Reimbursement
Insurer drew attention two years ago as the only Affordable Care Act co-op to make money from its exchange products, reporting a net income of $7.3 million in 2014.
A higher chargemaster price can increase the payment from private insurers, which often pay for outpatient and ancillary services based on discounted chargemaster prices.
Consumers Union wants to know why the cost projections submitted by Anthem and Blue Shield are so much higher than some of their competitors and other industry-wide figures.
Aetna, however, said many insurers have been forced to leave the exchanges due to what it called the instability of the marketplace.
Hospitals that perform joint replacements on older, sicker patients under the program will suffer under reconciliation payment reductions, research suggested.
The number of those with high-deductible plans did rise significantly, according to the statistics.
Leaders from the House Ways and Means Committee and the House Energy and Commerce said healthcare providers need more time.
In 2015, patient-centered practices and hospitals received $58.9 million in care coordination and shared savings payments for reaching quality and savings goals, the company said.
Funds are awarded to organizations in 34 states that have a federally-facilitated marketplace.
Several states now require insurers to keep directories updated at least every quarter, among other guidelines.