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State Exchanges View All →

Specialty Care Is A Challenge In Some ACA Plans

7 days ago

Primary care doctors have reported problems making referrals for patients who have purchased some of the cheaper plans from the federal insurance marketplace.

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2015 Obamacare Rate Filings Reveal Changes in Out-of-Pocket Costs

7 days ago

As rate filings for 2015 Affordable Care Act health plans become public  and are compared to 2014, deductibles in the early public rate filings decreased with the exception of platinum plans. and out-of-pocket costs for covered medical services were more uneven when comparing 2015 early filings to 2014 averages. 

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Small Business Participation In Health Exchanges Likely To Remain Weak

3 weeks ago

Further delays and low participation among insurers are likely to dampen enrollment in a part of the Affordable Care Act that’s long been overshadowed: the Small Business Health Options Program.

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Consumers Who Stick With Current Exchange Plans May Face Significant Premium Increases in 2015

3 weeks ago

Consumers enrolled in exchange plans who receive federal assistance to reduce their monthly premiums may face substantial premium increases unless they switch insurance plans in 2015.

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HHS Announces ‘Auto-Enrollment’ for Exchanges

3 weeks ago

The Department of Health and Human Services (HHS) followed last week’s announcement of personnel changes with an announcement this week about automatic re-enrollment in health plans on the Affordable Care Act exchanges.

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Medicaid View All →

Hospitals See Troubles In Red States That Snubbed Obamacare’s Medicaid Deal

3 days ago

While record numbers of Americans sign up for the larger Medicaid health insurance program for the poor, financial issues are emerging for medical care providers in the two dozen states that didn’t go along with the expansion under the Affordable Care Act.

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The Medicaid Boom And State Budgets: How Federal Waivers Are Advancing State Flexibility

5 days ago

Due to political tensions, some states are seeking waiver approval from the Secretary to expand Medicaid, but in a way that they believe better serves their population.

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Medicaid can reap the rewards of medical homes

1 week ago

Medicaid programs could lower costs and boost quality care by implementing a patient-centered medical home model.

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Medicaid Adds Another Million Enrollees In May

1 week ago

While enrollment in private health insurance through online marketplaces may be closed until Nov. 15, Medicaid and the Children’s Health Insurance Program added almost a million new patients in May, according to the Centers for Medicare and Medicaid Services.

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Urban Institute: More uninsured went into Medicaid under ACA

4 weeks ago

Researchers at the Urban Institute Health Policy Center expect many will be surprised to learn that it appears many of those who lacked coverage went into Medicaid instead of a private plan.

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Emerging Healthcare Models View All →

University Hospitals, Aetna form accountable care organization (ACO) in Cleveland

5 days ago

University Hospitals and Aetna, the third largest U.S. health insurer, have launched an accountable care organization collaboration (ACO) designed to coordinate care and reduce costs for participants enrolled in the insurer’s health plans.

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UnitedHealthcare teams up with accountable care organization

7 days ago

Summit-based Optimus Healthcare Partners, an accountable care organization, and the health insurer UnitedHealthcare announced Wednesday they are working together to provide coordinated health care.

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CVS Caremark Announces New Clinical Affiliations with Four Major Health Care Providers

7 days ago

Clinical collaboration with CVS/pharmacy and MinuteClinic will increase access to care and help improve medication adherence for patients.

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Tenet and Humana Sign New Multi-Year National Agreement

1 week ago

Agreement expands in-network access to Humana Exchange members in five major markets.

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Reform Update: Preferred referrals gain favor with ACOs

2 weeks ago

The tactic of using a preferred referral list is one being tested by accountable care organizations eager to better manage patients who frequently shuttle from doctor to hospital to clinic to nursing home to specialist and back.

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Insurers View All →

To Prevent Surprise Bills, New Health Law Rules Could Widen Insurer Networks

4 days ago

The Obama administration and state insurance regulators are developing stricter standards to address the concerns of consumers who say that many health plans under the Affordable Care Act have unduly limited their choices of doctors and hospitals, leaving them with unexpected medical bills.

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Insurers push for change to medical-loss ratio

5 days ago

The health insurance industry is urging lawmakers to amend the Affordable Care Act’s medical-loss ratio provision-it wants payments to brokers and agents excluded from administrative costs.

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Early Effects of Medical Loss Ratio Requirements and Rebates on Insurers and Enrollees

2 weeks ago

  More than three quarters of insurers met or exceeded Medical Loss Ratio standards in 2011 and in 2012, and the median MLRs among all insurers was 88 percent.

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Bare-bones health plans may be small employers’ savior

3 weeks ago

Due to the Affordable Care Act’s employer mandate, benefit experts argue that employers across the country should consider “skinny” plans – the barebones, minimum essential health coverage option – in order to cover their full-time workforce, and not break the bank.

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Premiums Rise at Big Insurers, Fall at Small Rivals Under Health Law

1 month ago

Hundreds of thousands of consumers nationwide who bought insurance plans under the Affordable Care Act will face a choice this fall: swallow higher premiums to stay in their plan, or save money by switching.

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