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State Exchanges View All →

Enrollments Rise on State Health Exchanges

1 week ago

Enrollment increased in a number of state health exchanges for 2017, but it’s unclear if the numbers reflect a response to the expected repeal of the Affordable Care Act.

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15 things to know about the ACA’s affect on 5 state insurance marketplaces

1 week ago

A study to better understand the ACA’s implementation focuses on competition in California, Florida, Michigan, North Carolina and Texas.

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48 insurers that decreased their 2017 ACA exchange footprint

3 weeks ago

48 insurers which sold health insurance on ACA exchanges for 2016 but exited exchanges in some states or markets for the 2017 coverage year.

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48 insurers that decreased their 2017 ACA exchange footprint

4 weeks ago

Here are 48 insurers which sold health insurance on ACA exchanges for 2016 but exited exchanges in some states or markets for the 2017 coverage year.

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State Experiences Show Why Repealing the ACA’s Premium Subsidies and Individual Mandate Would Cripple Individual Health Insurance Markets

4 weeks ago

What happens if Congress and the new president push ahead with partial repeal without securing support for a replacement? The resulting regulatory landscape would look like what several states had in place prior to the ACA. Their experiences were poor.

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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 →

3 Key Questions: Section 1115 Medicaid Demonstration Waivers

3 days ago

Looking ahead, states are likely to continue to request waivers to implement provisions not allowed under current law; however, it is not yet clear what role Section 1115 waivers will play as the new administration and Congress move to repeal the ACA and debate possible broader changes to Medicaid financing.

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State Medicaid Programs Invest in Accountable Care Organizations

2 weeks ago

The number of state Medicaid programs operating accountable care organizations is steadily growing.

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An Early Look at Medicaid Expansion Waiver Implementation in Michigan and Indiana

2 weeks ago

Michigan and Indiana are among the seven states using a Section 1115 demonstration waiver to implement Medicaid expansions in ways that differ from the terms of the Affordable Care Act (ACA), although additional states have expressed interest in pursuing similar models.

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Avoidable Admissions for Long-Term Care Dual Eligibles Down 31%

4 weeks ago

Preventable hospital admissions for dually-eligible long-term care residents have plummeted thanks to investments in patient safety and value-based care.

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Avoidable Admissions for Long-Term Care Dual Eligibles Down 31%

4 weeks ago

Preventable hospital admissions for dually-eligible long-term care residents have plummeted thanks to investments in patient safety and value-based care.

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Emerging Healthcare Models View All →

HHS rule delay does not slow launch of bundled-payment models

3 days ago

The Trump administration’s move to delay the effective date for a rule that launched several new cardiac and orthopedic bundled-payment models under Medicare will not slow the launch of the initiatives, an HHS spokesman confirmed Thursday.

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Studies underscore importance of nuances, time in judging ACOs

3 days ago

In the ongoing debate over how accountable care organizations can lower costs and improve health, two new studies offer insights into the nuances of how ACOs affect spending, utilization and quality.

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Examining different accountable care organization payment models

3 days ago

Two new studies take a look at different accountable care organization (ACO) payment models.

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Aetna, UnitedHealth show increasing appetite for value-based care contracts

1 week ago

Aetna has long held a goal to reach 75 to 80 percent of its medical spend in value-based relationships by 2020.

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Provider Consolidation Not Directly Associated with Payment Reform

1 week ago

Although the prevailing wisdom is that payment reform will accelerate provider consolidation, new research published in Health Affairs finds minimal evidence that consolidation has been associated with accountable care organization (ACO) penetration.

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Insurers View All →

Aetna Gives Up On Merger, Will Pay Humana $1B Breakup Fee

3 days ago

Rather than seek an appeal, Aetna said it will now have to pay Humana $1 billion “as a result of the termination of the merger agreement.” Aetna will also end an agreement to sell certain Medicare Advantage plans to a smaller insurer, Molina Healthcare,  and will pay undisclosed termination fees associated with that deal.

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Blocked insurer mergers: What the decisions mean and what lies ahead

3 days ago

With both the Aetna-Humana and Anthem-Cigna deals struck down by the federal courts, the implications for both the health insurance industry and antitrust enforcement are just as powerful.

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Demand For Popular Short-Term Insurance Plans Could Surge If Health Law Is Relaxed

2 weeks ago

Short-term health plans have been around for decades and after the health law passed, some people gravitated toward them because they were willing to trade comprehensive coverage for a cheaper sticker price — even if it meant paying a tax penalty for not having the comprehensive coverage required in the law.

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Humana, Aetna, Cigna Invest in Value-Based Care Payment Models

1 month ago

National health insurers are continuing to advance value-based care payment models such as accountable care organizations.

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MACRA Pushes Payers to Adopt Value-Based Care Payment Models

2 months ago

With providers focused on meeting MACRA regulations, commercial payers are investing in value-based care payment models that align with the quality payment program.

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