A new class-action lawsuit, first reported by Bloomberg, alleges health insurance company Centene deceived customers about how many doctors accept its Affordable Care Act health plans. The lawsuit said Centene's provider network was largely "fictitious," resulting in many people having trouble finding in-network doctors.
The big picture: Centene is the largest ACA insurer, with about 1.4 million members, and the company said its networks are adequate. But the lawsuit epitomizes the struggle between insurers, who say narrow networks are needed to contain costs, and consumers, who say the plans restrict their ability to get care.
Executives from 21 not-for-profit hospitals and health systems offered some starkly conflicting messages this week as they mingled with bankers, bondholders and hedge fund analysts at the J.P. Morgan Healthcare Conference in San Francisco.
What they said: Strong inpatient volumes are a priority — but they are also committed to "value-based care" that, in theory, leads to fewer inpatient hospital stays as more people get care in outpatient sites or at home.
Humana has terminated its membership with the health insurance industry’s primary trade group, America’s Health Insurance Plans. The formal termination came on Dec. 31, though a Humana spokesman said the company "has not actively participated in AHIP since early 2017."
Why it matters: It's another blow to AHIP, renewing questions about the group's lobbying influence. Humana, one of the largest Medicare Advantage insurers in the country, is the third major defection since the middle of 2015, when former Obama administration official Marilyn Tavenner took over as AHIP's CEO. Aetna and UnitedHealth Group were the first big insurers to ditch AHIP in 2015.
New data from the JPMorgan Chase Institute suggests that when Americans get a tax refund, they use it to take care of health care needs they had been delaying.
The bottom line: People put off health care services based on their ability to pay.
After years of sharp declines in sleep-related infant deaths in the U.S., progress has slowed considerably, the Centers for Disease Control and Prevention warns in a new report.
Key stat: Roughly 3,500 infants die from sleep-related issues in America annually. The causes range from SIDS and accidental suffocation in cribs to deaths from unknown causes. Despite intensive public education efforts, only half of mothers say they receive “safe sleep” advice from healthcare providers during pre- and post-natal visits, CDC said.
