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Industry Updates

This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.

Doctors Urged To Move Beyond BMI Alone As A Health Measure

Roughly 200 years ago, a Belgian mathematician and statistician named Adolphe Quetelet, seeking to characterize “normal man,” observed that adults’ body weight in kilograms is roughly proportional to the square of their height in meters – a measurement that came to be referred to as the Quetelet index. It wasn’t until 1972, when physiologist Dr. Ancel Keys proposed it as ...

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The Coverage Reshuffle: Health Insurance Projections & Health Care Spending, 2023-33

The end of COVID continuous coverage requirements for Medicaid and the expiration of enhanced Obamacare premium subsidies after 2025 will affect both health-care spending and sources of coverage. The Congressional Budget Office in late May released its latest estimates for Americans younger than age 65.

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Compromise Struck To Preserve Obamacare’s Preventive Care Mandate

The Texas conservatives challenging Obamacare’s preventive care mandate have reached a tentative compromise with the Justice Department that preserves free coverage for a range of services — from syphilis tests to depression screenings.

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Denials Of Health Insurance Claims Are Rising: Are Algorithms To Blame?

Millions of Americans in the past few years have run into this experience: filing a health care insurance claim that once might have been paid immediately but instead is just as quickly denied. If the experience and the insurer’s explanation often seem arbitrary and absurd, that might be because companies appear increasingly likely to employ ...

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Insurers Clamping Down On Doctors Who Prescribe Ozempic For Weight Loss

The letters from the insurance company arrived in recent weeks, bearing a warning to health care providers who prescribe Ozempic, a diabetes drug that has gained popularity as a weight-loss treatment. “The Special Investigations Unit has completed a comprehensive review of your prescription and professional claims,” said one letter to a Missouri doctor from insurer ...

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CMS Announces New Decade-Long Primary Care Payment Experiment

The Biden administration on Thursday announced a 10-year experiment aimed at improving the way Medicare and Medicaid pay for primary care. Why it matters: The effort, dubbed the Making Care Primary Model, will ease safety-net and independent primary care providers — including federally qualified health centers — into getting paid for the value of services they provide, rather than the volume. Remember: The ...

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For Providers, Consolidation May Be Key To Staying Afloat, Experts Tell Senators

Consolidation has been the norm across healthcare for some time, and for those in the industry that want to stay independent, watching their peers unite can be intimidating. Chris Thomas is the president and CEO of Community Hospital, an independent hospital located in Grand Junction, Colorado. He told a key Senate panel on Thursday that ...

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The Great Grift: How Billions In COVID-19 Relief Aid Was Stolen Or Wasted

Fraudsters used the Social Security numbers of dead people and federal prisoners to get unemployment checks. Cheaters collected those benefits in multiple states. And federal loan applicants weren’t cross-checked against a Treasury Department database that would have raised red flags about sketchy borrowers.

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A Windfall in Health Insurance Rebates? It’s Not as Crazy as It Sounds

Former Democratic Sen. Al Franken tweeted recently that Americans will receive “$1.1 B in rebates from health insurance companies this year” because of a provision he wrote into the Affordable Care Act.

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To Fill Offices, Google Issues Ultimatum While Salesforce Tries Charity

The executives of corporate America are stepping up efforts to get workers back into the office, using a combination of threats and incentives to get employees to give up the work-from-home lifestyle they adopted in the first years of the covid-19 pandemic. For over a year, Google has asked workers to come in three days a ...

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