Reimbursement
New public insurance exchange enrollees are starting to use their prescription drug benefits, and so far their per-member costs are looking higher than in the average commercial plan.
Insurers offering Medicare Advantage plans got a bit of a reprieve this week when the Centers for Medicare & Medicaid Services gave them a rate increase instead of the expected cut. CMS' 2015 rate announcement also addressed concerns over provider terminations and beneficiary cost sharing.
Independence Blue Cross and DaVita HealthCare Partners are launching a new joint venture aiming to personalize, improve and ultimately reduce costs for chronic disease care in one of the country's most expensive healthcare markets.
The Centers for Medicare & Medicaid Services is easing back on some of the reductions to Medicare Advantage, although the negative impact could still be as much 3 percent for some insurers and many changes loom beyond 2015.
Competition from provider-owned health plans is increasing, with one of the country's largest national health systems scooping up an HMO in the South that could be a platform to enter other markets.
With about seven percent of all public and private health insurance claims paid incorrectly, insurers have a ways to go, beyond traditional models, if the healthcare spending crisis is to be reined in.
Patients don't fill first-time prescriptions nearly one-third of the time, which makes "nonadherence" an important factor working against proper disease management.
Health plans must calculate what they will charge for 2015 exchange plan premiums despite the lack of detailed data from the just-ended enrollment window. Rate filing deadlines are fast approaching: May for some states and June for those using the HealthCare.gov marketplace.
As more employers seek to integrate workers compensation into benefits packages, a range of market trends and regulations are slowing what could be a natural fit.
Michigan, the federal government and some of the country's largest insurers are getting ready to test key ideas about how to improve healthcare for some of the most vulnerable Americans.