When insurers implement bundled payment projects, they're transforming care by focusing on quality and lowering costs, making it a strong gateway to propel payment reform, according to a report from the Robert Wood Johnson Institute.
Experimentation is the name of the game in a vastly complex healthcare industry. Insurers toy with new, innovative payment methods constantly, and all have a similar goal in mind: improve the quality of care while also lowering costs.
Advocates have accused some insurers of discouraging HIV and AIDS patients from obtaining coverage under the ACA by levying high co-insurance charges for expensive prescription drugs. But soaring costs set by drug manufacturers and the number of new enrollees with specialty medicines is putting pressure on payers.
Frisbie Memorial Hospital in Rochester, N.H., one of 10 hospitals ousted from Anthem Blue Cross Blue Shield's provider network for individual health plans, is fighting to rejoin the ranks of participating providers, the Associated Press reported.
Health insurance exchanges have been in operation since October and 3 million consumers have signed up for plans, but have the new marketplaces actually increased competition and market share among participating insurers like the healthcare reform law intended?
insurers are dealing with their own technical and administrative problems. Plus, they're facing an increasingly frustrated public complaining that insurers can't confirm coverage, aren't providing adequate customer service, and haven't issued identification numbers needed to cover medical services.
State officials are fighting back against insurers offering health plans with narrow networks, in some cases taking regulatory action as well as introducing legislation and even lawsuits.
Anthem Blue Cross Blue Shield in New Hampshire is letting members renew policies with full networks for an additional year instead of forcing members to choose an Anthem plan on the state's health insurance exchange.
Anthem Blue Cross Blue Shield in Maine can't force its members to stop seeing their existing doctors who work for one of the state's hospital systems.
As the reform law ushers in a new wave of health plans with narrow networks, insurance execs find themselves at the receiving end of many public questionings. The latest insurer to feel the backlash of its decision to offer a narrow network plan is Anthem Blue Cross Blue Shield of New Hampshire.