Morning Briefing
Summaries of health policy coverage from major news organizations
Overpayments To Medicare Advantage Insurers Now Top $75 Billion Yearly
Overpayments to insurers administering Medicare Advantage plans now exceed $75 billion a year due to aggressive coding of patients' health conditions and easily-achieved bonus payments tied to quality, researchers with the USC Schaeffer Center for Health Policy & Economics found. (Bettelheim, 6/14)
In news about health care personnel 鈥
As a nurse at St. Louis University Hospital, Jessica Tulk expects physical and verbal assault by patients on any given day. Violence against nurses is one of the many problems union officials and staff called attention to at a protest Tuesday outside the hospital, which is part of the SSM Health system. (Halloran, 6/13)
A New Hampshire man has been ordered held on high bail after he allegedly stabbed a nurse at a hospital in Massachusetts on Monday night. ... The victim, Sharon Siew, was taken to UMass Memorial Medical Center in Worcester. She is expected to be OK. ... The attack did not surprise Karen Coughlin, RN, a psychiatric nurse for 34 years and chair of the Workplace Violence Task Force at the Massachusetts Nurses Association. MNA is the largest union in the state representing nurses. Its membership includes nurses at Heywood Hospital. 鈥淲e are seeing an increase in workplace violence across the spectrum,鈥 Coughlin said. 鈥淣urses are more likely to be assaulted 鈥 seven times more likely to be assaulted 鈥 than police officers.鈥 (Morelli and O'Laughlin, 6/13)
Duke University launched a four-year program this spring with a $3.9 million federal training grant aimed at helping better prepare nurses for a growing trend in healthcare: treating patients where they live. 鈥淚n the hospital, nurses really have all the power and the patients are literally stripped of their clothing,鈥 said Donna Biederman, associate clinical professor at Duke University School of Nursing. 鈥淚n the community, the nurse really needs to understand the dynamics. It can be very humbling when you are in a place where you鈥檙e not necessarily able to call all of the shots.鈥澛(Eastabrook, 6/13)
In other health care industry news 鈥
The American Medical Association on Tuesday strongly criticized the body mass index, urging doctors to de-emphasize its use in assessing health and obesity and acknowledging that the measurement has been used for 鈥渞acist exclusion鈥 and has caused 鈥渉istorical harm.鈥 (Trang and Chen, 6/13)
After a bitter dispute, the ALS Association has settled a lawsuit filed by 15 chapters that chafed at managerial moves by the national organization and will now break away to form an alternative organization for patients and their families combating the debilitating disease. (Silverman, 6/13)
For three years, nine months, and one week, Ram Sasisekharan lived under a gag order. In 2019, some of the Massachusetts Institute of Technology professor鈥檚 peers publicly accused his lab of falsifying research, setting in motion a lengthy internal investigation that sidelined his work, decimated his team, and barred him from speaking out in his own defense. (Garde, 6/14)
杨贵妃传媒視頻 Health News: At Least 1.7M Americans Use Health Sharing Arrangements, Despite Lack Of Protections聽
A new report has provided the first national count of Americans who rely on health care sharing plans 鈥 arrangements through which people agree to pay one another鈥檚 medical bills 鈥 and the number is higher than previously realized. The report from the Colorado Division of Insurance found that more than 1.7 million Americans rely on sharing plans and that many of the plans require members to ask for charity care before submitting their bills. (Hawryluk, 6/14)
Publicly traded health insurance companies enjoyed a profitable first quarter in 2023. But uncertainty looms about how the year will shake out for the insurance industry, which experienced strong performances during the COVID-19 pandemic. Investors are concerned about how regulatory updates will impact Medicare Advantage plans and risk-bearing providers, how Medicaid redeterminations will shake out, and how legislation targeting pharmacy benefit managers would impact operations and profits. (Tepper, 6/13)