Mary K. Caffrey

Patients need transparency if another surgeon will be consulting on their procedure so there are no surprises. The authors suggest payers should extend emergency provisions to intraoperative consultations when complications arise. The movement toward bundled payments will reduce the chance for out-of-network bills, as hospitals will divide payment.

The agreement would put an end to 17 straight fixes to the sustainable growth rate that have not found a permanent solution for addressing the Medicare cost cuts envisioned in the original legislation.

Mental health advocates say Florida ranks near the bottom of states for spending on mental health. Bills introduced last week would draw down more federal Medicaid dollars to increase payments to providers, expand services, and prevent those at risk from ending up in prison. The system also has limited experience with managed care.

Powerful cholesterol-fighting drugs, PCSK9 inhibitors, could break new ground for payers: a higher-priced therapy could replace generic statins for patients suffering a chronic condition, perhaps for an unspecified period of time.

An estimated 86 million Americans have prediabetes and 90% don't know it. The initiative announced yesterday seeks to reach this population and intervene before the disease progresses to type 2 diabetes mellitus, which costs $245 billion a year.

Blue Cross Blue Shield of Alabama and a large provider could not come to renewal terms, forcing 28,000 mental health patients to go elsewhere. Critics have said the episode is the latest in state's dismal record in mental health.

At a time of rapid change and consolidation in healthcare, California's attorney general put conditions on the Daughters of Charity sale that would restrict Prime Healthcare's growth and limit its ability to negotiate managed care contracts.

Congress came close to adopting a value-based payment formula for physicians last year, but the problem of funding the SGR, which has grown to $175 billion, prevents a solution.

New Hampshire's waiver features premium assistance to shop on the HealthCare.gov exchange and includes a work-referral requirement. CMS resisted linking a waiver to work-related requirements more than a year ago when granting Pennsylvania's waiver.

A unique coaching project included not only traditional elements like nutrition and exercise but also stress management and sleep.

The study, which will presented next week at the meeting of the American College of Cardiology, defined how much avoiding diabetes, obesity, and hypertension before age 45 matters if one is later diagnosed with heart failure.

The Supreme Court's liberal wing grilled the petitioner's attorney on whether today's argument squared with what he said in the 2012 challenge to the Affordable Care Act. Justice Kennedy asked how states could be forced to set up exchanges or see their residents lose tax credits.

Nina Pham was the first nurse at Texas Presbyterian Hospital in Dallas to contract the Ebola virus after caring for patient Thomas Eric Duncan, who died October 8, 2014. In an interview with The Dallas Morning News, Pham said she will sue the hospital's parent company today for unspecified damages, citing inadequate training and safety measures and for violations to her privacy.

Budget cuts mean county health clinics will be unable to fill hundreds of jobs, leaving smaller staffs to serve low-income people in state that declined to expand Medicaid despite pleas from its hospitals and business leaders.

A lengthy report published by the Kaiser Family Foundation predicts widespread market disruption if ACA premium subsidies are lost under King vs. Burwell. Adverse selection, insurers exiting markets, and higher rates are just some of the possibilities.

H&R Block, the largest consumer tax preparer, said those who underestimated their 2014 income must repay an average of $530. Those who failed to get coverage at all must pay an average penalty of $172.

A study published today in JAMA suggests that former long-term smokers who have quit for more than 15 years would benefit from access to the lung cancer screening recently approved for coverage by Medicare; however, these smokers no longer meet the criteria.

Governors in states without their own exchanges admit they have no fallback option if the Supreme Court takes away subsidies from an estimated 8 million consumers.

The 2015 Dietary Guidelines Advisory Committee met for more than a year to review scientific evidence and discuss "patterns" of food consumption, and those discussions are reflected in the report. After a 45-day comment period and public hearing, the US Secretaries of Agriculture and Health and Human Services will issue the final Dietary Guidelines for Americans, the nation's official nutrition policy.

Consumers would have to show they only learned about the tax penalty when they went to file their tax returns, according to CMS' Andrew Slavitt. Under the Affordable Care Act, penalties for not having coverage for 2015 are $325 or 2% of household income.

The article was part of a Lancet series which took aim at the "unacceptably slow" response to rising rates of childhood obesity, and the effects not only on health but also on its social and economic effects on children. Authors called on nations to rein in marketing aimed at children.