Reimbursement

Key decisions for Minnesota's health insurance exchange now have to be settled by a legislative conference committee, after House and Senate bills established different financing, board membership and regulatory provisions.

When the Centers for Medicare & Medicaid Services proposed, in mid-February, an additional 2.3 percent cut to the rates it pays private insurers for running Medicare Advantage plans in 2014, the reaction from America's Health Insurance Plans (AHIP) was swift, comprehensive and sustained.

A report issued this week by the Government Accountability Office reports that the Centers for Medicare & Medicaid Services overpaid the Medicare Advantage program run by private health insurers by between $3.2 billion and $5.1 billion for the years 2010-2012.

While many companies across the country are seeing positive results and cost savings through their workplace wellness programs, a new study from Health Affairs suggests that the savings employers may strive for with these programs may more likely come from cost shifting to the most vulnerable employees rather than employees' improved health.

Concerns over young buyer "sticker shock" and adverse selection associated with new 3:1 age rating rules have been largely overblown, according to an Urban Institute study finding that premium subsidies will offset increases for many young insurance consumers.

While Connecticut's 2014-2015 budget has yet to be finalized, hospitals and healthcare systems in the state are claiming that Gov. Dannel P. Malloy's proposed cuts of more than $500 million in hospital funding over the next two years would be devastating.

Two years after receiving federal planning grants and 9 months after inking an IT contract, the Minnesota Health Insurance Exchange's enabling legislation is being finalized by state lawmakers, amid competing visions for regulatory scope.

In an education session Monday at HIMSS13 titled "How Hospitals Improve Their Bottom Line and Improve Relationships with Uninsureds," two people on the front lines showcased an innovative, IT-enabled approach to "transition from seeing these patients as a burden," and toward a way to better engage them in financing their care.

A physicians commission co-chaired by former Senate majority leader Bill Frist, MD, a Republican and heart surgeon from Tennessee, is calling for the federal government to phase out the fee-for-service payment model within the next decade.

A physicians commission co-chaired by former Senate majority leader Bill Frist, MD, a Republican and heart surgeon from Tennessee, is calling for the federal government to phase out the fee-for-service payment model within the next decade.