Technology helps community clinics take enrollment to the street
Centers reach out to low-income populations.
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Engagement drives utilization of preventive services
Health plans are supporting providers by offering outcomes-driven engagement programs for members
State of the Industry: Small Employers
The small-group segment is a viable marketplace
PPOs remain most popular plan type
According to KFF/HRET, more than half of covered workers opt for PPO arrangements
State of the Industry: Bronze Plans
Bronze plans will serve the hold-outs who have not purchased insurance in the past
Scorecard shows location more critial than income
Commonwealth Fund: Low-income families have advantages in top performing states
State of the Industry: Preparedness for PPACA
Expect a few missteps as provisions phase in over time
State of the Industry: Obesity
AMA says obesity is a disease but the decision is up for debate
Kentucky co-op leverages outreach during open enrollment
New members likely to have more chronic conditions
State of the Industry: Rate negotiations
More complex reimbursement contracts make it tougher on providers
State of the Industry: Future of ACOs
Shared Savings model will have to mature and refine to adapt to industry changes
State of the Industry: ACO Formulary
Anticipate larger ACOs eventually opting for formularies
State of the Industry: ACO models
Physician-led models seem to have an advantage
State of the Industry: Specialty Pharmacy
New cost control ideas will be needed in the future
State of the Industry: Age-rate bands
One of many things that will cause rates to increase between 2013 and 2014.
CDC seeks answers on e-cigarette use among kids
CDC is concerned because young adults and children are beginning to use e-cigarettes, and the products’ safety is uncertain.
State of the Industry: Winners and losers
Managed care appears to fare well under PPACA
Keeping up with PPACA worth your time investment
Convenient sound bites do not take the place of true intelligence.
Marketplace Navigator roles still cause for question
Will the 34 federally-facilitated and state-partnership exchange programs be sufficient?
State of the Industry 2014
Managed care organizations will be remiss if they don’t seriously consider the evolving competitive landscape.
State of the Industry: Narrow and tiered networks
New network designs drive quality through data sharing
State of the Industry: Consumers
Consumers need in-person assistance to understand the health law and what it means to them
Insurers ante up for health reform with lower premium rates
While HHS touts big savings for consumers, insurers feel the pinch on prices
State of the Industry: Job impact
Employers are threatening to cut hours and workers to avoid PPACA requirements
Exchange formularies need flexibility beyond PPACA
Pharmacy leaders say benchmark plans too limited and PPACA too prescriptive
Role of EMRs shifting from data vessel to decision tool
A global Accenture study shows patients want access to EMRs so they can get more involved in their care
FACT FILE . . . Convenient Care Clinics
Payers warm up to retail clinics
Stakeholders weigh the pros and cons of convenient care clinics found in drug stores and grocery outlets
State of the Industry: Health Status
Young invincibles who are used to their parents' plans will no doubt want to continue coverage
State of the Industry: Primary care physician shortage
The significance and impact of the primary care physician shortage is evaluated by industry experts.