From Inside Health Insurance Exchanges - In March, it seemed improbable if not impossible that carriers could avoid double-digit rate hikes for 2015 policies sold on public insurance exchanges. With the health insurer tax, reinsurance fees, a marketplace user fee and scant information about their new enrollees, several actuaries told HEX that big rate hikes were almost certain (HEX 3/20/14, p. 1). But proposed and approved premium increases being touted by state regulators, so far, have been in the low single-digits. Why? Read more
From ACO Business News - It’s not easy to earn shared savings in either of Medicare’s accountable care organization programs: Only about one-quarter of Medicare Shared Savings Program (MSSP) ACOs will get a payout, along with half the Pioneers, financial and quality results released last month by CMS indicate. The results were positive for CMS, which was able to tout that 11 Pioneers and 53 MSSP providers had saved CMS $372 million while improving quality (see… Read more
From Inside Health Insurance Exchanges - Technology that would have allowed insurance carriers and web-broker entities (WBEs) to determine federal subsidy eligibility and directly enroll consumers wasn’t ready in time for the start of last year’s open-enrollment period. It’s not going to be ready this year, either. While the technology has improved, industry observers tell HEX that it’s far from ideal, which means most subsidy-eligible consumers will be restricted to HealthCare.gov and state-run exchange websites when enrolling… Read more
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