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

AnnJeanette Colwell

Contributor: AnnJeanette Colwell
Topic: Patient-centered medical home, Patient engagement, Primary care

Patients are the key to success for the patient-centered medical home model. That may seem like a no-brainer—after all, the word “patient” is part of the term itself. Yet the importance of patients, and more specifically patient engagement, was reiterated over and over at the 2014 Patient-Centered Primary Care Collaborative Western Regional Conference in Denver earlier this month.

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Posted on: 6/24/2014 1:01:35 PM


Chris SilvaContributor: Chris Silva
Topics: Medicaid, Anthem Blue Cross and Blue Shield of Virginia, Virginia Premier Health Plan, Amerigroup, Coventry Health Care of Virginia, Aetna

Virginia is at a stalemate over whether or not to expand Medicaid—a dispute so acrimonious that the state government could be headed for a shutdown. The looming debate has had an impact on the state’s Medicaid carriers, all of which have seen increases in enrollment in recent years. Read more.
Posted on: 6/23/2014 9:35:21 AM


Bill MelvilleContributor: Bill Melville
Topics: Exchange, ACA, New Hampshire

Leading up to open enrollment, New Hampshire became a favorite 2014 exchange punching bag.

Its partnership exchange beat enrollment estimates, with more than 40,000 people picking plans (HHS statistics, accessed May 2, 2014). But all its enrollees had only one insurer choice, Anthem Blue Cross and Blue Shield in New Hampshire. New Hampshire and West Virginia were the only states where exchange shoppers faced monopolies of a dominant Blue plan.

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Posted on: 6/19/2014 8:39:44 AM


Deborah WhiteContributor: Deborah White
Topics: Healthcare industry

Economist Uwe Reinhardt has a positive outlook about increasing value in the healthcare industry, but predicts there will be a few bumps and hard choices along the way.

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Posted on: 6/12/2014 9:16:50 AM


Bill MelvilleContributor: Bill Melville
Topics: exchanges, Washington, premiums

Forget about taking a deep, relaxing breath at the end of 2014’s open enrollment in the exchanges. Before anything from 2014 has settled, 2015 is already knocking at the front door.
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Posted on: 5/28/2014 10:28:57 AM


Chris LewisContributor: Chris Lewis
Topics: Sovaldi, hepatitis C, Gilead, Olysio

You know a pill is powerful when it brings the nation’s healthcare leaders into one room to debate its broad implications for U.S. health policy.

The lightning rod is Sovaldi, the new hepatitis C wonder drug that, at $1,000 a pill, has every payer in the country quaking in its boots about how to pay for it.

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Posted on: 5/27/2014 9:19:55 AM


Chris LewisContributor: Chris Lewis
Topics: asthma, exchanges, formularies

With 2014 approaching the halfway mark, health plans are already turning their attention to next year’s qualified health plans—and that means determining drug formularies for 2015. Payers’ continual challenge is balancing the need to control costs in the exchange environment with their members’ ability to get the drugs they need at a cost that does not deter adherence.

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Posted on: 5/20/2014 8:47:48 AM


Louis ManningContributor: Louis Manning
Topics: Hospital formularies

It’s a common experience for frustrated patients across the country. They receive treatment in the hospital or undergo an expensive medical procedure, and then the bill comes with a litany of unexpected charges.
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Posted on: 5/15/2014 1:03:05 PM


Bill MelvilleContributor: Bill Melville
Topics: Exchanges, ACA

Cover Oregon, we hardly knew ye.

That’s primarily because the site never worked properly or enrolled a single Oregonian for 2014 coverage. Now the state is getting out of the health exchange business.
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Posted on: 4/25/2014 4:19:49 PM


Ric GrossContributor: Ric Gross
Topic: ACA, Massachusetts, exchanges

When it comes to healthcare reform in Massachusetts, a line from the classic Grateful Dead song, “Truckin’,” comes to mind—“What a long, strange trip its’ been.”

The saga began in April 2006 with a grandiose event at Boston’s Faneuil Hall, when Massachusetts’ then-governor, Republican Mitt Romney, signed the state’s near-universal healthcare law into effect. It was a made-for-TV event that certainly raised Romney’s profile as a ‘can-do’ governor.  A local headline read, “A Campaign Commercial in the Making.”  It was theorized that with the healthcare bill’s signing, Gov. Romney had given himself a significant legislative achievement whose coattails he could perhaps ride to the White House. A piece of bipartisan legislation enacted for the greater good—even some local Democrats were worried the spotlight was shining too brightly on Romney.
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Posted on: 4/23/2014 10:57:03 AM


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