Affordable Care Act, Halbig v. Burwell, Medicaid, Health insurance exchanges
A case with the ability to turn the Affordable Care Act on its ear finally went mainstream. Halbig v. Burwell has been coming so long that it was originally filed under a different name (Halbig v. Sebelius). It took its time, but the case led to a 2-1 appellate court decision that has brought the long-running debate over health insurance exchanges to a boil.
Posted on: 7/24/2014 9:49:41 AM
ACO, pharmacy risk, physicians
In May, I flew to San Francisco and the steward, long before he offered me my complimentary beverage and six peanuts, tried to sell me an airline credit card. I was suitably outraged at this captive sales pitch. But in the non-stop flight called ACOs, the captive pitch could be the difference between success and failure. And physicians may be doing the selling.
Posted on: 7/23/2014 2:24:59 PM
Hospitals, Pharma, MCO, PBMs, Health Plans, Health Care Marketing
As hospitals and health systems seek to control drug costs through increasingly restrictive formularies, drug companies are eager to reach the people that call the shots on what treatments are covered.
Posted on: 7/16/2014 9:59:42 AM
Accountable care, health information technology, Medicare Advantage
Lawn service. Financial planning. eBay middle men. Virtually every area of our lives is supported by a service industry – an entity that will help us do the stuff we don’t have time for or just don’t want to. And so it goes with accountable care organizations and the growing number of facilitators that are supporting ACO operations.
Posted on: 7/14/2014 3:18:33 PM
Contributor: Jenny Kerr
Topic: Oscar Health Plan, America’s Health Insurance Plans, Affordable Care Act
At the recent America’s Health Insurance Plans Institute 2014 meeting in Seattle, most of the buzz among insurance executives focused on physicians and hospitals providing care that costs too much for the quality of care received.
Posted on: 7/11/2014 10:44:57 AM
ACOs, employers, narrow networks, hospital systems
Within the half year, a large employer and three hospital systems in the Seattle area are launching an unusual accountable care experiment that removes the insurance company middleman. Read more.
Posted on: 7/10/2014 12:54:18 PM
Contributor: AnnJeanette Colwell
Topic: Direct primary care, Concierge care, High-deductible plans, Patient-centered
At the 2014 Patient-Centered Primary Care Collaborative Western Regional Conference recently held in Denver, health system executives were asked to discuss the changes that physicians will face in the shifting reality of healthcare reform.
Posted on: 7/9/2014 3:36:43 PM
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Contributor: Lyda Phillips
Topic: Mergers/acquisitions, Hospital consolidation, Health insurance exchange, Health information exchange, Population health management, Clinical integration
While the healthcare industry in Michigan typically marches to its own beat, a new partnership involving two of the state’s largest health systems could set a pattern for others to follow across the nation.
Posted on: 7/8/2014 12:56:10 PM
Last year was widely considered the year of the blockbuster health system merger, with Tenet-Vanguard, HCA-IASIS, and CHS-HMA each announcing consolidation deals. For many, it appeared that 2014 would result in more strategic moves from industry players looking to expand their continuums of care to maximize patient reach and smaller players seeking the stability of a larger entity. Others believed there would be greater consolidation among long-term care and outpatient care providers, speaking to the importance of providing alternatives to emergency room care and preventing hospital readmissions. Read more.
Posted on: 7/1/2014 1:39:10 PM
Exchanges, WellPoint, Humana UnitedHealthcare, Blue Cross Blue Shield
Enrollment in the new health exchanges has exceeded the expectations of supporters and disproven predictions of naysayers, but how many have actually paid their premiums, and which health plans are getting the lion’s share of those enrollees?
Posted on: 6/30/2014 9:35:47 AM