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Monday, Sep 26 2022

Full Issue

Insurers Say Medicare Advantage Saves Money. Experts Say No

Stat says while the insurance industry is still trying to convince the public Medicare Advantage saves taxpayer money, experts point to federal data proving the opposite. Also: CommonSpirit Health's loss of $2 billion, a hospital chain making money off a poor neighborhood, more.

The health insurance industry is continuing its campaign to convince the public that Medicare Advantage saves taxpayers money, but experts say federal data still concludes the exact opposite 鈥 and that the program as currently designed is a drain on Medicare鈥檚 trust fund. (Herman, 9/26)

In other health care news 鈥

The Chicago-based company's performance during the fiscal year that ended June 30 compares to a聽$5.19 billion net gain during the prior 12-month period.聽Operating expenses聽were up 9% to $35.2 billion and revenue rose 2% to $33.9聽billion. CommonSpirit聽cited聽elevated labor costs, higher prices due to inflation, lower patient volumes and reimbursements that didn't keep pace with expenses as challenges. (Hudson, 9/23)

In late July, Norman Otey was rushed by ambulance to Richmond Community Hospital. The 63-year-old was doubled over in pain and babbling incoherently. Blood tests suggested septic shock, a grave emergency that required the resources and expertise of an intensive care unit. But Richmond Community, a struggling hospital in a predominantly Black neighborhood, had closed its I.C.U. in 2017. It took several hours for Mr. Otey to be transported to another hospital, according to his sister, Linda Jones-Smith. He deteriorated on the way there, and later died of sepsis. (Thomas and Silver-Greenberg, 9/24)

In 2018, senior executives at one of the country鈥檚 largest nonprofit hospital chains, Providence, were frustrated. They were spending hundreds of millions of dollars providing free health care to patients. It was eating into their bottom line. The executives, led by Providence鈥檚 chief financial officer at the time, devised a solution: a program called Rev-Up. Rev-Up provided Providence鈥檚 employees with a detailed playbook for wringing money out of patients 鈥 even those who were supposed to receive free care because of their low incomes, a New York Times investigation found. (Silver-Greenberg and Thomas, 9/24)

KHN: Embedded Bias: How Medical Records Sow Discrimination聽

David Confer, a bicyclist and an audio technician, told his doctor he 鈥渦sed to be Ph.D. level鈥 during a 2019 appointment in Washington, D.C. Confer, then 50, was speaking figuratively: He was experiencing brain fog 鈥 a symptom of his liver problems. But did his doctor take him seriously? Now, after his death, Confer鈥檚 partner, Cate Cohen, doesn鈥檛 think so. Confer, who was Black, had been diagnosed with non-Hodgkin lymphoma two years before. His prognosis was positive. But during chemotherapy, his symptoms 鈥 brain fog, vomiting, back pain 鈥 suggested trouble with his liver, and he was later diagnosed with cirrhosis. He died in 2020, unable to secure a transplant. Throughout, Cohen, now 45, felt her partner鈥檚 clinicians didn鈥檛 listen closely to him and had written him off. (Tahir, 9/26)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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