Health Plan Business

From Health Plan Week - Last time out was a disaster. This time will be different. That is the hope of health insurers as they prepare to implement strategies for the second public exchange open-enrollment period beginning on Nov. 15 and running to Feb. 15, 2015. What health plans and strategists expect this time around is a more nuanced, knowledgeable approach to how things work, from how plans are priced and marketed to consumers to how education efforts are conducted. The disaster of last year’s open-enrollment period was technical in nature, out of the control of health insurers; this year’s focus will be on “normal”… 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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