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HHS, CMS Announce Finalized Ruling for MACRA Legislation

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The Department of Health & Human Services (HHS) announced in a press release the discharge of the final ruling on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The MACRA legislation replaces the flawed Sustainable Growth...

VT All-Payer Model Aligns Costs for Public, Private Insurers

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The state of Vermont is moving forward with establishing an all-payer model that uses accountable care organizations and ensures a provider is reimbursed by an equal amount among all healthcare payers for a particular service. The Vermont government...

49M Americans Risk Losing Fixed Indemnity Health Insurance

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A new proposed rule called Expatriate Health Plans, Expatriate Health Plan Issuers, and Qualified Expatriates; Excepted Benefits; Lifetime and Annual Limits; and Short-Term, Limited-Duration Insurance may negatively impact access to fixed indemnity...

Medicare Advantage Premiums Drop 13% Due to Affordable Care Act

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The Centers for Medicare & Medicaid Services (CMS) announced in a press release late last week that the average Medicare Advantage monthly premium will be 13 percent lower in 2017 than before the Patient Protection and Affordable Care Act...

Comprehensive Primary Care Plus Program Selects Anthem BCBS

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The Centers for Medicare & Medicaid Services (CMS) has selected Anthem Blue Cross and Blue Shield in Colorado as a participant for their Comprehensive Primary Care Plus (CPC+) initiative, according to a company press release. The Comprehensive...

Lawmakers Push for Public Option on Health Insurance Exchanges

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A total of five senators and multiple organizations are looking to create a public option for healthcare coverage to be available among all Americans purchasing insurance through the Affordable Care Act’s health insurance exchanges. Senators...

CMS Accountable Health Communities Model Stresses Social Needs

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This past January, the Centers for Medicare & Medicaid Services (CMS) announced a new funding opportunity for a program called the Accountable Health Communities (AHC) Model, which focuses solely on the social needs of Medicare and Medicaid...

CMS Reveals 4 Options for Quality Payment Program Participation

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The Centers for Medicare & Medicaid Services (CMS) is working toward assisting healthcare providers in meeting some new regulations that are part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The meaningful use program...

CMS Grants Navigators $63M to Boost Health Insurance Marketplace

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The Centers for Medicare & Medicaid Services (CMS) announced in a press release earlier this week that it will be providing $63 million in grants to both new and older organizations returning to offer health plans through the public health...

Medicare Shared Savings Program Saved $466 Million in 2015

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The Centers for Medicare and Medicaid Services (CMS) announced last week the quality and financial results of the 2015 Medicare accountable care organizations. According to a press release from CMS, accountable care organizations operating under...

CMS Bundled Payment Models Address Cardiac Care, Hip Surgeries

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The Centers for Medicare & Medicaid Services (CMS) have recently begun implementing additional alternative payment models centered on episodes of care. CMS has proposed new rules for managing the costs of care and coordination among Medicare...

Aetna Leaving Health Insurance Exchanges Due to DOJ Lawsuit

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The latest news coming from the major health payer Aetna is its move to drop out of the majority of the health insurance exchanges it had been participating in this year. According to a press release from Aetna, it will leave most of the public...

Affordable Care Act Payment Program Boosts Care, Cuts Costs

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The Patient Protection and Affordable Care Act has a wide variety of reforms that have been implemented to improve care for American citizens. One of these reforms includes a payment model called the Independence at Home Demonstration operated...

Aetna Cancels its Expansion in Health Insurance Exchange

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The national health payer Aetna continues to make headlines in the month of August after the public learned last month about the Department of Justice’s move to block Aetna’s major health insurance merger with Humana. On August 2,...

Department of Justice Moves to Block Health Insurance Mergers

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While there have been talks of the Department of Justice (DOJ) looking to block the Anthem-Cigna and Aetna-Humana health insurance mergers by filing lawsuits, the final decision was announced today at a press conference. The DOJ will proceed...

California’s Health Insurance Exchange Premiums May Spike 13%

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Premium rates on the state health insurance exchanges are expected to continue rising over the next year due to some of the provisions of the Affordable Care Act (ACA). Since the ACA has brought more coverage options and a greater number of covered...

DOJ May File Lawsuits against Health Insurance Acquisitions

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The health insurance acquisitions between Anthem and Cigna along with Aetna and Humana is likely to be blocked by the Department of Justice (DOJ). According to the American Hospital Association (AHA), the Department of Justice will be filing...

President Obama Highlights Progress from Affordable Care Act

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When it comes to the Patient Protection and Affordable Care Act, the media has reported on a variety of opinions among healthcare experts and regulators regarding the benefits and disadvantages of the ACA. However, there has not been much in...

17 Health Payers Participating in CMS Oncology Care Model

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The Centers for Medicare & Medicaid Services (CMS) is implementing a new payment and healthcare delivery system called the Oncology Care Model. This particular reimbursement program will involve multi-payer arrangements in which healthcare...

Republicans Release Plan to Replace the Affordable Care Act

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It is well-known the the GOP base has attempted to repeal the Patient Protection and Affordable Care Act for years since its passage. However, the big question that everyone has always wondered is what the Republicans would replace the Affordable...

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