Healthcare Reform Blog

Fresh U.S. healthcare insights from expert analysts on Healthcare Reform, ACOs, Exchanges, Medicaid, Medicare, regional and national trends…and much more
Author: Chris Silva
Topics: Telemedicine, ”Mississippi Board of Medical Licensure” Teladoc, “American Telemedicine Association”


In Michael Mann’s biopic drama, ‘The Insider,’ Al Pacino and Russell Crowe play the key protagonists attempting to put a spotlight on Big Tobacco. The state of Mississippi plays a pivotal role as the setting where a key deposition takes place in a case that ultimately resulted in billions in settlements and changed the dynamics of tobacco advertising forever.
Read more.
Posted on: 8/31/2015 3:16:58 PM


Contributor: Sydney Hester
Topics: Medicaid Expansion, Affordable Care Act, ACA, Medicare Advantage, Mergers, Aetna, Humana

With the 50th anniversaries of Medicare and Medicaid marked on the calendar in July, the two federally funded programs are finally becoming a high priority for insurers aiming to spread their base. Though both programs have taken a back seat to commercial consumers in the past due to lower profit margins, payers are taking advantage of new growth opportunities in the markets.  Read more.
Posted on: 8/6/2015 3:26:45 PM


Contributor: Deborah White
Topics: Affiliations, bundled payments, hospitals, partnerships, reimbursement, post-acute care

Consolidation among insurers dominates the headlines these days, but another wave of deals is brewing—this time in the post-acute-care sector. A few health systems already have formed new partnerships with post-acute providers to increase integration and enhance care coordination. Read more.
Posted on: 8/5/2015 9:40:45 AM


Bill MelvilleContributor: Bill Melville
Topics: Blue Cross Blue Shield of Texas

Don’t look now, but the future of PPO plans sold in the individual market looks a lot shakier.

Lost in the noise over mega-mergers, one of the biggest carriers anywhere, Blue Cross Blue Shield of Texas, announced plans to stop selling its Blue Choice PPO on and off the exchange in 2016. Read more.
Posted on: 7/30/2015 3:53:58 PM


Ric GrossContributor: Ric Gross
Topics: Alaska, Medicaid, Montana, Utah

On July 30, 2015, the Medicaid program will officially turn 50 years old.  And while the event has certainly been commemorated, let’s just say that in many states, it wasn’t with quite the same enthusiasm of Marilyn Monroe’s “Happy Birthday, Mr. President” serenade to President John F. Kennedy for his birthday. Read more.
Posted on: 7/28/2015 4:45:18 PM


Paula WadeContributor: Paula Wade
Topics: Aetna, Anthem, Cigna, consolidation, Humana, M&A, UnitedHealth Group

The pending mega-mergers of Anthem with Cigna and of Aetna with Humana will most likely do what they’re designed to do: maximize profits of the companies’ corporate shareholders. But this will come at a price—still hard to quantify—to consumers of health insurance and to the sellers of healthcare services and goods. Read more.
Posted on: 7/28/2015 8:48:55 AM


Contributor: Sarah Wilson
Topics: Mergers & Acquisitions, Health Insurance, Medicare, UnitedHealth Group, Aetna, Anthem, Cigna, Humana

For years, there has been the “Big Five” of health insurance companies, but a change to the “Big Three” of Anthem-Cigna, UnitedHealth Group, and Aetna-Humana appears to be closer to reality. The idea that Aetna would acquire Humana or that Anthem would acquire Cigna seemed a more remote possibility earlier this year. Read more.
Posted on: 7/24/2015 2:07:26 PM


Bill MelvilleContributor: Bill Melville
Topics: Anthem, Cigna

With the long-awaited merger of giants Anthem and Cigna announced, the impact on the newest market segment in health insurance might could be significant.


Read more.
Posted on: 7/24/2015 2:04:27 PM


Contributor: Evan Camden
Topics: Medicaid expansion, ACA, reimbursements, healthcare access

Imagine, for the first time in your life, you are able to sign up for Netflix and have access to the movies you want, when you want them. You sign up, pay your monthly dues, then go to stream the movie you want, only to find out you don’t have access through Netflix. Hulu has the movie available, but your subscription doesn’t work with that service. Another option is to buy the movie, but that will cost a considerable amount more than you want to pay, which is why you signed up for Nexflix in the first place. If you can’t get the movie you want, when you want it, through your Netflix account, what is the point of having it? Read more.
Posted on: 7/21/2015 11:37:53 AM


Lyda PhillipsContributor: Lyda Phillips
Topics: Aetna, Catamaran, consolidation, CVS/caremark, EnvisionRx, Express Scripts, Humana, M&A, OptumRx, PBM

The year 2015 was in its infancy when a PBM executive remarked to a Decision Resources Group colleague, “You can expect more consolidation this year.”

Boy, was he right. Read more.
Posted on: 7/17/2015 4:54:56 PM


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