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Care Delivery

 

Group market insurance plans had premiums increase by an average of 3 percent this year, the sixth consecutive year of a single-digit hike and well below the 20 percent jump in non-group market premiums, while employers continue to search for ways to cut costs through different sites of care and wellness programs.

Just a month earlier, Anthem had announced it wouldn’t offer ACA exchange coverage in the state, blaming “continued uncertainty” surrounding the law.

Sixty-three cities and counties and more than 70,000 enrollees in Virginia are now at risk of having no insurer participating in their Affordable Care Act (ACA) exchange for 2018, a problem which had appeared to be solved in other parts of the country just two weeks prior.

Ground has been broken on a $270 million medical campus in Frisco, Texas, that will be jointly operated by Texas Health Resources and the University of Texas Southwestern Medical Center.

In the first three months of this year, 8.8 percent of the U.S. population lacked health insurance, a slight decrease from the final 2016 numbers as the big gains in coverage from the Affordable Care Act appear to have ended.

 

Recent Headlines

ACA participation: Anthem scales back in Nevada, Georgia; Intermountain stays put

Insurance giant Anthem continued its departure from Affordable Care Act (ACA) exchanges, announcing it will no longer offer plans in Nevada and 74 counties in Georgia.

CMS extends Florida’s managed care demonstration

CMS has approved a five-year extension of Florida’s statewide Medicaid managed care demonstration, including $1.5 billion in funding for support uncompensated care for low-income patients.

What declaring a national emergency on opioids could mean for healthcare

The White House commission set up by President Donald Trump to address the nation’s opioid addiction “epidemic” has recommended declaring a national public health emergency, which would impact healthcare providers.

Counties at risk of having no ACA insurers shrinking

On July 26, CMS said 40 counties in the U.S. were projected to have no insurers offering coverage on Affordable Care Act (ACA) exchanges. By July 31, that number had shrunk to 19 after five insurance companies announced plans to participate in parts of Ohio.

Women, DOs make up greater share of physicians

The total number of licensed physicians has increased by 12 percent since 2010, with women and Doctors of Osteopathic Medicine (DOs) making up a greater share of the physician population, according to a report released by the Federation of State Medical Boards (FSMB).

Adventist Health shutters financially troubled Washington hospital

Walla Walla General Hospital in Washington has been closed by owner Adventist Health, citing financial challenges and a failed plan to transfer ownership Providence Health & Services.

Hospitals cutting back on blood utilization

There appears to be a direct link between hospitals’ initiatives to improve blood use stewardship and a 20 percent decrease in blood utilization for 134 diagnoses which make up 80 percent of red blood cell usage.

Smaller systems aren’t embracing value-based care

Most healthcare organizations with revenue under $1 billion surveyed by the Ernst & Young LLP Advisory Health practice reported having no value-based reimbursement initiatives and placed a lower priority on bundled payments and alternative payment models than larger systems.

Benefits targeted by ACA repeal bills aren’t biggest drivers of cost

States would be able to waive requirements for insurers to cover the Affordable Care Act (ACA)’s “essential health benefits” (EHBs) under Republican plans to replace the law. The benefits most likely to be waived, however, make up small shares of premiums compared to other costs, according to an analysis from Urban Institute fellows Linda Blumberg, PhD, and John Holahan, PhD.

Value-based care doesn’t have to end independent practices

The transition to value-based care has led to consolidation and increased physician employment, but smaller practices may find a different option in pursuing alignments with other organizations which don’t involve giving up their independent status.

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