Health Reform

From AIS's Value-Based Care News - Medicare’s Bundled Payments for Care Improvement (BPCI) initiative, which got off to a relatively slow start as providers initially balked at accepting risk, has gained significant traction, with nearly one-third of the original participants now taking risk on tens of thousands of care bundles. But despite that slow start, CMS was quick to take some of the lessons learned in its first two years of BPCI and implement them in its first proposed mandatory value-based payment arrangement: the Comprehensive Care for Joint Replacement (CCJR) initiative, unveiled in July (VBC 8/15, p. 1). Read more

From AIS's Value-Based Care News - After several years of debate on whether to include accountable care in the state’s Medicaid program, North Carolina lawmakers have approved a compromise Medicaid reform plan in which provider-led entities (PLEs) will co-exist with commercial insurers in a fully capitated system. Under the reforms, which still need approval from CMS, North Carolina’s Primary Care Case Management system will be phased out, and care management for most of the state’s 1.9 million… 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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