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Editorial


Praluent is not like Sovaldi

David Williams

A few reasons why the want-to-be cholesterol blockbuster Praluent will not be as much of a “budget buster” as the medicine that cures most hepatitis C patients.


The less you know about health insurance, the harder it is to choose the right plan

Mary Politi, Washington University

Picking the right insurance plans for your budget and health needs is challenging. Weighing monthly premiums and co-pays against yearly deductibles and comparing the benefits different plans offer can make your head spin, especially if you are newly insured.

Feature Video

The Obama Administration recruited Seattle Seahawks quarterback Russell Wilson and cornerback Richard Sherman to the game of selling the Affordable Care Act.
 

President Obama acknowledges the technical issues with HealthCare.gov, pledging his Administration will resolve them soon and asserting that the distressed web portal is not the only way to shop for affordable health insurance available through the ACA.

 

Three years after launching a 750-patient Medicare Advantage collaborative care pilot, Portland, Maine-based independent physician practice NovaHealth and insurer Aetna have shown concrete results in improving care quality and reducing costs. Technology and provider-payer cooperation played a large part in the program's success.

Assurant is advancing plans to wind down its once-profitable health insurance business, though apparently has not found a buyer for it.

Like most mergers and acquisitions, the Aetna-Humana and Anthem-Cigna deals will need a fair amount of cultural alignment to yield the market complementaries and business synergies being promised amid the record-breaking valuations.

Another ACA-funded co-op is going under, dissolving rather than confront an "unhealthy future." Many of the others are also struggling to stay in the black.

Premiums for 1.3 million Covered California consumers will rise an average 4 percent, slightly less than last year's increase of 4.2 percent.

A "sleeper" provision when Congress created Medicare in 1965 to cover healthcare for seniors, Medicaid now provides coverage to nearly one in four Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes.

A $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money.

Some analysts who have looked at health insurers' proposed premiums for next year predict major increases for policies sold on state and federal health exchanges. Others say it's too soon to tell. One thing is clear: There's a battle brewing behind the scenes to keep plans affordable for consumers.

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