News

Four ways the ACA marketplace has changed coverage options

After just three years of growing pains, Affordable Care Act marketplaces are beginning to take shape, leading payers to refine plan options and premium pricing to better cater to consumers, according to a report released by PwC's Health Research Institute.

States foster marketplace competition through consumer education, rate review

A new brief from the Commonwealth Fund reveals how individual marketplaces in four states promote competition among insurers, educate consumers and ensure a level playing field for premiums through the rate review process.

Obama's 2017 budget proposal: What it means for payers

President Barack Obama unveiled his 2017 fiscal year budget Tuesday, including a host of provisions set to impact both public and private payers.

 

Cigna makes performance-based drug pricing deal with Novartis

Health insurer Cigna has teamed up with Swiss drugmaker Novartis AG to set the price for a new heart medication based on performance, Reuters reports.

 

Feds want Healthcare.gov to become an active purchaser

The government wants to take a more active role in selecting and designing health plans available on Healthcare.gov--similar to the approach California takes with its exchange.

 

Eight states see major drop in uninsured numbers

In the first nine months of 2015, eight states experienced a statistically significant drop in the number of their uninsured residents ages 18-64, according to the latest data from the Centers for Disease Control and Prevention's National Health Interview Survey. 

CMS announces limited-time special enrollment period

Though the Centers for Medicare & Medicaid Services has outlined how it will tighten the rules governing special enrollment periods, it also will add another SEP this year. 

With open enrollment over, Burwell sets sights on Medicaid expansion

Now that open enrollment is over, the Department of Health and Human Services is still trying to figure out a way to get the remaining uninsured the coverage they need.

 

Docs say oncologists--not payers--should determine cancer care pathways

Though the concept of designing cancer care "pathways" has potential, oncologists have reason to be concerned about the possibility of health insurers determining these pathways on their own, according to an opinion piece published in JAMA Oncology.

 

Most top-ranked hospitals in at least one ACA exchange network

Nearly all top-ranked regional hospitals are in at least one Affordable Care Act marketplace plan network, yet hospitals' network participation still "declined significantly" in 2016, a new analysis from the Robert Wood Johnson Foundation shows. The findings show that consumers have a lot of choice in hospitals, RWJF's Kathy Hempstead told FierceHealthPayer in an exclusive interview.

 

Cadillac tax opponents say full repeal is the only solution

Last week, White House economic advisers revealed that President Barack Obama would include an adjustment to the Cadillac tax in his 2017 budget proposal, but critics of the tax are not impressed.

No end in sight for BCBS of North Carolina technology woes

After two months of technology failures that led to overbilling and dropped coverage, Blue Cross Blue Shield of North Carolina will delay the transfer of 685,000 state health plan customers to its troubled software system, but offered no timeline for resolving existing data transfer problems, according to the News & Observer.

In struggle over future of ACA exchanges, consumers caught in the middle

I often think of the old expression "I only have two hands" when my plate seems too full or in any situation when people or organizations have expectations assigned to them that they...

Open enrollment sign-ups total 12.7 million

Affordable Care Act marketplace sign-ups for 2016 totaled about 12.7 million people, the federal government announced Thursday, including 9.6 million who enrolled through Healthcare.gov and 3.1 million through state exchanges.

Study: Great potential for Medicare Advantage to engage providers in value-based care

While Medicare Advantage plans present immense potential to accelerate the transition from volume to value in the healthcare industry, health plans still face challenges in convincing providers of the buisness case for value-based care in MA, according to a new study from Deloitte.

 

Why a national solution is needed for provider directories

A national solution is needed when it comes to collection and quality of provider information, according to panelists speaking at the eHealth Initiatives annual conference on Thursday.

High-deductible health plans reduce care, but at a cost

As high-deductible health plans become a more common fixture in the healthcare industry, the debate continues as to whether such benefit designs reduce care costs and usage--and how that influences consumers' health, according to a new issue brief from Health Affairs.

 

20 companies join in effort to keep employee healthcare costs low

Twenty major companies are teaming up to keep the amount they spend on employee healthcare as low as possible. 

Wellmark BCBS exec: Healthcare industry must improve breach detection

Security threats on the healthcare industry will never fully go away, but the risks can be managed, especially though threat detection, according to panelists at the eHealth Initiative's annual conference in the District of Columbia on Thursday.

A 2006 healthcare bill could serve as foundation for a single-payer system

A decade-old plan with a focus on cost-sharing could help the country successfully transition to a universal healthcare program, according to a Vox blog post.