Reimbursement

There is no shortage of uncertainty when it comes to the implementation of the state health insurance exchanges (HIX) by 2014, as required under the Affordable Care Act. Regardless of the snail's pace of guidance from HHS on key aspects of the HIX or even if the individual mandate is deemed unconstitutional, health plans should be making state-by-state analyses of how they will participate in these new marketplaces.

ICD-10 proponents are not going to like this one bit.

BancTec, which specializes in financial business process outsourcing, transaction automation and document management, has acquired certain assets of Richardson, Texas-based GTESS, a provider of claims pre-adjudication technology and services for the healthcare industry.

While AHIP Institute's session programming takes on most of the major and timely topics of the industry both in its general sessions and concurrent sessions, it also provides attendees who are early risers with highly focused information during its Networking Breakfasts program.

With technology playing a bigger and bigger role both in how healthcare is delivered to populations as well as where it is delivered, AHIP Institute 2012 will present a general session at 10 a.m. Thursday called "Brave New World of Health Care: At the Intersection of Science, Technology, and Delivery System Transformation" to help attendees better understand how emerging technologies are transforming the face of the industry.

Around 3,000 executives from the health insurance sector and related industries will converge beginning Wednesday in Salt Lake City for AHIP Institute 2012. This year's event is sure to be lively considering the impending Supreme Court ruling on the Affordable Care Act and the upcoming presidential election.

Insurance companies are faced with myriad challenges in today's market, not the least of which is finding how they will both upgrade their IT infrastructure and organizational capabilities in order to effectively execute new payment models. To help organizations develop a solid framework for these changes, enterprise-class software company HealthEdge will present a session, "Five Steps to Market Reinvention: Supporting ACOs, Exchanges and Other Reform Initiatives," at 7:00 a.m. on Friday at AHIP's Institute 2012.

The American Medical Association's fifth annual National Health Insurer Report Card shows that the number of medical claims paid incorrectly by the nation's largest health insurers was cut in half last year, down to 9.5 percent of claims.

They already are. For example, Social Security's replacement rate (the benefit as a percent of pre-retirement income) falls as income rises. Also, above very modest income thresholds, 50 percent and then 85 percent of Social Security benefits are subject to ordinary income taxes. But the term "Social Security benefits tax" is misleading.

The American Medical Group Association (AMGA) and Press Ganey Associates have launched a new survey tool designed to help accountable care organizations (ACOs) improve efficiency, quality and the patient's experience.