Health Plan Business

From Health Plan Week - As provider systems slowly transition to a more accessible online delivery system, health insurers are gradually responding by adjusting their payment models to include the time physicians spend consulting patients via email and over the phone. Read more

From Health Plan Week - The trend of health insurers evolving into retail-facing companies took a twist on Nov. 17 when Kaiser Permanente said it would open in-store clinics in four Southern California Target Corp. locations. Officials with Kaiser and market consultants say what is new with this latest development is how the Kaiser-Target arrangement may affect not just the two parties and their members-customers, but also the wider health plan marketplace. The growth of in-store… Read more

Health Plan Business Blog

By Jill Brown - December 17, 2014
Engaging your physicians while educating them on the legal and regulatory details of developing an accountable care organization will take significant resources, warn two attorneys who were deeply involved in crafting a five-year commercial ACO agreement between Hawaii Pacific Health and Hawaii...
By Steve Davis - December 5, 2014
In June, three years will have passed since the Supreme Court ruled that the Affordable Care Act (ACA) went too far by withholding all Medicaid funding from states that don’t expand program eligibility to adults with annual incomes up to 133% of the federal poverty level. Since that decision, just...
By Jill Brown - December 2, 2014
CMS on Dec. 1 issued proposed regs for the Medicare Shared Savings Program (MSSP) that would slow down providers’ transition to two-sided risk and create a new “Track 3” alongside one-sided risk (Track 1) and two-sided risk (Track 2). The proposal met with mixed reviews from an ACO group. Most...

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