Practice Management
The Affordable Care Act—also known as the ACA, or “Obamacare”—famously drove many insurers out of state exchanges due to the difficulty they had in turning a profit through their participation. President Trump says the plan he’d like to see in place would be both superior and less expensive than his predecessor’s. Humana isn’t planning on sticking around to find out, however, and has announced it will not be participating in any individual insurance market after …
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A lot of Republicans are angry that their elected officials have failed, thus far, to replace the Affordable Care Act (ACA, or “Obamacare”) with something more to their liking. There may be an equal number of Democrats railing about the prospect of Congress doing exactly that. Senators and Congresspersons can expect to get an earful from both over the 2-week spring recess. Healthcare providers are likely to make their wishes known, too. Some legislators have …
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Geisinger Health System is turning away from industry trends that see physicians being paid bonuses tied to quality and patient satisfaction, instead vowing to pay them straight salaries that are at or above national averages for compensation. Previously, Geisinger has paid their 1,600 physicians—including those staffing their urgent care centers—based on a formula of 80% salary and 20% performance bonus, as is common these days (though the percentages may vary somewhat from system to system). …
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Aetna Inc. and Humana Inc. have opted not to fight the decision a judge laid down to block their proposed merger based on the presumption that the $34 billion deal would violate antitrust laws. The two companies will continue to operate as separate entities, though the door is still open for either or both to seek other partners. Had the deal gone through, Aetna would have become a kingpin in Medicare Advantage. The implications for …
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As President Trump and members of both houses of Congress work to repeal the Affordable Care Act (ACA, or “Obamacare”), the Urgent Care Association (UCA) has revealed several health reform principles it will use to evaluate emerging legislative alternatives to the ACA. UCA says it will support policies that recognize urgent care should be treated as an essential health insurance benefit and included as an important element of value-based care, as well as those that …
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Data from the National Health Survey show healthcare considered routine by today’s standards is simply inaccessible for some 20.3 million children, in spite of the fact that the number of uninsured children has plummeted by nearly two thirds in the past decades (from 10 million uninsured in 1997 to 3.3 million in 2015). This is most evident in preventive medicine (including immunizations), management of acute and chronic medical conditions, and timely access to subspecialists, according …
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The Affordable Care Act (ACA, or “Obamacare”) has given millions of citizens access to healthcare they didn’t have before, driving up volume in some urgent care centers and emergency rooms. It’s also put sometimes unbearable pressure on insurers to find a way to stay profitable in the state-run exchanges; most that originally participated have bowed out because they were losing too much money, in fact. With the election of Donald Trump as our next president, …
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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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Blue Cross and Blue Shield of North Carolinas (BCBSNC) says the federal government is trying to run out on a bill that amounts to $147.5 million in overdue risk-corridor payments. The Justice Department counters that the suit—along with several others that revolve around the 3-year-old program—is premature because any payments wouldn’t be due until next year at the earliest. BCBSNC is eager to have its day in court though, and says the government’s defense is …
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Patients whose health is insured under marketplaces created via the Affordable Care Act (ACA, aka “Obamacare”) have become acutely cost conscious when it comes to their own care—to the extent that they may not be getting the care they need, according to a new survey. While that paints a picture of a dysfunctional system, urgent care may be reaping some rewards as patients seek out quality care that won’t cost them as much as a …
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