Anthem Will Look More Closely at ACA if Business Doesn’t Get Better

Anthem Will Look More Closely at ACA if Business Doesn’t Get Better

Like many insurers, Anthem says it’s had a hard time operating profitably in exchanges under the Affordable Care Act (ACA, or “Obamacare”). Unlike many insurers, it has stuck with its participation despite those woes. If the situation doesn’t improve, though, Anthem says it will probably switch gears and reconsider its offerings for 2018. The company, whose proposed merger with Cigna faces an antitrust challenge by the Justice Department, also says it would issue a request …

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Medicaid ‘Experiment’ Fails to Reduce Use of ED

Medicaid ‘Experiment’ Fails to Reduce Use of ED

A new study of the Oregon Health Insurance Experiment shows the program has fallen short on one of the key benefits promised—namely, that emergency room traffic would be reduced if state Medicaid rolls were opened up to low-income adults through a lottery system. Nearly 90,000 residents signed up for the lottery, but EDs are as crowded as ever. It’s beyond question that urgent care could reduce the congestion, but most Medicaid programs don’t offer urgent …

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Missouri Demands Medicaid Copay in the ED—But Not in Urgent Care

Missouri Demands Medicaid Copay in the ED—But Not in Urgent Care

Medicaid patients in Missouri will have to fork over an $8 copay before receiving care in the emergency room, thanks to a new bill that aims to reduce overusage in the ED. The bill allows for free visits to urgent care centers, however. Senate Bill 608 also gives physician offices the right to assess Medicaid patients a $5 penalty if they make a habit of missing appointments without 24-hours’ notice; miss an appointment once and …

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UnitedHealth Abdicating Almost All ACA Exchanges

UnitedHealth Abdicating Almost All ACA Exchanges

No longer satisfied with revealing states in which it plans to stop offering insurance under the Affordable Care Act (ACA, or “Obamacare”) a few at a time, UnitedHealth Group has acknowledged it will drop out of all but a “handful” of states by the end of this year. Right now, it participates in exchanges in 34 states; the dawn of 2017 will see it offering health coverage in just 12, as now planned. The market …

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