Joseph Andrey was 5 years old in 1927 when his impoverished mother sold him to the manager of a popular vaudeville act. He was 91 last year when he told the story again, propped in a wheelchair in the rehabilitation unit of a nursing home where it seemed as though age and infirmity had put a different kind of price on his head.
Craning his neck, he sought the eyes of his daughter, Maureen Stefanides, who had promised to get him out of this place. “I want to go home, to my books and my music,” he said, his voice whispery but intense.
He was still her handsome father, the song-and-dance man of her childhood, with a full head of wavy hair and blue eyes that lit up when he talked. But he was gaunt now, warped like a weathered plank, perhaps by late effects of an old stroke, certainly by muscle atrophy and bad circulation in his legs.
Now she was determined to fulfill her father’s dearest wish, the wish so common among frail, elderly people: to die at home.
But it seemed as if all the forces of the health care system were against her — hospitals, nursing homes, home health agencies, insurance companies, and the shifting crosscurrents of public health care spending.
Her father had been discharged by a hospital to a nursing home like this one, supposedly for rehabilitation, so many times that even she had lost count. The stays, long or short, had only left him weaker, harder to care for at home with a shrinking allotment of help from aides and more prone to the infections that sent him back to the hospital.
This time she had fiercely opposed his being discharged to anywhere but home, a small walk-up apartment in Manhattan that her parents shared for half a century before her mother’s death. Yet over her protests and his own, he had been transferred here anyway, to Jewish Home Lifecare in Morningside Heights, a sprawling institution an hour from where she lived. Later, he would ask, “Are you sure you didn’t put me here?”
“No matter what I do, they want you in a nursing home,” Ms. Stefanides told him, promising the placement would be temporary. “I think they’re making money off you.”
Records would show that her father’s case let the nursing home collect $682.48 a day from Medicare, about five times the cost of a day of home care.
By now Ms. Stefanides was a veteran of battles with the health care system, but it still baffled her. A public-school teacher, she could not afford out-of-pocket home care, and though her father qualified for both Medicaid and Medicare, the flow of money seemed to bypass what he actually wanted at the end of life.
Even hospice was limited. Now mostly for-profit, hospice companies would provide supervision and visits at home a few times a week through Medicare if a doctor certified that Mr. Andrey had only six months to live. The hidden catch: He would lose all Medicaid home care, the daily help he needed to be home at all.
As the story of Joseph Andrey’s last months shows, many Americans will end their lives in surroundings that only add to their misery. Those who hoped to die in their own beds are often forced into nursing homes, some of which mistreat patients. Even if home care is arranged, it too can be substandard, even abusive. And those who hope for government guidance can findunreliable information.
What can be done to ensure that the elderly get the care they want and need, particularly in their dying days?
When Jennifer Hopper raced to the emergency room after her husband, Craig, took a baseball in the face, she made sure they went to a hospital in their insurance network in Texas. So when they got a $937 bill from the emergency room doctor, she called the insurer, assuming it was in error.
But the bill was correct: UnitedHealthcare, the insurance company, had paid its customary fee of $151.02 and expected the Hoppers to pay the remaining $785.98, because the doctor at Seton Northwest Hospital in Austin did not participate in their network.
“It never occurred to me that the first line of defense, the person you have to see in an in-network emergency room, could be out of the network,” said Ms. Hopper, who has spent months fighting the bill. “In-network means we just get the building? I thought the doctor came with the E.R.”
Patients have no choice about which physician they see when they go to an emergency room, even if they have the presence of mind to visit a hospital that is in their insurance network. In the piles of forms that patients sign in those chaotic first moments is often an acknowledgment that they understand some providers may be out of network.
ut even the most basic visits with emergency room physicians and other doctors called in to consult are increasingly leaving patients with hefty bills: More and more, doctors who work in emergency rooms are private contractors who are out of network or do not accept any insurance plans.
When legislators in Texas demanded some data from insurers last year, they learned that up to half of the hospitals that participated with UnitedHealthcare, Humana and Blue Cross-Blue Shield — Texas’s three biggest insurers — had no in-network emergency room doctors. Out-of-network payments to emergency room physicians accounted for 40 to 70 percent of the money spent on emergency care at in-network hospitals, researchers with the Center for Public Policy Priorities in Austin found.
“It’s very common and there’s little consumers can do to prevent it and protect themselves — it’s a roll of the dice,” said Stacey Pogue, a senior policy analyst with the nonpartisan center and an author of the study.
Number of Latinos with insurance coverage surges under healthcare law By NOAM N. LEVEY
The federal healthcare law has dramatically increased coverage among Latinos, according to a new report that provides a comprehensive look at the effects of the Affordable Care Act on a historically underinsured community.
Overall, the percentage of Latinos ages 19 to 64 lacking health coverage fell from 36% to 23% between summer 2013 and spring 2014.
That parallels a broader increase in coverage that has taken place since insurance marketplaces opened last fall and states began expanding Medicaid under the healthcare law.
The overall uninsured rate for U.S. adults under 65 plummeted from 20% to 15% in the same period, according to the Commonwealth Fund, a nonprofit group that studies U.S. and global health systems. Other surveys have shown similar declines.
But many of the health law's supporters were concerned that the expansion in coverage would not reach Latinos and other groups that have traditionally struggled to access regular medical care.
"The Affordable Care Act appears to be working for millions of Latinos who, as a group, have long faced the nation's highest uninsured rates," said the Commonwealth Fund's Michelle Doty, the report's lead author. "These substantial improvements will mean better health and healthcare for millions of people."
Underinsured Enrollees Flood Community Health Centers
Some low-income consumers who bought bronze plans with low premiums but high deductibles are discovering they still can't afford health care and are turning to the community health centers which cannot turn anyone away. Meanwhile, a study finds insurance costs for small businesses are lower through the SHOP exchanges, and South Dakota lifts a $2M cap on employees' lifetime health costs.
Modern Healthcare: Underinsured ACA Enrollees Strain Community Health Centers
Obamacare enrollees are straining the finances of community health centers around the country, some health center leaders say. The issue is that many lower-income patients with insurance coverage through the federal and state exchanges bought bronze-tier plans with lower premiums but high deductibles, coinsurance and copayments and no federal cost-sharing subsidies. When these patients face high out-of-pocket costs for care that falls below the deductible, they can't afford it. So the centers are subsidizing that care by offering them means-tested sliding-scale fees. When the centers, which are not allowed to turn away patients for inability to pay, try to get the insurers to pay, the claims are usually denied, and the centers have to write it off as uncompensated care (Dickson, 9/25).
The Washington Post: Obamacare’s Small Business Exchanges Offer Cheaper Health Coverage, Study Shows
During the lead-up to the rollout of the health care law a year ago, President Obama was adamant that new insurance marketplaces for small businesses would provide a start-to-finish online shopping experience for employers, where they could compare and buy plans with the click of a mouse. In addition, he said, by placing rates from different insurers side-by-side and offering tax breaks, the marketplaces would provide less expensive plans that what had been available to small companies. ... It appears, based on one new study, that the exchanges are delivering [on the second promise] (Harrison, 9/24).
Kaiser Health News: Debate Grows Over Employer Plans With No Hospital Benefits
As companies prepare to offer medical coverage for 2015, debate has grown over government software that critics say can trap workers in inadequate plans while barring them from subsidies to buy fuller coverage on their own. At the center of contention is the calculator -- an online spreadsheet to certify whether plans meet the Affordable Care Act’s toughest standard for large employers, the ‘minimum value’ test for adequate benefits (Hancock, 9/26).
The Associated Press: State Lifts $2M Cap On Employee Health Care Costs
South Dakota can no longer limit how much it pays out in health care coverage over the lifetime of state employees, but officials say for now that shouldn't raise costs. Laurie Gill, the commissioner of the state's Bureau of Human Resources, briefed legislators this week on how changes mandated by the Affordable Care Act will affect the state's health plan. The Affordable Care Act prohibits health care plans from capping the amount of benefits employees incur over a lifetime. South Dakota had capped lifetime expenses at $2 million per individual, meaning any health care costs incurred over that amount weren't covered. The change means the state could end up paying out more, but Tom Steckel, the state's director of employee benefits, said in the past it's been rare for an employee to reach the $2 million limit. Steckel said his office has been looking into how many workers surpassed the cap. So far, he said, he wasn't aware that any had reached it last year (Burbach, 9/25).
This story is part of a partnership that includes WNYC, NPR and Kaiser Health News. It can be republished for free. (details) Special thanks to WNYC's Data Team.
It was September 2012 and it was life-long smoker Paula Faber's third cancer in a decade, but she did not hesitate.
"She was going to fight it every inch of the way," says her husband Ron Faber.
By August 2013 after much fighting, Paula Faber died at age 72. Ron Faber now regrets the intervening 11 months of chemotherapy, radiation, painkillers and side effects that reduced his wife to 67 pounds of frayed nerves. Instead, the pain could have been managed so she could focus on the quality of life.
"I would have rather have had a really okay four-and-a half months than this endless set of treatments," the stage actor said.
As they confronted Paula's terminal diagnosis, the decision the Fabers made is among the most difficult anyone can make. But it turns out that in the New York metropolitan region, patients opt for aggressive treatment much more often than other Americans.
The reasons they do this are many, but most experts agree that it has less to do with the unique characteristics and desires of people in New York and New Jersey than the health care system and culture that has evolved here.
The result: More people dying in the hospital, often in an intensive care unit on a ventilator or feeding tube; more doctor visits leading to tests, treatments and drug prescriptions; and more money being spent by the government, private insurers and patients themselves.
Specialists at the Dartmouth Healthcare Atlas maintain that one of the main drivers of this phenomenon is quantity: people end up in hospitals here so often, they say, because this region simply has a lot of hospital beds.
"One of the truisms of healthcare is that whatever resources are available, or whatever beds are built, they tend to get filled," Goodman says.
A second driver is that every region has its own medical "culture," and the one in New York is built around highly trained specialists and sub-specialists who see it as their job to cure illness. Dr. Diane Meier says that means, "that if there's a cancer it needs chemotherapy, that if there's heart failure, it needs a procedure."
IN medical circles, they call it the Hollywood Heart Attack. You’ve seen it: grimace of agony, clutching of chest, sudden collapse, the whole purple-prose panoply.
For my husband, Harold Lear, a doctor who became a patient just that suddenly, it was the first stop in a five-year medical odyssey, one cardiac crisis after another, ending with the ultimate stop in 1978.
Through all the years that followed, it remained my assumption that the Hollywood Heart Attack was it: the paradigm, the norm, the way heart attacks are supposed to happen.
I was relieved of this assumption two years ago, when I had one of my own.
Mine went like this: altogether well one moment, vaguely unwell the next; fluttery sensation at the sternum, rising into the throat; mild chest pressure; then chills, sudden nausea, vomiting, some diarrhea. No high drama, just a mixed bag of somethings that added up to nothing you could name. Maybe flu, maybe a bad mussel, maybe too much wine, but the chest pressure caused me to say to my second husband, “Could this be a heart attack?” “Of course not,” he said. “It’s a stomach bug.”
Still, that pressure, slight but there, nagged at me. I called my doctor and reported my symptoms. The mention of diarrhea, almost never a presenting symptom in heart attacks, skewed the picture. He said, “It doesn’t sound like your heart. I can’t say a thousand percent that it’s not, but it doesn’t seem necessary to go racing to the emergency room with the way you feel now. Just see it through and come in for an EKG in the morning.”
The pressure eased. I slept, and woke the next morning feeling well. I went for the test mainly because I had said that I would, fully expecting to be told that I was healthy. First the EKG and then the echocardiogram told a different story: a substantial heart attack, “less than massive,” my doctor said, “but more than mild.” We were both stunned.
Suddenly I found myself living in a sequel: same hospital where Hal had worked and died, same coronary unit, same cardiologist, same everything; different husband wheeling me in my wheelchair through the corridors where I had wheeled Hal in his. Ghosts in every corner.
With a stent implanted in an occluded artery, I recovered fast and was cleared to leave in four days, but a bad hospital-acquired infection kept me there four weeks — time enough for a revelatory education about women and hearts.
Surprise No. 1: The biggest killer of American women is not breast cancer, as many people believe. It is heart disease. Should I have been surprised? Of course not. The American Heart Association keeps telling us about our hearts and we keep not listening, possibly because we are so fearful of cancer that we have no fear to spare, as we lie on our beds dutifully palpating ourselves for the lumps that we pray not to find.
Our hearts kill more of us than all kinds of cancer combined.
Finding a doctor who takes Obamacare coverage could be just as frustrating for Californians in 2015 as the health-law expansion enters its second year.
The state's largest health insurers are sticking with their often-criticized narrow networks of doctors, and in some cases they are cutting the number of physicians even more, according to a Times analysis of company data. And the state's insurance exchange, Covered California, still has no comprehensive directory to help consumers match doctors with health plans.
This comes as insurers prepare to enroll hundreds of thousands of new patients this fall and get 1.2 million Californians to renew their policies under the Affordable Care Act.
Even as California's enrollment grows, many patients continue to complain about being offered fewer choices of doctors and having no easy way to find the ones that are available.
Some consumers have been saddled with huge medical bills after insurers refused to pay for care deemed out of network. These complaints have sparked a state investigation and consumer lawsuits against two big insurers.
Mary Edwards, a 63-year-old librarian in Mar Vista, was excited about a Health Net PPO she picked out last fall because it offered a wide selection of doctors at a reasonable price. But it turned out that several physicians listed on her plan didn't accept the insurance or weren't taking new patients.
"This is part of the Affordable Care Act that doesn't quite work yet," Edwards said. "This game of who's in and who's out is tiresome."
More than 80,000 medical providers are participating in Covered California next year, according to a Times analysis of health plan information. The data, current through August, were submitted to state regulators and obtained under the Public Records Act.
Altogether, the 10 insurers in Covered California have contracted with an estimated 75% of California's licensed physicians, or nearly 90% of those considered active in the state. However, many of those doctors are available in just one or two health plans.
All of these insurance networks for individual policies are subject to change and regulatory review before taking effect Jan. 1. The next open enrollment under the Affordable Care Act runs Nov. 15 to Feb. 15.
Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser Permanente dominated the first year of Obamacare enrollment in California, accounting for 94% of the individual market.
Health Net has proposed the most dramatic change for 2015, the data show. It's dumping the PPO network that Edwards and others purchased and switching to a plan with 54% fewer doctors and no out-of-network coverage, state data show.
Yet premiums for that stripped-down policy are going up as much as 9% compared with pricing for the PPO. State regulators have questioned the company's moves.
Health Net said its cutbacks were necessary to avoid even steeper rate hikes and it's confident the smaller network will be sufficient. Its separate HMO network is unchanged for 2015 after about 4,000 doctors were added this year.
The insurer is following the lead of its two rivals Anthem and Blue Shield, which opened last year with sharply limited networks.
SAN FRANCISCO — For years, Thomas Goetz had been a spirited armchair advocate of the use of digital technology and data to improve health care.
At Wired magazine, where he was executive editor, Mr. Goetz assigned and wrote articles on the subject. He organized conferences, lectured and wrote a book in 2010, “The Decision Tree,” which hailed a technology-led path toward personalized health care and better treatment decisions.
In early 2013, just as he was leaving Wired, Mr. Goetz met Matt Mohebbi, a Google engineer who shared his interest in technology and health. Their conversations continued for months, and prompted an epiphany.
“It struck me that I could help make it happen, not just write about using data to personalize and improve health care,” said Mr. Goetz, who has a master’s in public health from the University of California, Berkeley.
And so the two men founded a company, Iodine, in July 2013. Its offering, an online service for tailored drug-taking information and advice, is being introduced on Wednesday at the Health 2.0 conference here.
Iodine reflects sharply increasing interest and investment in digital health companies. Venture investment in digital health start-ups in the first half of 2014 surged to $2.3 billion, surpassing the total for all of last year, according to Rock Health, which conducts research and provides seed funding for start-ups.
The investor enthusiasm for health ventures, said Halle Tecco, managing director of Rock Health, is fueled by the belief that the health care industry is both huge and technologically backward, and thus ripe for an assault with clever software and data-driven decision-making.
Iodine joins a growing collection of health start-ups using data analysis in innovative ways, including Omada Health, Ginger.io and Propeller Health, sometimes employing sensors and smartphones to provide early warning signals about conditions like diabetes, depression and asthma.
Iodine is charting new territory with its ambitious use of Google Consumer Surveys as a research tool. With 100,000 surveys completed and more added daily, Mr. Goetz said that Iodine was building the largest survey ever taken of Americans’ drug experience, intended to help consumers and perhaps guide policy. Clinical trials to determine drug approval, by contrast, routinely involve a couple of hundred people.
Google Consumer Surveys, begun in 2012, is best known for its performance in the presidential campaign that year, being the most accurate of the Internet polls and second-most-accurate of the polls tracked by Nate Silver, editor in chief of the website FiveThirtyEight.
IT may have been the most influential magazine article of the past decade. In June of 2009, the doctor and writer Atul Gawande published a piece in The New Yorker called “The Cost Conundrum,” which examined why the small border city of McAllen, Tex., was the most expensive place for health care in the United States.
The article became mandatory readingin the White House. President Obama convened an Oval Office meeting to discuss its key finding that the high cost of health care in the country was directly tied to a system that rewarded the overuse of care. The president also brought up the article at a meeting with Democratic senators, emphasizing that McAllen represented the problem that needed to be fixed.
Five years later, the situation has changed. Where McAllen once illustrated the problem of American health care, the city is now showing us how the problem can be solved, largely because of the Affordable Care Act that Mr. Obama signed into law in 2010.
In his article, Dr. Gawande cited studies showing that patients in high-cost areas like the Rio Grande Valley, which includes McAllen, were much less likely to receive preventive services like cancer screenings or vaccines, but far more likely to be prescribed costly drugs, invasive procedures and expensive diagnostic tests. And they were not any healthier for it: Compared with places like El Paso, McAllen had worse health outcomes, despite spending twice as much per capita onMedicare.
The problem was that doctors in McAllen were responding to reimbursement incentives in the American health care system that rewarded activity rather than value. The more procedures and visits a doctor billed, the more he got paid.
The Affordable Care Act was designed to change that. One of its provisions created the Medicare Shared Savings Program, which rewards doctors for keeping their patients healthy. Participation in the program requires primary care doctors to create networks, called accountable care organizations, or A.C.O.s, to better coordinate patient care. These networks are reimbursed for delivering high-quality care below a baseline of historical Medicare costs.
A fast-growing Framingham company is responding to inquiries from federal investigators examining whether diagnostic firms improperly paid doctors who send them patients’ blood specimens to test their risk for cardiovascular disease.
Boston Heart Diagnostics Corp. said in a statement that it is “fully cooperating with the government’s information requests” in an investigation being conducted by the Department of Justice and the inspector general’s office of the Department of Health and Human Services.
The inquiry was first disclosed by The Wall Street Journal, which earlier this month reported that investigators were focusing on a Virginia company, Health Diagnostic Laboratory Inc., but also looking into a group of rival companies, including seven-year-old Boston Heart, as well as Quest’s Berkeley HeartLab, Singulex Inc., and Atherotech Diagnostics Lab.
Those companies have paid processing fees to the offices of physicians who send them blood samples that can be screened to identify patients vulnerable to conditions such as heart disease, stroke, or diabetes.
While the fees are considered reimbursement for packaging and labeling the specimens, investigators reportedly are trying to determine whether they are illegally designed to generate revenue by giving doctors incentives to order unnecessary tests.
Health insurance exchange different from single-payer
The League of Women Voters of Vermont strongly supports universal, state-supported health care for Vermont.
There seems to be a misconception that because Vermont Health Connect is having technical difficulties, administering a single-payer system will somehow be worse. There's every reason in the world to believe the opposite is true.
Under single payer, there will be:
• No need to determine the best balance of deductibles vs. premiums vs. copays.
• No need to submit personal financial data, so a complicated algorithm can determine eligibility for subsidy and how much that subsidy will be.
• No need to update that information when your circumstances change, and go through the eligibility determination again.
Everybody in, nobody out. All you need is to be a resident of Vermont.
How can that possibly be harder to administer than the exchange?
Hopkins is a member of the League of Women Voters of Vermont.
“Doctor, is it O.K. for our rabbi to visit my father?”
I was an intern on call in one of the internal medicine wards in an Israeli hospital just south of Tel Aviv. The first day of the Jewish holiday of Sukkot had just ended, and the ward was beginning to fill up with visitors who had been unable to drive until after sunset.
Looking up from what I was doing, I saw the son of one of my patients standing at the counter of the nursing station. He and I had already spoken several times that day about his 75-year-old father, who had been admitted the night before because of a stroke.
The father’s CT scan from the night before had been unremarkable, not unusual in patients whose strokes are caused by an interruption of blood flow to portions of the brain. I had explained this to the son, as well as what to expect over the next few days as his father would undergo further testing and then discharge to a rehabilitation facility. I told him that it was impossible at this early stage to predict how much function his father might recover, and cautioned against giving him anything to eat or drink until we were certain that his ability to swallow had not been affected. All of the son’s questions had been very appropriate and focused.
“Of course,” I responded, smiling and a little surprised that he had asked my permission. No one else had that evening.
Thanking me, he turned around towards the main door of the ward, located just beyond behind the nurses’ station. Bowing to the rabbi who was just out of sight, the son addressed him in the third person: “Please, may the honorable rabbi enter.” After kissing the rabbi’s hand, he straightened up and led the guest to his father’s room.
I followed them down the hall with my eyes. It was only as they were about to enter the room that I noticed that the rabbi was carrying a white chicken in his arms. Although quiet, the chicken was very much alive.
As the staff at a small Presque Isle health clinic prepared to see patients one day in July, they stopped short at their keyboards.
They soon realized they’d been locked out of the electronic health records for all of their 3,500 patients. Stuck behind a virtual wall, the records — digital medical histories detailing everything from blood pressure readings to medication lists and lab results — might as well have disappeared.
The vendor that maintained the records had taken the uncommon step of denying access because of a longstanding billing dispute with the practice, Full Circle Health Care.
CompuGroup Medical, a German firm with U.S. headquarters in Boston, showed no regard for the safety of the practice’s patients, said E. Victoria Grover, a physician assistant who runs the independent practice.
“They screwed us and I hope somehow they have to face the consequences,” said Grover, who first shared the story with The Boston Globe.
CompuGroup blocked the clinic’s 10 employees from a critical tool that medical providers rely on more than ever in treating patients. Electronic health records have been hailed as a way to improve health care by putting patient histories at clinicians’ fingertips, their adoption spurred by $30 billion in federal stimulus funds.
Doctors and nurses log nearly every interaction with patients in the records, aiming to prevent medical errors and dangerous drug interactions and better coordinate care.
Much of the debate around electronic health records has centered on their potential to improve care, patient privacy and the security of data. But possible pitfalls stemming from the legal relationships between vendors and health providers have gotten less attention.
In the wake of the rapid proliferation of electronic health records, similar disputes are likely to crop up, in Maine and across the country, according to Kate Healy, a partner in the health care group at the law firm Verrill Dana.
“I think this is probably the start of a new trend,” she said.
Eager to get the records online, vendors and providers signed contracts without always thinking far enough ahead, Healy said. Some overlooked how to proceed when things go south, she said, such as when a vendor or provider shuts down or a payment dispute arises. With more vendors jumping into the market, problems are bound to crop up, Healy said.
“When you switch vendors or terminate contracts, you’re going to have issues like those raised in this case,” she said.
At least one other health provider in Maine has been shut out of its patients’ electronic records. Earlier this year, a different vendor denied access to a small Freeport-area practice following a billing dispute, according to Gordon Smith of the Maine Medical Association. The vendor reportedly entered the practice’s office under the guise of updating or servicing the records system, then switched off the provider’s access, Smith said.
Healy said she’s working with a medical group in Massachusetts that encountered a situation similar to Full Circle’s.
It remains unclear how many health-care organizations CompuGroup serves in Maine. A company attorney didn’t respond to a request for comment from the Bangor Daily News.
(Reuters) - Your medical information is worth 10 times more than your credit card number on the black market.
Last month, the FBI warned healthcare providers to guard against cyber attacks after one of the largest U.S. hospital operators,Community Health Systems Inc, said Chinese hackers had broken into its computer network and stolen the personal information of 4.5 million patients.
Security experts say cyber criminals are increasingly targeting the $3 trillion U.S. healthcare industry, which has many companies still reliant on aging computer systems that do not use the latest security features.
"As attackers discover new methods to make money, the healthcare industry is becoming a much riper target because of the ability to sell large batches of personal data for profit," said Dave Kennedy, an expert on healthcare security and CEO of TrustedSEC LLC. "Hospitals have low security, so it's relatively easy for these hackers to get a large amount of personal data for medical fraud."
Interviews with nearly a dozen healthcare executives, cybersecurity investigators and fraud experts provide a detailed account of the underground market for stolen patient data.
The data for sale includes names, birth dates, policy numbers, diagnosis codes and billing information. Fraudsters use this data to create fake IDs to buy medical equipment or drugs that can be resold, or they combine a patient number with a false provider number and file made-up claims with insurers, according to experts who have investigated cyber attacks on healthcare organizations.
Medical identity theft is often not immediately identified by a patient or their provider, giving criminals years to milk such credentials. That makes medical data more valuable than credit cards, which tend to be quickly canceled by banks once fraud is detected.