United Healthcare has announced there will not be any individual/family off-exchange ACA marketplace plans available next year in 2017- except for in the state of Utah.
Indiana Department of Insurance just announced on May 25, 2016 that it has approved “the acquisition of control” of Cigna Healthcare of Indiana, Inc. by Anthem, Inc. Indiana Insurance Commissioner Stephen W. Robertson signed the Final Order to approve the acquisition. His signature follows “a thorough investigation of evidence and arguments presented at a public meeting on April 29, as well as all other materials filed with the Department.”
“As part of the Order, the Commissioner must receive written notice of the closing of the proposed acquisition within five days after the closing date. Anthem and Cigna are also ordered to perform a cybersecurity review to assure that the proposed change of control of Cigna will not result in any transfer of malware.” Source: Indiana Department of Insurance.
Federal regulators may ultimately approve the mega-merger of Aetna and Humana, but the resulting insurance behemoth will not be welcome to do certain business in Missouri.
However, Aetna and Humana have 30 days to “submit a plan to remedy the anti-competitive impact of the acquisition.” That likely means the state may push the health insurers to divest Medicare Advantage plans in areas where competition would have been smothered.
Most provider groups in Missouri, including the Missouri Hospital Association and the Missouri State Medical Association, filed statements opposing the Aetna deal. However, some individual providers such as Freeman Health System in Joplin, Mo., and Encompass Medical Group in Kansas City, Mo., actually supported the merger.
Missouri officials were most worried that competition in Medicare Advantage—Humana’s primary business and the key reason why Aetna struck the deal—would be stifled and therefore hurt seniors in the form of higher premiums. Aetna and Humana, combined, control 54% of the individual Medicare Advantage market in Missouri and 30% of the group Medicare Advantage market. There are 23 counties in Missouri where Aetna and Humana have more than 80% of the individual Medicare Advantage market.
Source: Modern Healthcare
“More than 90 percent of patients reported satisfaction with their primary care physician across several categories in a new survey. However, many also communicated concern regarding healthcare costs and medical debt.
“The survey was commissioned by the Physicians Foundation — a nonprofit organization seeking to empower physicians to take the lead on delivering high-quality, cost-efficient healthcare — and conducted by Harris Poll.
“The survey was comprised of 1,511 adult patients between the ages of 27 and 75 who had seen the same physician twice in the same year. According to the results, 95 percent of participants reported being satisfied with their physician’s ability to communicate medical information intelligibly, 96 percent reported feeling respected by their physician, 93 percent reported satisfaction with how well their physician listened to them and 92 percent conveyed satisfaction regarding their physician’s knowledge of their medical history.” Source: Becker’s Hospital Review, Physician Foundation
“New York insurers asked for large premium increases for 2017 as a way to counteract rising costs, and in some cases, gargantuan losses.
Insurers selling plans to individuals requested a 17.3% average increase and those selling small-group plans asked for an average 12% rate hike. The state insurance marketplace, known as New York State of Health, has seemed to be more stable than other markets nationally, but insurers here haven’t been immune to national trends that are driving up health care spending and increasing the costs of providing health insurance.
The New York Health Plan Association said the hikes are necessary. “The 2017 rate submissions reflect increases that are the direct result of the underlying cost of care and marketplace changes that continue to impact health plans’ operations,” Paul Macielak, HPA’s president and chief executive, said in a statement. Three main reasons for higher premiums are generally always cited: Medical costs have gone up, government programs that helped cover costs are ending, and insurance customers need and use more medical care than insurers and the government expected. Source: “Modern Healthcare.”
Beacon Health System in South Bend, Ind., has joined the Mayo Clinic Care Network.
Beacon is the first Indiana-based health system to join the network. The 2 health systems will remain independent of each other, but Beacon insured members now have access to Mayo Clinic’s specialists as in-network providers. Beacon staff will have access to Mayo Clinic’s specialty physicians, expert database on medical conditions, library and consulting services.
The North Central Indiana health system provides pediatric and gynecologic oncology care. Mayo Clinic, based in Rochester, Minnesota, has partnered with more than 35 providers across the U.S. since 2011. Source: “Modern Healthcare.”
Illinois is working on a House bill that would prompt the Illinois auditor general to examine Medicaid insurers.
The bill has more than 60 co-sponsors and was initiated because “there has been little information disseminated to the General Assembly” about how the state’s Medicaid managed-care program has fared financially and clinically. About 2/3 of Illinois’ 3.1 million Medicaid beneficiaries are now in a managed-care plan.
The Illinois Health and Hospital Association supports the new house bill and a separate state senate bill that promotes oversight and transparency of the Medicaid program. IHA spokesman Danny Chun said that bill, which passed the Senate and now awaits a vote in the House, is a “collaborative” effort among legislators, the state Medicaid agency, providers and insurers. Source: “Modern Healthcare.”
Necessity is still the mother of invention.
“UT, for example, is building a nine-month research and innovation block into its four-year program, and working with local health authorities to design a reimbursement system that rewards preventive care and long-term value. Dell Medical School is the first MD-training institution in nearly half a century to be built from the ground up at a top-tier US research university.” For Details Click Here.
“‘Family physicians across the country applaud the FDA’s final regulation of e-cigarettes, cigars, pipe and hookah tobacco, and other related products,’ said AAFP President Wanda Filer, M.D., M.B.A., of York, Pa.
“Key among those restrictions is the agency’s decision to prohibit the sale of all such products to individuals younger than 18, as well as a requirement that appropriate health warnings be displayed on “cigarette tobacco, roll-your-own tobacco, and covered tobacco product packages and in advertisements.” For Details Click Here.
Humana has announced that it is likely to exit some Affordable Care Act exchanges in 2017. Lower earnings and enrollments were cited as factors for the decision. Humana, like other insurers, is in the process of deciding whether it will sell coverage on the exchanges next year and what kinds of plans it will offer.