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Too Big To Fail? Now It’s ‘Too Big To Hack’

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Thu, 18 Apr 2024 18:00:00 +0000

The Host

Mary Agnes Carey
KFF Health News


@maryagnescarey


Read Mary Agnes’ stories.

Lawmakers in Washington this week held the first congressional hearing on the Change Healthcare cyberattack, a breach that sent shock waves through the health care system as payments for care ground to a halt and left some providers in financial trouble. Republicans and Democrats alike zeroed in on how big health care conglomerations — like Change’s parent company, UnitedHealth Group — are leaving patients vulnerable.

And nearly 1 in 4 adults who lost Medicaid coverage in the past year are now uninsured, according to a new KFF survey probing the effects of what’s known as the “unwinding” of enrollments in the government insurance program for low-income people since pandemic-era protections expired.

This week’s panelists are Mary Agnes Carey of KFF Health News, Jessie Hellmann of CQ Roll Call, Sarah Karlin-Smith of the Pink Sheet, and Lauren Weber of The Washington Post.

Panelists

Jessie Hellmann
CQ Roll Call


@jessiehellmann


Read Jessie’s stories.

Sarah Karlin-Smith
Pink Sheet


@SarahKarlin


Read Sarah’s stories.

Lauren Weber
The Washington Post


@LaurenWeberHP


Read Lauren’s stories.

Among the takeaways from this week’s episode:

  • Though the Change Healthcare hearing on Capitol Hill illuminated bipartisan agreement on the perils of vertical integration in health care, lawmakers did not agree on possible solutions. Addressing consolidation, however, could remedy issues in health care beyond cybersecurity.
  • The KFF survey on the unwinding found that nearly half of those who lost coverage signed back up for Medicaid weeks or months later, a signal that those enrollees should never have been dropped in the first place. Even a temporary loss in health coverage can have serious, lingering consequences.
  • Republicans in Arizona are grappling with the fallout from the state’s newly reinstated, Civil War-era abortion law — echoing recent problems for Alabama Republicans after a state Supreme Court ruling upended access to in vitro fertilization there. Softened stances from conservative hard-liners like Senate candidate Kari Lake point to the potential negative consequences for the party in a critical election year.
  • And the Centers for Disease Control and Prevention released new information about the current measles outbreak, revealing that many of those sickened are children, as well as adults who are unvaccinated or whose vaccination status is unknown.

Also this week, Julie Rovner, KFF Health News’ chief Washington correspondent, interviews Caroline Pearson of the Peterson Health Technology Institute.

Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:

Mary Agnes Carey: KFF Health News’ “When Rogue Brokers Switch People’s ACA Policies, Tax Surprises Can Follow,” by Julie Appleby. 

Jessie Hellmann: Tampa Bay Times’ “Vulnerable Florida Patients Scramble After Abrupt Medicaid Termination,” by Teghan Simonton. 

Sarah Karlin-Smith: Stat’s “Grocers Are Pushing Legislation They Claim Would Enhance Food Safety. Advocates Say It Would Gut FDA Rules,” by Nicholas Florko. 

Lauren Weber: The New York Times’ “Chinese Company Under Congressional Scrutiny Makes Key U.S. Drugs,” by Christina Jewett. 

Also mentioned on this week’s podcast:

Credits

Francis Ying
Audio producer

Emmarie Huetteman
Editor

To hear all our podcasts, click here.

And subscribe to KFF Health News’ “What the Health?” on SpotifyApple PodcastsPocket Casts, or wherever you listen to podcasts.

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Title: Too Big To Fail? Now It’s ‘Too Big To Hack’
Sourced From: kffhealthnews.org/news/podcast/what-the-health-343-health-care-consolidation-april-18-2024/
Published Date: Thu, 18 Apr 2024 18:00:00 +0000

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Kaiser Health News

Caseworkers Coax Homeless People out of Las Vegas’ Tunnels for Treatment

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kffhealthnews.org – Angela Hart – 2024-12-23 07:00:00

SUMMARY: In Las Vegas, case manager Bryon Johnson searches the underground tunnels for homeless individuals like Jay Flanders, who suffers from health issues and substance abuse. Escaping rising housing costs and law enforcement, around 1,200 to 1,500 people live in these tunnels, which provide shelter from extreme weather but pose significant health risks, especially during monsoon season. Outreach workers emphasize the dangers of drug addiction and untreated health conditions, urging residents to seek medical care above ground. As housing costs soar, many homeless individuals, including tourists, end up in these perilous conditions, seeking cover from societal judgment and harsh weather.

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Kaiser Health News

In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M

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kffhealthnews.org – Fred Schulte, KFF Health News – 2024-12-20 16:31:00

SUMMARY: Independent Health Association of Buffalo and Betsy Gaffney, CEO of medical analytics firm DxID, have agreed to a settlement of up to $100 million to resolve Justice Department allegations of fraudulent Medicare billing for exaggerated or non-existent health conditions. Independent Health will pay up to $98 million, while Gaffney will contribute $2 million. Neither party admitted wrongdoing. The case was triggered by whistleblower Teresa Ross, highlighting issues of “upcoding” in Medicare Advantage plans. Ross, having faced repercussions for her allegations, will receive at least $8.2 million from the settlement. This case underscores the challenges of regulating billing practices in the Medicare system.

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Kaiser Health News

Employers Press Congress To Cement Health Price Transparency Before Trump’s Return

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kffhealthnews.org – Julie Appleby, KFF Health News – 2024-12-20 04:00:00

SUMMARY: Despite regulations requiring hospitals and insurers to disclose negotiated prices for healthcare services, the impact on consumer costs remains unclear nearly four years later. While the Trump administration’s initial rules and Biden’s enhancements aimed to streamline this data, compliance is inconsistent; a 2022 audit found only 63 out of 100 hospitals met requirements. Some lawmakers proposed legislation to protect these regulations amid uncertainty about Trump’s potential return to office, but efforts fell short. Experts note the complexity of the data often leaves consumers struggling to understand their actual costs, emphasizing the need for improved transparency and enforcement to facilitate informed healthcare choices.

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