Reimbursement

The nation's highest rated health plan is going through some growing pains and trying to make it to 2015 intact.

Nationally, the new individual exchange market seems competitive going into its second year, with a variety of plans and reasonable premium increases. At the local level, though, consumers may experience some havoc.

The Affordable Care Act's online insurance exchanges launched this weekend with far fewer problems and less fanfare than last year. Many people qualified for federal subsidies that kept their monthly premiums well under $100.

By most accounts, the federal marketplace that handles enrollment for 37 states is running well, but there are still uncertainties, notably millions of confused American consumers. 

For many Americans, the ACA open enrollment period offers them an opportunity to have health insurance for the first time. But for hospitals and healthcare organizations, ACA open enrollments create financial and operational challenges.

Though slower than the worst spikes of the last decade, American companies and their workers continue to see healthcare costs increases, putting pressure on insurers to respond with new exchanges and plan designs.

More insurers are finding benefits in marketing new health plans with regional providers, as a way to leverage prominent brands, make networks more accessible and also create potential competitive threats.

In the Affordable Care Act's second enrollment period, insurers and exchange will again try to lure the young adult demographic, a challenge that will test risk adjustment policies and the best minds in marketing.

With new essential health benefit rules, some insurers are starting to take a more proactive approach to mental and behavioral health.

Taking stock of its diversification strategy, the nation's largest health insurer is creating a new enterprise oversight unit, moving around some key leaders and saying goodbye to others, all before a big enrollment push.