Value-based Care

Executive Order Eases ACA Rules on Association Health Plans

by Thomas Beaton

An executive order signed by President Trump will lighten rules on association health plans (AHPs), which could allow groups of businesses to provide lower cost insurance without essential health...

Health Plan Consumers Report Insufficient Payer Communications

by Thomas Beaton

Health plans may not be effectively communicating with consumers about member  benefits and largely fail to understand their members’ health and financial needs, a survey from Healthmine...

Senate to Vote on Funding CHIP for Five Additional Years

by Thomas Beaton

A bipartisan bill to continue CHIP funding for five more years and transition to a state-federal partnership will move to a Senate vote after being approved by the Senate Finance Committee.   The...

Medicaid Directors Voice Concerns for Graham-Cassidy Bill

by Thomas Beaton

The National Association of Medicaid Directors (NAMD) argues that a hasty passage of the Medicaid reforms presented in the Graham-Cassidy bill will have significant consequences for public payer...

Planning for Individual Insurance Exchange Stabilization in WA

by Thomas Beaton

State health insurance markets and their individual insurance exchanges have faced regular instability in the form of payer exits, imbalanced risk pools, and rising premiums that push out new and...

AHIP: Graham-Cassidy Bill a Poor Choice for Payers, Patients

by Thomas Beaton

AHIP believes that passage of the Graham-Cassidy Bill making the rounds in the Senate would adversely affect payer market through policies that destabilize the health insurance markets, reduce patient...

Veterans Gained Coverage under ACA, but May Lose Big from Repeal

by Thomas Beaton

While the Affordable Care Act (ACA) produced significant coverage gains for veterans, currently proposed repeal actions could hit this population particularly hard, according to a study from RAND...

AARP: Congress Must Take Action on ACA Market Stabilization Solutions

by Thomas Beaton

In order to protect healthcare consumers and stabilize the ACA marketplace, Congress must pass legislation that creates affordable and accessible coverage options, protects Medicaid and Medicare...

Governors Propose Health Insurance Market Stabilization Plan

by Thomas Beaton

Eight state governors have outlined their proposals for a health insurance market stabilization plan that would control premium increases and improve competition in the federal and state health...

Medicaid Reform Requires Outcomes-Based Innovation, Better Data

by Thomas Beaton

Medicaid has steadily provided low-income patients with quality healthcare coverage and could further improve by addressing problematic areas through outcomes-based innovation and data analytics...

Boston Children’s, Cleveland Clinic Partner for Pediatric Care

by Thomas Beaton

Boston Children’s Hospital and Cleveland Clinic have announced a partnership to provide complex pediatric heart care through Cleveland Clinic’s national employer-based insurance...

ACA “Skinny Repeal” Dies in Senate, Leaving Next Steps Uncertain

by Jennifer Bresnick

In the early hours of Friday morning, the Senate failed to pass its attempt at a “skinny repeal” of the Affordable Care Act, which would have eliminated the tax penalties associated with...

Can Healthcare Payers Inspire ACOs to Take on Two-Sided Risk?

by Jennifer Bresnick

While two-sided risk arrangements are attractive for healthcare payers, even experienced accountable care organizations (ACOs) are wary of jumping into contracts which make them financially responsible...

Senate Nixes Better Care Reconciliation Act, But Isn’t Done Yet

by Jennifer Bresnick

After a nail-biting procedural vote on Tuesday afternoon that required Vice President Mike Pence to break the tie, the Senate continued its tumultuous afternoon by voting down the Better Care...

Tiebreaker Vote in Senate Opens ACA Repeal, Replacement Debate

by Thomas Beaton

In a 50-50 procedural vote, Vice President Mike Pence broke the tie as the US Senate voted to open debate for a future vote on American Health Care Act (AHCA), and the possible addition of...

CBO Score Finds 22 Million People Will Lose Health Coverage

by Thomas Beaton

UPDATE: GOP Senators delayed the vote on the BCRA until after the July 4th congressional recess.  The Congressional Budget Office (CBO) released their revised cost estimate on the new...

Anthem BCBS Expands Value-Based Care Options with Premier Health

by Jesse Migneault

Anthem Blue Cross Blue Shield has partnered with Ohio-based Premier Health to expand its value-based care offerings to its employer-based, individual and Medicare Advantage members. The agreement...

Flexibility and Innovation Needed to Control Medicaid Costs

by Jesse Migneault

As state and federal regulators debate the future of Medicaid spending, health researchers have identified the need for flexibility and innovation in Medicaid policies involving payment models,...

Aetna, Oscar Health Create Provider-Based Health Insurance Plans

by Jesse Migneault

Two new provider-based health insurance plans will be available in 2018, as Aetna and Oscar Health align with Sutter Health and the Cleveland Clinic, respectively, to offer new coverage options for...

Payers, Providers Differ in Value Based Care, Health IT Opinions

by Jesse Migneault

Payers see the move towards value-based care as a permanent fixture in the nation’s healthcare delivery system, with 82 percent of organizations responding to a Quest Diagnostics and Inovalon...