- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
CMS Continues Implementation of ACA's Premium Stabilization Programs
CMS has begun to implement risk adjustment and reinsurance programs, 2 premium stabilization programs of the Affordable Care Act. The report highlighted the estimated reinsurance payments issuer in addition to summary level information on the programs, which helps to keep premiums affordable as well as various coverage options available to consumers.
CMS has begun to implement risk adjustment and reinsurance programs, 2 premium stabilization programs of the Affordable Care Act (ACA). The report highlighted the estimated reinsurance payments issuer in addition to summary level information on the programs, which helps to keep premiums affordable as well as various coverage options available to consumers.
These premium stabilization programs help to secure a market of now guaranteed access that before the ACA denied coverage to people with preexisting conditions.
“These important programs are protecting consumers’ access to a wide range of affordable coverage choices in a new health insurance market in which no one can be denied coverage or charged higher premiums simply due to a pre-existing condition,” Kevin Counihan, chief executive officer of the Health Insurance Marketplaces, said in a statement. “The early results for the risk adjustment and reinsurance premium stabilization programs demonstrate that these programs are working as intended, which will help keep premiums stable and encourage insurance companies to compete on quality and price, not who can attract the healthiest enrollees.”
After several months of working with issuers and analyzing data submissions on premium stabilization programs, CMS found that a number of high-cost claim expenses were lower than expected and as a result, CMS announced it will pay 100% of eligible high-claims cost for the 2014 benefit year.
The report further detailed issuer’s risk adjustment charge or payment information and an early assessment of risk adjustment programs.
California Aims for Equity by Redefining Cancer Care
December 8th 2023Authors highlight key aspects of the California Cancer Care Equity Act, including its focus on Medi-Cal beneficiaries, the requirement for managed care plans to contract with specialized cancer centers, and the definition of complex cancers.
Read More
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
What We’re Reading: RSV Vaccine Demand; Permanent Contraception; Drug Negotiation Impact
December 8th 2023The Biden administration recently met with manufacturers of respiratory syncytial virus (RSV) immunizations to encourage them to increase access to the vaccine; since the Dobbs v Jackson decision, many patients have been seeking more permanent reproductive health care solutions; a Mathematica analysis showed that Medicare prescription drug price negotiations could have cut seniors’ out-of-pocket costs by nearly a quarter had the program been in effect in 2021.
Read More
Insufficient Data, Disparities Plague Lung Cancer Risk Factor Documentation
September 24th 2023On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.
Listen
New Insights on Breast Cancer Outcomes Among Sexual, Gender Minorities
December 7th 2023Despite there being a great demand for data collection on sexual orientation and gender identity in the cancer space, individuals who identify as a sexual and gender minority remain poorly represented.
Read More
Research Reveals the Role of Structural Racism in Lung Cancer Risk
December 7th 2023Spanning 22 studies, the analysis illuminated housing disparities, occupational hazards, unequal health care access, economic inequality, and discriminatory industry practices and how they collectively contribute to heightened lung cancer risks.
Read More
