Health Reform

From AIS's Value-Based Care News - Iora Primary Care doesn’t believe in fee-for-service payment, and its 12 practices don’t accept it. The primary care company, founded as value-based payment was gathering steam, is now growing rapidly, contracting with Humana Inc. to build four dedicated Humana Medicare Advantage practices this year and talking with other insurers about doing the same thing. Read more

From AIS's Value-Based Care News - Regulators from the Federal Trade Commission (FTC) and the HHS Office of Inspector General (OIG) are signaling increased scrutiny of accountable care organizations and other value-based payment arrangements, especially those making “creative” use of the antitrust and fraud and abuse waivers in place for Medicare ACOs. 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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