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State Exchanges View All →

Fewer Choices and Higher Premiums in the Affordable Care Act’s Exchanges

1 month ago

People shopping around on the insurance exchanges when the Affordable Care Act’s Open Enrollment period begins next week will find that the choices they have are limited and that insurance premiums have gone up significantly.

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2017 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces

1 month ago

Health insurance premiums on the Affordable Care Act’s marketplaces (also called exchanges) are expected to increase faster in 2017 than in previous years due to a combination of factors, including substantial losses experienced by many insurers in this market and the phasing out of the ACA’s reinsurance program.

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Obama administration announces double-digit premium hikes for Affordable Care Act

1 month ago

Obamacare premiums will soar in 2017, the administration acknowledged Monday, with the price of the most popular benchmark plans jumping an average of 22 percent as the law continues to rely on older, sicker customers than its backers had envisioned.

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More Than a Million People on Obamacare Could Lose Their Insurance Plans

2 months ago

Insurers pulling back on Obamacare could cause some 1.4 million people to lose their coverage, according to a new analysis.

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To Keep Obamacare Viable, Insurers Are Restricting Access To Doctors

2 months ago

Limited access to doctors and hospitals could become the norm for those buying individual coverage under the Affordable Care Act as insurers move rapidly to narrow medical care provider networks, a new analysis and recent insurer disclosures indicate.

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Medicaid View All →

6 Massachusetts health networks test ACO pilot program for Medicaid

6 days ago

Six Massachusetts health systems are launching programs Thursday that will change the way they are paid for care provided to 160,000 Medicaid recipients.

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Long-Term Care Is Increasingly Becoming Managed Care At Home

1 month ago

Medicaid long-term care is rapidly changing, and some of those trends may eventually remake the way all of us receive personal assistance as we age or become disabled.

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The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid

1 month ago

As of September 2016, 19 states had not expanded Medicaid and eligibility for adults in states that did not expand their programs is quite limited.

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Medicaid Expansion Causes Surge In ER Visits

1 month ago

A new study released in the New England Journal of Medicine suggests that the assumption that the ACA would lead to lower ER use was wrong.

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Six Medicaid ACOs Vary in Consumer Engagement Success

2 months ago

Consumer engagement in a number of Medicaid accountable care organizations (ACOs) tend to vary significantly, according to a September 2016 report from the Center for Consumer Engagement in Health Innovation.

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Emerging Healthcare Models View All →

Vermont’s new payment model could ignite a national trend

6 days ago

The architects of Vermont’s new value-based payment model believe it could serve as a blueprint for payment reform across the country by focusing on quality care, reducing healthcare costs and improving access to care.

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How Alternative Payment Models Decrease Cancer Care Costs

7 days ago

Oncology alternative payment models should focus on clinical pathway adherence and patient-centered strategies to lower cancer care costs, a report contended.

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HealthCare Partners Saves $1.6 million in Anthem Blue Cross Enhanced Personal Health Care Program

3 weeks ago

Third Consecutive Year HealthCare Partners Produces Savings from Anthem Accountable Care Programs

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ASCO Launches Oncology Medical Home Model

3 weeks ago

A new initiative launched by the American Society of Clinical Oncology (ASCO) aims to help community oncology practices move away from volume-based towards value-based care by structuring reimbursement around the full range of services needed by patients with cancer.

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ACOs Well-Suited to Address Nonmedical Needs

3 weeks ago

Research published in the journal Health Affairs indicates that accountable care organizations are well-suited to help patients meet nonmedical needs associated with significant medical and financial consequences.

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Insurers View All →

Humana Serves 63% of Members through Value-Based Care Payment

6 days ago

Health payers are finding the rapid pace to transition to value-based care payment models difficult.

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Humana Distributes More Than $93 Million in Quality Payments to Providers Nationwide

3 weeks ago

Approximately 4,465 provider groups in value-based relationships with Humana recognized for quality care outcomes.

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Humana touts success of value-based Medicare Advantage reimbursement models

1 month ago

Humana says its Medicare Advantage members enrolled in value-based arrangements experience better care quality and healthier outcomes–all while helping trim costs.

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UnitedHealth Group Launches National ACO

1 month ago

United Health Group,  the nation’s largest health insurer, will launch a nationally branded accountable care organization, committing more resources to a value-based care push designed to attract self-funded employers.

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ACA plans hamper Molina Healthcare, but Medicaid continues turnaround

1 month ago

Molina Healthcare’s Medicaid business improved in the third quarter after a rocky start to the year, but worse-than-expected results from the Affordable Care Act individual and small-group marketplaces weighed down the insurer’s profit.

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