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Value-Based Care Outperforms Fee-for-Service Health Plans

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Health plans that include value-based care (VBC) principles are more cost-effective than fee-for-service (FFS) options and are starting to produce better patient outcomes, Humana asserts in a new report. The total healthcare costs...

Maine Referendum Expands Medicaid Despite Governor Opposition

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The state of Maine has become the first state to expand Medicaid through a ballot vote that overrides Governor Paul R. LePage’s (ME-R) previous decisions to block the expansion, according to national news outlets. On Tuesday, Maine...

Emergency Response Devices Add Value to Medicare Advantage Plan

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Anthem BlueCross BlueShield plans to add value onto consumer Medicare Advantage (MA) plans by offering personal emergency response systems (PERS) to beneficiaries, the payer announced in a series of press releases. MA beneficiaries in...

ACA Open Enrollment Rate Expected to Drop Up to 13% in 2018

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Analysts expect up to a 13 percent drop in open enrollment on the ACA marketplace exchange in 2018,  according to Standard and Poor’s Global (S&P Global). Only 10.1 million to 11.4 million individuals are expected in enroll...

AHIP Launches Initiative To Combat Nationwide Opioid Crisis

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AHIP launched the Safe, Transparent Opioid Prescribing (STOP) Initiative to support health plans’ widespread adoption of clinical guidelines for pain care and opioid prescribing, and combat the national opioid crisis, the...

Mercy Health, Centene Form Medicaid Accountable Care Organization

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Mercy Health of Arkansas and the Centene Corporation have received approval to operate an accountable care organization within the state focusing on Medicaid beneficiaries, the organizations announced in a press release. Centene...

CBO: Alexander-Murray Healthcare Bill Could Save $3.8B

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The Bipartisan Health Care Stabilization Act of 2017, also known as the Alexander-Murray compromise bill, would save the federal government $3.8 billion without drastically changing the number of individuals with health insurance, the...

Iowa Withdraws 1332 Waiver for Insurance Market Stabilization

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Iowa Insurance Commissioner Doug Ommen has withdrawn his state’s application for a 1332 waiver to stabilize its insurance markets in 2018.   The proposed stopgap measure  included a single, standardized plan available to...

Anthem Adds Home Meal Delivery to Medicare Advantage Plans

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Anthem is offering home meal delivery service to its post-discharge Medicare Advantage plan members in  in several states including Georgia, Kentucky, Missouri, and Wisconsin the payer announced. Anthem is partnering with GA foods to...

Bipartisan Senate Compromise May Reinstate CSRs, Alter 1332 Waivers

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Senators Lamar Alexander (R-TX) and Patty Murray (D-WH)  have floated a bipartisan deal to reinstate the ACA’s cost-sharing reductions (CSRs) and boost individual enrollment outreach in exchange for alterations to the state 1332...

Executive Order Eases ACA Rules on Association Health Plans

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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 benefits (EHBs), as reported by multiple...

CMS Releases 2018 Medicare Advantage Star Ratings for Health Plans

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CMS has updated the 2018 Medicare Advantage star ratings on health plans, allowing consumers to explore options that will best suit their individual needs.   The star ratings are based on several consumer engagement and care quality...

Senate to Vote on Funding CHIP for Five Additional Years

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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 “Keep Kids’ Insurance...

HHS Nixes Proposed Rule for Health Plan Compliance Documents

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HHS has withdrawn a proposal for a rule that would have required controlling health plans (CHPs) to submit additional information and documentation demonstrating compliance with HHS operating rules, the agency posted in the Federal...

Blue Shield of CA to Offer Statewide Healthcare Provider Directory

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Blue Shield of California plans to develop a statewide healthcare provider directory, with the help of Integrated Healthcare Association (IHA), that gives members access to current information on providers, the payer announced in a press...

NB and IA Offer New Individual Market Plan For Open Enrollment

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An new individual market plan created out of Medica and CHI Health will be available to consumers during the open enrollment period in Nebraska and Iowa, the health networks announced in a press release. The Medica with CHI Health plan...

Nevada Blue to Offer Supplemental Medicare Coverage to Members

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On October 1, Blue Cross Blue Shield (BCBS) of Nevada members can enroll in Medicare Supplemental Innovation Plans F, G, or N that provide preventative care services and extended benefits, the payer announced earlier this week. The plans...

Anthem to Acquire FL Medicare Advantage Organization HealthSun

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Anthem entered into an agreement to acquire Florida-based HealthSun, a payer and integrated health system that provides care and coverage to 40,000 Medicare Advantage beneficiaries, the payer announced in a press release.   Leaders...

HHS to Spend $10M on Affordable Care Act Navigator Program

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HHS and CMS announced that they will allocate $10 million to support the Affordable Care Act Navigator program, which helps health insurance consumers find coverage solutions during the Open Enrollment period. Launched in 2013, the...

MS Medicaid Recovers $8.6M in Fraud, Improper Payments

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The Mississippi Division of Medicaid (DOM) recovered $8.6 million dollars from claims that were either directly fraudulent or improperly filed, the DOM announced in a press release. Through collaboration between Medicaid Fraud Control...

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