Contributor: Bill Melville
Topic: Health exchanges, health plans, ACA
Every time a health plan reveals its health exchange strategy, the market winces. The same holds true when health exchanges pulling back the curtain on participating plans.
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Contributor: Carolyn McMeekin
Topic: ACA, medical devices, health plans, hospital systems
If you felt a shudder last week, it may have been the collective medical device industry imagining its future now that UnitedHealth Group and some large health systems have banded together to conduct independent studies on the long-term effectiveness of some medical devices.
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Contributor: Sarah Wilson
Topic: M&A, ACA, hospitals, physician groups, health plans
When the ball dropped on New Year’s Eve, it ushered in more than the annual, half-hearted decision to diet and exercise… starting bright and early the next morning. Jan. 1 also rang in a renewed resolve by healthcare firms to consolidate, continuing a trend accelerated by healthcare reform. Health systems, physician groups, health plans, and other industry members have examined and implemented every possible consolidation model as a way to prepare for the upcoming changes facing the industry come Jan. 1, 2014.
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Contributor: Jenny Kerr
Topic: ACOs, hospitals, health plans, physicians
At the Third National ACO Congress in Los Angeles last month, it was clear that all players in the three-legged stool of hospitals, health plans and physicians see ACOs as the future of reshaping healthcare cost and delivery. However, hospitals remain the biggest holdout in the evolution to population-based care that pays providers based on quality and outcomes instead of by service.
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Contributor: Jane DuBose
Topic: Provider Reimbursement, Care Coordination, Medical Homes
In a signal that care-coordination has gone well beyond lip service, there was news last week that the American Medical Association is adding new codes to its 2013 Bible on provider reimbursement. The book, 2013 CPT Professional Edition, is the essential link between providers’ office activity and the payments they receive from insurers.
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Contributor: Jane DuBose
Topic: Healthcare reform, Rebates, Medical Loss Ratio
While Wall Street has focused on the obvious pick-ups in Medicare and Medicaid business that Aetna’s purchase of Coventry Health Care will generate, there may also be gems in the commercial treasure chest that Coventry opens to its bigger rival.
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Contributer: Sheri Sellmeyer
Topic: State employee health plans
The biggest perk of state employment has always been having great benefits; many a professional has opted for a government job not for stellar pay, but for excellent health insurance and the promise of a government pension.
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Contributor: Laura Beerman
Topic: Health plans
On Jan. 12, 2012, Stephen Colbert of Comedy Central’s The Colbert Report announced his possible candidacy for the presidency in South Carolina. But first, he had to do one very important thing: transfer control of his super PAC to Jon Stewart.
Perhaps he was taking a page out of UnitedHealth Group’s playbook.
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Contributor: Bill Melville
Topic: Narrow network health plans
The wave of narrow-network health plans has not yet crested, and an early adopter remains in the best position to ride out the trend. California-based Health Net has quickly emerged as a leader in the narrow-network movement.
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Contributor: Jane DuBose
Topic: Consumer Driven Health Plans
Consumer-driven health plan enrollment represents anywhere from 10 percent to 13 percent of the employer-sponsored health benefits market and it’s been growing at a good clip through the recent recession. If healthcare reform continues as planned and if estimates are to be believed, CDHP enrollment could be half of the private insurance market by 2019.
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