Contributor: Bill Melville
Topic: Medicaid, exchanges, hospitals
On the surface, Nevada should not be so far along in ACA implementation. The state joined the lawsuit against the Affordable Care Act, and it has a Republican governor. Yet now, Nevada could become Exhibit A in how a state with a high uninsured rate and a barebones Medicaid program adapts to the law’s changes.
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Contributor: Paula Wade
Topic: Medicaid, Exchanges
Now that most of the nation’s anti-Obamacare GOP governors have ceded control of their state health exchanges to the feds, it only makes sense that the Obama Administration can’t allow the states to piecemeal the ACA’s Medicaid Expansion.
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Contributor: Sheri Sellmeyer
Topic: Medicaid, states
As state legislative sessions begin to crank up in early 2013, look for some backtracking on the part of politicians who have vowed they won’t expand Medicaid.
Officially, there are now eight states that say they will not expand Medicaid.
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Contributor: Jane Dubose
Topic: Exchanges
What do you get when you put 500 health plan executives, health benefits consultants and a few IT folks in a room with the federal official charged with implementing the upcoming health benefits exchanges? Lots of questions.
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Contributor: Sheri Sellmeyer
Topic: IDNs, ACOs, care management
If you’ve had this feeling of déjà vu lately when it comes to hearing about integrated delivery systems, it’s because we’ve been through this before.
Now the buzzwords are ACOs and bundled payments; 15 years ago they were all about capitation and the inevitability of the California delegated model. Integrated delivery networks of the 1990s didn’t deliver on most fronts, not on being profitable in many instances, and especially not in truly integrating care. And they were pretty lousy at running managed care organizations.
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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: ACA, Exchanges
In the weeks since President Obama’s re-election assured the future of health benefits exchanges, many stakeholders have demanded details on how the exchanges and essential benefits would actually work.
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Contributor: Paula Wade
Topic: Healthcare reform, Medicaid, Medicare
Regardless of how you may feel personally about President Barack Obama or his landmark healthcare reforms, the U.S. healthcare industry ought to be giving a sigh of relief right now.
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Contributor: Lyda Phillips
Topic: Hospitals, M&A, Michigan
The two largest health systems in Eastern Michigan—Henry Ford and Beaumont—have announced their wedding plans. If the marriage is approved by all the powerful interests involved, the healthcare system will be the largest in Michigan, with 10 hospitals and $6.4 billion in annual revenue.
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Contributor: Jane Dubose
Topic: Quality, NCQA, population health management
There was a lot of positive news around health plan quality improvements from a webinar recently sponsored by the National Committee on Quality Assurance. Obesity screenings for adults and children are increasing, and largely because of the Star rating program in Medicare, the quality of care delivered to seniors through Medicare Advantage plans is also dramatically going up.
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