Policy & Regulations

This channel includes news coverage of healthcare policy and regulations set by Congress, the states, Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), U.S. Food and Drug Administration (FDA), and medical associations and societies. 

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Patients more likely to switch hospitals to give birth if they receive a surprise bill

Mothers who gave birth twice were more likely to switch to another hospital after the first birth if they received a surprise bill following care, according to a recent study published in Health Affairs.

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After pricing pushback, Eli Lilly will sell a half-price insulin drug

Drug manufacturer Eli Lilly plans to offer a half-priced version of its insulin medication Humalog, the company announced March 4.

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Blue Cross Blue Shield Association proposes health insurance improvements

The Blue Cross Blue Shield Association (BCBSA) published three proposals that would lower premiums by one-third for Obamacare insurance coverage and expand access to coverage for more than 4 million additional people.

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Marketplace insurers deny many claims—and enrollees seldom push back

Health insurers selling their services through Healthcare.gov denied nearly one-fifth of claims in 2017. And only a tiny fraction of the affected consumers—less than one-half of one percent—appealed the decisions.

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Uninsured rate remains below 10% as more choose high-deductible plans

Nearly 30 million individuals of all ages in the U.S. were uninsured during the first nine months of 2018. This figure represents a little over 9 percent of the population, and it’s similar to the uncovered headcount from 2017. Still, it’s a notable improvement from 2010, when the Affordable Care Act was nascent and 19 million more people lacked coverage.

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Medicare for all introduced in Congress

As more of the Democratic party comes on board with the idea of Medicare for all, a new bill was introduced in the House this week to make universal healthcare a reality. Rep. Pramila Jayapal (D-Washington) introduced the bill on Feb. 27. The bill has more than 100 co-sponsors.

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Out-of-pocket costs have little to do with price of procedures

As hospitals start to publish prices of their services, patients should theoretically be able to save money by shopping around. However, out-of-pocket costs to patients have little correlation with the amount insurers pay or the overall price of a procedure, according to a recent study of 14 representative Massachusetts hospitals by Pioneer Institute.

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Physicians generate $2.4M for hospitals annually

Physicians are major drivers of hospital revenue, generating about $2.4 million each year, according to a new survey from Merritt Hawkins.

Around the web

With generative AI coming into its own, AI regulators must avoid relying too much on principles of risk management—and not enough on those of uncertainty management.

Cardiovascular devices are more likely to be in a Class I recall than any other device type. The FDA's approval process appears to be at least partially responsible, though the agency is working to make some serious changes. We spoke to a researcher who has been tracking these data for years to learn more. 

Updated compensation data includes good news for multiple subspecialties. The new report also examines private equity's impact on employment models and how much male cardiologists earn compared to females.

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