Reimbursement
Taking a cue from Aetna, Ascension Health and companies beyond the healthcare industry, Tufts Health Plan is raising its minimum base wage.
Anthem is scrambling to save a $53 billion takeover of Cigna, while encountering some deep criticisms of its own future potential.
According to iVantage, these hospitals excel at managing risk, achieving high quality, outcomes and patient satisfaction while running on lower reimbursements and charges than their peers.
While the modest impact continues in 2015, there are a number of influences that the ACA may have on costs in the large employer market over the next few years.
California health officials failed to ensure that more than 9 million residents enrolled in Medicaid managed care plans had access to doctors when they needed them, the state auditor said in a stinging report.
Fallon Health is departing from Massachusetts' Medicare-Medicaid managed care program, another sign that the sought-after benefits and savings will be hard to achieve.
A bipartisan group of House and Senate legislators introduced bills last week that would require health plans to cover the growing number of oral chemotherapy pills as favorably as they do intravenous chemotherapy.
While pent-up demand and new individual customers have contributed to higher-than-hoped-for premium increases, extraordinary claims have been less than feared, leaving some more money to spread around.
National insurers think they need to get bigger or risk losing out, so payers like United and Aetna are looking expand their core health plan businesses and take new services to market.
Massachusetts health insurers and their small business customers will have another year with a sort-of sharing risk rating system, although eventually they'll be in for reckoning.