Healthcare Reform Blog

Bill MelvilleContributor: Bill Melville
Topics: Healthcare.gov, Nevada Health Link, MNSure, Affordable Care Act

As difficult as the launch of Healthcare.gov was initially, it was a smoother ride than many state-run public health insurance exchanges. Facing mounting costs and uncertainty, state-run exchanges may become a rarity, if not in 2016, then the not-so-distant future.
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Posted on: 9/18/2014 10:37:42 AM


Deborah WhiteContributor: Deborah White
Topics: CVS/MinuteClinic, Texas Health Resources, Baylor Health Care System, Walgreens’ Healthcare Clinics, Seton Healthcare Family, RediClinic, Rite Aid

Three health systems in Texas have new affiliations with retail drug stores this year as part of a strategic focus on population health management and accountable care organizations.  At first glance, the affiliations may seem odd especially now that retail clinics are offering more primary healthcare services. Wouldn’t the clinics be considered a competitive threat?
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Posted on: 9/16/2014 4:17:38 PM


Bill MelvilleContributor: Bill Melville
Topics: Mergers/acquisitions, ACOs, Healthcare reform, Health system consolidation, Affordable Care Act

A few months back, Banner Health’s recent expansions into outlying parts of the Phoenix metro area pointed in an intriguing direction: Tucson. Despite the possible stepping stone of purchasing Casa Grande Regional Medical Center between Phoenix and Tucson, it wasn’t clear how Banner would enter the southern Arizona market.
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Posted on: 9/8/2014 8:57:38 AM


Lyda PhillipsContributor: Paula Wade
Topic: UnitedHealth Group, exchanges, Alabama, Florida, Mississippi, Nevada, Texas

The nation’s largest private insurer, UnitedHealth Group, is jumping into the public insurance exchange market in 2015—heightening competition in at least 15 states in which it plans to compete for individual business.

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Posted on: 9/4/2014 5:17:31 PM


Contributer: Laura Beerman
Topics: ACOs, Centers of Excellence, Atlantic ACO, Optimus Healthcare Partners, UnitedHealthcare, University Hospitals


If you Google “ACO” and “Centers of Excellence,” you get mixed results – which might also be the outcome of combining these approaches to improve healthcare quality and cost efficiency. First, a definition:  Centers of Excellence are generally hyper-focused on the treatment of a particular disease or condition. Examples include bariatric surgery, stroke care and breast cancer care. For these three conditions, there are external organizations that grant formal COE accreditation. But in most cases, a Center of Excellence is a self-dubbed designation used by a hospital or health system to promote a specific service line and team of specialists.
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Posted on: 9/2/2014 10:34:53 AM


AnnJeanette Colwell

Contributor: AnnJeanette Colwell
Topic: Clinical Integration, Academic medicine, Health system consolidation, Acquisition/mergers

The Cleveland Clinic has national and international clout, including a strong reputation for high quality healthcare. But hospital consolidation in Ohio could challenge the world-renowned system, which is facing intense competition from powerful health systems, two in particular, that have strengthened their integrated delivery networks in recent years and will likely give Cleveland Clinic a run for its money in its home state.

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Posted on: 8/18/2014 3:26:57 PM


Lyda PhillipsContributor: Paula Wade
Topic: Medicaid expansion, uninsured, Wal-Mart

More than 7.2 million people have gained Medicaid coverage since the Affordable Care Act’s marketplaces opened in October—an impressive number, considering that only half of states (25 plus the District of Columbia) have opted to expand their Medicaid programs as called for in the ACA. These figures, which represent the end of June 2014, exclude Maine and North Dakota.

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Posted on: 8/15/2014 2:24:33 PM


Ric GrossContributor: Ric Gross
Topic: Medicaid, Arkansas, Indiana, Michigan

In the full-speed ahead Republican battle against Obamacare’s expansion of Medicaid, some GOP-heavy states have taken an off-ramp straight into their own version of Frankenstein’s laboratory. There, states have taken the Medicaid program, tinkered with it, and added enough ancillary parts to expand the program while still trying to appease the party base. Not an easy task, as regardless of the finished product, some villagers will always be carrying torches.
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Posted on: 8/14/2014 11:38:02 AM


Chris LewisContributor: Chris Lewis
Topics: biosimilars, filgrastim, Neupogen, Sandoz, Amgen

Faced with the onslaught of high-cost specialty drugs—a reality brought to the fore by the high-priced hepatitis C drug Sovaldi—many plan sponsors no doubt heaved a sigh of relief at the first U.S. filing for approval of a biosimilar last month.

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Posted on: 8/13/2014 4:51:08 PM


Merk CherryContributor: Mark Cherry
Topics: Florida Blue, exchanges, MLR, rebates, premium increases, Florida

Opponents of Obamacare were delivered fresh fodder when Florida Blue announced plans to raise 2015 exchange premiums by 17.6 percent. But instead of being a direct result of the Affordable Care Act, the Blue plan’s increase may have been caused by one of several efforts by the state legislature to undermine the law. Read more.
Posted on: 8/4/2014 9:17:09 AM


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