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Industry Groups Weigh in on HHS' Drug Price Blueprint

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Organizations from across the healthcare industry weighed in on the administration's drug price blueprint in time for a Monday deadline. In May, the Department of Health and Human Services issued a request for information shortly after the president unveiled his administration's "American Patients First: plan to lower drug prices. In the policy blu...
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Most ACOs Would Flee Medicare Program if Pushed to Take on More Risk

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A huge chunk of organizations says they would leave the Medicare Shared Savings Program if they're forced to take on financial risk, which could slow the system's transition to value-based care.  It’s also unclear whether the Centers for Medicare & Medicaid Services (CMS), which oversee the program, will make any new changes. A recent letter from the agency offered a vague response about a possible drop in participation, even as another agency indicated it is reviewing proposed changes to th...
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Simplified Health Policies Cheaper but Riskier Than ACA Plans

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Insurance agents say individuals are buying indemnity plans instead of ACA coverage, which has become far more costly Sales are growing for a type of limited health policy offering a cheaper alternative to traditional insurance but leaves buyers risking big bills if they have major medical needs.  Known as fixed indemnity plans, the products offer limited help, typically paying set amounts toward the cost of doctor visits, hospital days or other services. These plans carry restrictions on people...
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Waiver – Medicare Advantage Expands

Recently, the Centers for Medicare & Medicaid Services (CMS) announced a plan to expand products and services covered by Medicare Advantage plans. The department has revised its definition of “primarily health-related” benefits to help Medicare Advantage enrollees lead more independent lives. Some of the new services could include minor home modifications such as grab bars, transportation to and from medical appointments, and home-delivered meals. A prescription is not needed for...
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Health Care Tops Americans' Worries for Third Year

Health care is the issue Americans worry about the most, topping the economy as the public's primary concern for the third year in a row. More than half of adults – 55 percent – in a new National Gallup Survey say they worry "a great deal" about the availability and affordability of health care, while nearly a quarter say they say they worry a fair amount. Significant health care concern has registered above a majority each year since Gallup began asking the question in 2001 – the only such issu...
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Can Healthcare Be Fixed?

Even though the U.S. economy appears to be doing well, Americans are concerned about what Congress will be doing in the next six months about the ACA. The Current State The ACA has single handedly tripled the overall cost of health care since it was signed into law. Insurance premiums and deductibles have skyrocketed. Even though the number of insured individuals is higher, the total percentage of insured cost is down by about half since 2010. Insurance failures are rampant, and very few insurer...
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Medicaid Program Tilting Out of Control From ACA Influence

At least 21,000 Americans have died waiting to enroll in Medicaid, thanks in part to the expansion of the ACA government healthcare program, based on research reported by the Foundation for Government Accountability (FGA). See “ The Medicaid Waiting List Crisis ” report The report focuses primarily on the waiting lists generated by the Home and Community-Based Services (HCBS) waiver program. That program, created in 1981, allows states to extend Medicaid services to individuals in th...
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ICE Promises Employers More I-9 Audits

Important I-9 Audit Information Employer’s Must Know The administration proposed budget for FY19 includes $47.5 billion for DHS for "strengthening border security, ensuring enforcement of immigration laws, and reforming the legal immigration system." The administration’s proposed $571 million to hire 2,000 additional Immigration and Customs Enforcement (ICE) officers and $132 million for E-Verify; The administration called on Congress to require all employers to use E-Verify to check...
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The Real Competitive Advantage For Insurers

Up to 75% of insurance companies’ premium income goes toward paying claims. That’s why reducing the cost of claims processes offers insurers the best opportunity to impact their bottom lines. Companies that achieve operational excellence and differentiation in claims management can realize a competitive advantage resulting in better claims outcomes, reduced costs, and greater efficiency. By carefully evaluating and optimizing end-to-end claims processes, managing the quality and cost...
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Healthcare – ACA Update

The Administration voted on 2-20-18 to allow health insurers to sell lower-cost, less-comprehensive medical plans as an alternative to those required under the ACA program.   Insurers would have to make clear that the plans, which could last for less than 12 months, would be liberated from the ACA’s benefit and other mandates. The proposed regulations would: Allow insurers to sell individual consumers "short-term" policies that can last up to 12 months, have fewer benefits, and come with l...
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