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As ACA Debate Lingers, Non-Marketplace Members Present Risks

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While much of the national debate over health insurance has focused on the options open to ACA marketplace enrollees, payers should be careful not to neglect coverage choices for their private plan customers, who tend to be healthier and...

Payers May Be Neglecting a Growing Medicare Advantage Market

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Payers may be able to secure more of the growing Medicare Advantage (MA) marketplace by expanding their member messaging efforts and improving consumer education about what the supplementary plan has to offer, according to a new J.D. Power...

BCBS Minnesota Launches Prediabetes Prevention Campaign

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Blue Cross Blue Shield (BCBS) of Minnesota is launching a prediabetes prevention campaign to lessen the rate of diabetes in local communities, the payer announced in a press release. Titled “Reverse It,” the campaign focuses on...

Boston Children’s, Cleveland Clinic Partner for Pediatric Care

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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 network. “Together, our goal to develop...

Tiebreaker Vote in Senate Opens ACA Repeal, Replacement Debate

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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 amendments to the bill. After failing to...

Humana Foundation Awards $735K To Improve Community Health

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The Humana Foundation announced awards totaling $735,000 to help South Florida nonprofits to help improve community health. As part of the payer’s philanthropic pursuits, the grants are being awarded during their 2017 donation cycle...

BCBS of Louisiana Offers Online Consumer Price Comparison Portal

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In an effort to improve transparency and customer engagement, Blue Cross Blue Shield (BCBS) of Louisiana launched an online consumer price comparison portal. The portal, called SmartShopper, allows any BCBS  customer in Louisiana to...

Sick Members More Likely to Leave Medicare Advantage Plans

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A recent study of the Medicare Advantage (MA) landscape shows that sicker members are leaving their plans in greater numbers than their healthy counterparts. The study by the non-partisan Government Accounting Office (GAO) evaluated...

Commercial Payer Prices Outpace Medicare, Medicare Advantage

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Commercial payers charge significantly higher prices for common clinical services than Medicare fee-for-service (FFS) and Medicare Advantage plans, according to a new report from the Congressional Budget Office (CBO). Commercial insurers...

Consumers Voice Opinions on Effective Healthcare Marketing

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Spending for healthcare marketing was $9.7 billion in 2015 alone, a double-digit increase from the previous year.  In all forms of media across the nation, there is no shortage of healthcare messaging being sent towards the...

Senate Has Released Bill to Revise ACA Repeal Legislation

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The Senate has released the working draft of the Better Care Reconciliation Act of 2017, revising the recently House-passed AHCA.   Both bills aim to repeal and replace the Affordable Care Act (ACA), which was passed in...

Healthcare Spending Growing at Slower Than Expected Rate

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Expenditures on healthcare grew at a historically low rate between 2009 and 2013, according to a recent report, defying the conventional wisdom that healthcare spending has skyrocketed.  A Robert Wood Johnson Foundation report looked...

Anthem BCBS Expands Value-Based Care Options with Premier Health

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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 aligns Premier’s population health...

AHIP: Congress Must Stabilize Payer Market, Consider Reforms

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With passage of the AHCA, the insurance industry group AHIP has sent its response to congress and presented its recommendations for what direction to go in with healthcare reform The payer industry organization submitted recommendations...

DOJ Sues UnitedHealth over Alleged $1B Medicare Fraud

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The Department of Justice is suing UnitedHealth  for alleged Medicare Advantage fraud in a civil case.  The complaint, filed in the Western District court, is “for monies unlawfully obtained or retained from the insurers...

CMS to Shutter Small Business Health Options Program Website

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As of 2018, HealthCare.gov will no longer host the Small Business Health Options Program (SHOP) Marketplace.   Usage of the healthcare insurance exchange by insurance producers and overall enrollment through SHOP never met...

Two-Thirds of Physicians Disapprove of American Health Care Act

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Two-thirds of physicians in a new Merritt Hawkins survey reported having a negative impression of the American Health Care Act (AHCA).  This includes 58 percent of physicians who have a “strongly” negative take on...

Anthem Terminates Cigna Merger, but Refuses to Pay Out $1.8B

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After a court ruling in Delaware, Anthem has notified Cigna that their proposed $54 billion merger is off, but that doesn’t mean the two insurance companies are amicably parting ways. Anthem has stated that it will not pay Cigna a...

Cardiologists: Senate Must Ensure “Meaningful Insurance Coverage”

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In a letter sent to Senate leadership, American College of Cardiology President Mary Norine Walsh, MD, advised lawmakers to ensure access to “meaningful insurance coverage and quality, cost-effective care” for the...

Maine Medicaid Waiver Would Increase Patient Responsibility

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Maine will apply for a Section 1115 Medicaid waiver from the Centers for Medicare and Medicaid Services (CMS) to be granted flexibility to circumvent federal regulations and impose reforms on its Medicaid program. The state’s...

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