In January, CMS proposed overhauling the way it evaluates if and how much money ACOs are saving in the Medicare Shared Savings Program (MSSP). Under the revised methodology, the agency would adjust cost benchmarks based on regional rather than national spending data when an ACO signs up for a second three-year contract period. Of 434 ACOs…

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The Affordable Care Act’s tax increases are many, two are front and center this month: the individual and employer mandates. They were both supposed to increase coverage, but in reality they’re limiting career opportunities and taking more out of families’ and individuals’ wallets.

After six years of Obamacare and three years of the exchanges Americans have learned a few lessons. The healthcare.gov disaster was due to the complexity of the website, an awful procurement system, and lack of adequate management by the administrationg. Establishing an insurance company is more than just paying claims, as you can see with…

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The Association of Medical Colleges released a report that says America will be short a million doctors by 2025 and that the shortage of primary care physicians makes up a third of that number. There are several reasons for the shortage of primary care physicians including “fee for service” payment model and the mandate for doctors…

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Obamacare created a system that actually made insurance more expensive, decreasing access to the poor and sick, while pricing out average Americans from affordable health care coverage. Millions more have been added to Medicaid, millions have seen double or triple their annual premiums and millions have opted not to be insured at all.

The Internal Revenue Service doesn’t tell the 10 million uninsured tax filers that their low and moderate incomes likely mean their households qualify for Medicaid or subsidies to buy coverage on the insurance exchanges.

Only the top five insurers have profits in excess of $1 billion. All the others had 2014 profits of less than $300 million. But the top five also have membership of at least 20 million, with Humana being the lowest (21.4 million) and CIGNA and UnitedHealthGroup having the highest (86 and 85 million members worldwide,…

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In the March 8 rule, the Department of Health and Human Services (HHS) stated that Health Savings Account (HSA) eligibility was not a meaningful distinction for health plans because consumers can determine whether a plan is HSA-qualified by examining a plan’s cost-sharing amounts. Therefore, it will not require HSA-qualified plans to be designated as such. Two…

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Highmark Health lost $590 million in its health plans that were sold on the ACA exchange in 2015. Highmark is still owed $500 million under the risk-corridor program, and HHS has said it will find a way to fund the program. Highmark Health CEO, David Holmberg said Highmark has met with government officials “regularly to…

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Despite the extraordinarily large growth in Medicaid spending and the evidence that much of that spending is of low value to enrollees, the president is requesting more than $100 billion in additional Medicaid spending over the next decade.