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

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 | with 2 comments

Contributer: Sheri Sellmeyer
Topics: Exchanges, uninsured, Medicaid

The latest data on healthcare exchange enrollment underscore a troublesome fact for Republicans: These online marketplaces are quite popular in some very red states.
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Posted on: 7/29/2014 5:24:26 PM

Bill MelvilleContributor: Bill Melville
Topics: 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.
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Posted on: 7/24/2014 9:49:41 AM

Contributer: Laura Beerman
Topics: 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.
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Posted on: 7/23/2014 2:24:59 PM

matt-arnold-81x99.pngContributer: Matthew Arnold
Topics: 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.
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Posted on: 7/16/2014 9:59:42 AM

Contributer: Laura Beerman
Topics: 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.
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Posted on: 7/14/2014 3:18:33 PM

Jenny Kerr

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.

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Posted on: 7/11/2014 10:44:57 AM

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