Health Reform

From Inside Health Insurance Exchanges - Based on recent proposals from CMS, the agency in 2017 intends to take on a bigger regulatory role in reviewing premium rates and categorizing provider networks for qualified health plans (QHPs) offered via the 36 insurance exchanges that rely on the federal platform. Two days before Christmas, CMS issued its fourth annual draft Letter to Issuers that participate in the federally facilitated exchanges (FFEs). Read more

From AIS's Value-Based Care News - Initial cost results are promising for a two-year-old Maryland experiment in which all health care payers, including Medicare, have agreed to move hospital revenue into global budgets. Still, the state has work to do in order to bring down high utilization rates, according to an analysis of the program. Growth in per-capita hospital costs in 2014, the first year of the program, was limited to 1.47%, 2.11 percentage points lower than… Read more

Health Reform Blog

By Steve Davis - June 1, 2015
While determining rates for the 2016 plan year, health plan actuaries had a better understanding of who purchased coverage through a public exchange...and their health risks. It turns out that enrollees are older, sicker and use more prescription drugs than actuaries estimated for the first two...
By Steve Davis - April 10, 2015
A few months back, I interviewed a small business owner who decided to transition to the federal Small Business Health Options Program (SHOP). He liked the idea of giving his workers more health insurance choices and was intrigued by the small-business tax credit, which is available only through...
By Steve Davis - March 17, 2015
For the record, I don’t think the Supreme Court will decide only state-based exchanges can distribute federal premium subsidies. The court had its chance to strike down the individual mandate in 2012 but didn’t. But if I’m wrong, will a decision against HHS mean the end of public insurance...

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