Contributor: Jenny Kerr
Topic: ACOs, Pioneer, ACA
At least one Pioneer ACO in California has saved money from Medicare’s ambitious accountable care experiment. San Francisco’s Brown & Toland, an independent physician practice with about 1,500 physicians, reported savings of $10.6 million in 2012. About 190 physicians treated 18,000 Medicare patients in the Pioneer ACO, and generated savings by coordinating care and avoiding unnecessary hospitalizations, the group said. Read more.
Posted on: 8/13/2013 4:23:27 PM
Small-group exchanges, SHOP, exchanges, healthcare reform, Anthem
Anthem Blue Cross’s absence from the California small-business health insurance exchange is curious on many levels. Why would one of the state’s biggest small-group insurers shun a ready-made source of business, with the muscle of a massive federally funded marketing campaign behind it? Read more.
Posted on: 8/8/2013 3:47:29 PM
ACA, Exchanges, MCOs
Call it a case of diminished expectations: UnitedHealthcare initially planned to participate in up to 25 state marketplaces. With each successive quarterly earnings call, however, the carrier’s planned exchange profile seemed to fade. Now, you can count exchanges where UnitedHealth has applied with two hands. The carrier could still play in 10-12 exchanges, but it is being extremely picky. Read more.
Posted on: 7/25/2013 11:43:12 AM
Contributor: AnnJeanette Colwell
Topic: Health plans, managed care, ACA
The Affordable Care Act was touted as a way to increase competition among insurers in order to drive down costs for consumers, as well as provide an opportunity for small to mid-size carriers to expand their business. However, the recent exit of a strong regional plan from most of its markets indicates that the ACA could be having the opposite effect. Read more.
Posted on: 7/24/2013 11:37:20 AM
Contributor: Lyda Phillips Read more.
Topic: Medicaid, ACA, Michigan
Michigan and Ohio are the biggest of the last few states still on the fence about Medicaid expansion.
And Michigan seems close to endorsing expansion. Backed by both the Obama administration and conservative Republican Gov. Rick Snyder, the expansion of Medicaid to an estimated 470,000 Michiganders hangs only on a vote in the state Senate.
Posted on: 7/23/2013 12:33:47 PM
M&A, hospitals, ACA
The American healthcare industry continues to consolidate at a rapid pace, especially in light of healthcare reform. Catholic health systems have taken the opportunity to create larger systems, consolidating with other Catholic entities and increasingly, secular entities. HealthLeaders-InterStudy has tracked the increasing merger and acquisition activity, and notes the three largest nonprofit health systems in the country are affiliated with the Catholic Church: Ascension Health, Catholic Health Initiatives, and Trinity Health. From the recent uptick of Catholic health system M&A, distinct trends are emerging. Read more.
Posted on: 7/23/2013 10:05:59 AM
ACOs, physicians, hospitals, pay for performance
In the world of healthcare reimbursement news, July 16, 2013, was a pretty big day. For months, there was speculation about how the accountable care organizations serving Medicare beneficiaries would perform. When the news finally arrived, some called it mixed, but I’d definitely give the joint performance of the 32 Pioneer ACOs at least a C+ or better.
Posted on: 7/16/2013 4:48:08 PM
Medicaid, exchanges, Vermont, Maine
Rolling out provisions of the Affordable Care Act will be a challenge for all states, regardless of size. Witness Maine and Vermont – not exactly sprawling metropolises, but both are enduring their fair share of bumps along the road to implementation. Read more.
Posted on: 7/12/2013 12:06:03 PM
Contributor: Mark Cherry Read more.
Topic: Medicaid, ACA, Employers
While the eventual effect of the employer mandate on the uninsured rate may turn out to be underwhelming, the provision’s near-term political impact on the business community was galvanizing. The mandate seemed more like a diabolical plot to induce business lobbies (traditionally Republican-leaning) to endorse Medicaid eligibility expansion rather than a method to actually provide insurance to a significant number of people. And it would have worked, if it weren’t for those pesky state legislators.
Posted on: 7/12/2013 10:54:09 AM
Contributor: Sheri Sellmeyer
Topics: Employer mandate, exchanges
There are both glass-half-empty and glass-half-full ways to react to the Obama administration’s delay of the employer mandate for healthcare coverage until 2015.
The announcement doesn’t mean that ObamaCare is going away, or that scores of employers will dump their employees into the exchanges next year. After all, most large employers already provide health insurance for their employees, and good benefit packages are still a way to attract and retain talent.
Posted on: 7/9/2013 10:09:00 AM