The American Hospital Association has warned the Affordable Care Act marketplaces lack stability as insurers exit and concern over drastically rising premiums continues.
Earlier this week, a prominent health economist offered what he called “simple way” to reduce the risk of more insurers leaping off the Obamacare exchange ship: “Make the Obamacare exchange one big marketplace for everyone buying individual health insurance coverage."
Despite news of reduced competition and higher premium rates, the federal government argues most consumers will be able to find marketplace coverage for $75 a month or less.
More than a third of the Affordable Care Act's exchanges will have only one participating health insurer in 2017, significantly up from 4% reported this year, according to a recent analysis.
Aetna and Humana fought back against the U.S. Justice Department's challenge to their proposed $37 billion merger, saying the feds' arguments ignore the fluid nature of Medicare Advantage markets.
Leading consulting firms and a growing list of niche advisers are competing aggressively to help major insurers use big data to identify high-risk patients and manage their costs.
Some consulting firms pitching insurers are emphasizing their unique ability to identify customers who won't cost very much.
The CMS is asking the public for information about providers and organizations that may be steering Medicare- or Medicaid-eligible patients toward the Affordable Care Act's insurance exchanges in order to receive higher reimbursement rates.
This week, Pennsylvania's Department of Human Services expects to award contracts worth more than $7 billion annually that cover almost 421,000 low-income, disabled adults. But the contracts were scheduled to be awarded in June.
Kaiser Permanente is “absolutely” sticking with the marketplaces, CEO Bernard Tyson told Modern Healthcare. Some peers that are fleeing exchanges, he said, priced low to gain market share and lost money when Congress underfunded the ACA's risk-adjustment program.
The startling withdrawal of Aetna from many Affordable Care Act exchanges has accelerated the search for ways to preserve competition in those markets, such as making participation a condition for Medicaid contracts or a concession for proceeding with proposed mergers.
Aetna will drastically cut back its 2017 participation on the individual markets, the for-profit insurer said Monday evening, just months after expressing optimism in the future of the Affordable Care Act's exchanges.