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UBS shifts airline stocksIn April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online and other , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the with health care debt, 12% attribute at least some of it to maternity care, according to . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the , plan benefits, and health complications, said , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.
It’s almost that time of year: Spotify is gearing up to release its annual Wrapped, personalized recaps of users' listening habits and year in audio. Spotify has been giving its listeners breakdowns of their data since 2016. And each year, it’s become a bigger production — and internet sensation. Spotify said its 2023 Wrapped was the “biggest ever created,” in terms of audience reach and the kind of data it provided. So, what will 2024 have in store? Here’s a look at what to know ahead of this year’s Spotify Wrapped. What exactly is Spotify Wrapped? It’s the streaming service's annual overview of individual listening trends, as well as trends around the world. Users learn their top artists, songs, genres, albums and podcasts, all wrapped into one interactive presentation. The campaign has become a social media sensation, as people share and compare their Wrapped data with their friends and followers online. Past iterations have provided users with all kinds of breakdowns and facts, including whether they’re among an artist’s top listeners, as well as a personalized playlist of their top 100 songs of that year to save, share and listen to whenever they’re feeling nostalgic. Spotify also creates a series of playlists that reflect national and global listening trends, featuring the top streamed artists and songs. In 2023, Taylor Swift was Spotify's most streamed artist, unseating Bad Bunny who had held the title for three years in a row. Each year has something new in store. In 2019, Wrapped included a summary of users’ streaming trends for the entire decade. Last year, Spotify matched listeners to a Sound Town based on their artist affinities and how it lined up with those in other parts of the world. When is the expected release date? So far, the streaming platform has kept the highly anticipated release date of Wrapped under ... er, wraps. In past years, it’s been released after Thanksgiving, between Nov. 30 and Dec. 6. Each year, rumors tend to swell on social media around when Spotify stops collecting data in order to prepare their Wrapped results, and this year was no exception. Spotify quickly squashed those presumptions, assuring on social media that “Spotify Wrapped doesn’t stop counting on October 31st.” A representative for Spotify did not respond to a request for comment on when the company stops tracking data for Wrapped. Where can I find my Spotify Wrapped? When Wrapped is released, each user's Spotify account will prompt them to view their interactive data roundup. It can be accessed through the Spotify smartphone app, or by logging on to the Spotify website. Wrapped is available to users with and without Premium subscriptions. What else can I learn with my Spotify data? There are a handful of third-party sites that you can connect your Spotify account to that will analyze your Wrapped data. How Bad is Your Spotify is an AI bot that judges your music taste. Receiptify gives you your top songs on a sharable graphic that looks like, yes, a receipt. Instafest gives you your own personal music festival-style lineup based on your top artists. How NPRCore Are You assesses how similar your music taste is to NPR Music's. What if I don’t have Spotify? Other major streaming platforms such as Apple Music and YouTube Music have developed their own versions of Wrapped in recent years. Apple Music’s Replay not only gives its subscribers a year-end digest of their listening habits but monthly summaries as well — a feature that helps differentiate itself from the one-time Spotify recap. That's released at the end of the calendar year. YouTube Music, meanwhile, has a similar end-of-the-year release for its listeners, as well as periodic seasonal releases throughout the year. It released its annual Recap for users earlier this month.None
BIG TEN THIS WEEKNEW YORK (AP) — U.S. stocks climbed after market superstar Nvidia and another round of companies said they’re making even fatter profits than expected. The S&P 500 pulled 0.5% higher Thursday after flipping between modest gains and losses several times in the morning. The Dow Jones Industrial Average jumped 1.1%, and the Nasdaq composite edged up less than 0.1%. Banks, smaller companies and other areas of the stock market that tend to do best when the economy is strong helped lead the way, while bitcoin briefly broke above $99,000. Crude oil, meanwhile, continued to rise. Treasury yields edged higher in the bond market. THIS IS A BREAKING NEWS UPDATE. AP’s earlier story follows below. NEW YORK (AP) — U.S. stocks are climbing Thursday after market superstar Nvidia and another round of companies said they’re making even fatter profits than expected. The S&P 500 was pulling 0.7% higher, as of 2:45 p.m. Eastern time, after flipping between modest gains and losses several times in the morning. Banks, smaller companies and other areas of the stock market that tend do best when the economy is strong helped lead the way, while bitcoin briefly broke above $99,000. Crude oil, meanwhile, continued to rise. The Dow Jones Industrial Average jumped 532 points, or 1.2%, and the Nasdaq composite gained 0.2%. Nvidia's rise of 1.4% was the strongest force pushing the S&P 500 upward after yet again beating analysts’ estimates for profit and revenue. It also gave a forecast for revenue in the current quarter that topped most analysts’ expectations thanks to voracious demand for its chips used in artificial-intelligence technology. Its stock initially sank in afterhours trading Wednesday following the release of the results. Some investors said the market might have been looking for Nvidia's revenue forecast to surpass expectations by even more. But its stock recovered in premarket trading Thursday, and Wedbush analyst Dan Ives said it was another “flawless” profit report provided by Nvidia and CEO Jensen Huang, whom Ives calls “the Godfather of AI.” How Nvidia’s stock performs has tremendous impact because it’s quickly grown into Wall Street’s most valuable company at roughly $3.6 trillion. Its meandering up and down through the day dragged the S&P 500 and other indexes back and forth. The frenzy around AI is sweeping up other stocks, and Snowflake jumped 32.3% after reporting stronger results for the latest quarter than analysts expected. The company, whose platform helps customers get a better view of all their silos of data and use AI, also reported stronger revenue growth than expected. BJ’S Wholesale Club rose 9.1% after likewise delivering a bigger profit than expected. That may help calm worries about how resilient U.S. shoppers can remain, given high prices across the economy and still-high interest rates. A day earlier, Target tumbled after reporting sluggish sales in the latest quarter and giving a dour forecast for the holiday shopping season. It followed Walmart , which gave a much more encouraging outlook. Nearly 90% of the stocks in the S&P 500 were also rising, and the gains were even bigger among smaller companies. The Russell 2000 index of smaller stocks jumped a market-leading 1.9%. Google’s parent company, Alphabet, helped keep indexes in check. It fell 5.5% after U.S. regulators asked a judge to break up the tech giant by forcing it to sell its industry-leading Chrome web browser. In a 23-page document filed late Wednesday, the U.S. Department of Justice called for sweeping punishments that would include restrictions preventing Android from favoring its own search engine. Regulators stopped short of demanding Google sell Android but left the door open to it if the company’s oversight committee continues to see evidence of misconduct. Drops for other Big Tech stocks also weighed on the market, including a 2.4% slide for Amazon. In stock markets abroad, shares of India’s Adani Enterprises plunged 22.6% Thursday after the U.S. charged founder Gautam Adani, 62, in a federal indictment with securities fraud and conspiracy to commit securities and wire fraud. The businessman and one of the world’s richest people is accused of duping investors by concealing that his company’s huge solar energy project on the subcontinent was being facilitated by an alleged bribery scheme. Indexes elsewhere in Asia and Europe were mixed. In the crypto market, bitcoin eclipsed $99,000 for the first time before easing back to roughly $98,250, according to CoinDesk. It’s more than doubled so far this year, and its climb has accelerated since Election Day. President-elect Donald Trump has pledged to make the country “the crypto capital of the planet” and create a “strategic reserve” of bitcoin. Bitcoin also got a boost after Gary Gensler, the chair of the Securities and Exchange Commission who has pushed for more protection for crypto investors, said he would step down in January . Bitcoin and related investments, of course, have a notorious history of big price swings in both directions. MicroStrategy, a company that's been raising cash expressly to buy bitcoin, saw an early gain of 14.6% for its stock on Thursday quickly disappear. It was most recently down 10.7%. In the oil market, a barrel of benchmark U.S. crude rose 2% to bring its gain for the week to 4.8%. Brent crude, the international standard, climbed 1.8%. Oil has been rising amid escalations in the Russia-Ukraine war. In the bond market, Treasury yields edged higher following some mixed reports on the U.S. economy. The yield on the 10-year Treasury rose to 4.43% from 4.41% late Wednesday. One report said fewer U.S. workers applied for unemployment benefits last week in the latest signal that the job market remains solid. Another report, though, said manufacturing in the mid-Atlantic region unexpectedly shrank. Sales of previously occupied homes, meanwhile, strengthened last month by more than expected. AP Business Writers Matt Ott and Yuri Kageyama contributed.Saints say Taysom Hill 'likely' has a season-ending knee injuryStock market today: Wall Street climbs as bitcoin bursts above $99,000
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The 2024 Imperial Springs International Forum is held in Madrid, Spain on December 12, 2024. Photo: Wang Wenwen/GT Chinese President Xi Jinping on Thursday sent a congratulatory letter to the 2024 Imperial Springs International Forum held in Madrid, Spain. Xi pointed out that since its establishment 10 years ago, the forum has adhered to advocating multilateralism, conducted in-depth discussions on global governance issues, actively shared China's propositions, and played a positive role in enhancing exchanges and understanding between China and countries worldwide, Xinhua News Agency reported. Xi emphasized that in a world marked by intertwined changes and turmoil, peace and development remain the shared aspirations of all peoples. China stands ready to work with other countries in the spirit of "promoting global solidarity," upholding fairness and justice to safeguard global peace and stability, adhering to win-win cooperation to promote sustainable global development, and committing to inclusiveness and mutual learning to advance human civilization to new heights, Xi said. The 2024 Imperial Springs International Forum was held in Madrid, Spain on Wednesday and Thursday under the theme "Collective Action for One Future." In his opening remarks, Yang Wanming, president of the Chinese People's Association for Friendship with Foreign Countries, said that facing the future, all parties should take practical actions to strengthen unity and cooperation, work together to respond to global challenges, defend and practice true multilateralism, stand on the right side of history, promote the building of a community with a shared future for mankind in the spirit of "promoting global solidarity," and contribute to promoting world peace, stability and prosperity. Xue Lan, dean of the Schwarzman College, Tsinghua University who was present at the forum, noted that Xi's letter shows that the Chinese government has utmost sincerity in cooperating with the international community to cope with challenges. "China has accumulated enough experience to fully understand the problems faced by today's world. The key is consensus and the will to solve the problems. It is easier for countries to make a statement on international occasions, but actions matter the most - that's why the theme of this year's forum is significant," Xue told the Global Times on the sidelines of the forum. More than 200 participants from the political, academic, and business circles in over 50 countries from Asia, Europe, Africa, America and Oceania, including over 50 former heads of state, heads of government, and leaders of international organizations, and over 90 internationally renowned experts, scholars, and business leaders attended the forum. Inaugurated in 2014, the Imperial Springs International Forum is now jointly organized by the Chinese People's Association for Friendship with Foreign Countries, the Australia China Friendship and Exchange Association, the People's Government of Guangdong Province, and World Leadership Alliance-Club de Madrid. This year's forum mainly focused on the following topics: global strategic stability, financing for development, enhancing global cooperation, traditional and non-traditional challenges to global security, tackling challenges facing the world economy, United Nations Summit of the Future, the Future of Global Governance, AI and green technology, sustainable development, and people-to-people exchanges and mutual learning among civilizations. The Imperial Springs International Forum has been held for eight consecutive sessions, and has become a new type of high-end platform for China to conduct in-depth communication with the rest of the world. This year was the first time that the forum has been held abroad. Josipovic, the former president of Croatia, said that this change is significant as it shows the will to cooperate is even more intensive. Csaba Korosi, a Hungarian diplomat who served as president of the 77th United Nations General Assembly, was also a participant of the forum. He believes that the zero-sum game mentality prevailing in the world is starting to overshadow the necessity of global cooperation on global common goods, and the Imperial Springs International Forum with this year's theme of "Collective Action for One Future" provides an inspiring platform to discuss how countries can tackle it. "The result is a lose-lose game. So it cannot be an alternative for us. It cannot be an acceptable outcome for us. Our responsibility is the collective action, where we can still have a kind of race, but where we have to find the ways of cooperation," Korosi told the Global Times. Maria Fernanda Espinosa, former minister of foreign affairs of Ecuador, told the Global Times that cooperation fits into today's world. "When you think about the security challenges that the world faces, the conflicts that we are experiencing, the environmental crisis, the crisis of poverty and inequalities, all of these challenges require more cooperation in a multilateral system, and that's what it's all about at the end." She expressed appreciation for China's efforts to gather global voices. "China has shown that the voices of the world are important, bringing a community of current and former leaders to discuss the challenges of our times to come up with innovative ideas and solutions. It's really valued," she noted.
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