Value-based Care

Senate Bill Proposes Medicare Health Plan for All Ages

by Thomas Beaton

Senator Jeff Merkley (D-OR), with sponsorship from 11 other Democrats, has introduced a bill to create a Medicare health plan for all ages that would be offered in state and federal health exchanges,...

HHS Appoints James Parker to Address Health Insurance Costs

by Thomas Beaton

HHS Secretary Alex Azar has appointed James Parker as Senior Advisor to the Secretary of the Office of Health Reform to address healthcare challenges related to health insurance costs and health plan...

Health Plan Variety Does Not Boost Managed Medicaid Performance

by Thomas Beaton

Managed Medicaid performance does not increase as state Medicaid programs introduce more health plan variety, but a single health plan with value-based characteristics may be more effective in...

How Payers Can Succeed in Association Health Plan Markets

by Thomas Beaton

Association health plans (AHPs) may completely alter the nation’s health insurance markets with increasing support from federal entities and a handful of state insurance commissions. An...

Humana Expands Bundled Payment Model for Medicare Advantage

by Thomas Beaton

Humana has expanded a bundled payment model into seven additional states that will cover hip and knee replacements within Medicare Advantage populations. The payer has teamed up with orthopedic...

Experts Support Medicaid Work Requirements Lawsuit Against KY

by Thomas Beaton

A lawsuit that contends the legality of Medicaid work requirements in Kentucky has received support from 43 public health experts and 8 medical school deans who say the work requirements directly...

Policy, Market Changes May Harm Employer-Sponsored Insurance

by Thomas Beaton

Significant changes to the employer-sponsored insurance market, such as increasing medical costs, policy changes, and improvements in other payer markets may cause employers to stop providing health...

Proposed Rule Deregulates Medicaid Managed Care, Fee-for-Service

by Thomas Beaton

CMS has proposed a new rule that deregulates certain aspects of Medicaid managed care and Medicaid fee-for-service (FFS) programs in order to reduce regulatory burdens at the state level. The rule...

AL Medicaid Work Requirements Linked to Health Equity Challenges

by Thomas Beaton

Alabama’s proposed Medicaid work requirements are likely to lead to health equity challenges by inadvertently creating eligibility barriers for vulnerable populations, according to research from...

Proposed Legislation May Lower Individual Premiums by 40%

by Thomas Beaton

Senator Lamar Alexander (R-TN), Senator Susan Collins (R-ME), House Energy and Commerce Committee Chairman Greg Walden (R-OR) and Representative Ryan Costello (R-PA) have proposed legislation that aims...

Tavenner Steps Down from AHIP, Hands Leadership to Matt Eyles

by Thomas Beaton

The AHIP Board of Directors has appointed Matt Eyles as the organization’s new President and CEO to replace Marilyn Tavenner after she retires on June 1st, 2018.    Eyles was elected...

Individual Insurance Premiums to Soar Without Policy Actions

by Thomas Beaton

Individual insurance premiums may rise between 12 and 32 percent nationally by 2019, with cumulative increases of 34 to 94 percent by 2021, according to new research conducted by health plan actuaries...

CMS: Idaho Association Health Plan Expansion Violates ACA

by Thomas Beaton

CMS Administrator Seema Verma informed Idaho governor C.L. “Butch” Otter (R-ID) and state insurance officials that efforts to launch an expansion of association health plan (AHPs) sales...

AR Medicaid Demonstration Adds 9-Month Re-Enrollment Block

by Thomas Beaton

Arkansas received approval from CMS for a 1115 Medicaid demonstration that adds work requirements for Medicaid eligibility and adds a nine-month block on member re-enrollment if individuals don’t...

BCBS Earned Positive ACA Health Plan Revenues in Uncertain Market

by Thomas Beaton

BlueCross BlueShield of North Carolina (BCBS of NC) earned positive ACA health plan revenues after years of financial losses, citing low medical claims and more available consumers after other payers...

Idaho’s Expansion of Association Health Plans Risks ACA Market

by Thomas Beaton

The Academy of Actuaries warned insurance officials and government leaders in Idaho that the decision to expand the sale of association health plans (AHP) will destabilize ACA individual health plan...

Uninsured Adults Apprehensive About Health Insurance Costs

by Thomas Beaton

About 71 percent of uninsured adults aware of open enrollment periods did not enroll in state or federally-based health plans because of apprehension to rising health insurance costs and waning...

Value-Based Care Key to Bipartisan Healthcare System Reform

by Thomas Beaton

A group of five governors developed a bipartisan plan to reform the US healthcare system by using value-based care strategies such as quality reporting, insurance stabilization policies, and...

GAO: Insufficient Data on Success of 1115 Medicaid Demonstrations

by Thomas Beaton

State and federal evaluations of 1115 Medicaid demonstrations have insufficient data to determine demonstration success because states tend report fragmented program results, according a new GAO...

Reinsurance, CSR Reinstatement May Stabilize Individual Premiums

by Thomas Beaton

AHIP supports a number of policy solutions that could reverse Trump Administration actions that have resulted in higher premiums and unstable markets. In a new policy brief, the payer advocacy group...