Healthcare Reform Blog

Chris LewisContributor: Chris Lewis
Topics: Covered California, Exchanges, Affordable Care Act

More than two weeks into open enrollment, shoppers in the Covered California insurance exchange lack access to two critical pieces of information to help them select a plan: a directory of in-network providers and the drug formularies.
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Posted on: 10/21/2013 1:56:22 PM


Holly FultsContributor: Holly Fults
Topics: Employers, narrow networks, ACOs, quality

Retail giants Walmart and Lowe's have announced a new healthcare benefit for their employees: no-cost knee and hip replacements. As of Jan.1, care and consultations for the procedures will be covered at 100 percent, with no copays or deductibles.
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Posted on: 10/21/2013 10:20:52 AM


Sheri SellmeyerContributor: Sheri Sellmeyer
Topics: Exchanges, pharmacy benefits, copay coupons

The blogosphere has lately been abuzz with an important question for pharma: Can copay coupons be used for enrollees in the new health benefit exchanges that launched this month?

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Posted on: 10/10/2013 10:00:24 AM


Bill MelvilleContributor: Bill Melville
Topics: ACA, Exchanges

When searching for Week 1 winners in the Great Health Exchange Rollout, it’s probably best to avoid healthcare.gov. You can’t log onto the site anyway. If you live in Louisiana, you probably haven’t tried (seven enrollees as of Oct. 7).

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Posted on: 10/9/2013 11:35:15 AM


Merk CherryContributor: Mark Cherry
Topics: ACA, Exchanges, Obamacare

If you are still having trouble getting into the online health insurance marketplace, or your governor has essentially outlawed healthcare navigators, you may want to check out your local supermarket or strip mall. With health insurance now a required commodity, health plans are looking for new ways to engage potential customers, and that includes going into the traditional retail space.
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Posted on: 10/4/2013 2:31:56 PM


Sheri SellmeyerContributor: Sheri Sellmeyer
Topics: Exchanges, ACA

Today the new healthcare exchanges officially launched, but if I had wanted to sign up for an insurance plan in Georgia, Michigan, California, or Rhode Island, I would have been out of luck – at least as of 11:30 Central Time.
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Posted on: 10/1/2013 2:15:08 PM


Chris LewisContributor: Chris Lewis
Topics: PBMs, Private Exchanges, Defined Contribution

Recent news of high-profile companies moving employers to private insurance exchanges has pressured the share prices of publicly traded pharmacy benefit managers. It may be an overreaction—as a chorus of stock analysts suggests—but there’s a reason investors are a bit spooked.
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Posted on: 9/30/2013 3:02:40 PM


Merk CherryContributor: Mark Cherry
Topics: Hospitals, Consolidation, ACA, Narrow Networks

Like in Fantasy Football, Fantasy Health System is about matchups. But instead of racking up passing yards against a weak secondary, or sacks against a weak O-line, a Fantasy Health System must garner a sufficient number of hospitals and physicians in order to influence its reimbursement rate from payers.
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Posted on: 9/26/2013 3:59:38 AM


Jane DuboseContributor: Jane Dubose
Topic: ACA, Exchanges, MCOs, HHS

After more than three years of legal challenges, political grandstanding, rulemaking and technology building, it’s almost show time for the public health benefits exchanges. In a matter of days, Americans will get their first look under the hood of one of the largest new programs ever undertaken by federal and state governments.

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Posted on: 9/25/2013 1:25:24 PM


Bill MelvilleContributor: Bill Melville
Topics: Healthcare reform, Medicaid, exchanges, Kentucky

As the tremors of health reform grow more forceful every day, their epicenter can be hard to pinpoint. Every state has approached the law differently, from Maryland moving ahead on a health exchange in March 2010 to numerous states refusing any role in implementation. Can a single state serve as an indicator for ACA success?

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Posted on: 9/12/2013 3:35:34 PM


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