Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance Exchange

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, versus...

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 to our...

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 program...

Aetna Will Abandon All Health Insurance Exchanges for 2018

by Jesse Migneault

Aetna is ending participation in the Delaware and Nebraska ACA health insurance exchanges, completing its retreat from the public marketplace.   The company also made announcements earlier this year that it would be leaving the Virginia...

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 area....

MD Health Insurance Exchange Rates Up Double-Digits for 2018

by Jesse Migneault

Patients in Maryland looking for insurance in 2018 may have bigger bills than they bargained for. The health insurance exchange rates for individual and group plans in the state have risen by up to 58 percent as payers try to cope with uncertainty,...

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 percent in...

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 lowering...

Aetna Will Exit Iowa ACA Health Insurance Exchange in 2018

by Thomas Beaton

Aetna has announced that it will stop participating in the Iowa health insurance exchange in 2018, citing financial losses and market instability as primary reasons to exit.   "Earlier today we informed the appropriate federal and state...

Wellmark BCBS Latest to Exit ACA Health Insurance Exchanges

by Thomas Beaton

Wellmark Blue Cross Blue Shield, which operates in Iowa and South Dakota, will not renew or sell individual plans on the Affordable Care Act health insurance exchanges effective Jan 1, 2018. The decision follows three-year losses of approximately...

Payers Face 9.6% Underwriting Loss on Health Insurance Exchange

by Jacqueline Belliveau

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 Affordable...

2017 ACA Open Enrollment Data Shows 12.2M Marketplace Signups

by Thomas Beaton

During the 2017 ACA Open Enrollment Period (OEP), more than 12.2 million healthcare consumers purchased or renewed insurance through Healthcare.gov or their local state exchanges, said CMS in a new data brief.   Marketplace consumers either...

HHS Offers Waivers for Health Insurance Exchange Stability

by Jacqueline Belliveau

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 particularly...

ACA Consumers Dissatisfied After Private Payer Exchange Exit

by Thomas Beaton

Consumer satisfaction with the Affordable Care Act fell following the departure of three private payers from the health insurance exchange, according to recent findings from Black Book. The survey comprises feedback from 34,800 consumers continually...

CMS Proposes New Rule to Stabilize Health Insurance Exchanges

by Jacqueline Belliveau

CMS recently announced a proposed rule designed to help stabilize health insurance exchanges by promoting more coverage options and improving the risk pool for insurers. The proposed rule comes just one day after Humana publicized its decision...

Humana to Leave ACA Health Insurance Exchanges by 2018

by Thomas Beaton

Humana will halt sales of individual health insurance plans through the Affordable Care Act’s exchanges by 2018, which will leave more than 150,000 Humana customers without a carrier.   Amid ongoing political uncertainty, Humana said...

Shareholder Class Action Lawsuit Filed Against Aetna

by Vera Gruessner

A shareholder class action lawsuit has been filed against the national health insurance company Aetna Inc., according to a press release from the law firm of Kessler Topaz Meltzer & Check, LLP. The announcement came earlier this...

Key Best Practices for Success on the Health Insurance Exchanges

by Vera Gruessner

Which healthcare insurers are succeeding in the health insurance exchanges? What best practices can be taken from these payers? The weekly newsletter Washington Health Policy Week in Review published an editorial answering these questions by...

6.4 Million Enrollees Sign Up on Affordable Care Act Exchanges

by Vera Gruessner

As of December 21, a total of 6.4 million consumers have enrolled in health plans through the Affordable Care Act exchanges on HealthCare.gov, reported the Centers for Medicare & Medicaid Services (CMS) in a fact sheet. The number of enrollees...

ACA Health Insurance Exchanges Bring Challenges for 2017

by Vera Gruessner

The Affordable Care Act (ACA) health insurance exchanges will have some key differences next year. Health insurance companies have faced various obstacles when selling health plans through the exchanges. These challenges include a higher risk...

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