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Policy and Regulation News

74% of PCPs Prefer Affordable Care Act Changes Over Repeal

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Only about 15 percent of primary care providers favored a complete repeal of the Affordable Care Act, a recent New England Journal of Medicine study stated. While some of the 426 primary care providers surveyed between December 2016 and January...

84% of Physicians Unsure of Quality Payment Program Conditions

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As many as 84 percent of polled independent physicians and medical staff are unaware of how to meet the requirements of MACRA’s Quality Payment Program, according to a survey from Kareo. The majority of surveyed physicians, however,...

20% of Surveyed Physicians Familiar with MACRA Regulations

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No more than 20.6 percent of primary care physicians and 19.5 percent of specialists are “very or somewhat familiar” with MACRA regulations, according to a survey completed in 2016 by Merritt Hawkins for The Physicians Foundation....

Top 3 Health Insurance Industry Headlines of December 2016

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Now that the final month of the year is wrapping up and everyone is planning their New Year’s celebrations, a review of the most popular headlines for the health insurance industry may be beneficial as we head into 2017. Patients Need More...

6.4 Million Enrollees Sign Up on Affordable Care Act Exchanges

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As of December 21, a total of 6.4 million consumers have enrolled in health plans through the Affordable Care Act exchanges on HealthCare.gov, reported the Centers for Medicare & Medicaid Services (CMS) in a fact sheet. The number of enrollees...

ACA Health Insurance Exchanges Bring Challenges for 2017

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The Affordable Care Act (ACA) health insurance exchanges will have some key differences next year. Health insurance companies have faced various obstacles when selling health plans through the exchanges. These challenges include a higher risk...

Senate, House of Representatives Pass 21st Century Cures Act

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This week, Congress passed the 21st Century Cures Act. President Obama signed the legislation into law on Tuesday, December 13. The 21st Century Cures Act passed with bipartisan support 94-5 in the Senate and 392-26 in the House of Representatives....

Premier Offers Healthcare Policy Improvements for ACOs, Payers

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Earlier this year, the provider alliance organization Premier Inc. announced in a company press release a number of recommendations meant to improve the framework of healthcare policy. The key points meant to improve the creation of healthcare...

How the 21st Century Cures Act will Impact Healthcare Payers

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Last week, the House of Representatives passed the 21st Century Cures Act by 392-26 votes. The 21st Century Cures Act affects the health insurance market through a provision that establishes small business health reimbursement arrangements (HRAs),...

Affordable Care Act Replacement Seeks Automatic Enrollment

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Since the Presidential election of Donald J. Trump, a number of differing viewpoints came out emphasizing how the Patient Protection and Affordable Care Act will be impacted. For the last several years, the Republican Party has attempted to repeal...

How to Fix Obama’s Affordable Care Act Without a Repeal

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Now that a new President and a Republican-controlled Congress has been elected, what does the future for healthcare reform and the Affordable Care Act (ACA) look like? What will happen to the Affordable Care Act cannot be answered simply since...

AMA Pledges to Prevent Loss of Americans’ Healthcare Coverage

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The American Medical Association (AMA) released a statement yesterday reaffirming its commitment to ensuring that every American who currently has healthcare coverage will continue to have insurance and access to medical care. In particular,...

House Speaker Paul Ryan Proposes a Privatized Medicare System

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House Speaker Paul Ryan announced in an interview with Fox News Channel several days after the presidential election that the Republican-controlled Congress and White House will look to create a privatized Medicare system and cut funding from...

How MACRA Requirements Impact Accountable Care Organizations

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MACRA legislation impacts a number of healthcare providers and entities including accountable care organizations (ACOs). Only a few Medicare accountable care organizations will actually be able to participate in Advanced Alternative Payment Models...

Vermont’s All-Payer Model Limits Medical Spending Growth

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Vermont has been working on regulatory actions that would reform healthcare payment throughout the state specifically through an all-payer model. Last week, the Centers for Medicare & Medicaid Services (CMS) announced in a press release the...

Premium Rates on Affordable Care Act Exchanges Rise 25% in 2017

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Monthly premium costs on the Affordable Care Act exchanges is expected to rise an average of 25 percent in 2017, according to a report from the Department of Health & Human Services (HHS). This percentage is based solely on the premiums for...

How a Public Option May Preserve Health Insurance Exchanges

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Multiple healthcare payers have been struggling with operating successfully on the Affordable Care Act’s health insurance exchanges. Some experts and lawmakers suggest that establishing a public option on the health insurance exchanges...

Did HHS Act Illegally in Transitional Reinsurance Program?

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At the end of September, the Government Accountability Office (GAO) announced in a briefing that the Department of Health & Human Services (HHS) does not have the authority to transfer funds from the collections within the transitional reinsurance...

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...

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