Healthcare Finance Staff
The National Women's Law Center (NWLC) has filed federal discrimination complaints against five large employers, arguing that their exclusion of pregnancy coverage in health benefits for dependent children violates the Affordable Care Act's nondiscrimination provisions.
Adding more mixed evidence to the Medicaid expansion debate, health researchers found that extending coverage to low-income, childless adults in Wisconsin corresponded with a decrease in preventable hospitalizations but also increases in outpatient and emergency department visits.
The 2013 AHIP Institute will have special significance this year, with the annual gathering taking place shortly before major components of the Affordable Care Act are activated.
The New Hampshire Governor's Commission on Medicaid Care Management is recommending expanding Medicaid eligibility under the Affordable Care Act, "due to its necessity" in transitioning the state's Medicaid program from fee-for-service to managed care.
The managed care programs of several states profiled in a new Urban Institute report show a range of policy options available as new Medicaid rules and eligibility expansion (in 21 states for now) takes effect next year.
Healthcare organizations have often been criticized for being slow to adapt to changes in the marketplace. A recent accelerator program spearheaded by Independence Blue Cross (IBC), Penn Medicine and DreamIt Ventures hopes to change that by backing 10 innovative healthcare startups. And while none of these startups are likely to revolutionize medicine, they do suggest that there are many entrepreneurs with promising solutions that may reduce the cost of care while maintaining its quality.
The Medicare Trustees have projected in their annual report that the program's hospital insurance trust fund will remain solvent until 2026, two years later than predicted last year, while Social Security's solvency is estimated to last through 2033.
Health exchanges are projected to be the conduit for up to 38 million people obtaining health coverage – a huge market opportunity for payers who participate and a threat for those who cannot compete effectively. The recently solidifying requirements and the prospect of changes in the coming years create uncertainty and yet opportunity for those prepared to meet the market with flexibility, speed, and in this year, the considered basics to compete.
The GAO has concluded that the states across the country setting up health insurance exchanges will be ready for enrollment by the Oct. 1, 2013 deadline. Coverage is set to begin Jan. 1, 2014.
It took six months and a letter to the governor with a picture of their newborn for two Philadelphia graduate students to successfully enroll their son in CHIP -- and even then their premiums were miscalculated, based on a system reporting error that tripled their actual income.