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Big insurers who manage private Medicare plans are driving up seniors’ health costs, US Senator Elizabeth Warren said, urging the Biden administration to finalize new rules that would rein in how much the program pays companies. (Tozzi, 3/28)

As Medicare drug price negotiation looms, congressional Republicans are scrambling to push through a limit that Democrats argue could hobble the agency’s efforts before they have even begun. A House committee last week advanced a bill that would bar federal health agencies from using a controversial value metric known as quality-adjusted life years, or QALYs. The metric places value not just on extension of life but also on various quality of life factors, which critics argue assigns a lower value to the life of someone who could be living with a debilitating disease. (Owermohle, 3/28)

KHN: A Progress Check On Hospital Price Transparency 

For decades, U.S. hospitals have generally stonewalled patients who wanted to know ahead of time how much their care would cost. Now that’s changing — but there’s a vigorous debate over what hospitals are disclosing. Under a federal rule in effect since 2021, hospitals nationwide have been laboring to post a mountain of data online that spells out their prices for every service, drug, and item they provide, including the actual prices they’ve negotiated with insurers and the amounts that cash-paying patients would be charged. They’ve done so begrudgingly and only after losing a lawsuit that challenged the federal rule. How well they’re doing depends on whom you ask. (Andrews, 3/29)

KHN: ER’s Error Lands A 4-Year-Old In Collections (For Care He Didn’t Receive)

Dr. Sara McLin thought she made the right choice by going to an in-network emergency room near her Florida home after her 4-year-old burned his hand on a stove last Memorial Day weekend. Her family is insured through her husband’s employer, HCA Healthcare, a Nashville-based health system that operates more hospitals than any other system in the nation. So McLin knew that a nearby stand-alone emergency room, HCA Florida Lutz Emergency, would be in their plan’s provider network. (Chang, 3/29)

Do you experience sticker shock when you’re at a pharmacy to fill prescriptions? Many older people say they have. Eleven percent of Americans 65 and older — 6 million people — report that they or a loved one have skipped prescribed meds to save money, according to a 2021 Gallup survey. (Levine, 3/27)

The Texas Department of Insurance has placed Friday Health Plans under receivership after the health insurance company declared insolvency. The Lone Star State’s insurance commissioner has seized the Friday Health Plans' assets and is charged with liquidating its local property, technology, bank accounts and other valuables to pay outstanding claims, according to a liquidation order issued Thursday. (Tepper, 3/28)

Amazon executives said Tuesday they are excited to move forward in healthcare, despite the sector's potential challenges. “Amazon comes at this with a lot of humility,” said Amazon Clinic’s chief medical officer and general manager Dr. Nworah Ayogu at ViVE, the digital health conference held in Nashville, Tennessee. “The company is no stranger to going into hard industries and making them better. Twenty years ago in retail, it was not common to have two-day shipping or easy returns.” (Perna, 3/28)

A lot of hype surrounds AI in healthcare and the rush of digital health companies seeking to cash in. But experts are unsure how generative AI applications like ChatGPT and GPT-4 will influence clinical diagnosis and decision-making. Most say the first wave of adoption will take place in areas where administrative redundancies exist. (Turner, 3/28)

KHN: Listen To The Latest ‘KHN Health Minute’

This week’s KHN Health Minute asks what code-switching in the doctor’s office says about race and health care, and how efforts to curb the opioid crisis affect the care of patients with chronic pain. (3/28)