health care

Healthcare
3:28 am
Tue September 23, 2014

Avoid The Rush! Some ERs Are Taking Appointments

Michael Granillo and his wife Sonia await treatment at an emergency room in Northridge, Calif.
Anna Gorman, Kaiser Health News

Originally published on Sat September 27, 2014 12:19 pm

Three times in one week, 34-year-old Michael Granillo returned to the emergency room of the Northridge Hospital Medical Center in Southern California, seeking relief from intense back pain. Each time, Granillo waited a little while and then left the ER without ever being seen by a doctor.

"I was in so much pain, I wanted to be taken care of 'now,' " says Granillo. "I didn't want to sit and wait."

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Power Of Price
8:51 pm
Fri September 19, 2014

Mt. Sinai CEO's Broken Transparency Promise

Credit freedigitalphotos.net

In May 2013, Mt. Sinai Medical Center CEO Steve Sonenreich promised on WLRN's Sunshine Economy to make public the contracted reimbursement rates his hospital receives from insurance companies. He didn't know his facility already had agreed to keep those prices secret.

Sonenreich now says he was unaware of non-disclosure agreements Mt. Sinai Medical Center has with insurance companies regarding those contracted prices.

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Power Of Price
7:11 pm
Thu September 18, 2014

The Troubles With Negotiating Health Care Pricing In The Dark

The email to Mr. Smith detailing his negotiated prices for his August hernia operation. He paid in full prior to the surgery.
Credit Tom Hudson

Paying $850 per month for health insurance for a family of three is not out of the ordinary, even when that insurance comes with a $5,000 annual deductible. But it become just too much for a man we'll call Mr. Smith, from Hollywood.

Mr. Smith is 52 years old and works in the marine industry. He's lived in Hollywood since 2000. He requested we don't use his first name due to privacy concerns, but he wasn't shy about his recent hernia surgery.

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Power Of Price
4:04 pm
Thu September 18, 2014

In Health Care, Price Transparency Varies By State

The All-Payer Claims Database Council--one of the organizations Denise Love works with--tracks which states have developed or are working on APCDs.
Credit All-Payer Claims Database Council / www.apcdcouncil.org/state/map

Richard Coll isn’t exactly racing out the door to get a colonoscopy, but at 63-years-old, he knows he shouldn’t put it off any longer. One thing stands in the way, though: getting a price for the procedure, up front.

“Shopping around, and everyone I asked, whether it was the doctor or an institution like a hospital, they looked at me like I was crazy,” says Coll.

He lives in Manchester, New Hampshire, where he makes his living as a self-employed property manager. The job awards him flexibility, but not health coverage.

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Power Of Price
6:58 pm
Tue September 16, 2014

The Secret Prices Of Health Care: How What You Don’t Know Can Cost You

Health care pricing is shrouded in secrecy.
Credit Marcolm / freedigitalphotos.net

When Uwe Reinhardt tries to explains the Gordian Knot of hospital pricing to his health care economics students at Princeton University, he has a go-to metaphor:

“It's almost like blindfolding people, shoving them into Macy's and saying, ‘buy — efficiently — for a shirt.’ Well you come out with a pair of shorts,” says Reinhardt.

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News
2:32 am
Tue September 16, 2014

Miami Grower Challenges Pot Licensee Rule

Gov. Scott and the Florida Legislature earlier this year legalized a strain of non-euphoric marijuana.
Credit Los Angeles County Sheriff's Department / lacounty.gov

Almost before the ink was dry, the state's largest nursery is protesting a rule floated by health regulators setting up the framework for Florida's new medical-marijuana industry.

Miami-based Costa Farms filed a challenge Monday in the state Division of Administrative Hearings, questioning the proposed use of a lottery to pick five licensees --- one in each region of the state --- to grow, process and distribute the non-euphoric strains of cannabis legalized by the Legislature and Gov. Rick Scott this spring.

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Power Of Price
2:00 am
Tue September 16, 2014

When Transparency Isn't Always Enough: A Conversation On Health Care Pricing

Credit freedigitalphotos.net

In our Power of Price series, we’ve been exploring how the secrecy shrouding health care pricing can raise costs — the cost of the care itself and the cost to employees who get their insurance through work.

There’s a movement to make those prices more transparent. More than a dozen other states have started something called an “all-payer claims database.”

These databases track what actually gets paid for care at different hospitals by various insurers. They can be used to analyze the true cost of health care and make it public.

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Power Of Price
1:57 am
Mon September 15, 2014

Health Care Pricing Is Complicated. Here's A Beginner's Guide.

If only health care financing was this straightforward.
Credit Pakorn / freedigitalphotos.net

Figuring out the real price of health care is complicated — even if you've already paid your bills. You can hear just how complicated it is here:

And if health care pricing wasn’t convoluted enough, it’s hard to talk about it without running into some conversation-stopping jargon. Words that mean one thing to the rest of the English-speaking world can mean something completely different in health care — like a “charge” that isn’t the same as the price.

To help clarify, here’s a glossary of common terms in the world of health care finance:

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The Sunshine Economy
6:55 pm
Fri September 12, 2014

Power Of Price: A Special Hour On Health Care's Complexity, Secrecy And Cost In South Florida

Patients can know what health care costs them, but can they really know what it costs?
Credit phasinphoto / freedigitalphotos.net

  Almost a year and a half ago, Mt. Sinai Medical Center CEO Steve Sonenreich pledged on WLRN to make public what insurance companies pay his hospital.

He later told us that because of non-disclosure agreements between the hospital and the region’s insurance companies, he legally couldn’t share that information after all.

It turns out these secrecy agreements are standard practice between South Florida insurers and hospitals.

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Health News Florida
11:51 am
Tue September 9, 2014

Adult Obesity Rate Inches Up in FL

Originally published on Fri September 5, 2014 9:24 am

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The Florida Roundup
11:10 am
Fri August 1, 2014

The Florida Roundup: Doctors Banned From Asking About Guns

Under the 2011 Firearms Owners' Privacy Act, doctors who ask about a patient's gun ownership could risk losing their license to practice medicine.
Credit Timmy Gunz / Creative Commons/Flickr

    

On The Florida Roundup: It’s been called the “physician gag rule” or a law that pitted “docs versus glocks.” And a recent federal appeals court upheld the 2011 state law prohibiting doctors from inquiring about patients' gun ownership. The Florida law was the first of its kind in the U.S.

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The Florida Roundup
10:59 am
Fri July 25, 2014

The Florida Roundup: Taking The "Affordable" Out Of The Affordable Care Act?

Health insurance subsidies are on shaky ground after two contradictory court rulings.
Credit cooldesign / freedigitalphotos.net

This week on the Florida Roundup, we're exploring why subsidies to help nearly a million Floridians buy health insurance are on shaky ground.

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Health Care
9:36 pm
Tue July 22, 2014

Dueling Appeals Court Decisions Leave Obamacare Subsidies In Limbo

Credit Amenic181 / freedigitalphotos.net

Some Obamacare insurance subsidies were struck down by one court but upheld by another during a tumultuous day for the Affordable Care Act. One of the rulings is a direct threat to the tax credits that have recently helped thousands of Floridians buy health insurance.

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Health
5:04 pm
Wed July 16, 2014

South Florida Health Center Receives $2 Million Grant Under the Affordable Care Act

Thirteen medical residents started their training on July 1.
Credit Community Health of South Florida

Community of Health of South Florida received a $2 million grant to train primary physicians. The center is the first in the state to receive funding from the Health Resource and Services Administration.  

Thirteen medical residents started a training program this month to meet the needs of many patients newly insured under the Affordable Care Act.

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Health Care
3:22 pm
Wed July 16, 2014

Florida First In Medicaid Coverage For Mentally Ill

Florida is rolling out new Medicaid plans specifically for people with severe mental health diagnoses.
Credit Creative Commons of Charles Bell's Anatomy of the Brain, c. 1802 / Flickr user Shaheen Lakhan

  This month, Florida became the first state to offer a Medicaid plan dedicated to people who are diagnosed with severe mental health disorders.

It’s part of a larger move by the state’s Medicaid officials to move coverage towards a managed care system. It means one organization takes care of and coordinates all of a person’s health care needs: no more separate dental, vision, and internal medicine plans.

Mental health issues are almost twice as prevalent among Medicaid recipients than in the general population.

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