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.
A story in USA Today examines how the Affordable Care Act has prompted to open stores in malls as a way for the newly consumer-focused insurers to draw the uninsured to the plans they are offering in state exchanges starting Oct. 1.
Meanwhile, consumer advocates worry that the new stores will attract uninsured people who should be shopping on their state’s health exchange where they can compare all the plans offered for sale.
What do you think of this retailization of health insurance?
See the full story at USAToday.com
MOUNTAIN VIEW, CA–(Marketwired – Sep 24, 2013) – eHealth, Inc. (NASDAQ: EHTH), the nation’s leading private online health insurance exchange for individual and family health insurance, today announced that it has entered into a relationship with Intuit Inc. (NASDAQ:INTU) in an effort to expand consumer enrollment in individual and family health insurance plans.
Through the planned integration with Intuit TurboTax®, many of the more than 25 million people projected to use TurboTax will be able to more easily explore their health insurance options using eHealth’s online health insurance marketplace. In addition to major medical coverage, TurboTax users may also be able to enroll in Medicare Advantage plans, Medicare Supplement plans and stand-alone Medicare prescription drug plans.
See the full story at MarketWired.com
Federal health officials released the framework for ObamaCare’s long-awaited “Basic Health Program,” an initiative designed to provide a scaled-down, lower-cost coverage option to people who cannot afford health plans on the new insurance exchanges.
The Basic Health Plan will be available to citizens who aren’t eligible for Medicaid but might not be able to afford health coverage for the new insurance exchanges. Legally present non-citizens who qualify for the exchanges and those that would otherwise qualify for Medicaid may also enroll.
See the full story at TheHill.com
The Jersey City Medical Center and a major insurance carrier have entered into an agreement to work together improve care and lower patient costs, the hospital announced.
“We look forward to successfully developing a patient-centered program with Jersey City Medical Center to help ensure our members receive high-quality, efficient health care services,” said Jim Albano, vice president of network management and Horizon healthcare innovations at Horizon BCBSNJ.
“Rather than becoming an insurance company, we want to collaborate with an insurance company to provide the most efficient patient career,” said Joe Scott, President and CEO of Jersey City Medical Center.
See the full story at NJ.com
At its current level, health care spending is “unsustainable,” Highmark CEO and President Dr. William Winkenwerder Jr. told an assemblage of business leaders attending the West Virginia Chamber of Commerce’s annual meeting at The Greenbrier Thursday morning.
His company, Winkenwerder said, is working on several fronts to stem the tide of health care spending through such programs as an in-house wellness and prevention initiative that lowers health insurance premiums for Highmark employees who take steps like quitting smoking, losing weight and adopting a regular exercise regimen.
Another Highmark initiative seeks to boost “cost/quality transparency,” a needed service, according to Winkenwerder, because nobody appears to know how much each item in health care costs.
See the full story at Register-Herald.com
The move by Cigna Corp. to require genetic counseling before selected tests are performed on its members will likely be adopted by other major carriers, reflecting not only the insurance industry’s attention to costs, but also to improving care in the highly complex field of genetic medicine, market consultants say. Beginning Sept. 16, Cigna will mandate that members considering tests to determine their risk of developing three conditions — breast cancer, colon cancer or the heart rhythm disorder Long QT syndrome — first undergo genetic counseling to gauge whether the tests are needed.
Read the full story at AISHealth.com
Satisfaction levels are rising for Americans with consumer-driven health plans just as satisfaction — as well as popularity — slip for traditional health plans, according to new research from the nonpartisan Employee Benefit Research Institute.
Consumer-driven health plans — and their associated products, such as health savings accounts — are becoming more popular among both employers and employees.
According to analysis from the American Association of Preferred Provider Organizations, enrollment in consumer-directed health plans grew by 19 percent in 2012, increasing from 33 million in 2011 to 39 million last year.
Read the full story at BenefitsPro.com
Corporate America is taking a hard look at moving retirees and part-time workers into health insurance marketplaces created by the Affordable Care Act, suggests a survey by the National Business Group on Health.
To a lesser extent large companies also expect coverage for their full-time workers employee spouses to shift to the online, state-based marketplaces known as exchanges, according to the annual survey published Wednesday.
Read the full story at KaiserHealthNews.org
Three friends, and technology entrepreneurs, teamed up to do something that has been inconceivable to date—create a start-up health insurance company to take on conventional health insurers on the NY exchange.
Oscar co-founders, Josh Kushner, Kevin Nazemi and Mario Schlosser, plan to change the health insurance industry through technological interfaces, telemedicine and real transparency. Their goal is to redesign insurance to be geared toward the user experience, to make patients seek out their insurer before their doctor.
Read the full story at Forbes.com