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High deductibles, higher stakes: Story angles for journalists
When compared with the medical care patients get in other high-income nations, the U.S. health system often ranks last in access, affordability and outcomes, as we explained here. One reason for that low rank among those 10 nations is that health care is unaffordable for many Americans, according to a 2024 Commonwealth Fund report. Unlike…
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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…
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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…
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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…
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