quality or performance of one hospital from another, finds a new study in Health Services Research.
Better Benefits Help Medicaid Recipients Quit Smoking
HBNS STORY | March 6, 2014
Expanded smoking cessation benefits offered under the Affordable Care Act (ACA) should give more people the opportunity to quit, finds a new study in the American Journal of Preventive Medicine.
'Me' Versus 'We' in Obamacare
PREPARED PATIENT BLOG | February 25, 2014 | Trudy Lieberman
The Obama administration and Affordable Care Act supporters have not bothered to explain how the law includes cross-subsidization, missing an opportunity to talk about the "we" aspects of the law. As one 58-year-old woman put it: "The chances of me having a child at this age is zero. Why do I have to pay an additional $5,000 a year for coverage that I will never, ever need?" Here's how it works...
Backlash Against Narrow Provider Networks Begins
PREPARED PATIENT BLOG | February 18, 2014 | Trudy Lieberman
Seniors are starting to realize that fewer doctors and hospitals may be available to them if they select a Medicare Advantage plan. Restricting these choices – in theory – is a way to control the price of health care. There's just one problem: Consumers still want to choose their doctors or stick with the ones they've got...
Why Low-Income Seniors Fail to Get Help Paying for Health Care
PREPARED PATIENT BLOG | February 11, 2014 | Trudy Lieberman
A couple weeks ago, the Medicare Rights Center, a well-known New York-based advocacy group, released a report card showing that seniors on Medicare are struggling to pay for their health care. This finding brings up an important question: Why aren't seniors using the variety of state and federal programs that have been set up to help people in this situation?
Do Patients Care How Much Money Their Doctors Make?
PREPARED PATIENT BLOG | January 28, 2014 | Trudy Lieberman
I am all for transparency when it comes to health care. So when Medicare announced a few weeks ago that it would begin to tell the public how much doctors are paid to treat Medicare patients, my first thought was "hooray." Still, I keep returning to the question: What will the data do for the average person?...
Hospitals Serving Elderly Poor More Likely to Be Penalized for Readmissions
HBNS STORY | January 7, 2014
Hospitals that treat more poor seniors who are on both Medicaid and Medicare tend to have higher rates of readmissions, triggering costly penalties, finds a new study in Health Services Research.
Lack of Access Still to Blame
PREPARED PATIENT BLOG | January 7, 2014 | CFAH Staff
What's the key to reducing costly emergency room visits and readmissions? People who lack convenient access to a health care provider, with or without insurance, return to the emergency department or hospital out of need and desperation...
More Funding for Community Health Centers Improves Access to Care
HBNS STORY | January 2, 2014
Increased federal funding for community health centers has helped low-income adults get access to primary and dental care, according to a new study in Health Services Research.
Advice for People New to Health Insurance (Part 4): How Much Will Health Care Services Cost?
PREPARED PATIENT BLOG | December 26, 2013 | CFAH Staff
In part four of our series, we look at a few ways to estimate the cost of your care ahead of time so you can make the best choice for you and your loved ones. Our 'Be a Prepared Patient' resources offer trusted websites and tips to get started...
Advice for People New to Health Insurance (Part 2): Medicare and Medicaid Explained
PREPARED PATIENT BLOG | December 24, 2013 | CFAH Staff
In part two of our series, we look at the difference between Medicare and Medicaid. Our 'Be a Prepared Patient' resources can help you figure out if you qualify for either of these or other special health care programs...
Advice for People New to Health Insurance (Part 1): Getting Covered
PREPARED PATIENT BLOG | December 23, 2013 | CFAH Staff
In part one of our series, we look at the basics of picking a health insurance plan that's right for you, your family or a loved one. Our 'Be a Prepared Patient' resources can help you find the best coverage at the best price for your health needs...
Is Shopping for an Exchange Policy an Impossible Task?
PREPARED PATIENT BLOG | December 18, 2013 | Trudy Lieberman
Last week at a New York City meeting of the Association of Health Care Journalists, Elisabeth Benjamin, a vice president of the Community Service Society, tried to explain the New York health insurance exchange to a group of skeptical journalists who had more than a passing familiarity with the topic...
What I Expect From the Medicare Program
PREPARED PATIENT BLOG | December 16, 2013 | Jeff Goldsmith
After half a lifetime of following the Medicare program, on October 1, 2013, I became a Medicare beneficiary. I'm part of the leading edge of baby boomers joining the program, ten thousand a day. Here are some reflections upon joining...
A Better Health System for Frail and Disabled Elders
PREPARED PATIENT BLOG | December 9, 2013 | Ken Covinsky
Let's stop telling the public that exercising and eating blueberries are guarantees for avoiding frailty and disability. Let's start talking about how to maintain our quality of life as we age and inevitably encounter health problems.
Where, Oh Where Are Those Insurance Summaries for Consumers?
PREPARED PATIENT BLOG | December 3, 2013 | Trudy Lieberman
Buying health insurance through the state shopping exchanges was supposed to be a breeze — like buying an airline ticket from Travelocity. But it isn’t, and the reason why has nothing to do with the technical glitches of HealthCare.gov...
The Great Canadian Experiment to House the Homeless
PREPARED PATIENT BLOG | November 13, 2013 | Trudy Lieberman
At Home/Chez Soi, a Canadian program for the mentally ill, is built on the concept that providing housing is the first order of business. An approach that reinforces the truism that good health is more than swallowing the latest wonder drug.
What Are Medicare and Medicaid?
PREPARED PATIENT RESOURCE | Pay for Your Health Care
Learn more about the U.S. government’s health insurance programs for older adults and people with low-incomes and resources.
How Much Will Your Health Care Cost?
PREPARED PATIENT RESOURCE | Pay for Your Health Care
It can be hard to figure out how much your health care will cost ahead of time. Here are some tips for preparing for the cost of your procedures.
Political Football Season Starts for Medicare
PREPARED PATIENT BLOG | August 28, 2013 | Trudy Lieberman
It’s the silly season again for Medicare. It comes around whenever a political campaign is about to begin as it is for next year’s mid-term elections….Politicians love to play ball with benefits for seniors.
Who’s Left Out of Obamacare?
PREPARED PATIENT BLOG | August 14, 2013 | Trudy Lieberman
The main purpose of health reform, the president said at his press conference last Friday, was to provide health insurance to people at affordable rates…Whether that coverage will be affordable or comprehensive for families remains to be seen.
The Cost of Missing Health Care Prices
PREPARED PATIENT BLOG | August 12, 2013 | Conversation Continues
People continue to struggle finding information on how much health care services cost. Toni Brayer, Barbara Bronson Gray and Ray Burow weigh in.
Haggling for Health Care
PREPARED PATIENT BLOG | July 2, 2013 | Naomi Freundlich
I’m not a big fan of bargaining and my half-hearted attempts to get a better price for a used car, garage sale find or contractor’s service have been mostly unsuccessful. There’s always that nagging feeling that the seller is laughing with delight once I’m gone, thinking, “I really pulled one over on that rube!” And so it has come as somewhat of a shock to me that medical care has become the new garage sale, as far as haggling goes.
Nursing Homes with More Black Residents Do Poorly
HBNS STORY | June 25, 2013
Nursing homes with higher proportions of Black residents do worse financially and deliver lower-quality care than nursing homes with few or no Black residents, finds a new study in Health Services Research.
Are We Finally Getting Closer to Price Transparency?
PREPARED PATIENT BLOG | May 8, 2013 | Trudy Lieberman
The revelations by the Centers for Medicare and Medicaid Services on Wednesday that hospitals vary widely in what they “charge” for the same procedure—sometimes as much as 10 or 20 times more than Medicare reimburses—confirms what health policy wonks have known for a long time. There’s no consistency in pricing for health care services…
Is “Guaranteed Coverage for Life” in the Cards for Medicare Seniors?
PREPARED PATIENT BLOG | May 1, 2013 | Trudy Lieberman
A few days ago, Empire Blue Cross Blue Shield sent me one of those Medigap sales brochures that seniors usually expect during the fall open enrollment season.
How the President’s Medicare Proposals Affect Seniors’ Pocketbooks
PREPARED PATIENT BLOG | April 16, 2013 | Trudy Lieberman
The president’s budget proposals released last week call for more seniors to pay more money for their Medicare benefits. While the president’s plan to require beneficiaries to pay higher premiums came as no surprise to Washington insiders, it probably was to people who will feel the pinch.
Those Confusing EOBs…Once Again!
PREPARED PATIENT BLOG | February 27, 2013 | Trudy Lieberman
Let’s face it. Despite all the rhetoric about health care transparency, most health care providers really don’t want patients to know the price of their products and services.
Comparative Effectiveness Research: Bill Vaughan of the National Committee to Preserve Social Security and Medicare
PREPARED PATIENT BLOG | October 17, 2012 | Bill Vaughan
When you look at what can be done to save Medicare with this growing aging population, what do you do? One of most important things to do is to quit paying for things that don't work or don't work very well.
Safety Net Health Centers Fill In Urban Gaps
HBNS STORY | July 19, 2012
Urban areas that are segregated by race, ethnicity or income have more Federally Qualified Health Centers (FQHC), which provide primary care services for disadvantaged populations, despite an adequate supply of private sector physicians, reveals new findings published in Health Services Research.
Assisted Living Options Grow, Nursing Home Occupancy Declines
HBNS STORY | May 23, 2012
A new study finds an association between an increase in assisted living options, which provide older adults with an array of services such as help with everyday tasks in homelike settings, and a decline in nursing home occupancy. This shift in delivery of care has both positive and negative implications for seniors.
Health Reform's First Casualty
PREPARED PATIENT BLOG | October 27, 2011 | Trudy Lieberman
The Obama administration has dealt a mighty blow to one part of the health reform law by effectively killing off the CLASS Act, which was to be a baby step in the development of a national program to pay for long-term care.
Safety Net Hospital Closures Hit Poor, Uninsured Hardest
HBNS STORY | September 19, 2011
When safety net hospitals close or switch from not-for-profit to for-profit status, certain vulnerable groups suffer disproportionately, a new study finds.