Reimbursement
An estimated three million people currently receive employer health benefits through a private exchange, according to new report released Thursday at AHIP Institute 2014.
Sovaldi has brought high prices of specialty drugs to the fore. Less examined so far are proactive approaches insurers and drug benefits managers can use to curb the growth trend without sacrificing quality or access.
Of the states that built their own health insurance exchanges that are now operational, Washington, Kentucky and Minnesota enjoyed some successes that might be replicated.
The value-based reimbursement model predicted by hospital/health system and payer leaders to dominate the reimbursement market is also the one they say will be hardest to implement.
Insurers selling public exchange plans last year faced a lot of uncertainty. This year it's a bit better, but the plans remain a product design experiment with confounding variables in an environment much in flux.
The value-based reimbursement model predicted by many to dominate the reimbursement market is also the one they say will be hardest to implement.
If your state is building a health insurance exchange, or you hope it ultimately will, the experience of Washington, Kentucky and Minnesota can help.
To some, many of the new bronze-level health plans sold in public exchanges are de facto catastrophic plans. Others say, "Not so," as young people especially need more low-premium plans.
In the new era of individual consumer-based health insurance, insurers have to earn the trust of Americans if they want to address the costly chronic disease burden.
Medicare's ACOs have had mixed early outcomes, but some commercial accountable care ventures, including PPO plans, are showing promise.