FOCUS OF THE WEEK
Private Health Insurance Exchanges See 'Hyper-Growth'
Although the state and federal health insurance exchanges have most recently taken the national spotlight, attention may soon turn to private health exchanges.
Spikes in Uncovered Medical Costs Concern Consumers Under Narrow Networks Plans
The Obama administration and state insurance commissioners are developing new standards to oversee narrow networks as consumers begin to express concerns of limited physician choice and unexpected out-of-network costs.
Health Law Challenged by Courts, Insurance Loophole
This week, the nation turned its attention to the split rulings of 2 state federal court of appeals.
Dual-Eligibles Not Opting Into State Care Coordination Programs
To better align the care of beneficiaries insured under both the Medicaid and Medicare programs, CMS invited states to participate in a 3-year demonstration project. However, it seems that many beneficiaries have opted out of these care coordination programs that are offered across the country.
DC Court Ruling is a Setback for ACA
A federal appeals court panel ruling in Washington, DC, if upheld, could majorly impact the Affordable Care Act.
CMS Announces Changes to Medicare Hospice Drug Rule
Changes to a hospice drug rule will reduce the types of medications that require prior authorization. Previous rules prohibited Medicare hospice patients from filling their Part D medications until they had confirmed that hospice providers did not cover them first.
Value-Based Care: Thinking Beyond Financial Incentives
When it comes to value-based decision making, several factors can influence physician behavior. Although many organizations rely on financial incentives, the Commonwealth Fund argued in a report released Tuesday that healthcare leaders should think beyond the dollars and dimes.
Stakeholders See Benefits with the Use of Telehealth
Health insurers are increasingly turning to telehealth, a transition that will change the way that providers assess and treat patients.
HHS Provides $100M to Support States' Medicaid Reform Efforts
HHS announced that it would distribute more than $100 million to states in a new initiative called The Medicaid Innovation Accelerator Program (IAP). The program intends to improve Medicaid programs and lower costs through technical support from the agency.
NCQA Proposes Integration of Medical Homes and Ambulatory Clinics
The National Committee for Quality Assurance (NCQA) proposed a program that would integrate patient-centered medical homes (PCMHs) with nontraditional ambulatory sites. If adopted, the program would assess the quality of care delivered at practices such as ambulatory care, urgent care centers, retail clinics, and worksite clinics.