Reimbursement
While the average premium for the least expensive closed network silver plan -- principally HMOs -- rose from $274 to $299, a 9 percent increase, the average premium for the least expensive PPO or other silver-level open access plan grew from $291 to $339, an 17 percent jump.
The state's only health insurance co-op will shut down operations on December 31, after failing to find additional financing, Meritus officials announced November 25.
The state's only health insurance co-op will shut down operations on December 31, after failing to find additional financing, Meritus officials announced November 25.
While the average premium for the least expensive closed network silver plan--principally HMOs--rose from $274 to $299, a 9 percent increase, the average premium for the least expensive PPO or other silver-level open access plan grew from $291 to $339, an 17 percent jump.
Many co-op plans were priced low, and customers poured in. But these new customers had high health costs, so the co-ops had to start paying a lot of bills. The math didn't add up
Halfway through the open enrollment period, another half million consumers signed up in the federal marketplace during the week of November 15-21, according to the Centers for Medicare and Medicaid Services.
CMS is requesting comment on whether health plans should designate network strength, such as indicating whether a plan has a broad number of doctors or health facilities in the network or not.
While CMS said it was "pleased to report that claims are processing normally," it's worth keeping in mind that the government agency has taken several temporary steps to smooth the transition to ICD-10 which may be masking problems that could manifest themselves down the road.
CMS is requesting comment on whether health plans should designate network strength, such as indicating whether a plan has a broad number of doctors or health facilities in the network or not.
Many primary care practitioners will be a little poorer next year because of the expiration of a health law program that has been paying them a 10 percent bonus for caring for Medicare patients.