Even with insurance, Mass. residents often can’t afford care
By Felice J. Freyer - Boston GlobeNearly all Massachusetts adults have health insurance, but being insured is no guarantee patients can afford health care or even find someone to provide it, according to a survey released Wednesday.
Despite the state’s landmark health care overhaul, the report found, cost and access remain problems for a significant share of residents.
Medicare Proposal Takes Aim at Diabetes
by Robert Pear - NYT
WASHINGTON — The Obama administration plans on Wednesday to propose expanding Medicare to cover programs to prevent diabetes among millions of people at high risk of developing the disease, marking the sixth anniversary of the Affordable Care Act with the prospect of a new benefit, federal officials said.
Sylvia Mathews Burwell, the secretary of health and human services, is scheduled to announce the proposal at a Y.M.C.A. here. Under the plan, Medicare would pay for certain “lifestyle change programs” in which trained counselors would coach consumers on healthier eating habits and increased physical activity as ways to prevent Type 2 diabetes, formerly called adult onset diabetes. Such programs have been found effective in people with a condition known as prediabetes, meaning that they have blood sugar levels that are higher than normal but not high enough to be considered diabetes.
Soaring prescription prices cause a nasty divorce in the healthcare market
by Michael Hiltzik - LA Times
Money always ranks high among the reasons for divorce. In the failing
marriage between Anthem Blue Cross and Express Scripts, it's
reasons one through 15 billion. That's how many dollars the party of the
first part thinks its been cheated by the party of the second part.
For those who missed the wedding announcement back in 2009, the first is the nation's second-largest health insurance company and his (or her) partner is the nation's biggest pharmacy benefits management firm, or PBM. They seemed to be in a marriage made in heaven, until household finances strained the relationship to the breaking point. To be precise, the issue is the run-up in pharmaceutical prices, which Express Scripts was tasked with moderating but -- according to Anthem -- failed to deliver or even pocketed the savings.http://www.latimes.com/business/hiltzik/la-fi-hiltzik-anthem-express-20160322-snap-htmlstory.html
For those who missed the wedding announcement back in 2009, the first is the nation's second-largest health insurance company and his (or her) partner is the nation's biggest pharmacy benefits management firm, or PBM. They seemed to be in a marriage made in heaven, until household finances strained the relationship to the breaking point. To be precise, the issue is the run-up in pharmaceutical prices, which Express Scripts was tasked with moderating but -- according to Anthem -- failed to deliver or even pocketed the savings.http://www.latimes.com/business/hiltzik/la-fi-hiltzik-anthem-express-20160322-snap-htmlstory.html
Maine sought to put struggling health insurance co-op into receivership
The Bureau of Insurance hoped to stem Community Health Options' losses, partly by ending as many as 17,000 policies, but a federal agency rejected the temporary plan.
by Edward D. Murphy - Portland Press Herald
http://www.pressherald.com/2016/03/23/state-sought-to-put-struggling-health-co-op-into-receivership/
Maine’s largest Obamacare insurer to raise rates
PORTLAND, Maine — Maine Community Health Options, the state’s largest individual health insurer, expects to raise rates for its 2017 plans after closing 2015 in the red.
The financial troubles have put the insurer under closer watch from state regulators, who said they tried to stop enrollment in the fall to stem projected premium losses estimated at $43 million for 2016.
The company posted a total $74 million shortfall last year, which includes the $43 million it will set aside to cover projected losses in the year ahead. In 2014, it was the only co-op in the country to turn a profit from its plans offered under the new Affordable Care Act.
Michael Gendreau, a spokesman for the insurer, said the insurer is not going to close and that state regulators’ scrutiny after 2015’s financial hit “does not affect our member’s coverage whatsoever.”
Our View: Insurance co-ops should have federal backing
The still-new organizations have not been given the time or financial support they need.
Editorial - Portland Press Herald
In just a year, Community Health Options went from being a national success story to a company on the verge of insolvency. It would be tempting to blame that change on local management, particularly the decision to give hefty pay raises to its top executives.
But if overpaying executives killed health insurance companies, there wouldn’t be any still in business.
Our View: Maine prescription compromise won’t heal flawed health care system
Limits on opioid dispensing here are a good start, but the addiction epidemic grows out of national policies.
PNHP Report Card: 2016 Selected Presidential Candidates’ Health Proposals
By Physicians for a National Health Program
Updated March 22, 2016
Updated March 22, 2016
How to Stop the Bouncing Between Insurance Plans Under Obamacare
by Dhruv Cruller - NYT
In a fight between nurses and doctors, the nurses are slowly winning
More states are allowing nurses to provide all the kinds of care they learned about in school.
Amid a flurry of legislation to pass in the final days of spring state legislative sessions last week, nurses won two more victories in a long war for independence.
For decades, most of the country has required physician oversight for nurses to conduct certain procedures, and especially to prescribe drugs. But that’s slowly changing, as the nation’s health-care needs rise, and nurses fight for the right to practice everything they learned in school.
The most recent wins came in West Virginia and Florida, where after many years of trying, lawmakers passed measures freeing up “advanced practice” nurses — those with more graduate education than just a nursing degree — to administer a wider range of care and prescribe most drugs without having to maintain a relationship with a physician.
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