As the COVID-19 crisis continues to ramp up in the United States, projections about how it will affect various business sectors — including managed care — are evolving rapidly. But one concept that industry analysts seem to agree on is that health insurers with diversified business models may be better equipped to weather the storm.

For Peter Manoogian, principal at the health care consultancy ZS Associates, a main reason for the value of diversification comes from simple math. During the last financial crisis in the mid-2000s, about 5 million people shifted out of the employer-sponsored plan market when they lost their jobs, Manoogian tells AIS Health.

Like scores of other businesses across the country, a major part of health insurers’ response to the coronavirus outbreak has involved transitioning employees from working in an office to working remotely. However, that task is not always as simple as telling associates to skip their commute, as one health insurance executive tells AIS Health.

In recent days, actuaries and economists have begun to estimate how much it will cost to care for those stricken by COVID-19, the disease caused by the novel coronavirus. Since the crisis is still at an early stage, and medical data collection and analysis is limited, those estimates have a wide range. Covered California, the […]

CMS has now approved 29 Medicaid Section 1135 waivers in an effort to give states’ Medicaid programs additional flexibility to augment their COVID-19 response by relaxing certain federal requirements.

Observers say they anticipate more states approaching CMS with similar requests as the crisis progresses, although the waivers may not streamline care very much for managed care organizations operating within state Medicaid programs.

Jeff Myers, senior vice president of reimbursement strategy and market access at Catalyst Healthcare Consulting, says some of the waivers address “things the plans are trying to do anyway,” such as fixing the provider enrollment process. The true impact on plan operation may not be large, Myers tells AIS Health.

by Jinghong Chen Total U.S. health care spending is projected to increase at an annual average rate of 5.4% over the next decade, reaching $6.2 trillion by 2028, according to CMS. Health expenditures’ share of Gross Domestic Product will rise from 17.8% in 2019 to 19.7% in 2028, as health spending growth will be 1.1 […]