Health Plan Business

From Health Plan Week - With 30% of its employees having chosen to enroll in direct contract accountable care plans that it first premiered in 2015 in the Seattle area, The Boeing Company on June 21 said it will now offer the option to 15,000 workers (37,000 total counting dependents and retirees) in Southern California starting Jan. 1, 2017, the first time the Golden State has seen such a health benefits model presented to group health members. Read more

From Health Plan Week - Now that the Dept. of Justice (DOJ) has filed a lawsuit against Carolinas HealthCare System (CHS) for allegedly anti-competitive contracting with health insurers (HPW 6/13/16, p. 7), industry stakeholders are assessing what widespread impact, if any, the action will have nationally in the provider-payer contracting universe. One leading lawyer in the space says it is too broad to say the actions by DOJ will cause contract reviews in every locale,… Read more

Health Plan Business Blog

By Patrick Connole - June 6, 2016
If you were in charge of a U.S. health insurer, what issue would make you lose sleep as you peer ahead to the rest of 2016 and into next year? When a pair of consultants and a noted lawyer were asked that question, they produced a list of challenges for health insurers that amounted to a virtual...
By Patrick Connole - May 31, 2016
When the Missouri insurance regulator came out on May 24 with a preliminary finding declaring its opposition to the pending Aetna Inc. acquisition of Humana Inc., industry watchers and stakeholders immediately took to form and either said (1) this spells doom for the deal’s overall approval, or (2...
By Steve Davis - April 28, 2016
CMS is considering several tweaks to its risk-adjustment program established by the Affordable Care Act (ACA) including a high-risk pool, partial-year enrollments and the inclusion of prescription drug claims as predictors of diagnoses or severity of illness. On April 11, I moderated a well-...

It's quick and easy to sign up for FREE access to AISHealth.com!

Why do I need to register?