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Private Payers News

Affordable Care Act, Exchanges Challenge Health Payers

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Ever since the passage of the Patient Protection and Affordable Care Act (ACA), a number of opponents have found factors to criticize within the landmark healthcare law. But has it truly brought more problems for the healthcare industry? From...

Aetna Cancels its Expansion in Health Insurance Exchange

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The national health payer Aetna continues to make headlines in the month of August after the public learned last month about the Department of Justice’s move to block Aetna’s major health insurance merger with Humana. On August 2,...

Does Blocking Health Insurance Mergers Impact ACA Exchanges?

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Last week, the Department of Justice announced that it will be filing lawsuits against the Anthem-Cigna and Aetna-Humana health insurance mergers. The issue at hand is that these health insurance mergers would increase concentration and hurt...

California’s Health Insurance Exchange Premiums May Spike 13%

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Premium rates on the state health insurance exchanges are expected to continue rising over the next year due to some of the provisions of the Affordable Care Act (ACA). Since the ACA has brought more coverage options and a greater number of covered...

Minnesota’s Biggest Payer Leaves Health Insurance Exchanges

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State health insurance exchanges are likely to see more disruption in the health insurance market with some payers either leaving the individual consumer marketplace or limiting their offerings in the coming year. The health payer UnitedHealthcare...

Why Payers Should Include Consumer Engagement in Health Plans

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In order to ensure that the health insurance exchange successfully reduces healthcare spending, it may be necessary to strengthen consumer engagement and education so that policyholders continually purchase the right health coverage for their...

CMS Awards $22M for Cost Transparency Under Affordable Care Act

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Last week, the Centers for Medicare & Medicaid Services (CMS) announced in a press release that $22 million of funds are available to help state regulators with issuer compliance according to consumer protections under the Affordable Care...

Slavitt: Health Insurance Marketplace Boosts Patient Engagement

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The federal government has taken a wide variety of steps to strengthen patient care and healthcare revenue systems throughout the country. Specifically, the Centers for Medicare & Medicaid Services (CMS) and the health insurance marketplace...

Payers Adopt Value-Based Care via Health Insurance Marketplace

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The health insurance marketplace created through the Patient Protection and Affordable Care Act has had a variety of success ever since its inception. This new model of healthcare coverage has provided health insurance for an additional 20 million...

What Health Insurance Exchanges Should Do to Cut Premium Costs

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The costs of premiums sold on the state health insurance exchanges tend to vary greatly, finds a report from The Commonwealth Fund. For instance, in 2016, the state of Tennessee saw a 38 percent increase in their health insurance premium costs...

Health Plan Solutions: Do Employers Choose Private Exchanges?

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Today employers are searching for multiple solutions to meet their health plan needs in order to reduce costs and provide the optimal benefits to their employees. The multitude of healthcare regulations hitting the market today is making quite...

Health Insurance Market Faces Restricted Provider Networks

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Last week, Scott Gottlieb, MD, Resident Fellow at the American Enterprise Institute, spoke in front of the House Committee on Energy and Commerce Subcommittee on Health delivering key information about certain reforms for the health insurance...

Healthcare Affordability Difficult for Marketplace Consumers

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Healthcare affordability remains a top issue throughout the United States. The Henry J. Kaiser Family Foundation released a brief discussing how many Americans still have difficulty with healthcare affordability since the price of premiums and...

Health Insurance Exchange Consumers Satisfied with Health Plans

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Despite the fact that the House of Representatives and the Senate attempted to repeal the Affordable Care Act at the end of 2015, consumers seem to be satisfied with their healthcare coverage options after purchasing health plans on the health...

What will the Future Bring for the Affordable Care Act?

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The future of the Affordable Care Act and health insurance exchanges may not be as favorable as the Obama administration had hoped. Many fear that the major health insurer UnitedHealthcare leaving the state-based exchanges could lead other payers...

Health Insurance Exchange Displays 2 Consumer Engagement Tools

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The health insurance exchange under the Affordable Care Act is undergoing some renovations over the next year, reports Kevin Counihan, CEO of HealthCare.gov and Dr. Patrick Conway, Principal Deputy Administrator of CMS. In The CMS Blog, Conway...

How the Affordable Care Act Impacts First Quarter Earnings

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The health insurance industry has had a topsy turvy time learning how to function effectively in the new landscape the Affordable Care Act has brought to the medical field. When it comes to the financial well-being of top payers, the Affordable...

Consumer Engagement Vital in Health Insurance Exchanges

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The Patient Protection and Affordable Care Act has brought a variety of changes for both insurers and healthcare providers with the establishment of health insurance exchanges holding a top place in reforming reimbursement between payers and...

Risk Adjustment Affects Plans on Health Insurance Exchanges

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The trade association AMGA, which entails a large membership of medical groups and healthcare delivery systems, submitted comments last week to the Centers for Medicare & Medicaid Services (CMS) regarding its proposal to change risk adjustment...

40% Health Plans Sold via Health Insurance Marketplace Overlap

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Various health plans sold through the health insurance marketplace may actually overlapped with Medicaid coverage. The Association for Community Affiliated Plans (ACAP) released a study that shows about 40 percent of issuers providing Qualified...

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