Insurers Are Overestimating Costs, Lowering Rebates Owed to Policyholders
April 30th 2021A recent study from American Accounting Association finds health insurance companies are overestimating costs associated with patient care to avoid triggering rebate provisions in the Affordable Care Act.
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Pursuing the Holy Grail of Value-Based Care? Penn’s LDI Says Head This Way.
April 14th 2021Whether the cup of value-based care is half empty or half full may depend on your point of view. But the grail certainly isn’t full. Some of the leading lights at the Leonard Davis Institute (LDI) of Health Economics at the University of Pennsylvania have released recommendations to hasten the volume-to-value healthcare transformation.
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Amazon Continues to Step, Not Leap, Into Healthcare
April 13th 2021A couple of years ago, there was a lot of chatter about the Amazonifcation of healthcare. Well, that hasn’t happened. But the company is breaking into a sector of the economy that accounts for almost 18% of the American gross domestic product. Perhaps healthcare’s journey of Amazonifcation has started but is going step by step.
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A Faster Path to Medicare Coverage for Devices May Get Slower. Or Vanish Altogether
April 13th 2021The Biden administration put a hold on the new and pending rule changes that the outgoing Trump administration made, so whether the Medicare Coverage of Innovative Technology pathway will ever take effect is uncertain. But many providers and payers — and presumably most device makers — are keeping a close watch on the fate of the pathway.
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New Analysis Shows Benefits of Electronic Prior Authorization for Patients and Providers
March 25th 2021Electronic prior authorizations (ePA) can significantly reduce the time between a request for prior authorization and a decision and the time to a patient receiving care. These were two of the top findings from an initiative launched by America’s Health Insurance Plans (AHIP) to better understand the impact of ePA on the prior authorization process.
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ACLI Responds to Misinformation about COVID-19 Vaccine
March 18th 2021The American Council of Life Insurers (ACLI) senior vice president of Policy Development, Paul Graham, recently responded to the social media news which suggested COVID-19 vaccines could be a factor a life insurer considers in the claims-paying process.
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Examining Health Equity Among Different Racial and Ethnic Subpopulations With Multiple Sclerosis
March 15th 2021Multiple sclerosis (MS) is a chronic disease that involves demyelination of plaque throughout the white and gray matter of the central nervous system. The early stages of MS are usually marked by a relapsing-remitting course of neurological deficits, which progress toward continuous, permanent dysfunction and disability. Of those with a diagnosis of MS, 74% are women.
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CVS Health Poised to Reenter ACA Marketplaces
March 5th 2021Aetna got out of the ACA marketplace business in 2018. Now CVS Health, which completed its acquisition of the insurance company in late 2018, is hopping back in and will brand the policies as a “CVS Health-Aetna” product for the first time.
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