The Takeaways: Week 30 of 2022

Articles

Julie Appleby, KHN. Health Insurance Price Data: It’s Out There, but It’s Not for the Faint of Heart (July 27, 2022)

Insurers are complying with federal rules aimed at price transparency that took effect July 1, she and others said. Realistically, though, consumer use of the data may have to wait until private firms synthesize it — or additional federal requirements start to kick in next year aimed at making it easier for consumers to use the price information to shop for scheduled medical care.

The requirement for insurers is broader than that faced by hospitals, although it does not include cash prices. It includes negotiated rates paid not only to hospitals, but also to surgery centers, imaging services, laboratories, and even doctors. Amounts billed and paid for “out-of-network” care are also included.

Still, even the tables of contents are huge. UnitedHealthcare’s webpage warns it could take “up to 5 minutes” for the page to load. When it does, there are more than 45,000 entries, each listed by the year and name of the plan or employer for job-based policies.

Seth Godin, Seth's Blog. Paths not taken (July 25, 2022)

Leading a project is about causing the death of a million ‘ands’.

If we’re going to create anything at all, if we’re going to ship the work, the positive path is to look for the constraints and grab them. They’re the point. No constraints, no project. When we see them as stepping stones on the way to the work we hope to do, they’re not a problem, they’re a sign that we’re onto something.

Pranshu Verma, The Washington Post. The fight between authors and librarians tearing book lovers apart (July 25, 2022)

The lending of physical books takes place under the legal principle of first-sale doctrine, which limits the rights of content creators to control how their works are resold, said Mehtab Khan, a resident fellow at the Yale Law School’s Information Society Project. But that principle does not apply to digital books, mainly because case law has not caught up with how digital books have changed the landscape of libraries and publishing, experts said.

The controlled digital lending legal theory [which the Internet Archive has cited as justification for its digital lending program], however, was created by Michelle Wu in the early 2000s. Wu, a librarian at the University of Houston at the time, saw floods destroy much of her library’s collection, and she sought to create a way to digitize and preserve the rest of the books under her purview.

Bernard J. Wolfson, KHN. Even Well-Intended Laws Can’t Protect Us From Inaccurate Provider Directories (July 26, 2022)

A study published in June in the Journal of Health Politics, Policy and Law analyzed data from the California Department of Managed Health Care on directory accuracy and timely access to care. It found that in the best case, consumers could get timely appointments in urgent cases with just 54% of the doctors listed in a directory. In the worst case: 28%. For general care appointments, the best case was 64% and the worst case 35%.

A key takeaway, the authors write, is that “even progressive and pro-consumer legislation and regulations have effectively failed to offer substantial protection for consumers.”

Consumer health advocates say insurers are not taking directory accuracy seriously...Industry analysts and academic researchers say it’s more complicated than that.

Health plans contract with hundreds of thousands of providers and must constantly hound them to send updates. Are they still with the same practice? At the same address? Accepting new patients?

For doctors and other practitioners, responding to such surveys — sometimes from dozens of health plans — is hardly at the top of their to-do list. Insurers typically offer multiple health plans, each with a different constellation of providers, who don’t always know which ones they’re in.