Network Adequacy Standards and Enforcement
Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.
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Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.
In this column for the JAMA Health Forum, Larry Levitt examines how the No Surprises Act that prohibits unexpected out-of-network charges for patients could lead to lower payment rates and revenues for some doctors and other care providers.
In this Axios column, Drew Altman looks at how the heroic performance of the nation's doctors on the frontlines of coronavirus care and effective communication by many physician scientists on television, is shifting the public's views, with twice as many Americans now saying doctors put people ahead of profits than they did in earlier KFF polling.
This brief survey examines how the public views the motivations of doctors, nurses, insurance companies, and drug companies when it comes to making profits vs. working for the public good. It updates a question asked in 2005 to measure how views have changed over time. TOPLINE & METHODOLOGY Download
Compared to most similarly large and wealthy countries, the U.S. has fewer practicing physicians per capita but has a similar number of licensed nurses per capita. Looking specifically at the hospital setting, the U.S. has more hospital-based employees per capita than most other comparable countries, but nearly half of these hospital workers are non-clinical staff.
A new analysis and chart collection finds that the U.S. has fewer hospital beds and practicing physicians per capita than many similarly large and wealthy countries with health care systems already strained by the ongoing COVID-19 pandemic. Compared to Italy and Spain, two countries in which hospitals have already been overwhelmed by an influx of COVID-19 patients, the U.S. has fewer practicing physicians per capita - 2.6 per 1,000 people, compared to 4.0 in Italy…
More than half of U.S. health spending went toward hospital and physician services in 2018. Learn more about the breakdown of the nation's health spending in the Peterson-KFF Health System Tracker.
This perspective highlights the important relationship between medicine and trust in news media and articulates three ways that clinicians, health care organizations, and journalists might begin to rebuild the foundation of trust on which both medicine and journalism rely. Co-authored by KFF's David Rousseau, Vineet M. Arora of University of Chicago Medicine, and Gary Schwitzer of the University of Minnesota School of Public Health, it appears in the Journal of the American Medical Association.
Changes in Medicare’s private contracting laws could have significant implications for beneficiaries, doctors, and the Medicare program. This brief summarizes the three options that physicians and practitioners currently have for charging Medicare patients, explains how private contracting works in Medicare under current law, and reviews current proposals on changes to private contracting in Medicare, as well as their implications for patients, physicians, and the Medicare program.
This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.
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