-
Reports show Medicare insurers boosted income in questionable ways
In 2024, the Office of Inspector General (OIG) found that health insurers added new — and questionable — diagnoses to 1.7 million Medicare Advantage (MA) members, generating approximately $7.5 billion in higher payments for those insurers. For journalists, payments that raise questions from regulators translate into a major story because they can harm patients and…
-
Are bigger hospitals and insurers better for consumers?
UnitedHealthcare corporate headquarters in Minnetonka, Minn. in 2024. Photo by Chad Davis (CC BY 2.0) Over the past 30 years, consolidation of health care systems in the United States has accelerated through mergers and acquisitions, researchers reported last year in the Journal of the American College of Surgeons. After reviewing 34 years worth of studies…
-
How Wall Street Journal reporters uncovered Medicare Advantage overbilling
In the fall of 2022, a team of Wall Street Journal reporters asked the federal Centers for Medicare and Medicaid Services (CMS) for access to Medicare data for a series on suspected overbilling in Medicare Advantage. “We basically took the unusual step of asking CMS to treat a group of journalists as researchers for purposes…
-
Stories to cover as Americans seek affordable health insurance
Millions of Americans will have trouble finding affordable health insurance this year. As a result, many of them will find it difficult or impossible to pay for health care for themselves and family members. Health care journalists have been writing this story for years and will continue to cover this story well into the future.…
-
What freelancers should know about the impending health insurance premium hikes
If you have health insurance as a freelancer — and you should — there’s a good chance you bought it through the Affordable Care Act’s health insurance marketplace. The federal system offers options for people who are self-employed, employees of small businesses or who otherwise don’t have health insurance elsewhere, like through their job, parents…
-
Reports show health insurers skirt medical loss ratio rules
UnitedHealthcare corporate headquarters in Minnetonka, Minn. in 2024. Photo by Chad Davis (CC BY 2.0) Health care spending data from five states (Connecticut, Delaware, Massachusetts, Oregon, and Rhode Island) show health care spending exceeded each state’s target in 2023, according to an analysis by Health Affairs in August. Those five states are among nine that,…
-
Magazine editor shares how he got access to health insurer’s darkest secrets
How does a magazine copy editor get former executives to reveal the unsavory details of the U.S. health insurance industry? For Chris Stanton, an editor at New York Magazine who also writes about culture, politics and health insurance, the answer is twofold: First, be prepared for the unexpected, and second, have good sources. Or at…
Got any book recommendations?