Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Affordable Care Act

BCBS of Kansas City Will Leave ACA Health Insurance Exchange

by Jesse Migneault

The exit of Blue KC from the ACA health insurance exchange in 2018 will affect a 32-county service area in Kansas and Missouri, and leave both urban and rural counties without any marketplace exchange insurers. The payer blamed losses...

AHCA CBO Score Predicts 23M Uninsured, Higher Out-of-Pocket Costs

by Jesse Migneault

The CBO report on the American Health Care Act (AHCA) found the bill would result in 23 million people losing insurance coverage over the next decade.  Other impacts of the bill include higher out-of-pocket costs for most patients and...

WA Health Insurance Exchange In Flux With CSR Confusion

by Jesse Migneault

Washington State has thus far been a success for the health insurance exchange marketplace.  The state has seen robust payer participation, increased enrollment and a trend-bending eight percent benchmark premium increase in 2017,...

Kaiser Permanente Will Stay in ACA Health Insurance Exchange

by Jesse Migneault

Kaiser Permanente will continue to offer coverage options through the ACA health insurance exchanges during 2018, the payer and provider announced this week. “Kaiser Permanente will continue to offer coverage—including access...

CMS Adds Stricter Health Insurance Exchange Enrollment Rules

by Jesse Migneault

Slated to begin in June 2017, the Centers for Medicare and Medicaid Services (CMS) will be rolling out a pilot program aimed at tightening scrutiny of those using the special enrollment period on the ACA health insurance exchanges. The...

Two-Thirds of Physicians Disapprove of American Health Care Act

by Jesse Migneault

Two-thirds of physicians in a new Merritt Hawkins survey reported having a negative impression of the American Health Care Act (AHCA).  This includes 58 percent of physicians who have a “strongly” negative take on...

BCBS Moves into Vacant TN Health Insurance Exchange

by Jesse Migneault

Blue Cross-Blue Shield (BCBS) has announced its plans to offer coverage options on Tennessee’s Affordable Care Act health insurance exchange in 2018.  The separate rating area consists of 16 counties in the greater Knoxville...

House Passes AHCA To Repeal and Replace ACA By 1 Vote Margin

by Jesse Migneault

The House has successfully passed the American Health Care Act (AHCA) to repeal-and-replace the ACA.  This was the House GOP’s second attempt to pass the bill, after the first vote was abruptly cancelled by Speaker Paul...

Health Insurance Actuaries Propose Ways to Stabilize Market

by Jesse Migneault

A stable health insurance marketplace is good for payers and consumers. Speculation over potential payer mergers, repeal or modification of the ACA, and the future of high-risk and low income subsidy payments have left premium rates and...

Affordable Care Act Cuts Uninsured Rate by 6.4% Since 2013

by Jesse Migneault

From 2013 to the end of 2016, the percentage of individuals without health insurance dropped across the nation, according to a recent Gallup-Healthways study. The national percentage of those without health insurance went from 17.3...

Payer Groups Urge Congress to Keep ACA Cost Sharing Reductions

by Jesse Migneault

In a recent letter to the President and leading members of Congress, insurance payer groups and the nation’s largest provider organizations detailed their case to retain the cost sharing reductions (CSR) provision in the...

CMS Issues ACA Health Insurance Exchange Stabilization Rule

by Jesse Migneault

CMS  issued the final version of the 2018 Market Stabilization rule for the Affordable Care Act (ACA) health insurance exchange.   The rule focuses on stabilizing the individual and small group health insurance markets while...

House GOP Leaders Pull American Health Care Act Before Vote

by Thomas Beaton

Before it could reach the House of Representatives for a vote, Republican party leaders pulled the American Health Care Act (AHCA). Because lawmakers could not agree on the structure or substance of the conservative healthcare framework,...

Payers Face 9.6% Underwriting Loss on Health Insurance Exchange

by Jacqueline LaPointe

Underwriting margins for payers selling individual plans on the health insurance exchange dropped from a 6 percent earned premium loss in 2014 to a 9.6 percent loss in 2015, Milliman recently reported. The financial losses stemmed from the...

House Reps Add Amendments to the American Health Care Act

by Thomas Beaton

House Republicans recently added 21 pages of  updates and changes to the American Health Care Act (AHCA) to push forward the potential Affordable Care Act (ACA) repeal and replace bill. Many of the legislation’s changes would...

HHS Launches Webpage Detailing ACA Repeal Actions

by Thomas Beaton

HHS created a new online resource that highlights the regulatory and administrative actions the federal department has taken for an Affordable Care Act (ACA) repeal. HHS believes that these actions are necessary to relieve burdens of...

CBO Score Confirms Industry’s American Health Care Act Concerns

by Thomas Beaton

After the Congressional Budget Office released their cost estimate on the American Health Care Act (AHCA) several healthcare industry leadership groups reaffirmed their concerns about the bill, which may leave approximately  14...

HHS Offers Waivers for Health Insurance Exchange Stability

by Jacqueline LaPointe

The Department of Health and Human Services (HHS) recently encouraged states to apply for State Innovation Waivers as a way to stabilize the health insurance exchanges and boost consumer access health plans and services. States should...

Industry Groups Express Concerns Over Proposed ACA Repeal Bills

by Jacqueline LaPointe

Earlier this week, House Republicans started a potential Affordable Care Act repeal by introducing the American Health Care Act. But some industry groups recently expressed concerns that the legislation would inappropriately shift more...

HHS Secretary Price Voices Support for House ACA Repeal

by Thomas Beaton

The Secretary of the Department of Health & Human Services Secretary (HHS) penned a letter to the two House Republicans behind the American Health Care Act praising the new legislation that would replace the Affordable Care...

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