Hospitals around the country are afraid to send out hundreds of thousands of bills related to COVID-19 testing. That’s because Congress mandated there would be no copays and no out-of-pocket costs for patients. But many employers with self-funded health plans seem to believe they’re exempt from the rules.
The issue comes down to an interpretation of whether the new federal legislation applies to health plans offered by larger employers. Those companies, which usually have at least a few hundred employees, often use their own money to pay claims as a way to drive down costs. A survey by the Kaiser Family Foundation finds a majority of Americans with health coverage are in this type of plan. Read More: KHN
Due to disruptions in previously anticipated health care services caused by the COVID-19 pandemic, Blue Cross Blue Shield of Michigan and Blue Care Network will be returning more than $100 million to many fully insured customers this year. The refunds are in addition to $494 million that BCBSM has invested in expanding the availability of no-cost benefits for members and to support health providers in response to COVID-19 – bringing the BCBSM enterprise’s commitment in response to the crisis to nearly $600 million. Read More: BCBSMI
With tens of millions of Americans without health insurance and filing for unemployment, Ann Arbor officials are calling for health care reform.
City Council went on record this week endorsing the single-payer health insurance proposal known as Medicare for All.
“I don’t know that we could get a better illustration of the need for universal health care than the impact of the pandemic on employment and the fact that, when people need health insurance most, they’re losing their jobs and their health insurance,” said Council Member Jack Eaton, D-4th Ward. Read More: MLive
Sally Poblete at BenefitsPro lists three lessons health insurance incumbents can learn from the auto insurance industry to better meet customer expectations, boost sales, and ensure long-term competitiveness. Read more.
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?
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.
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.
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.
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.