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Cigna is expanding its health coverage offerings in three new states and 93 new counties for customers using the Affordable Care Act marketplaces. Pending final regulatory approvals, Cigna's individual and family plans will be available in Georgia, Mississippi and Pennsylvania, as well as in additional counties in Arizona, Florida and Virginia, potentially reaching 1.5 million new customers. (Devereaux, 8/26)

Around California — and the nation — nurses are trading in high-pressure jobs for a career change, early retirement or less demanding assignments, leading to staffing shortages in many hospitals. Hospitals are struggling to comply with the state’s nurse staffing requirements as pandemic-induced burnout has exacerbated an already chronic nursing shortage nationwide. But burnout isn’t the only thing compounding California’s nursing shortage: The state’s new vaccine mandate for health care workers is already causing headaches for understaffed hospitals before it is even implemented. Some traveling nurses — who are in high demand nationwide — are turning down California assignments because they don’t want to get vaccinated. (Hwang, 8/26)

The two new for-profit medical schools planned for Montana are designed to give students four years of education in the state. The promise is that when the young doctors graduate many will stay in Montana, easing the state’s pronounced physician shortage. But, students attending Rocky Vista University in Billings and Touro University in Great Falls, may only get two years in the state. The growing competition for limited clinical rotation opportunities for third- and fourth-year students, and residencies for graduates may force many Montana medical students to complete their education out of state, where studies suggest they are likely to stay. (Schabacker, 8/26)

Signing up for Medicare sometimes means deciding that a supplement plan — aka Medigap — suits your situation. That is, you want extra insurance to at least partially cover the cost-sharing aspects of Medicare — deductibles, copays and coinsurance. However, Medigap plans do have limitations to be aware of. (O'Brien, 8/26)

More hospitals are experimenting with outcome guarantees to attract cost-conscious employers. Geisinger has incrementally expanded its 90-day warranty on knee and hip replacements to two-year or lifetime guarantees on knee, hip and shoulder surgeries that cover avoidable complications. Virginia Mason Hospital in Seattle and Hoag Orthopedic Institute in Irvine, California, have surgical warranties for privately insured patients in bundled payment contracts. (Kacik, 8/26)

KHN: Jaw Surgery Takes A $27,119 Bite Out Of One Man’s Budget

For years, Ely Bair dealt with migraine headaches, jaw pain and high blood pressure, until a dentist recommended surgery to realign his jaw to get to the root of his health problems. The fix would involve two surgeries over a couple of years and wearing braces on his teeth before and in between the procedures. Bair had the first surgery, on his upper jaw, in 2018 at Swedish Medical Center, First Hill Campus in Seattle. The surgery was covered by his Premera Blue Cross plan, and Bair’s out-of-pocket hospital expense was $3,000. (Galewitz, 8/27)