As the Affordable Care Act turns six years old this week, the Obama administration is marking the occasion by highlighting its successes and laying out plans for how it might transform the healthcare system going forward.
read more
Category: FierceHealthPayer
Medicaid expansion saves states millions, boosts payer revenues
The 31 states and the District of Columbia that expanded their Medicaid program under the Affordable Care Act are saving millions, while revenues are up for both the states and its insurers, according to the Robert Wood Johnson Foundation.rea…
AHIP launches initiative to improve accuracy of provider directories
A new pilot project announced by America’s Health Insurance Plans aims to improve the accuracy of provider directories that have been plagued by imprecise information, leading to confusion among consumers seeking in-network care.
Express Scripts CEO wants to resolve dispute with Anthem
The incoming CEO for Express Scripts wants to resolve a longstanding drug pricing dispute with its largest client that has morphed into a lawsuit, a confrontation that underscores the growing negotiating power for large insurers and questions Express Scripts’ independent business model.
Value-based payment model design pitfalls
To ensure that alternative payment models succeed, insurers and providers must avoid common missteps. read more
Affordable Care Act, not economy, drives health insurance gains
Multiple reports indicate that the sizable increase in the number of Americans with healthcare coverage is mostly a result of the Affordable Care Act, rather than an uptick in the economy, according to the Associated Press.
read more
Other states may hold answer to New Jersey’s Omnia dilemma
As the controversy continues over Horizon Blue Cross Blue Shield of New Jersey’s Omnia health plans, some say it’s worth looking at other states to decide how to regulate tiered networks.
Anthem sues Express Scripts over drug prices
Anthem’s public spat with Express Scripts has escalated into a lawsuit against the pharmacy benefits management company charging it with failing to pass on prescription drug savings.
