Health Plan Weekly

  • Insurers, Feds Move to Promote ACA Special Enrollment Period

    Both insurers and the federal government are pushing hard to promote the special enrollment period for the federal health insurance exchange: America’s Health Insurance Plans (AHIP) is launching an online decision tool for consumers, while CMS will spend $50 million to promote the SEP and educate potential enrollees.

    The SEP began on Feb. 15 and will run through Aug. 15. CMS’s educational campaign, which will last until the end of the SEP, focuses on raising awareness among the uninsured about the new savings opportunities associated with recently expanded premium assistance for those who qualify. In addition, CMS says it is communicating with current enrollees to let them know they can update their enrollment information and access the expanded financial assistance.

  • MCO Stock Performance, March 2021

  • Health Care Spending Bounces Back, but Still Falls 1% Year Over Year

    by Jinghong Chen
    Although health care utilization started to rebound toward the end of 2020, spending on health care services was down by 1.0% in 2020 compared to 2019, according to a recent analysis by the Kaiser Family Foundation. Among health care facilities, outpatient care centers and physicians’ offices saw drops in revenue year-to-date, while revenue for laboratories and nursing homes went up. The analysis also compared health spending in the quarter before, the quarter of and the four quarters following the beginning of economic recessions, and found that the COVID-19 recession is the first of the past five during which health spending has decreased year over year.

  • Study Challenges Cost-Saving Potential of Urgent Care

    Although urgent care centers have long been trumpeted as a more economical care option than the emergency department (ED) for non-life-threatening conditions, a new study suggests that health insurers might want to re-evaluate that truism.

    The study, published in the April issue of Health Affairs, builds on past research by confirming that the presence of urgent care centers in any given area does in fact reduce lower-acuity ED visits. Yet researchers went a step further and asked whether urgent care centers reduced ED visits enough “to make up for the fact that more people are going to go to care when it’s more convenient and lower cost and closer and presumably lower wait time,” explains Ari Friedman, M.D., one of the study’s co-authors and an assistant professor of emergency medicine, medical ethics and health policy at the University of Pennsylvania.

  • Experts Dissect Anesthesiologists’ Suit Against UnitedHealth

    UnitedHealthcare is facing a pair of headline-grabbing lawsuits that accuse the country’s largest health insurer of forcing U.S. Anesthesia Partners (USAP) out of its network and then using “unlawful tactics and pressure campaigns” to induce hospitals, surgeons and patients to stop doing business with the physician group. Yet health policy and law experts say it’s not clear that the anesthesiologists have valid claims against UnitedHealth, which might not be breaking any laws even if it is angering physicians.

    “Some of the complaints USAP makes are honestly a bit odd, as they’re basically just complaining that an insurer is trying to use leverage in its negotiations, which is what we’d expect everyone to be doing here,” says Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy.

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