Health Plan Business

From Health Plan Week - Globetrotting Americans may be falling through the cracks of the Affordable Care Act, says GeoBlue, which on Sept. 30 hit the market with its new Xplorer Select plan that allows U.S. expatriates and mobile world travelers living stateside in stretches to buy coverage that fulfills the ACA’s individual mandate requirements. This new product is an example of how health plans are seeking fatter margin businesses by serving Americans living overseas or traveling abroad frequently. They are achieving this by selling directly to consumers and large groups, by seeking partnerships for entry into international markets with domestic operators, or by outright… Read more

From The AIS Report on Blue Cross and Blue Shield Plans - In terms of market share, Blue Cross and Blue Shield plans owned public insurance exchanges this year. But when the next open-enrollment period kicks off on Nov. 15, they will face a wave of new competitors ranging from small Consumer Operated and Oriented Plans (CO-OPs) expanding into new markets, to national health plan operators that largely sat on the sidelines last year. And incumbent carriers that priced products conservatively last… Read more

Health Plan Business Blog

By Patrick Connole - October 14, 2014
Two experts in the health care space say new payment models are not going to squelch reimbursement for new technology, like medical devices used in heart surgery procedures, as some in the device industry have stated in recent weeks. Value-based payment will, however, put an emphasis on providers...
By Jill Brown - October 1, 2014
Today Baylor Scott & White Health celebrated its first anniversary after merging in fall 2013 by reporting quality and financial results of its accountable care organization (ACO), which it said helped to validate its claim that “the merger would create tangible benefits.” The Dallas-based...
By Jill Brown - September 12, 2014
In an effort to avoid preventable hospitalizations, one accountable care organization is working to find patients among its Medicare Shared Savings Program (MSSP) population who are not very engaged with their physicians. To help in that search, Jacksonville, Fla.-based Orange Accountable Care has...

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