Hepatitis C cure underused mainly because of superior price tag and insurance coverage restrictions : Shots

June 30, 2023 Vera

Hepatitis C can bring about serious liver hurt and potential customers to about 15,000 deaths in the U.S. each individual yr.

James Cavallini /BSIP/Common Photos

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James Cavallini /BSIP/Common Photos

Hepatitis C can lead to significant liver hurt and potential customers to about 15,000 fatalities in the U.S. just about every 12 months.

James Cavallini /BSIP/Universal Images

Ten several years in the past, harmless and productive treatment options for hepatitis C became accessible.

These drugs are uncomplicated-to-consider oral antivirals with number of facet effects. They treatment 95% of clients who acquire them. The treatment plans are also highly-priced, coming in at $20 to 25,000 bucks a system.

A new report from the Facilities for Condition Control and Prevention finds that the large value of the drugs, together with protection constraints imposed by insurers, have stored lots of people diagnosed with hepatitis C from accessing curative solutions in the past 10 years.

The CDC estimates that 2.4 million men and women in the U.S. are dwelling with hepatitis C, a liver sickness brought on by a virus that spreads by means of call with the blood of an infected particular person. Now, the most popular route of an infection in the U.S. is by means of sharing needles and syringes utilized for injecting medicine. It can also be transmitted via sex, and via childbirth. Untreated, it can bring about intense liver hurt and liver most cancers, and it qualified prospects to some 15,000 deaths in the U.S. each yr.

“We have the resources…to remove hep C in our place,” suggests Dr. Carolyn Wester, director of the CDC’s Division of Viral Hepatitis, “It really is a make any difference of obtaining the will as a society to make confident these assets are readily available to all populations with hep C.”

CDC Recommends Hepatitis C Testing For All Boomers

High charge and insurance policies restrictions restrict obtain

In accordance to CDC’s examination, just 34% of individuals acknowledged to have hep C in the previous ten years have been healed or cleared of the virus. Practically a million people in the U.S. are dwelling with undiagnosed hep C. Amid individuals who have received hep C diagnoses above the previous ten years, more than 50 percent a million have not accessed treatment plans.

The medication’s significant price has led insurers to place “obstacles in the way of people and their physicians,” Wester claims. Some professional coverage companies and point

Some ACA health insurance plans have lots of enrollees, few providers : Shots

April 12, 2023 Vera

The Affordable Care Act saw a record number of sign ups this year, but some people are having trouble finding doctors in their health plan networks.

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The Affordable Care Act saw a record number of sign ups this year, but some people are having trouble finding doctors in their health plan networks.

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The Affordable Care Act may be struggling with its own success.

Record enrollment over the last two years brought more consumers into the health insurance market. At the same time, many insurers began offering smaller networks of doctors and hospitals, partly to be price competitive.

That combination left some patients scrambling to find an available in-network physician or medical facility. That can be a challenge, especially when enrollees must rely on inaccurate provider lists from their insurance company. A recent federal report found that 243 out of 375 insurance company plans reviewed by regulators failed to meet network standards.

‘The last thing she needed’

Take what happened to a central Pennsylvania policyholder, who in January fell and broke her arm and a bone near her eye.

She was directed by the hospital that provided her emergency care to follow up with an orthopedist, recounted Kelly Althouse, the patient’s insurance agent, who works near Reading, Pa. Althouse’s client spent hours calling orthopedic doctors listed in the provider directory of her new health plan from insurer Ambetter Health, a national carrier that in 2019 started offering ACA plans in Pennsylvania. Several doctors said they weren’t part of the network, despite being listed by the company, Althouse said. It took about 15 tries before her client found an in-network doctor who would see her.

That “was the last thing she needed when she was already feeling terrible,” said Althouse.

It’s a story that has been repeated to her multiple times since January, when the new plan year began. Her clients have “bombarded” her with calls, saying a range of physicians and other providers were not accepting the insurance, even if that provider was listed in the plan’s own directory. “The thing that shocked me was how many offices told my clients, ‘We have never heard of this company,'” Althouse said.

For its part, Ambetter officials said in a written statement to KHN that their network in Pennsylvania “meets or exceeds regulatory standards.”

The size of insurers’ networks of contracted doctors

Inflation and money woes are forcing Americans to delay medical care : Shots

March 13, 2023 Vera

Substitute teacher Crystal Clyburn, 51, doesn’t have health insurance. She got her blood pressure checked at a health fair in Sarasota, Fla.

Stephanie Colombini/WUSF

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Substitute teacher Crystal Clyburn, 51, doesn’t have health insurance. She got her blood pressure checked at a health fair in Sarasota, Fla.

Stephanie Colombini/WUSF

At a health-screening event in Sarasota, Florida, people milled around a parking lot waiting their turn for blood pressure or diabetes checks. The event was held in Sarasota’s Newtown neighborhood, a historically Black community.

Local resident Tracy Green, 54, joined the line outside a pink and white bus offering free mammograms.

“It’s a blessing, because some people, like me, are not fortunate and so this is what I needed,” she said.

Green said she wanted the exam because cancer runs in her family. And there’s another health concern: her breasts are large and cause her severe back pain. A doctor once recommended she get reduction surgery, she said, but she’s uninsured and can’t afford it.

In a recent Gallup poll, 38% of Americans surveyed said they had put off medical treatment last year due to cost, up from 26% in 2021. The new figure is the highest since Gallup started tracking the issue in 2001.

A survey by The Kaiser Family Foundation last summer showed similar results. It found people were most likely to delay dental care, followed by vision services and doctor’s office visits. Many didn’t take medications as prescribed.

The health screening event is part of an ongoing effort provide health services to low-income Floridians who are uninsured. Attendees could have their blood pressure checked or receive screenings for diabetes. A bus also delivered mammogram services.

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Stephanie Colombini/WUSF

The neighborhood screening event in Newtown — organized by the non-profit Multicultural Health Institute in partnership with a local hospital and other health groups — is part of an effort to fill in the coverage gap for low-income people.

Tracy Green explained that her teeth are in bad shape too, but dental care will also have to wait. She doesn’t have health insurance or a stable job. When she

Medical debt soars for consumers with hospital credit cards : Shots

January 16, 2023 Vera

Many hospitals are now partnering with financing companies to offer payment plans when patients and their families can’t afford their bills. The catch: the plans can come with interest that significantly increases a patient’s debt.

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Patients at North Carolina-based Atrium Health get what looks like an enticing pitch when they go to the nonprofit hospital system’s website: a payment plan from lender AccessOne. The plans offer “easy ways to make monthly payments” on medical bills, the website says. You don’t need good credit to get a loan. Everyone is approved. Nothing is reported to credit agencies.

In Minnesota, Allina Health encourages its patients to sign up for an account with MedCredit Financial Services to “consolidate your health expenses.” In Southern California, Chino Valley Medical Center, part of the Prime Healthcare chain, touts “promotional financing options with the CareCredit credit card to help you get the care you need, when you need it.”

As Americans are overwhelmed with medical bills, patient financing is now a multibillion-dollar business, with private equity and big banks lined up to cash in when patients and their families can’t pay for care. By one estimate from research firm IBISWorld, profit margins top 29% in the patient financing industry, seven times what is considered a solid hospital margin.

Why Black Americans are more likely to be saddled with medical debt

Hospitals and other providers, which historically put their patients in interest-free payment plans, have welcomed the financing, signing contracts with lenders and enrolling patients in financing plans with rosy promises about convenient bills and easy payments.

For patients, the payment plans often mean something more ominous: yet more debt.

Millions of people are paying interest on these plans, on top of what they owe for medical or dental care, an investigation by KHN and NPR shows. Even with lower rates than a traditional credit card, the interest can add hundreds, even thousands of dollars to medical bills and ratchet up financial strains when patients are most vulnerable.

Robin Milcowitz, a Florida woman who found herself enrolled in an AccessOne loan at a Tampa hospital in 2018 after having a hysterectomy for ovarian cancer, said she was appalled by the financing

Mistaken identity leads to big hospital bill mix-up : Shots

December 22, 2022 Vera

In 2013, Grace E. Elliott spent a night in a hospital in Florida for a kidney infection that was treated with antibiotics. Eight years later, she got a large bill from the health system that bought the hospital. This bill was for an unrelated surgical procedure she didn’t need and never received. It was a case of mistaken identity, she knew, but proving that wasn’t easy.

Shelby Knowles for KHN

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Shelby Knowles for KHN

Earlier this year, Grace Elizabeth Elliott got a mysterious hospital bill for medical care she had never received.

She soon discovered how far a clerical error can reach — even across a continent — and how frustrating it can be to fix.

During a college break in 2013, Elliott, then 22, began to feel faint and feverish while visiting her parents in Venice, Fla., which is about an hour south of Tampa. Her mother, a nurse, drove her to a facility that locals knew simply as Venice Hospital.

In the emergency department, Elliott was diagnosed with a kidney infection and held overnight before being discharged with a prescription for antibiotics, a common treatment for the illness.

“My hospital bill was about $100, which I remember because that was a lot of money for me as an undergrad,” said Elliott, now 31.

She recovered and eventually moved to California to teach preschool. Venice Regional Medical Center was bought by Community Health Systems, based in Franklin, Tenn., in 2014 and eventually renamed ShorePoint Health Venice.

The kidney infection and overnight stay in the E.R. would have been little more than a memory for Elliott.

Then another bill came.

The Patients: Grace E. Elliott, 31, a preschool teacher living with her husband in San Francisco, and Grace A. Elliott, 81, a retiree in Venice, Fla.

Medical Services: For Grace E., an emergency department visit and overnight stay, plus antibiotics to treat a kidney infection in 2013. For Grace A., a shoulder replacement and rehabilitation services

To prevent medical debt, the U.S. could learn from Germany’s health care system : Shots

December 20, 2022 Vera

Dr. Eckart Rolshoven examines a patient at his clinic in Püttlingen, a small town in Germany’s Saarland region. Although Germany has a largely private health care system, patients pay nothing out-of-pocket when they come to see him.

Pasquale D’Angiolillo for KHN

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Pasquale D’Angiolillo for KHN

PÜTTLINGEN, Germany — Almost every day, Dr. Eckart Rolshoven sees the long shadow of coal mining in his clinic near the big brownstone church that dominates this small town in Germany’s Saarland.

The region’s last-operating coal shaft, just a few miles away, closed a decade ago, ending centuries of mining in the Saarland, a mostly rural state tucked between the Rhine River and the French border. But the mines left a difficult legacy, as they have in coal regions in the United States, including West Virginia.

Many of Rolshoven’s patients battle lung diseases and chronic pain from years of work underground. “We had an industry with a lot of illnesses,” said Rolshoven, a genial primary care physician who at 71 is nearing the end of a long career.

The Saarland’s residents are sicker than elsewhere in Germany. And like West Virginia, the region faces economic hurdles. For decades, German politicians, business leaders and unions have labored to adjust to the mining industry’s slow demise.

How banks and hospitals are cashing in when patients can't pay for health care

But this is a healthier place than West Virginia in many respects. The region’s residents are less likely to die prematurely, data shows. And on average, they live four years longer than West Virginians.

There is another important difference between this former coal territory and its Appalachian counterpart: West Virginia’s economic struggles have been compounded by medical debt, a burden that affects about 100 million people in the U.S. — in no state more than West Virginia.

In the Saarland, medical debt is practically nonexistent. It’s so rare in Germany that the federal government’s statistical office doesn’t even track it.

The reason isn’t government health care. Germany, like the U.S., has a largely private health care system that relies on private doctors and private insurers. Like Americans, many Germans enroll in a health plan through work, splitting the cost with their employer.

But Germany has