Health Reform

From AIS's Value-Based Care News - Digestive HealthCare Center in Hillsborough, N.J., is seeing benefits from two bundled payment contracts for colonoscopy, but major barriers still stand in the way of gastroenterologists who want to ink value-based contracts with payers. That’s the word from Charles Accurso, M.D., medical director of the Digestive HealthCare Center and Central Jersey Ambulatory Surgery Center. Read more

From AIS's Value-Based Care News - Commercial and Medicaid insurers and employers are starting to test bundled payment arrangements in a major cost area: maternity care. Although maternity bundled payment programs are far from widespread right now, they represent an obvious target for bundles: the episodes are easy to define, and there’s a real opportunity to improve care and patient satisfaction while lowering costs. Horizon Blue Cross Blue Shield of New Jersey has an extensive bundled payment program,… 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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