Health Plan Weekly
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Execs: To Reduce Disparities, Insurers Must Constantly Target AI Bias
As artificial intelligence software proliferates in the health care sector, a good deal of attention has focused on the ways that AI could make existing health disparities worse. Experts say that AI also has the potential to mitigate or reverse health disparities — so long as health care organizations, and insurers in particular, proactively and continuously counter biases in their current and future software platforms.
“We’re at this inflection point where we have new tools. We have new technology that actually may have that opportunity to address health inequality in a way we haven’t been able to before. But we’re at this inflection point where that same tool can actually amplify that bias, amplify the inequality that already exists,” said Maia Hightower, M.D., during a March 26 panel organized by the National Institute for Health Care Management (NIHCM) Foundation.
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Email ‘Nudges’ Spur Small Increase in Switching to Superior ACA Exchange Plans
Sending informational emails helped lead to some California residents switching to superior Affordable Care Act exchange plans, according to a study published on March 29 in JAMA Health Forum. However, Marina Lovchikova, Ph.D., the trial’s lead author, points out that the vast majority of households remained in their original plans and the impact on health care utilization was minimal. This suggests that more can be done to make sure enrollees are fully aware of their options and eligibility for more generous plans, she tells AIS Health, a division of MMIT.
Lovchikova, a senior researcher at Covered California, says the state’s exchange is “trying to get people to the coverage that could be most affordable for them and increase the access for their coverage. Some methods the state employs are sending emails or doing other low-cost, so-called nudges, which attempt to inform residents of their options but not automatically enroll them in another plan without their consent.
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MCO Stock Performance, March 2024
Here’s how major health insurers’ stock performed in March 2024. Elevance Health, Inc. had the highest closing stock price among major commercial insurers as of March 28, 2024, at $518.24. Humana Inc. had the highest closing stock price among major Medicare insurers at $346.72.
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Market Concentration Pushes up ACA Plan Premiums, Analysis Shows
High gross premiums in the Affordable Care Act marketplaces are related to limited choices of health plans and high levels of hospital concentration, a recent Urban Institute report shows.
The study analyzed insurer and premium participation data from more than 503 rating areas on HealthCare.gov and state-based marketplaces from 2019 to 2024. In 2024, the average national benchmark premium — the second-lowest-cost silver premium — is $473. State average benchmark premiums range from $335 in New Hampshire to $886 in Alaska. Average annual premium growth between 2019 and 2024 was modest, averaging 0.2% per year.
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News Briefs: Judge OKs Clover Settlement With Shareholders
Clover Health Investments Corp. said on April 4 that a federal district court preliminarily approved its settlement agreement to resolve multiple shareholder-filed lawsuits against the Medicare Advantage startup. Clover had faced several class-action lawsuits that accused it of concealing material information from investors — including an active Dept. of Justice investigation — when it went public in 2021. That litigation stemmed from a highly critical report from an activist short-selling firm. In April 2023, Clover agreed to pay $22 million to pay one of the consolidated shareholder lawsuits against it. The more recent settlement agreement — which was first disclosed last June and received preliminary court approval on March 5 — would resolve the remaining shareholder-led civil cases filed against Clover in Delaware, New York, and Tennessee courts. While this settlement does not involve any monetary payment, it will require Clover to “implement a suite of corporate governance enhancements.”
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