Policy Alerts的动态

?? Is healthcare sharing the right choice for you and your family? Before you decide, ask yourself these 3 essential questions! ???? In today's complex financial and healthcare world, finding the right care can be overwhelming for many U.S. families. According to the 2023 Milliman Medical Index, a typical family of four with employer-provided PPO coverage spends a whopping $31,065 annually. ???? Want to learn more? Dive into the full article here: Read More ?? https://newsby.us/VeZMo ???

New healthcare price transparency study out now in AJMC - The American Journal of Managed Care. The first research of its kind, the piece compares hospital and insurer price transparency data for maternity-related services negotiated between Blue Cross & Blue Shield of Mississippi and 26 Mississippi hospitals. While co-author Morgan Henderson and I find a relatively low degree of overlap between the two pricing data sources, when the two data sources do overlap, there is a strong level of concordance. This suggests that these data sources are capturing pricing information from the same underlying contracts, as intended. Work supported by Arnold Ventures, authors affiliated with University of Maryland Baltimore County and The Hilltop Institute at UMBC #TiC #pricetransparency #hospitalpricing #insurerpricing

Hot off the presses: Elevance Health also is suing CMS for 2025 Star ratings. So now we have United, Humana, Centene, and Elevance Health all filing lawsuits on Star Year 2025 calculations. I will read the whole complaint this weekend, but the Elevance suit seems more along the lines of Humana's hard-hitting filing, which also has raised structural and procedural issues with Star ratings in addition to challenging certain 2025 Star measure calculations. Elevance's suit says plans deserve to see all the data necessary to calculate Star measures. As hard as it is to sue the person that pays so much to you, Humana and Elevance are not wrong on this. #cms #stars #medicareadvantage Lilac Software The Healthcare Labyrinth

?? Steward Health Care to Sell Doctor Network to UnitedHealth's Optum Deal Overview: * Troubled Steward Health Care plans to sell its nationwide physician network, Stewardship Health, to UnitedHealth's Optum unit. Financial Crisis Impact: * Steward aims to shore up its finances and strengthen its network of 33 hospitals after facing financial difficulties, including missed bill payments. Massachusetts Concerns: * Massachusetts policymakers seek assurances that proceeds from the sale will support struggling hospitals and prevent closures. Political Response: * Senator Elizabeth Warren raises concerns about the sale's impact on public health and calls for a focus on preserving Massachusetts hospitals. Regulatory Scrutiny: * Massachusetts Health Policy Commission to review the deal's impact on healthcare costs, quality, access, and equity. Community Concerns: * Community leaders express worries about potential weakening of Steward hospitals and impact on vital community healthcare services. Optum's Strategy: * Optum's aggressive expansion raises questions about its intentions and the future of healthcare delivery in Massachusetts. Antitrust Concerns: * Acquisition may face antitrust scrutiny due to Optum's significant presence in Massachusetts and nationwide. Previous Acquisitions: * Optum has expanded its presence in Massachusetts through acquisitions of Reliant Medical Group and Atrius Health. Steward's Financial Challenges: * Steward's financial crisis, marked by lawsuits and equipment loss, prompts asset sales and new loans. Steward's History: * Formed in 2010, Steward Health Care faced financial instability, leading to strategic shifts and relocation of its headquarters to Dallas. Calls for Action: * Politicians, including Governor Maura Healey, call for Steward's exit from Massachusetts amid ongoing challenges. https://lnkd.in/gWY3W9-f

https://lnkd.in/gKMWnQJB This is an industry-wide issue, likely to impact downstream providers and beneficiaries alike. "The shares fell as much as 10.3%, the biggest intraday decline since March 2020. Stocks of rivals Elevance Health Inc., CVS Health Corp., Humana Inc. and Centene Corp. also dropped, a sign that investors see UnitedHealth’s troubles threatening the entire sector." HMA can help providers and delivery systems prepare for the impact. Contact me to learn more about how HMA can support your needs with a wide range of services, from actuarial to value-based contracting strategies.

Our vision is one where healthcare is not merely a reactive 'sick-care' system but a proactive and consumer-centric approach that puts individuals back in the driver's seat of their health and well-being. Looking forward to the future where stakeholders come together to truly address the root cause of chronic disease with #pricetransparency and access to #qualityproviders for all #consumers. #nabip #revolutionary #employeebenefits #healthinsurance

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As many of you are aware, the healthcare landscape in Oregon—and indeed across the nation—is facing a troubling trend. The increasing corporate acquisition of medical clinics and other healthcare entities has led to worrying consequences: a decline in patient care quality, a rise in premature deaths, and escalating costs. These acquisitions are often shrouded in complexity, concealed behind a web of shell companies and subsidiaries, making it challenging to grasp their full impact. Here's where the beacon of hope shines: Oregon's HB 4130. This bipartisan bill, currently under consideration by the Oregon Legislature, is a robust response to these challenges. It aims to cut through the loopholes that big corporations exploit, ensuring that physicians retain control over patient care decisions. This legislation not only champions physician independence by banning non-compete clauses and regulating gag orders but also brings much-needed transparency to clinic ownership. However, this shouldn't just be an Oregon story. The issues we face here are mirrored nationwide. This is why we need to advocate for similar legislation at a federal level. By implementing these measures nationally, we can safeguard the quality of patient care, enhance physician autonomy, and ensure transparency in healthcare across the United States. I urge my network, especially those in healthcare and policy, to support and promote the ethos of HB 4130 beyond Oregon's borders. Let's unite in this crucial endeavor to ensure that healthcare decisions remain in the hands of those dedicated to the well-being of patients, not in the profit-driven calculations of corporations. #HealthcareReform #PatientCare #PhysicianAutonomy #TransparencyInHealthcare #FederalLegislationNeeded Centivox Healthcare For Action Share your thoughts and let's amplify this conversation for the betterment of our healthcare system! ?????? https://lnkd.in/gmSyWYsD

I recently spoke with Jakob Emerson from Becker's Healthcare about the factors driving the growth of Medicare Advantage for Aetna, a CVS Health Company.?? ? We discussed how #care, #convenience, choice and compelling core benefits combined with the power of CVS Health assets are all keys to our success.? To learn more about our conversation, you can read the full article here: https://bit.ly/49niFgK?

Centene is joining other health insurers in expressing dissatisfaction with regulators' handling of quality ratings for 2025. This discontent stems from concerns over the methodologies and criteria used to assess quality, which some insurers believe could impact their competitiveness and funding. Centene's move highlights ongoing tensions between insurers and regulatory bodies regarding quality assessment in the healthcare industry. #Centene #Healthplan #USheathcare #Starrating