Politics and Policy

The industry is challenged by a number of issues in 2015 including cost control, technology threats, and the emerging consumer market.

An estimated 50,000 fewer patients died in hospitals and approximately $12 billion was saved between 2010 and 2013 because of reduced hospital-acquired conditions,according to the U.S. Department of Health and Human Services (HHS).

Total national health spending slowed from 4.1% in 2012 to 3.6% in 2013, the slowest rate of growth since it was first tracked in 1960, according to a report from the Office of the Actuary (OACT) at the Centers for Medicare and Medicaid Services (CMS).

The launch of the Small Business Health Options (SHOP) marketplace drew 200,000 visitors during the first week of open enrollment.

The 2014 deadline for eligible hospitals and critical access hospitals (CAHs) to attest to meaningful use of electronic health records (EHRs) has been extended to December 31 by the Centers for Medicare and Medicaid Services (CMS).

Opposition to the Affordable Care Act (ACA) may explain why two pairs of states had very different performance outcomes in the federally facilitated marketplace (FFM) during the first open enrollment period.

Considering the challenges they faced during the first open enrollment period, Consumer Operated and Oriented Plans (CO-OPs) overall are doing very well, having signed up some 450,000 members across the nation, or 18% of all ACA exchange plan enrollees to date.

As many as 7 million new enrollees could sign up for health insurance during the Affordable Care Act’s second open enrollment cycle which begins November 15, according to the Congressional Budget Office (CBO).

Employer-sponsored healthcare benefits are not insulated from the changes taking place in the broader healthcare marketplace. However employers, particularly large employers, are attempting to drive the conversation and actions toward issues that are important to them. One of the best ways to do that is to pressure health plans to help them achieve their healthcare goals

The U.S. Supreme Court, in a decision expected by July of 2015, will hear arguments on the legality of the federal tax subsidies available to low and moderate income consumers that are a key component of the Affordable Care Act (ACA).

Certain group health plans that don’t provide minimally-defined coverage for in-patient hospitalization services will be disallowed if they were purchased after Nov. 4, 2014, the U.S. Department of Treasury has announced.

Audits of Medicare Advantage (MA) plans and healthcare plans offering financial assistance as part of the Affordable Care Act (ACA) will be conducted by the Health and Human Services Office of Inspector General (OIG), according to the Center for Public Integrity.

After beating third quarter Wall Street estimates and with their stock prices at all time highs, the nation’s leading insurers are expanding their presence on state exchanges (also known as marketplaces) in response to a contracting employer-driven market.

A new Kaiser health tracking poll shows 90% of uninsured Americans are not aware of the Affordable Care Act’s (ACA’s) next open enrollment period.

EXCLUSIVE INTERVIEW: Karen DeSalvo, MD, MPH, MSc, the national for Health Information Technology (HIT), explains that healthcare is a decade away from a national, interoperable health information technology platform.

More states, including some initial hold-out Republican states, are joining the ranks of those that have already expanded Medicaid under the ACA.

As of January 1, 2015, the U.S. Centers for Medicare and Medicaid will only be awarding payments to MA plans that receive 4 stars or higher.

Employers are attempting to mitigate rising costs resulting from the ACA by shifting them to employees, according to a new survey from the Darla Moore School of Business at the University of South Carolina.

Looming rate cuts and policy changes fuel grassroots effort

Adaptability and flexibility is and will continue to be the key to both survival and success

Insurers weigh risks, demographics in setting premiums for 2015

Many children are without dental benefits

Plans seek new strategies to assess drug value, ensure appropriate prescribing

The justices' 5-4 decision is the first time the high court has ruled in favor of for-profit businesses holding religious views under federal law

Expectations surpassed, but back-end fixes need to ensure data, payments