Revenue Cycle and Payer News 11-29-2017

In the News…

Sound Healthcare & Financial announces Unprecedented True Group Health Insurance Plan with Nashville Musicians Association
Nashville-based insurance and music healthcare advocacy organization, Sound Healthcare & Financial (@mysoundhealth), has announced the formation of a true group health insurance policy plan with Blue Cross Blue Shield of TN, that is exclusively available for members of the Nashville Musicians Association, AFM Local 257 and only available through SH & F.

As Health Care Changes, Insurers, Hospitals and Drugstores Team Up
They seem like odd couples: Aetna, one of the nation’s largest health insurers, is in talks to combine with CVS Health, which manages pharmacy benefits. The Cleveland Clinic, a highly regarded health system, joined forces with an insurance start-up, Oscar Health, to offer individuals a health plan in Ohio. According to The New York Times, these established players are venturing beyond their traditional lines of business, now that federal officials have quashed the mega-mergers proposed by the biggest insurers and blocked a deal between two large drugstore chains. Former adversaries are banding together, girding against upheaval in a rapidly changing health care environment.

Murkowski backs repealing ObamaCare mandate in boost to tax reform
According to The Hill, Sen. Lisa Murkowski (R-Alaska) said that she supports repealing ObamaCare’s individual insurance mandate, in what appeared to be a significant boost to the GOP tax bill that includes mandate repeal. Murkowski, a key moderate swing vote, wrote in the Fairbanks Daily News-Miner that she supports giving people additional freedom by repealing the mandate, which requires people to have health insurance or pay a fine.

CIGNA, Good Samaritan Health and SCCIPA form New Alliance to Improve Health Care for Santa Clara County Customers
Good Samaritan Health System, which includes Regional Medical Center of San Jose, Good Samaritan Hospital, and Santa Clara County IPA (SCCIPA), an independent practice group with over 800 physicians, have entered into an alliance with Cigna (@Cigna) to offer a simple, comprehensive and focused approach to quality care with improved affordability in Santa Clara County. Health plans will be available starting January 1, 2018.

Obamacare Sign-Ups Are Surging, but There’s a Twist
According to The New York Times, despite the Trump administration’s efforts to scale back the health law, about 300,000 more people have signed up for health insurance in the Affordable Care Act marketplaces in the first weeks of this enrollment period than last year. But it’s still early in the 2018 enrollment period, and people who sign up early are often those who need health care the most.

AHIP Commends CMS for a Strong, Positive Step Forward with 2019 Proposed Rule
Marilyn Tavenner, president and CEO of America’s Health Insurance Plans, issued the following statement on the Centers for Medicare & Medicaid Services (@CMSGov) proposed 2019 Medicare Advantage and Part D rule. “We commend CMS’ leadership and staff for their responsiveness to stakeholder input, and for their hard work on behalf of everyone Medicare serves. AHIP will offer detailed feedback during the formal comment period. We appreciate CMS’ commitment to working together to improve care, outcomes, and costs for our nation’s seniors and those with disabilities.”

In State News:

Baptist Health joins CareSource Health Plan Network
CareSource and Baptist Health have reached an agreement to provide quality access to health care for consumers in Kentucky and southern Indiana through the Health Insurance Marketplace.
Beginning in January 2018, Baptist Health providers in both states will accept CareSource Marketplace members seeking health care and physician services.

Group tries to fill health-insurance gap left by Trump’s neglect of Obamacare
With the Trump administration having defunded advertising for enrollment in health-care exchanges, some private nonprofits are trying to pick up the slack with one group, Get Ohio Covered, held a press conference in Nelsonville on Monday, November 27th.

Letters of Confusion over Health Insurance Sent in New Hampshire and Utah
There seems to be some confusion in New Hampshire and Utah for those insured through the marketplace. Many thousands of new Hampshire residents looking for health insurance have received letters from Anthem that imply they have been automatically signed up for a policy and are being billed for it, leading to so much confusion that the state is trying to clarify things. In Utah, bills will be showing up in the mailbox of tens-of-thousands of Utahans from Selecthealth, since Molina health insurance health has pulled out, telling them they have automatically been enrolled in a Selecthealth plan and can simply pay up to avoid losing coverage.

Enrollment on Colorado’s health insurance marketplace up 33% so far from 2016
Colorado’s health insurance marketplace, Connect for Health Colorado, has seen a 33-percent increase in signups in the first two weeks of open enrollment this year when compared to 2016. More than 22,600 Coloradans have picked a plan on the state’s ACA marketplace—an increase of more than 5,000 people who signed up for coverage between Nov. 1 and Nov. 15 of last year.

Middle-Class Families Confront Soaring Health Insurance Costs
According to The New York Times, consumers in Charlottesville, Virginia at first did not believe the health insurance premiums they saw when they went shopping for coverage this month on HealthCare.gov. Only five plans were available, and for a family of four with parents in their mid-30s, the cheapest plan went typically for more than $2,400 a month, nearly $30,000 a year. With the deadline for a decision less than a month away, consumers are desperately weighing their options, dismayed at the choices they have under the Affordable Care Act and convinced that political forces in Washington are toying with their health and well-being.

Upcoming AHIP Conferences:

Consumer Experience & Digital Health Forum
When: December 5 – 7, 2017
Register for this event.
Twitter: @AHIPCoverage
Event Hashtag: #AHIPDigital

The Consumer Experience & Digital Health Forum will take place in Nashville, TN in partnership with the Nashville Health Care Council. Experience the nexus of consumer satisfaction and targeted technology. During AHIP’s Consumer Experience & Digital Health Forum, in partnership with the Nashville Health Care Council, discover how smart technology and consumer-focused strategies can advance affordability, value, and customer satisfaction. You’ll take home timely ideas, partnership prospects, and digital tools that can optimize your organization’s collaboration and connectivity.

National Health Policy Conference
When: March 7 – 8, 2018
Register for this event.
Twitter: @AHIPCoverage

Where will we be in 2018? What health policy issues will be in the spotlight? On what priorities should your organization focus? AHIP’s National Health Policy Conference will deliver expert insights, top-level dialogue, and innovative solutions as we work together to advance a health care system focused on quality and sustainability.

National Conference on the Individual and Small-Group Markets
When: March 8 – 9, 2018
Register for this event.
Twitter: @AHIPCoverage

What will be the key policy and operational issues for those serving the Individual and Small-Group markets? Join us in March as thought leaders from throughout the health care industry share where we are and what’s needed next to succeed in these important markets. You’ll leave with innovative ideas from states, what’s next for small groups, how to best tackle affordability and access, and more. Located immediately following AHIP’s National Health Policy Conference (March 7-8), combine both conferences with one trip.