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How expensive are knee replacements in the 20 largest US cities?

On February 16, 2017
By Laura Dyrda

Total knee replacement surgery price varies by geographic region.

The total price includes hospital services, physician services and anesthesia, according to Healthcare Blue Book. The hospital services assume a four day admission and the physician fee is for the procedure and routine postoperative care. The anesthesia price assumes average surgery time of 2 1/2 hours.

Here are the prices for the 20 largest cities based on population from the 2010 U.S. Census.

CMS projects next decade of health expenditures: 5 takeaways

On February 16, 2017
By Ayla Ellison

National health spending is expected to grow at an average annual rate of 5.6 percent from 2016 through 2025, with expenditures projected to hit $5.5 trillion in 2025, according to new estimates from CMS’ Office of the Actuary published Wednesday in Health Affairs.

Although congressional Republicans are working on a plan to repeal and replace the ACA, it isn’t possible to determine the impact of potential policy changes on health spending and health insurance at this time. Therefore, the national health expenditure projections are constructed using current law and do not assume potential legislative changes over the projection period.

Here are five takeaways from the CMS report.

IRS loosening enforcement of ObamaCare mandate

On February 15, 2017
By Peter Sullivan

The IRS says it will not reject tax forms from people who fail to answer whether they had health insurance, a sign of loosening up on enforcement of ObamaCare’s individual mandate.

Tax forms ask people whether they had health coverage in the previous year to determine whether they need to pay a financial penalty under ObamaCare’s mandate to have coverage.

Read more…

Humana Plans to Pull Out of Obamacare’s Insurance Exchanges

On February 15, 2017
By REED ABELSON

Humana announced on Tuesday that it would no longer offer health insurance coverage in the state marketplaces created under the federal health care law, becoming the first major insurer to cast a no-confidence vote over selling individual plans on the public exchanges for 2018.

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Land of 10,000 Stories: Cop and Homeless Veteran

On February 15, 2017
wkyc.com

CLEVELAND – Big medical bills are a problem for many Americans.
But few services deliver a bigger surprise hit than a life-saving ride on an air ambulance.
Here in Northeast Ohio, we found dozens of court battles with one of the nation’s largest private, for-profit air ambulance companies.
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Empower Your Plans!

On February 14, 2017
By: Adam Russo, Esq.The United Benefit Advisors recently came out with the average cost of premiums for health insurance in every state.  Massachusetts has an average monthly premium for single people of $554 and $1320 for family plans.  How is my company, The Phia Group, able to have premiums of $120 for individuals and $220 for families with no co-pay for generic drugs, no deductibles, and no co-pay for urgent care? Simply put, because our employees are educated about the cost of care and are incentivized to identify cheaper, quality options.  We can do the same for you, but you need to act.  Empower your plans!Ab

From the Waiting Room: Health Insurance

On February 9, 2017
By: Ron Peck. Esq.

I recently found myself in a doctor’s waiting room.  I overheard another patient arguing with the office administrator.  The gist of it was that he was being balance billed for an amount exceeding what insurance paid.  His anger was directed at the insurance.  “How can they say what is medically necessary?  Only the doctor can say what’s necessary.” A nurse emerged, and to her credit, I heard her explain that insurance defines medical necessity as the least costly option likely to resolve the medical issue.  She then explained that the doctor provided the patient with options, and he chose the option that was more intensive. That another, less thorough treatment might have resolved the issue. Well done, I thought. Yet, to my horror, the patient screamed, “Insurance!  Crooks!  How dare they decide what’s necessary!  They aren’t my doctor.”

10 Things to Know About Athena Health

On February 6, 2017
By Jessica Kim Cohen

Here are 10 things to know about Watertown, Mass.-based athena health, one of the largest publicly traded companies in the world providing medical record, revenue cycle, patient engagement, care coordination and population health services.

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For Some, the Affordable Care Act Is a Lifesaver. For Others, a Burden.

On February 1, 2017
By SONA PATEL and FAHIMA HAQUE

After President Trump and the Republican-controlled Congress vowed to repeal and replace the Affordable Care Act, millions of Americans have been left wondering about the future of their health care. We asked readers to tell us how they would be affected if the law were repealed. These are some of their stories, condensed and edited for clarity.

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Diabetes patients sue 3 drug companies over alleged fraudulent insulin pricing

On February 1, 2017
By Kelly Gooch

Eleven diabetes patients are suing several drug companies for alleged collusion on insulin pricing, reports The Washington Post.

The lawsuit was filed Monday in U.S. District Court in Massachusetts against Indianapolis-based Eli Lilly, French pharmaceutical company Sanofi and Danish drugmaker Novo Nordisk. The suit claims the companies systematically increased insulin list prices for years in an alleged fraudulent-pricing scheme that left patients with “crushing out-of-pocket expenses,” according to the article. The companies, the lawsuit says, increased the insulin list prices to expand their discounts without lowering the overall price tag, according to the report.

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