Tricha Shivas’ Post

(USA TODAY) - "Nearly Half Of Insured Americans Get Surprise Expenses In Medical Bills, Survey Finds." The survey, from the Commonwealth Fund in New York City, found 45% of working-age consumers last year were erroneously billed, however, fewer than half of those patients challenged their health insurance company or a medical provider about the unexpected charges. Finally Access To AFFORDABLE Health Insurance Plans At: HI4E.org #SurpriseMedicalBilling #NoSurprisesAct #TrumpHospitalPriceTransparencyRules #TrumpHealthPlans #BidenHealthcare #TrumpDrugPriceControls #TrumpHealthcareReforms #ObamacareLimitedDoctors #TrumpSurpriseMedicalBillsRule #HospitalBillings #HI4E.Org #SurpriseMedicalBills #MedicalBilling #TrumpMedicalTransparencyPricingRules #TrumpCanadianDrugImportRules #HealthcareCosts #USAToday #HealthInsuranceForEveryone #ObamacareLimitedProviderNetworks #ObamacareHighOutOfPocketExpenses #HealthAndLifeSolutionsLLC #ObamacareHigherDeductibles

New findings from The Commonwealth Fund’s 2024 Biennial Health Insurance Survey show concerning gaps in health coverage: nearly one-fifth of adults were uninsured at some point this past year, and 23% of insured individuals had health insurance but had plans that left them underinsured and potentially unable to afford the health care they need. With high out-of-pocket costs often making care inaccessible, these insights underscore the need for policy interventions to ensure that #healthinsurance of all types enables affordable access to timely care.     Learn more about our key recommendations for affordable, accessible, equitable health care ⤵️

A big win for #raredisease patients and families today! The Centers for Medicare & Medicaid Services #CMS just released a final rule to crack down on 'junk insurance' plans. #Healthinsurance coverage is a key determinant in timely access to care. But, clearly, not all health insurance is created equal. One option that tends to be particularly misleading for consumers: Short-term, limited-duration insurance (STLDI) - often referred to as 'junk insurance'. STLDI is primarily designed to cover temporary gaps in insurance as beneficiaries transition from one source of health insurance coverage to another; yet, until today they could be renewed for years. STLDI plans are NOT subject to the Affordable Care Act’s (#ACA’s) critical consumer protections including guaranteeing coverage for people with #preexistingconditions and prohibiting discrimination based on health status, age, or gender. This can leave consumers not or insufficiently covered for needed healthcare they assumed was covered. Today's rule limits the duration of STLDI to be truly short-term, and ensures these plans are fairly marketed and provide clear, easy-to-understand disclosures so consumers can make truly informed choices. Today marks important progress for the #raredisease community and patients around the country! Read more here: https://lnkd.in/egbBgbpC

We are continuing to track health insurance coverage using Household Pulse Survey Data to monitor the #MedicaidUnwinding. Check out the update along with our researchers' insights at the link below. https://lnkd.in/dYcNwDPG #householdpulsesurveydata #surveydata #medicaid #medicaidunwinding #publichealth #insurancecoverage #householdpulsesurvey

An important study released yesterday by The Commonwealth Fund highlights the needs of the underinsured, now 23% of the population. We'd add one more recommendation to their list of ways to improve plan design— 💡 Bundle or build in a patient-centered payment design feature to all plans. Many may not know that 60M Americans will have a flexible payment solution in their Medicare Part D, ACA, or employer-sponsored plan in 2025 that allows them to spread costs over time without the burden of interest or fees. This feature ensures that even when costs are unknown, plan members have Certainty of Affordability, aka confidence that whatever the cost, they will be able to design a payment plan that works for their budget. Proud to be working with forward thinking payers and employers like Dawn Beaudin of Hyatt and Angela Evans, CBP of Advantage Solutions who are bringing certainty of affordability through Paytient to their employees. Thank you The Commonwealth Fund for this important research, especially authors: Robyn Rapoport, Rob Manley, and Paula Armendariz of SSRS; and Anthony Shih, MD, MPH, Corinne Lewis, MSW, Arnav Shah, Chris Hollander, Paul Frame, Jennifer Wilson, Kristen Kolb, MPH, RN, Carson Richards, and Evan D. Gumas.

State insurance departments are responsible for enforcing laws that protect consumers from unlawful denials of insurance coverage. Unfortunately, many of these agencies lack the resources to effectively investigate and prevent these denials. Researchers, consumer advocates, and even some regulators agree that these agencies are ill-equipped to handle their responsibilities. State insurance departments oversee all types of insurance, including health plans purchased on HealthCare.gov, but they employed fewer people last year than they did a decade ago. Making sure plans remain solvent is a priority, but protecting consumers from denials often takes a backseat. As a result, agencies often only investigate health insurance denials when policyholders or their families complain. This puts an unfair burden on those already dealing with difficult circumstances. One study found that people with plans purchased on HealthCare.gov appealed less than 1% of the time. More needs to be done to ensure that state insurance departments have the resources they need to protect consumers from unlawful denials of insurance coverage. #healthplans #healthinsurancedenials #populationhealthmanagement #healthcarefinance #healthinsurers #healthinsuranceappeals #healthinsurance

Here's today's Healthcare News: 🚨 CMS Proposes Rule to Tackle Health Insurance Scams on ACA Marketplace 🛑 The Centers for Medicare & Medicaid Services (CMS) is cracking down on deceptive health insurance brokers who enroll consumers in low-value plans without informed consent. A new proposed rule would give CMS the power to suspend brokers and agents who fraudulently sign people up for health plans, often switching patients from better plans without their knowledge. Key Points: CMS aims to block brokers who pose a risk to consumers by enrolling them in scammy ACA plans. Complaints are rising about consumers being switched to low-value plans without consent. The proposed rule adds stricter consent requirements for brokers. CMS is accepting public comments on the rule until Nov. 12. 🛡️ Stay vigilant and informed during this open enrollment period! #ACA #HealthInsuranceScams #HealthcareFraud #CMS #MCG #SBMU #SBM101 #ConsumerProtection #OpenEnrollment https://lnkd.in/g8HMp6S7

Even with health insurance, many U.S. adults face unexpected medical bills and coverage denials for doctor-recommended care. Our new survey finds that close to half of insured, working-age adults received a medical bill or copayment in the past year for a service they thought should have been covered by insurance, and nearly 1 in 5 were denied coverage for a doctor-recommended service. The research also points to ways patients can advocate for themselves — challenging coverage denials and medical bills often works (50 percent and 38 percent of the time, respectively). However, about half of people who didn’t challenge billing errors didn’t know they could. Where can we go from here? The study authors note policy shifts that could better protect consumers, including: o  Enhanced monitoring of claim denials o  Stronger accountability measures for insurers o  Increased consumer awareness and support Learn more: https://lnkd.in/e9fHrxwn

How health insurance companies use artificial intelligence to avoid paying for treatments which doctors recommend for patients, in order to cut spending. EviCore markets itself to insurance companies by promising a 3-to-1 return on investment — that is, for every $1 spent on EviCore, the insurer will pay out $3 less on medical care for their insured patients.

What trends are currently shaping the business of health insurance? #healthcaretrends #healthcareinsurance #healthcarebusiness #healthcarenews #healthcare2024