Tag Archives: Healthcare

Sanford-Fairview merger is a symptom of a larger problem, MinnPost, Kip Sullivan. Minnesota has a hospital merger problem. But it didn’t begin last fall when Sanford Health and Fairview Health Services announced their intention to merge. It began in the 1980s and accelerated in the 1990s in response to mergers of unprecedented size among health insurance companies. By the early 2000s, Minnesota’s hospital sector had been transformed into a few...

Have Medicare Advantage plans been over coding? According the MedPac 2022 report for year 2020 they have been. The funds of which come out of Medicare funding. The amount of which was an ~$12 billion for 2020 alone. But it is not just 2020, “Medicare Advantage has Overcharged FFS Medicare by Billions for Years,” Angry Bear. “Aggregate Medicare payments to Medicare Advantage plans” have never been lower than FFS Medicare spending. MedPac 2022 Chapter...

This is a story or at least I tried to make it into more like one. The longer version can be found at the Propublica link. I took parts of it linking them together using mostly their wording and blending it with mine. Money and Corporate influence still wins . . . The U.S. Never Banned Asbestos. These Workers Are Paying the Price, ProPublica, Kathleen McGrory and Neil Bedi A few miles up from Niagara Falls was the OxyChem’ facility. The plant’s...

What fired me up this morning? I retrieved a post sitting in the trash. A News clipping posted by Fred Dobbs considered to be dangerous by the Angry Bear system. I retrieved it and it sits at the end of my commentary on Wisconsin. The clipping is a nice history lesson on Wisconsin. Mine is editorial. I (we) lived in Wisconsin for almost a decade in the city built on an Isthmus. When I would fly home from some consulting manufacturing/supply chain...

If you have read Medicare Advantage uses Algorithms to block care for Seniors, Angry Bear, (STAT Investigation, Casey Ross and Bob Herman) you might think this is a relatively new phenomena in healthcare. At the bottom of the post you will find a link to another commentary. Why did I put another commentary site there as written by different authors? Number one, so I would not forget it. Number two, to make a point of showing the use of algorithms...

Taking a one day break from the more technical stuff. I ran across this story a couple(?) maybe more days ago. The first thing which came to mind was the Tuskegee Syphilis Study as conducted by the PHS’ Center for Disease Control in Atlanta (AP). Some will say this is not as serious, they were prisons. they agreed to take the drugs, etc. The point here is we used our power to administer what they thought would be of help to them the same as...

More on the practices of Medicare Advantage plains and also ACA, Medicaid and Medicare. The practice being delayed prior authorizations, the amount of time it takes, and the resulting tragedies. CMS proposes prior authorization rule changes for health plans, BenefitsPRO, Lauren Sausser Starting in 2026, a proposed CMS rule would require plans to respond to a standard request within seven days. This is instead of the current 14 days, and within...

Kip Sullivan has been writing about the issues with Medicare Advantage. I have joined with Kip in bringing the issues of Medicare Advantage to the forefront. Angry Bear has featured Kip and I have added to the dialogue. This next commentary details how Healthcare Insurance, mostly Medicare Advantage has been using artificial intelligence in the form of an algorithm to limit treatment or deny coverage. STAT Investigation has been providing the detail...

An early attempt as to explaining the drug market. It is a start and I have to program myself to understand what is said. Brief and down to earth with pictures too! Much of this is a C&P with some editing. Much credit to the authors for giving us this opportunity to understand. Welcoming a New Year with new drug prices, 46brooklyn Research This year has proven to be little different from past years. In keeping with tradition (for as long...

This article is easy reading exploring some the differences and why people may choose one plan over the other plan. Attached is also a Commonwealth Fund article with more detail. Medicare Plan Commissions May Steer Beneficiaries to Wrong Coverage, MedPage Today, Cheryl Clark. Agents and brokers selling Medicare plan coverage often steer their clients to a Medicare Advantage (MA) plan because it earns them a higher commission compared with a...