Susan Morse
Premiums for benchmark plans are projected to increase by about 15% this year to next, and by about 7% per year between 2019 and 2028.
States with at least 85% of their Medicaid population in managed care could implement nominal payment cuts without ensuring providers will assure access to care.
Plans may be losing out on millions in missing the 20- to 40-percent of buyers who are not ready to sign up for Medicare at age 65.
The deal signals another move by an insurer to get into the provider business for more integrated care to lower costs.
CEO Mitchell Katz says it and other hospitals have been benefitting private insurance companies by not pursuing denied claims effectively enough.
Drug and medical costs account for close to 50% of premium prices, while profits make up 2.3%, according to AHIP research.
Even necessary distractions from treating patients, which happen as often as 10 times every hour, trigger stress for doctors and nurses alike.
New regional network would include Exeter Health Resources and Wentworth-Douglass Hospital in New Hampshire as a subsidiary of Massachusetts General.
Denise Olivares explains how to piece together various data sets with healthcare payers to identify risk within a patient population.
CMS existing policy requires plan sponsors to ensure enrollees pay the lesser of the Part D negotiated price or copay.