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Remaking Health Care

This blog explores how health reform is changing the ways in which we pay for and deliver health care in the U.S. On any given week, that could mean a look at how Republican plans to repeal Obamacare could reshape the individual insurance market, how the safety net system is adapting to new financial pressures, or whether Trumpcare will affect the trend of doctors and hospitals merging into ever-larger entities. We also explore health care costs and whether Obamacare or its successor plans can live up the promise to rein them in. Throughout, we keep watch on how the goals of health reform intersect with the shaping power of markets and human behavior. Contributors include veteran health journalist Trudy Lieberman, David Lansky, executive director of the Pacific Business Group on Health, and independent health journalist Kellie SchmittRyan White, content editor of Center for Health Journalism Digital, serves as the blog's principal editor. 

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By aggressively documenting a patient’s conditions, insurers can inflate the amount of money they get from Medicare Advantage patients. Here's what reporters should understand about the hidden practice of "upcoding."

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Victims of the Affordable Care Act's "family glitch" include the Devors family of Salem, Ill., who now find themselves caught in a dire health crisis, without adequate coverage.

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So-called "surprise bills" can leave unsuspecting patients on the hook for thousands of dollars. And market solutions haven't fixed the problem so far, writes UCLA health policy expert Gerald Kominski.

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Do undocumented residents have to pay the Obamacare penalty for not having health insurance? Despite advocates' efforts, you might be surprised at how much confusion there is — even from tax preparers.

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On health care, the talk from presidential candidates has been way too sketchy and uninformative, argues contributing editor Trudy Lieberman. Policy details remain vague, and no one has gotten to the heart of what ails the system.

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A new Health Matters webinar this week explored just how different the health care spending map looks when researchers are given access to price and spending data from private insurance plans.

Picture of Trudy  Lieberman

With the third open enrollment period closing last Sunday and predictions suggesting fewer sign-ups than expected, it’s time to be clear about why it’s so difficult to get the remaining holdouts insured.

Picture of Trudy  Lieberman

Are insurance policies too complicated to understand? They always have been and always will be unless there are changes in the way policies work, or until there are rules to make it easier for buyers to compare options.

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A complaint filed this week alleges that California is engaging in unlawful discrimination by paying some of the lowest reimbursement rates in the country to the state’s Medicaid providers. As some coverage pointed out, the notion that low rates are limiting access to doctors is “not unfounded."

Picture of Judy  Silber

The health insurance marketplaces offer consumers a multitude of options, but sorting out which plan bests suit their needs can be a slog. That’s especially true when it comes to figuring out whether a particular doctor is part of a plan’s network, since the directories are famously unreliable.

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