August 11, 2022

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The new rules will help people get upfront cost estimates for about 500 so-called “shoppable” services, meaning medical care they can schedule ahead of time.

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The new rules will help people get upfront cost estimates for about 500 so-called “shoppable” services, meaning medical care they can schedule ahead of time.

DNY59/Getty Images

Consumers, employers and just about everyone else interested in health care prices will soon get an unprecedented look at what insurers pay for care, perhaps helping answer a question that has long dogged those who buy insurance: Are we getting the best deal we can?

Starting July 1, health insurers and self-insured employers must post on websites just about every price they’ve negotiated with providers for health care services, item by item. About the only exclusion is the prices paid for prescription drugs, except those administered in hospitals or doctors’ offices.

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The federally required data release could affect future prices or even how employers contract for health care. Many will see for the first time how well their insurers are doing compared with others.

The new rules are far broader than those that went into effect last year requiring hospitals to post their negotiated rates for the public to see. Now insurers must post the amounts paid for “every physician in network, every hospital, every surgery center, every nursing facility,” said Jeffrey Leibach, a partner at the consulting firm Guidehouse.

“When you start doing the math, you’re talking trillions of records,” he said. The fines the federal government could impose for noncompliance are also heftier than the penalties that hospitals face.

Federal officials learned from the hospital experience and gave insurers more direction on what was expected, said Leibach. Insurers or self-insured employers could be fined as much as $100 a day for each violation and each affected enrollee if they fail to provide the data.

“Get your calculator out: All of a sudden you are in the millions pretty fast,” Leibach said.

Determined consumers, especially those with high-deductible health plans, may try to dig in right away and use the data to try comparing what they will have to pay at different hospitals, clinics, or doctor offices for specific services.

But each database’s enormous size may mean that most people “will find it very hard to use the data in a nuanced way,” said Katherine Baicker, dean of the University of Chicago Harris School of Public Policy.

At least at first.

Entrepreneurs are expected to quickly translate the information into more user-friendly formats so it can be incorporated into new or existing services that estimate costs for patients. And starting Jan. 1, the rules require insurers to provide online tools that will help people get upfront cost estimates for about 500 so-called “shoppable” services, meaning medical care they can schedule ahead of time.

Once those things happen, “you’ll at least have the options in front of you,” said Chris Severn, CEO of Turquoise Health, an

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2 min read

How to get rid of medical debt — or avoid it in the first place

Patients and the consumer advocates say there are things people should do to try to avoid, or navigate, the medical debt trap. Financial assistance is available, but it all requires self-advocacy.

Lori Mangum was 32 when apple-sized tumors sprouted on her head. Now — six years and 10 surgeries later — the skin cancer is gone. But her pain lives on, in the form of medical debt.

Even with insurance, Mangum paid $36,000 out-of-pocket, charges that stemmed from the hospital, the surgeon, the anesthesiologist, the pharmacy, and follow-up care. And she still has about $7,000 more to pay.

While she was trying to manage her treatment and medical costs, Mangum remembers thinking, “I should be able to figure this out. I should be able to do this for myself.”

But medical billing and health insurance systems in the U.S. are complex, and many patients have difficulty navigating them.

“It’s incredibly humbling — and sometimes even to the point of humiliating — to feel like you have no idea what to do,” Mangum said.

If you’re worried about incurring debt during a health crisis or are struggling to deal with bills you already have, you’re not alone. Some 100 million people — including 41% of U.S. adults — have health care debt, according to a recent survey by KFF (Kaiser Family Foundation).

But you can inform and protect yourself. NPR and KHN spoke with patients, consumer advocates, and researchers to glean their hard-won insights on how to avoid or manage medical debt.

“It shouldn’t be on the patients who are experiencing the medical issues to navigate this complicated system,” said Nicolas Cordova, a health care lawyer with the New Mexico Center on Law and Poverty. But consumers who inform themselves have a better chance of avoiding debt traps.

That means knowing the ins and outs of various policies — whether it’s your insurance coverage, or a hospital’s financial assistance program, or a state’s consumer protection laws. Ask a lot of questions and persist. “Don’t take ‘no’ for an answer,” said Cordova, “because sometimes you might get a ‘yes’.”

Even people with health insurance can land in debt; indeed, one of the biggest problems, consumer advocates said, is that so many people are underinsured, which means they can get hit with huge out-of-pocket costs from coinsurance and high deductibles.

Here is some practical advice about facing down medical debt, at every stage of care and after.

Before You Get Care

Get familiar with your insurance coverage and out-of-pocket costs

Get the best insurance coverage you can afford — even when you’re healthy. Make sure you know what the copays, coinsurance, and deductibles will be. Don’t hesitate to call the insurer and ask someone to walk you through all the potential out-of-pocket costs. Keep in mind that you cannot make changes to your policy except during certain windows of time, such as open enrollment (typically in the fall or early winter) or after a major life event.

Sign up for public insurance if you qualify

If you’re uninsured but need health care, you might qualify for

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3 min read

The Web of Points (IoT) could be about to remodel practically just about every component of people’s lives. Overall health care is a person business by now looking at important adoption of IoT know-how. Connected professional medical products are assisting medical doctors and nurses remotely watch people, access health and fitness details, and perform adhere to-ups on-line. As a outcome, IoT in health and fitness care could revolutionize the business more than the following couple several years.

How Does the Wellbeing Treatment Field Use Linked Gadgets? 

The World wide web of Clinical Issues (IoMT) contains numerous products utilized inside of and outside the house wellness treatment amenities. In most situations, these objects give a several of the exact same rewards — like streamlined treatment method, diminished threat of mistake, and greater availability of essential info, like details on patient vitals.

Wise Affected individual Checking Devices

Just one common software of IoT in wellness care is the good affected individual observe. This unit continuously collects wellbeing care info from a individual, which include information on coronary heart fee, blood strain, temperature, and blood oxygen concentrations. 

These equipment assistance make patient wellness details more available to physicians and nurses within facilities. A patient’s professional medical team can speedily and remotely test their vitals from a hospital workstation or a safe gadget any place in the earth. The smart affected person observe can also inform team if someone’s vitals exceed safe stages.

Good health care wearables and remote individual displays allow medical doctors to go on monitoring patient vitals without the need of requiring them to continue to be in the facility. In addition, people today who have been not long ago discharged from the clinic may possibly carry clever client screens with them, allowing them to send crucial health information to health professionals with no possessing to return to the medical center for a comply with-up. They can also obtain this info and get a important window into their write-up-launch well being.

The affected individual and their medical doctor can talk about any about overall health info in excess of the world wide web making use of a telemedicine movie get in touch with option. The medical doctor can also immediately remember the affected person to the hospital if the check indicates their overall health is in danger.

Various IoMT affected person checking products exist, ranging from significant equipment designed for clinic options to light-weight well being-monitoring wearables folks can consider with them where ever they go. 

Distinct use-situations for IoMT monitoring technologies include things like standard-reason sensible patient monitors, movement sensors that keep track of the progression of Parkinson’s sickness signs, and temper sensors that can help medical practitioners regulate a patient’s mental health and fitness.

Clever Infusion Pumps and Medication Shipping Units

The right way dosing and delivering medicine is critical for affected individual therapy. Having said that, medicine mistakes stay a typical challenge in quite a few professional medical environments. These mistakes can induce major accidents or adverse reactions

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2 min read

Cannabinoids are a group of chemicals found in cannabis. While they’re most famous for their psychoactive properties, they also have many other therapeutic uses. Cannabinoids are what make the marijuana plant so unique. They interact with our body’s endocannabinoid system (ECS), which regulates things like pain, appetite, and mood.

The most well-known cannabinoid is delta-9 tetrahydrocannabinol (THC). THC is responsible for the “high” you get from smoking or eating marijuana. It also has medical benefits like reducing muscle spasms and relieving nausea caused by chemotherapy. Cannabinoid pharmaceutical companies extract THC and sell it to deal with various medical problems. 

Other cannabinoids common among cannabinoid pharmaceutical companies include cannabidiol (CBD), cannabinol (CBN), and cannabigerol (CBG). CBD doesn’t produce any high or euphoric feeling, but it does have significant medical benefits like reducing inflammation and relieving pain.

THC is responsible for the psychoactive effects of marijuana, which means it can affect your brain by altering your mood or behavior. THC also has pain-relieving properties, as well as anti-inflammatory abilities.

CBD is non-psychoactive, which means it doesn’t get you high, but still has many medicinal applications. It’s used to treat anxiety and depression, reduce inflammation and pain, and help people with insomnia fall asleep faster by reducing anxiety-related sleep disruptions.

Here are some of the ways cannabinoids can improve your quality of life

  • Cannabinoids relieve pain and inflammation.
  • Cannabinoids can help people with sleep issues by encouraging relaxation and helping them fall asleep faster.
  • Cannabinoids can also help people who suffer from mood disorders like depression or anxiety by calming them down, making them less likely to lash out at others when they’re feeling down.
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2 min read

By Lara Cooper

Above the earlier seven times, Immediate Reduction shipped 330 shipments of requested professional medical aid to 48 U.S. states and territories and seven countries worldwide, which include Ukraine.

The shipments contained 4.3 million defined everyday doses of treatment, such as N-95 masks, mental wellness prescription drugs, antibiotics, chronic disease drugs, nutritional products, insulin, and most cancers solutions.

This 7 days, a shipment of prenatal nutritional vitamins departed for Afghanistan to help pregnancy care provided by a clinic in Kabul. The shipment, weighing additional than 1,700 pounds, includes 1,231,000 described each day doses of multivitamins. Direct Reduction has furnished extra than 187 tons of healthcare help to well being services in Afghanistan considering that 2008.

UKRAINE Reaction TO Date

Because February 24, Immediate Aid has delivered health care assist weighing a lot more than 1.2 million lbs, or 600 tons in bodyweight, with much more on the way. This 7 days, cancer therapies, insulin, antibiotics, IV fluids to assistance dialysis treatment, surgical provides and more departed Immediate Relief’s warehouse for overall health providers in Ukraine.

A major infusion of IV fluids arrived in Ukraine this week, a substantial portion of the 140 tons delivered to the country in the last seven times.

On Friday, a large shipment of IV fluids weighing additional than 18 tons, donated by Baxter Global, arrived in Odessa, Ukraine. The cargo will support well being amenities furnishing treatment in the area.

Immediate Reduction has been responding directly to precise professional medical requests from Ukraine’s Ministry of Overall health, as nicely as NGOs and local organizations supporting overall health care in Ukraine.

7 subject hospital kits, every that contains 50 beds, trauma treatment and oxygen supplies and more, have since been deployed to frontline parts of the conflict needing clinical guidance. A person team coordinating the deployment of the kits to frontline regions is Faucets-Ukraine in Dnipro, and the kits were being donated by the Point out of California Place of work of Emergency Expert services and transported by Direct Aid.

IN THE Information

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