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May 2, 2017

Hot Topic

Here’s a look at health insurers’ efforts to partner with providers to develop bundled payment programs:

Fla. Cancer Care Provider Starts New Bundle With UnitedHealth
Moffitt Cancer Care in Tampa, Fla., and UnitedHealthcare launched a three-year pilot program to test a new bundled payment model for early-stage lung cancer....

Report: Insurers Remain Ahead of Providers in Value-Based Payment
Payers are ahead of providers when it comes to implementing VBR as they are on average better positioned to offer the incentives that fuel the shifting of payment structures from traditional fee-for-service...

New Law Offers Clarity to Plans, Docs in Coding Options for Care
Health care providers and in turn health plans should be able to pinpoint more precisely the workflow of medical care for patients and members if the implementation of an overlooked part of the physician payment law, MACRA, is done correctly...

Today's AIS Health Datapoint

$42 ... is the average 30-day retail copay for preferred brand drugs, in network, for gold-tier HMO plans on 2017 individual marketplaces. The average Rx deductible for these plans is $379.08, although only 11% use this cost-sharing method. Roughly 14% of plans require an overall deductible to be paid before cost-sharing begins.


            Check out a demo of AIS Health's Rx benefit database

Quote of the Day

“Health care will keep its powder dry. No one has any idea what’s happening with health care reform, who is in charge, what their plans are, or how health care can best shape the conversation.”

— Industry consultant Joseph Paduda, a principal with Health Strategy Associates, LLC, predicts that the health industry will slow down lobbying spend until clarity emerges on reform efforts.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared — "When It Comes to Lobbying and Donations, Health Industry Places Bets on Sure Thing" (Free for HPW subscribers; $17 for non-subscribers.)


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