Healthcare Reform Blog

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


Sheri SellmeyerContributor: 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.

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Posted on: 7/9/2013 10:09:00 AM


Bill MelvilleContributor: Bill Melville
Topics: Blue Cross Blue Shield, exchanges

Several state health benefit exchanges now look a lot less Blue, and that could leave consumers far from happy.

In three states, Blue Cross Blue Shield plans have opted against selling exchange policies. Another one, Regence Blue Cross and Blue Shield, opted out of the Oregon health exchange but will still sell individual exchange policies through a subsidiary.

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Posted on: 7/8/2013 3:57:51 PM


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