High-cost hepatitis C treatments hits big insurer

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$100-dollar bill inside a capsuleBy Jay Hancock
KHN

UnitedHealth Group spent $100 million on hepatitis C drugs in the first three months of the year, much more than expected, the company said Thursday.

The news helped drive down the biggest insurance company’s stock and underscores the challenge for all health care payers in covering Sovaldi, an expensive new pill for hepatitis C.

“We’ve been surprised on the volume — the pent-up demand across all three businesses” — commercial insurance and private Medicare and Medicaid plans, said Daniel Schumacher, chief financial officer of UnitedHealth’s insurance wing. Continue reading

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Obama announces 8 million have enrolled in Marketplace plans

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In a White House news conference Thursday, President Barack Obama announced that 8 million people have enrolled in health plans through the health insurance exchanges created by the Affordable Care Act and that 35 percent of people who enrolled on the federally run healthcare.gov marketplace are under age 35.

A transcript follows. Continue reading

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Tobacco use among Asian and Pacific Islanders varies widely

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Cigarette SmokeBy Stephanie Stephens
Contributing Writer
Health Behavior News

While past research has shown that, as a whole, Asian Americans and Native Hawaiian/Pacific Islanders living in the U.S. smoke at a lower rate than the national average, a new study in American Journal of Health Behaviorfinds significant differences in tobacco use when analyzed by specific Asian or Pacific Islander ethnicity.

Dramatic social, demographic and behavioral differences exist between Asian American (AA) and Native Hawaiian/Pacific Islander (NHPI) groups, said lead study author Arnab Mukherjea, Dr.P.H., M.P.H., who was a postdoctoral scholar at the Center for Tobacco Control Research & Education at the University of California, San Francisco at the time of the study. Continue reading

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Nearly 350,000 in Washington have enrolled in private plans since Oct. 1

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ACA health reform logoSince October 1, when the open enrollment began under the Affordable Care Act, 324,900 people in Washington state have signed up for private insurance, according to updated enrollment information reported by health insurers to the Office of the Insurance Commissioner this week.

This number includes 178,981 enrolled outside the Exchange and 146,000 enrolled inside the Exchange, Washington Healthplanfinder, as of March 31. The total is expected to increase as late enrollments through the Exchange are processed and reconciled.  Continue reading

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Health news headlines — April 17

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State disciplines healthcare providers — April 16th

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Seal_of_WashingtonPeriodically Washington State Department of Health issues an update on disciplinary actions taken against health care providers, including suspensions and revocations of licenses, certifications, or registrations of providers in the state.

The department also suspends the credentials of people who have been prohibited from practicing in other states.

Information about health care providers is also on the agency’s website.

To find this information click on “Provider Credential Search” on the left hand side of the Department of Health home page (www.doh.wa.gov).

The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998.

This information is also available by calling 360-236-4700.

Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Here is the April 16th update issued by the Washington State Department of Health: Continue reading

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Health law’s free contraceptive coverage saved US women $483 million in 2013

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Twenty-dollar bill in a pill bottleThe Affordable Care Act provision that requires insurers to cover contraceptives with zero co-pay saved US women $483 million last year — $269 on average, according to a new report from the IMS Institute for Healthcare Informatics.

Overall, 24 million more prescriptions for oral contraceptives were filled in 2013, the first full year the health law’s contraceptive provision was in force, compared to 2012.

“The share of women with no out-of-pocket cost for these forms of birth control increased to 56% from 14% one year ago,” the report says.

To learn more read: 

IMS Institute for Healthcare Informatics. Medicine use and the shifting costs of healthcare: A review of the use of medicines in the United States in 2013. April 2014. LINK:

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States target asthma care as number of patients grow

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Washington is one of the few states that has made the Asthma and Allergy Foundation of America honor roll of states that have adopted comprehensive public policies supporting people with asthma, food allergies, anaphylaxis risk and related allergic diseases in schools.

Illustration of the lungs in blueBy Michael Ollove
Stateline Staff Writer

April 16, 2014 

In a valley wedged between the Mississippi and Missouri rivers, St. Louis often finds itself beset by a stationary air mass that only a severe storm of some kind can dislodge.

St. Louis is also an industrial city with high humidity, so it’s no wonder it usually makes the list of worst places for asthmatics to live.

But the state has also pioneered advances in addressing asthma treatment and costs. Two years ago, the Missouri legislature became the first to allow schools to stock quick-relief asthma medications for emergencies.  Continue reading

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FAQ on ACOs: Accountable Care Organizations, explained

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Accountable care organizations are practically a footnote in the health law, but advocates say they’ll be critical to holding down the cost of care while improving quality

By Jenny Gold
KHN Staff Writer
APR 16, 2014

One of the main ways the Affordable Care Act seeks to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form networks which coordinate patient care and become eligible for bonuses when they deliver that care more efficiently.

A doctor walking through a mazeThe law takes a carrot-and-stick approach by encouraging the formation of Accountable Care Organizations (ACOs) in the Medicare program. Providers make more if they keep their patients healthy. About four million Medicare beneficiaries are now in an ACO, and, combined with the private sector, more than 428 provider groups have already signed up.

An estimated 14 percent of the U.S. population is now being served by an ACO. You may even be in one and not know it.

While ACOs are touted as a way to help fix an inefficient payment system that rewards more, not better, care, some economists warn they could lead to greater consolidation in the health care industry, which could allow some providers to charge more if they’re the only game in town.  

ACOs have become one of the most talked about new ideas in Obamacare. Here are answers to some of the more common questions about how they work:  Continue reading

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Health news headlines — April 16th

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Patients often win if they appeal a denied health claim

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The health law set national rules for appealing a denied claim, and advocates say consumers should take advantage of them

rejected

Image: sundesigns

By Pauline Bartolone, Capital Public Radio

APR 14, 2014

This KHN story was produced in collaboration with NPR

SACRAMENTO, Calif. — Federal rules ensure that none of the millions of people who signed up for Obamacare can be denied insurance — but there is no guarantee that all health services will be covered.

To help make sure a patient’s claims aren’t improperly denied, the Affordable Care Act creates national standards allowing appeals to the insurer and, if necessary, to a third-party reviewer.

For Tony Simek, a software engineer in El Mirage, Ariz., appealing was the only way he was able to get additional treatment for sleep apnea.  Continue reading

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Focus one exchange enrollment overlooks millions who bought private insurance

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ACA health reform logoBy Annie Feidt, APRN

Want to know how many people have signed up for private insurance under Obamacare? Like the health care law itself, the answer is exceedingly complicated.

The Obama administration is tracking the number of plans purchased on the federal website healthcare.gov and on the state marketplaces, and this month reported that It had exceeded expectations by signing up 7.5 million people. In addition, federal officials have said that 3 million people have enrolled in Medicaid since October.

But often overlooked is that enrollment in private health plans outside the marketplaces is also booming. The federal government hasn’t been counting the number of people who buy new plans directly from insurance carriers — and that number could be substantial. Continue reading

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Health news headlines — April 15th

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When naming unwise treatments, doctors overlook lucrative procedures

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Twenty-dollar bill in a pill bottleBy Jordan Rau
KHN Staff Writer

APR 14, 2014

This KHN story was produced in collaboration with the 

 

When America’s joint surgeons were challenged to come up with a list of unnecessary procedures in their field, their selections shared one thing: none significantly impacted their incomes.

The American Academy of Orthopaedic Surgeons discouraged patients with joint pain from taking two types of dietary supplements, wearing custom shoe inserts or overusing wrist splints after carpal tunnel surgery.

The surgeons also condemned an infrequently performed procedure where doctors wash a pained knee joint with saline.

“They could have chosen many surgical procedures that are commonly done, where evidence has shown over the years that they don’t work or where they’re being done with no evidence,” said Dr. James Rickert, an assistant professor of orthopedic surgery at Indiana University. “They chose stuff of no material consequence that nobody really does.” Continue reading

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