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Kevin Roche

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

Oct 29 2015

According to an Advisory Board survey, providers are requiring more upfront payment of cost-sharing amounts by patients, largely as a result of the growth of high-deductible plans.

http://www.prnewswire.com/news-releases/high-deductible-health-plans-propel-sweeping-change-in-how-providers-collect-for-care-300167851.html
Oct 29 2015

CMS released findings for the latest year of hospital value-based purchasing, indicating that based on 2014 performance, for 2016 payments 1800 hospitals will get some "bonus" reimbursement.  Note, however, that the bonus is after everyone had their payment docked 1.75% to fund the program.  Only a few hospitals will see an actual increase in payment from what the baseline would otherwise be.  For the vast majority of hospitals, the net effect is very minor.

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-26.html
Oct 29 2015

By Headlines No Comments

Markets & Markets issues a report claiming that the elusive but all-encompassing “population health management” market will have $40.6 billion in revenue by 2018.

Oct 28 2015

In a report indicating just how pathetic the controls in the reform law are for protecting Medicaid and the subsidy program from fraud, ten of ten fictitious people created by the Government Accounting Office were able to incorrectly obtain either Medicaid coverage or a public exchange subsidy.  Your tax dollars at work.

http://www.gao.gov/products/GAO-16-159T
Oct 28 2015

Walgreens is proposing to buy Rite-Aid for $9.4 billion, in another major consolidation of the US health care system which needs very careful regulatory scrutiny.

https://www.pehub.com/2015/10/walgreens-to-buy-rival-rite-aid-for-9-4-billion-reuters/
Oct 27 2015

exchange rates

By Headlines No Comments

Although they attempt to hide it in a blizzard of other numbers, HHS revealed that the average premium on the federal exchanges for benchmark plans will go up by 7.5%.  Yep, we are all enjoying that 10% premium reduction that the reform law was going to bring.  And we all got 7.5% income increases for next year too.

Oct 23 2015

Research in Health Affairs finds that prescription copays under the typical exchange silver plan are twice as high as in average employer plans.  More good news for health care reform.

http://content.healthaffairs.org/content/34/10/1695.abstract
Oct 22 2015

You may have noticed that there soon will be none of the health insurance cooperatives established (and taxpayer-funded) under the reform law, as every week brings news of closures of more of them.  Strangely, no boasting from the Administration about this latest indication of the great success of their health reform.

http://www.vaildaily.com/news/18720558-113/colorado-health-co-op-calling-it-quits
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