Healthcare Finance Staff
Even thought the recent fiscal cliff compromise brokered in the Senate will only patch two months, the legislation has permanently cut more than $1.4 billion in funding that was earmarked to help consumer operated and oriented (CO-OP) health plans become established in all 50 states.
If one person could be credited with first conceptualizing and promoting the idea of health insurance exchanges, it's probably Alain Enthoven, an 82-year-old economist and retired Stanford University business professor.
Now that Obamacare is likely here to stay, it's time to get serious about reforming key elements of our healthcare system. One area that deserves attention is the simplification of administrative processes that weigh on every transaction in healthcare. While it is not a new concept, it is one that is ready for prime time.
A federal judge in Atlanta has temporarily blocked Georgia's new prompt payment law for self-funded plans' third party administrators, siding with America's Health Insurance Plans (AHIP) in citing the preemption of federal law.
Insurers looking to compete in the ever-changing healthcare marketplace will continue to focus on technology in 2013 both as a means of improving payment models and partnerships with provider groups and as the industry looks to make the transition to consumer-focused products it will offer on health insurance exchanges.
The Department of Health and Human Services estimates that some 25 million Americans will be buying health insurance through Affordable Care Act-certified exchanges within the next few years. But that and a lot of other HIX outcomes remain to be seen.
In the 166 pages of health insurance exchange rules published by the Department of Health and Human Services last March, one provision came as a pleasant surprise to some private HIX firms -- section 155.220, letting public exchanges contract with "web-based entities" to market and sell qualified health plans.
Kroll Advisory Solutions has released its 2013 Cyber Security Forecast, spotlighting some of the pressing and perhaps unexpected privacy and security issues healthcare and other organizations may be grappling with in the coming year.
Hospital readmissions are costly and often preventable events. Yet intense efforts to decrease readmissions rates and avoid penalties under the 2010 federal healthcare reform law have yet to have a significant impact, as one in five hospitalized Medicare beneficiaries are still being readmitted within 30 days of discharge.
After three terms in Congress and a primary loss last spring, Pennsylvania Congressman Jason Altmire is heading to Florida Blue as senior VP for government affairs, leaving one of the most fractious institutions in the country for one of the most tumultuous industries.