Fallon Health Partners With Cognizant to Become the First Massachusetts Health Insurer to Provide Quotes for Merged Market Plans Under Affordable Care Act

TEANECK, N.J., Feb. 25, 2014 /PRNewswire/ — Cognizant (NASDAQ: CTSH) today announced that it has enabled Fallon Health, a Massachusetts-based not-for-profit health care services organization, to become the first Massachusetts health insurer to provide quotes for merged market plans mandated by the Affordable Care Act (ACA). Continue reading

New Research Shows ACA Exchanges Will Compete with Private Insurers; None are Easy

CHANGE SCIENCES HEALTH INSURANCE INFOGRAPHICNEW YORK, /PRNewswire/ — Web researchers Change Sciences Group released new data this week comparing the insurance shopping experience on public health exchange web sites, including the new HealthCare.gov site, with the shopping experience on private health insurance sites. According to the research, the new HealthCare.gov site (released on November 30) offers an insurance shopping experience which is now on par with leading private insurer web sites such as Aetna, eHealth and Kaiser Permanente. Continue reading

Independence Blue Cross Enhances its Consumer Outreach and Engagement Strategy

Independence Blue Cross, (IBC) has announced that it extended its partnership with Relay , a new channel for customer communications, to enhance its successful mobile communication program, IBX Wire™.

Launched earlier this year, IBX Wire helps IBC members stay on top of vital personal health information, complete transactions, and get customized support from their smartphones. IBC is now taking this capability beyond its member base to educate and engage with consumers to help them understand the changes driven by the Affordable Care Act, and provide an easy way to get more information or enroll in a health plan.

IBC said that this mobile communication program is a key element of its consumer outreach and engagement strategy which also includes multi-lingual educational materials; online resources like ibx.com/careforme and ibx4you.com ; social media outreach; outreach through seminars and webinars by trained health care reform experts; and direct mail. In addition, IBC launched the Independence Express , a state-of-the-art, mobile education and retail health care experience that has been traveling throughout Southeastern Pennsylvania this summer and fall helping consumers understand the important changes associated with the Affordable Care Act. – See more information at IBX.com.

BCBSM Give Michigan Consumers Option to Text to Determine ACA Subsidy Qualification Status

Blue Cross Blue Shield of Michigan says it is first health plan to give Michigan consumers the ability to determine eligibility for ACA subsidies through text messaging.

Under Blue Cross’ “Text for Subsidy” program, people can text “4Subsidy” to 222-752 to initiate a back and forth exchange, detailing their eligibility. Normal data plan charges will apply. The consumer will be asked to provide their zip code, age, income and number of dependents. Blue Cross will respond with whether or not they are eligible for a subsidy. – For more information see BCBSM.com.

 

 

Will ACOs Usher in a New Era of HMO-Style Managed Care?

Amber May has published an article on BenefitsPro.com that recalls a time in the 1990s when HMOs were the biggest thing in health care. She points out that the most obvious benefit of an HMO system is the coordination of care the organizations facilitate and how, since 1995, the National Health Insurance Law in Israel made participation in one of the four Israeli HMOs compulsory for all Israeli citizens.

May points out that once again the United States is experimenting with managed care. She notes that the Patient Protection and Affordable Care Act (PPACA) is attempting to address the lack of care coordination that’s developed in the American health care system by creating provisions for accountable care organizations (ACOS), coordinated groups of health care providers that provide care for specific populations of patients and are accountable for the quality, cost and outcomes of that care.

She notes that through PPACA, ACOs are tied to Medicare and speculates that a universal managed care system similar to Israel’s may be a long way off for the U.S. – To learn more see benefitspro.com.

Medical Home Common Theme in ACA State Grant Programs

We have been tracking some of the health plan innovations that are being funding as part of the Affordable Care Act. (ACA). Stateline, the daily news service of the Pew Charitable Trusts, has published an article that looks into the progress states are making in their efforts to grapple with the relatively high cost and low quality of U.S. health care.

Stateline notes that out of the $1.8 trillion the ACA is projected to cost over the next decade, $10 billion is dedicated to innovation programs. Susan Dentzer of the Robert Wood Johnson Foundation, a nonprofit group that promotes improvements in the U.S. health care system told Stateline, “The idea is to take governors up on their claim that states are the laboratories of democracy where meaningful innovations can occur.”

So far, Stateline reports, Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont have applied for funds under the under an ACA program called the State Innovation Models Initiative, and this year, they began testing new health care financing models. Another 19 states are in various stages of developing similar experiments. Continue reading

Are CO-OPs Doomed to Fail?

Over on FierceHealthPayer is asking the question: Are Co-Ops doomed to fail? She notes that of the 24 Co-Ops now open for business, one has closed, another is struggling and at least nine other startup insurance companies are projected to have financial problems.

Where they not designed with enough financial support, or are there other problems at work? – See more at FierceHealthPayer.com.

 

Should Health Care Systems Become Insurers?

A new article published in the Journal of the American Medical Association (JAMA) asks the question: Should Health Care Systems Become Insurers?

An introduction to the article explains that incentives under the Affordable Care Act (ACA) are spurring increasing numbers of health care systems to assume the risk of paying for patient care, blurring the boundaries between care delivery organizations and insurers. New arrangements such as bundled payments, value-based purchasing, and accountable care organizations (ACOs) transfer financial risk from payers to health care systems. The union of payer and care delivery functions may engender opportunities for health systems to invest in prevention and more comprehensive, coordinated, patient-centered care.

The entire article is available at JAMANetwork.com and is available to registered members.

CAQH CORE, the Quiet Side of the Affordable Care Act

With health care exchanges dominating the news with regard to the Affordable Care Act (ACA), another piece of the health care reform legislation that will affect more people than the individual mandate or the public exchanges is being implemented with much less fanfare and media attention.

Those are the sections of the law that require administrative simplification and the development of standards for financial and administrative transactions. Sections 1104 and 10109 of ACA will impact nearly everyone who uses, pays for or delivers health care.

Essentially these sections of the law are aimed at bringing the health care industry (hospitals, health plans and other stakeholders) to a place that the financial services industry has been for years. That is having universal standards in place that allow financial institutions to communicate with one another in the same electronic language. It is what allows someone to use an ATM at a bank branch or at a gas station.  Continue reading

BCBSM Refocusing Welcome Centers to Help Consumers Navigate ACA Marketplace Changes

Blue Cross Blue Shield of Michigan (BCBSM) has announced that it is re-focusing its 10 welcome centers located across the state of Michigan to help consumers understand and navigate ACA marketplace changes.

The walk-in centers allow consumers to talk directly with a health plan advisor or licensed Blue Cross agent.

“Of the many questions consumers have, the most common include cost, being able to determine subsidy eligibility and understanding the difference between products,” said Terry Burke, vice president for individual business, BCBSM.

In addition to the walk-in centers, Blue Cross Blue Shield of Michigan is hosting a number of community education sessions throughout the month of October

See the full story at BCBSM.com.