James Gelfand

Aug 9, 2024 | healthaffairs.org | Chris Deacon |James Gelfand |Peter Goldberger |Shawn Gremminger

This article is the latest in the Health Affairs Forefront series, Provider Prices in the Commercial Sector, featuring analysis and discussion of physician, hospital, and other health care provider prices in the private-sector markets and their contribution to overall spending therein. Additional articles will be published throughout 2023. Readers are encouraged to review the Call for Submissions for this series. We are grateful to Arnold Ventures for their support of this work.

Apr 23, 2024 | prescottenews.com | James Gelfand

Large hospital systems nationwide are adopting an alarming and dangerous tactic to force insurance companies to pay more when patients use employer insurance plans: proactively taking themselves out of network for Medicaid and Medicare Advantage patients, even though reimbursement rates for those plans are not in dispute. This hardball tactic leaves society’s most vulnerable patients scrambling to find new, in-network providers and disrupts much-needed medical care.

Apr 22, 2024 | dcjournal.com | James Gelfand |Ray Walker

Large hospital systems nationwide are adopting an alarming and dangerous tactic to force insurance companies to pay more when patients use employer insurance plans: proactively taking themselves out of network for Medicaid and Medicare Advantage patients, even though reimbursement rates for those plans are not in dispute. This hardball tactic leaves society’s most vulnerable patients scrambling to find new, in-network providers and disrupts much-needed medical care.

Sep 13, 2023 | daytondailynews.com | James Gelfand

Editor’s Note: A response to today’s contributed column will be published tomorrow. Like a phoenix rising from its ashes, our nation continues to rebuild from the effects of COVID. Wages are rising, despite a pandemic that massively hurt the economy and gave way to crippling inflation. Yet so too are health care premiums and costs, putting pressure both on employers and working families. The Kaiser Family Foundation found last year that health insurance costs for a family exceeded $22,000.

Mar 16, 2023 | benefitnews.com | James Gelfand

The impending loss of access to telehealth benefits for many patients enrolled in employer-sponsored health plans could be a significant loss for millions of workers and their families. Widely permitted during the COVID-19-driven public health emergency (PHE) that's set to end on May 11, telehealth became the default option for most medical visits and significantly raised the public's comfort level with virtual care. It is an affordable, convenient and efficient option for all key stakeholders.