Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Uncategorized' Category

ACA and Commercial Underwriting

The ACA (aka Oabamacare) has a “guaranteed issue” provision that requires insurers to offer coverage to all individuals who apply.  The ACA also prohibits insurers from taking into account patients’ pre-existing conditions when setting premiums and mandates the coverage of certain services, such as preventive services and an annual check-up. This sounds like a great idea.  Everyone can get insurance; […]

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Some good news

The Ebola epidemic in Liberia has ended according to the WHO.  The NY Times reports: “The outbreak of Ebola virus disease in Liberia is over,” the W.H.O. said in a statement read by Dr. Alex Gasasira, the group’s representative to Liberia, in a packed conference room at the emergency command center in Monrovia, the capital. […]

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Tuesday Links

How to write a resume (advice from da Vinci). Additional cost of ACA dependent care coverage. Marketing vs. Science. Faster drug reviews at the FDA? Mental health and the NFL draft.

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Quotation of the Day

“We are what we pretend to be, so we must be careful about what we pretend to be.” -Kurt Vonnegut

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FDA’s Breakthrough Therapy Designation

Many of you may have heard of the FDA’s Fast Track Development program. For drugs that treat a serious medical condition and address an unmet medical need, the FDA will provide expedited review. In fact, the FDA has 4 different accelerated review processes: Breakthrough Therapy Priority Review Accelerated Approval Fast Track These other 3 programs, […]

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Medicare starts using prior authorization

Included within the many changes to physician payment in HR2, is one provision that may surprise people; a subset of Medicare physicians will be required to receive prior authorization to conduct imaging services. Beginning with 2017, and in consultation with stakeholders, the Secretary will identify ordering professionals with low adherence to applicable [appropriate use criteria] […]

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Friday Links

Measuring healthcare prices. Negative findings. The overdose. The end of the independent doc? Does parenting skills make a difference: yes vs. no.

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Insurance expansions reduce ER Use

One promise of the Affordable Care Act (ACA) was that by giving more people access to health insurance, patients would be more likely to have a regular source of care and would be less likely to use the emergency room. Rick Kronick–the Director of the Agency for Healthcare Research and Quality (AHRQ) and a member […]

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Insurers: Non-profit or For-profit?

The answer is “no” according to the California Franchise Tax Board. California tax authorities have stripped Blue Shield of California, the state’s third largest insurer, of its tax-exempt status in California and ordered the firm to file returns dating to 2013, potentially costing the company tens of millions of dollars. Why did California claim that […]

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King v. Burwell

On Wednesday, the Supreme Court will begin hearing arguments in King v. Burwell.  The plaintiffs argue that the Affordable Care Act (i.e., Obamacare) does not permit subsidies to individuals if they receive health insurance from a federally-run health insurance exchange. Why would they argue this?  Well, Section 1401(a)(2)of the law says that subsidies would go only to […]

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