Healthcare Reform Blog

Bill MelvilleContributor: Bill Melville
Topics: Exchanges, ACA

For most of its brief existence, the Washington Health Plan Finder looked like a model state-run exchange. Nine carriers representing a good mix of commercial and Medicaid players filed to sell policies. The state moved quickly to build its exchange infrastructure and chose to operate as an active purchaser, requiring insurers to bid on exchange business.

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Posted on: 8/26/2013 1:00:56 PM


Jenny Kerr

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.

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Posted on: 8/13/2013 4:23:27 PM


Chris LewisContributor: Chris Lewis
Topics: 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?
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Posted on: 8/8/2013 3:47:29 PM


Bill MelvilleContributor: Bill Melville
Topics: 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.
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Posted on: 7/25/2013 11:43:12 AM


AnnJeanette Colwell

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.

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Posted on: 7/24/2013 11:37:20 AM


Lyda PhillipsContributor: Lyda Phillips
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.

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Posted on: 7/23/2013 12:33:47 PM


Sarah WilsonContributor: Sarah Wilson
Topic: 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.
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Posted on: 7/23/2013 10:05:59 AM


Jane DuboseContributor: Jane Dubose
Topic: 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.

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Posted on: 7/16/2013 4:48:08 PM


Ric GrossContributor: Ric Gross
Topic: 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.
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Posted on: 7/12/2013 12:06:03 PM


Chris SilvaContributor: Mark Cherry
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.

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Posted on: 7/12/2013 10:54:09 AM


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