Health Plan Business

From Health Plan Week - Highmark Health in Pittsburgh has designed an innovation program called VITAL that will act as a test bed to increase use of FDA-approved medical devices and treatments. These technologies may already be deployed in a patient population but are not yet covered by most commercial plans. VITAL bridges the gap by piloting these ideas and bringing about swifter reimbursement decisions on their use by using both the provider and insurer sides of the integrated health care company, Highmark says. Read more

From Health Plan Week - Three months before the third open-enrollment season commences for Affordable Care Act (ACA) exchanges, health insurers are prepping strategies to sell coverage for returning and potential enrollees in the individual market. Along with government-sponsored Medicare and Medicaid programs, the ACA exchanges are a potentially huge growth segment for insurers even if many carriers are still trying to figure out how to price plans and lure younger, healthier lives to their… Read more

Health Plan Business Blog

By Steve Davis - August 28, 2015
On Aug. 26, the Nevada Health CO-OP became the third Community Operated and Oriented Plan to end operations this year. There are 21 CO-OPs left, and I expect state regulators will announce a few more casualties well before open enrollment begins in November. The surviving CO-OPs will have an uphill...
By Steve Davis - August 4, 2015
It might not disappear entirely, but the small-group market is changing due, in large part, to the Affordable Care Act (ACA). To help retain clients, some health insurers have launched administrative services only (ASO) products designed for increasingly smaller employers. Not long ago, few...
By Jill Brown - July 29, 2015
As Cleveland Clinic has transitioned to population health management, one area of focus has been improved access to care. “Access is actually getting to see the care provider. We’ve put a lot of effort on this over the last couple of years. [Patients] should be able to see a physician anytime,...

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