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State Exchanges View All →

5 states where PPACA exchange silver plan costs soared

2 weeks ago

Active bargain hunters who were willing to change health plans could get good prices for coverage from the typical Patient Protection and Affordable Care Act public exchange-except in 5 states.

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HHS: More Than 1M Exchange Enrollees Chose New Plans for 2015

3 weeks ago

More than one million U.S. residents who signed up for exchange plans this year selected new coverage, which the Obama administration said could help to keep down premium costs.

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Insurers’ Drug Tiering Can Keep Sickest Patients Away

2 months ago

Researchers studying how insurers categorize prices of drugs say some payers are using a practice called “adverse tiering” to discourage high-cost patients from enrolling in their plans.

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Health Insurance CO-OPs Fight Insolvency

2 months ago

The U.S. Department of Health and Human Services announced in December that two struggling health insurance cooperatives were given emergency solvency loans.

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More PPACA exchange users get premium subsidies

3 months ago

The U.S. Department of Health and Human Services (HHS) says at least 4 million people are set to have private exchange plan coverage in place Jan. 1, 2015.

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Looking for Affordable Care Act activity for a particular state? Select here to find out what's going on:

Medicaid View All →

Economy boosts safety-net hospitals in states not expanding Medicaid

4 weeks ago

Hospitals that treat many poor and uninsured patients were expected to face tough financial times in states that did not expand Medicaid under the Affordable Care Act.  But in some of the largest states that did not expand Medicaid, many “safety net” hospitals fared pretty well last year — better than in 2013 in many […]

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More States Lean Toward Medicaid Expansion

2 months ago

In accepting Indiana’s Medicaid Expansion plan, the Obama administration demonstrated its determination to increase the number of expansion states, even if it means waiving traditional Medicaid rules.

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3.2 Million Newly Eligible Adults Enrolled In Medicaid In Early 2014, CMS Reports

2 months ago

The CMS is taking a deep data dive into Medicaid enrollment data to uncover just how many new adults have joined the state programs since the Affordable Care Act motivated many states to expand eligibility last year.

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Medicaid Reimbursement Increases Under ACA Boost Access

2 months ago

A temporary increase in reimbursements under the Affordable Care Act for primary care physicians who treat Medicaid beneficiaries resulted in easier access to appointments, according to a study published Wednesday in the New England Journal of Medicine.

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As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care

3 months ago

Just as millions of people are gaining insurance through Medicaid, the program is poised to make deep cuts in payments to many doctors, prompting some physicians and consumer advocates to warn that the reductions could make it more difficult for Medicaid patients to obtain care.

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Emerging Healthcare Models View All →

A Medicaid ACO?

2 weeks ago

Medicare ACOs-would such a model work for Medicaid?

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The Affordable Care Act CO-OP Program: Facing Both Barriers and Opportunities for More Competitive Health Insurance Markets

3 weeks ago

The failure of the health insurance CO-OP operating in Iowa and Nebraska and recent analysis documenting significant losses among all but one CO-OP have caught the attention of policymakers and raised questions about the long-term viability of the Affordable Care Act’s Consumer Operated and Oriented Plan (CO-OP) program.

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Heritage Provider Network and Fresenius Medical Care Announce Physician Network Development and Care Coordination Collaboration

3 weeks ago

Heritage Development Organization, an affiliate of Heritage Provider Network (HPN), a national leader in coordinated care and integrated delivery network development and Fresenius Medical Care (FMS), a diversified health care company and North America’s largest provider of kidney care and hospitalist services, announced an agreement today to develop physician networks and care coordination and population […]

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Groups Praise New ACO Model’s Expanded Telehealth Coverage

3 weeks ago

Several health IT stakeholders say technology will play a key role in CMS’ new “Next Generation Accountable Care Organization Model,” which will expand coverage of telehealth services.

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Pioneering Pediatric ACO Drops Costs but Quality Gains Prove Elusive

1 month ago

Those involved with Partners for Kids effort hope to start national conversation about more thoughtful quality metrics.

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Insurers View All →

Insurers show greater compliance with medical loss ratio

5 days ago

Rebates that insurers owe patients are dropping, Commonwealth Fund finds

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Employers Warm To Obamacare, Stick With Coverage

5 days ago

Five years after employers were considering terminating health coverage due to costs and other issues related to the Affordable Care Act, companies have largely changed their tune as fears have not been realized, according to a new analysis.

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Implementing Health Reform: Wraparound Benefits Final Rule; Coverage Report

2 weeks ago

With open enrollment closed for 2015 and the Departments having finalized the Benefit and Payment Parameters Rule and Letter to Issuers for 2016, we have entered the Spring Affordable Care Act regulatory doldrums.  This post addresses the final wraparound coverage excepted benefits rule, and a report on health insurance coverage and the ACA (technical appendix here), […]

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Rethink the link between insurance premiums and wellness programs

4 weeks ago

Wellness programs that track physical activity and use incentives to reward progress are seen as a novel way to make health insurance pricing more equitable, but there is a fine line between rewarding personal responsibility and discriminatory pricing schemes.

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Implementing Health Reform: 2016 Benefit And Payment Final Rule, Insurance Provisions

1 month ago

This post will analyze the parts of the rule that deal with the insurance market reforms; the reinsurance, risk adjustment, and risk corridor programs; health insurance rate review; and the individual and SHOP exchanges.

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