A Look at Two Blues’ Distinct Approaches to Changing the Healthcare Model
May 16—Two dominant not-for-profit health plans—both Blue Cross insurers—are moving aggressively in very different directions.
Ask the Experts: Credit Balances
How do other Florida hospitals initiate and work credit balances?
New MA Rules Benefit Provider-Sponsored Plans
April 18—Recently announced Medicare Advantage (MA) rates and rule changes could help sometimes-struggling provider-sponsored plans improve their performance.
Ask the Experts: Cost Sharing Programs
I am looking for more information about how to manage patients covered by cost sharing programs.
Medicare Advantage Rates, Policies Draw Insurer Praise
April 3—Medicare Advantage (MA) plans received an unexpected pay boost and generally beneficial policies in the final call letter and rules issued this week for 2019.
March 19-23 Policy Watch: Push to Include ACA Marketplace Stabilization in Funding Bill
March 15—Healthcare leaders are renewing their push to include a stabilization measure in a must-pass federal funding bill that is required by the end of next week.
How One ACA Insurer Had Its Best Year in 2018
March 6—In a year when individual-market insurance enrollment dipped nationally, the dominant insurer in Florida had its largest enrollment yet.
Short-Term Limited Duration Insurance Proposed Rule
This document summarizes the proposed rule published by The Departments of Treasury, Labor, and Health and Human Services amending the definition of short term, limited duration (STLD) insurance for purposes of its exclusion from the definition of individual health insurance coverage.
Ask the Experts: Payer Preference for Imaging Centers
Our hospital is beginning to feel the sting of payers steering their members from scheduled high-end imaging procedures at our facility to free-standing imaging centers. How are other hospitals and health systems responding to or reacting to this practice?
Ask the Experts: Managed Care Contracting Benchmarks
Do you know of other avenues besides our state Department of Insurance that we can pursue to resolve health plan payment issues?