From Inside Health Insurance Exchanges - Without a 60-vote majority in the Senate, it’s unlikely that President-elect Donald Trump — and Republican leaders in Congress — can make good on the promise to quickly repeal and replace the Affordable Care Act (ACA). But a full repeal isn’t needed to gut the law. And while the new administration and Congress won’t assume power until January, the impact of the election is expected to have an immediate effect on the public exchanges (see box, p. 12). Read more
From Inside Health Insurance Exchanges - Last year, insurance carriers received just 12 cents for every dollar owed for the 2014 plan year — the first year of the risk-corridors program (HEX 10/15, p. 1). Now it looks as though payments owed to carriers for the final year of the three-year reinsurance program could be in jeopardy. According to a Sept. 29 report (B-328016) from the Government Accountability Office, HHS inappropriately hung on to $1.7 billion collected… Read more
From AIS's Value-Based Care News - CMS is expanding a Medicare Advantage value-based model that hasn’t even officially started yet, indicating the agency’s desire to foster population health initiatives within the health plans that are serving the MA market. The Medicare Advantage Value-Based Insurance Design model, which has largely flown under the radar as the agency implements higher-profile initiatives such as its accountable care organization and bundled payment programs, will allow MA plans to offer reduced cost-sharing… Read more
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