| “I think there will be a continued march to more value-based payment models. I just don't see us going back; I see us going forward. That is going to continue to drive towards more cost-effective and convenient settings. So, you'll continue to see value-based models evolve and consumers make choices. They're going to want it to be more convenient and cost-effective. You're going to continue to see things pushed to the more effective [settings] for convenience and cost, in the channels that continue to evolve like home care, telehealth, inpatient, and outpatient. There will continue to be a push down to the lower-cost settings.” | ||
| -Bruce Broussard, President and CEO, Humana Inc. |
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Trends in Out-of-Pocket Healthcare Expenses Before and After Passage of the Patient Protection and Affordable Care Act
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7 Facts about the 2021
Marketplace special enrollment period 1. 528,005 Americans signed up for health insurance in HealthCare.gov States from 2/15/21 through 3/31/21 2. In 2020 and 2019, 209,000 and 171,000 consumers signed up for health insurance respectively 3. New Consumers Requesting Coverage on an Application Submitted on or after February 15: 1,022,917 4. New Consumers Requesting Coverage who are Marketplace Eligible: 871,483 5. New Consumers Requesting Coverage who are Medicaid/CHIP Eligible: 148,709 6. Of enrollees who identified a race from 2/15 through 3/31/21, 17% identified as Black, compared to about 11% during the same period in both 2020 and 2019 7. Among consumers requesting financial assistance, 41% have a household income between 100% and 138% of the federal poverty level, compared to 38% in 2020 and 33% in 2019. Source: CMS |
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Health Care Reform: Is the Massachusetts Model the Rx for the
U.S.?
Harvard Kennedy School's Institute of Politics. A
discussion of Massachusetts health care reform and what this
means for health for reform nationally. |
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HealthshareTV, the
home for health care videos |
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One-Year Retrospective on COVID-19: Looking Back,
Looking Ahead In the spring of 2020, the American healthcare industry experienced an unexpected paradigm shift as COVID-19 spread rapidly across the country. For many hospital and health system leaders, early February was when they began to recognize the first signs of what would eventually become a global pandemic. What followed were weeks and months of economic calamity, public health confusion, and hospitals stressed beyond the point of capacity. The healthcare sector, like the country at large, still hasn't fully recovered from the damage sustained last spring. HealthLeaders, April 1, 2021 One Year After COVID: How Uncertainty Shaped Healthcare Finance Just over a year after COVID-19 spread across the U.S. and caused an unprecedented strain on the financial standing of healthcare organizations, finance executives are looking to the future with a new perspective and appreciation. HealthLeaders, March 25, 2021 Improving Health Equity Through Medicaid Managed Care Everyone deserves affordable high-quality health coverage and care regardless of health status, race, color, national origin, sex, gender identity, sexual orientation, age, or disability. For years, America has struggled to improve health equity for African Americans and other communities of color. As leaders come together to make real progress toward this shared commitment, Medicaid managed care organizations (MCO) are a proven valuable partner for creating tailored solutions that work, utilizing insight from deep experience working with people who rely on Medicaid, and building on strong community partnerships to meet people where they are. AHIP, March 2021 Federal Policy Recommendations to Advance Health Equity The pandemic has exposed a stubborn, harsh truth about life in America, and revealed glaring failures in our public policies. Robert Wood Johnson Foundation, March 2021 COVID-19: 1 year later Many milestones could be considered to mark the one year point into the COVID-19 pandemic in the United States. The first known coronavirus patient in the country was seen at Providence Medical Center on Jan. 21, 2020. The federal government declared the public health emergency 10 days later. The World Health Organization said the novel coronavirus was officially a pandemic on March 11. Then CMS suggested hospitals cease elective procedures on March 18 in order to free up space for potential surges of COVID-19 patients. HealthcareDive Series, March 2021 Outgoing Better Medicare Alliance CEO On Where Federal Health Policy Will Go Despite a new presidential administration and change of control in Congress, healthcare remains a contentious issue on the federal level as the nation reels from the impact of the COVID-19 pandemic. HealthLeaders, March 18, 2021 |
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Microsoft Makes Big Bet on Health-Care AI
Technology With Nuance Microsoft Corp. is making a massive bet on health-care artificial intelligence. The software giant is set to buy Nuance Communications Inc., tapping the company tied to the Siri voice technology to overhaul solutions that free doctors from note-taking and better predict a patient’s needs. Bloomberg, April 11, 2021 ACA slowed healthcare out-of-pocket spending growth, study says The Affordable Care Act has slowed increases in out-of-pocket costs for those with health insurance coverage under the law by about 80%, an analysis published Friday by JAMA Network Open found. Since the ACA, also known as Obamacare, was enacted in 2010, average out-of-pocket expenses for doctor visits, prescription drugs and other services have risen by an average of 0.2% per year, the data showed. UPI, April 9, 2021 Google is exploring a health record tool for patients After 13 years, Google is coming back for patient health records. The tech giant has launched an early user feedback program aimed at exploring how patients might want to see, organize, and share their own medical record data. The work could inform the creation of a consumer-facing medical records tool along the lines of Apple’s Health Records app. It also follows an early attempt by Google — later panned by medical experts — at creating a new version of the electronic medical record in 2008. STAT, April 9, 2021 Value of hospital deals soared in Q1, Kaufman Hall says The number of transactions involving hospitals and healthcare systems was down in the first quarter of the year compared to the same period in 2020, but the size of consummated transactions was significantly larger, according to a new report from Kaufman Hall. Healthcare Dive, April 9, 2021 Cigna, Oscar Health expanding reach of co-branded plans in California Cigna and Oscar Health are expanding access to their co-branded health plan to more regions in California. When the two insurers unveiled their Cigna + Oscar plans—which target small businesses—last summer, the plans were initially available in Atlanta, Tennessee and select California counties, namely the San Francisco bay area. FierceHealthcare, April 8, 2021 Biden Revokes Medicaid Work Requirements in 2 More States The Biden administration has rescinded permissions for Michigan and Wisconsin to require Medicaid beneficiaries to either work or attend school or job training in order to enroll in the public health program for lower-income Americans. The administration’s actions follow recissions of similar requirements in Arkansas and New Hampshire. Stateline, April 7, 2021 Health care leads the way for top private AI firms A new list of the top 100 private AI companies shows that health is driving investment in the industry. Why it matters: COVID-19 has shown the power and potential of AI applications for health, and the growth of the field will continue long after the pandemic has finally ended. Axios, April 6, 2021 Despite Covid, Many Wealthy Hospitals Had a Banner Year With Federal Bailout Last May, Baylor Scott & White Health, the largest nonprofit hospital system in Texas, laid off 1,200 employees and furloughed others as it braced for the then-novel coronavirus to spread. The cancellation of lucrative elective procedures as the hospital pivoted to treat a new and less profitable infectious disease presaged financial distress, if not ruin. The federal government rushed $454 million in relief funds to help shore up its operations. But Baylor not only weathered the crisis, it thrived. Kaiser Health News, April 5, 2021 Indiana’s Medicaid Expansion Panned in Federal Report Indiana’s Medicaid expansion — with its “personal responsibility” provisions that require enrollees to pay monthly premiums and manage health savings accounts — proved no better at improving health and access to care than other state expansions, a federally commissioned study found. Even when compared with states that did not expand Medicaid, Indiana showed only mixed results in improving the health of low-income residents, the report said. Kaiser Health News, April 1, 2021 Anthem Plans to Acquire myNEXUS, Expand Home Healthcare Services Anthem has announced plans to acquire myNEXUS, Inc (myNEXUS) to provide a higher quality of home healthcare services for seniors. Assuming the closing conditions and procedures continue without any issues, Anthem and myNEXUS leadership anticipate that the deal will be closed in the second quarter of 2021. HealthPayerIntelligence, March 26, 2021 Telehealth Consults Increased More Than 50-Fold During Pandemic's First Phase A study co-authored by researchers at the Johns Hopkins Bloomberg School of Public Health found that telehealth consults among privately insured working-age patients accounted for almost 24 percent of outpatient consults with health care providers during the early phase of the pandemic, March to June 2020, up from less than 0.3 percent during the same period in 2019. Johns Hopkins Press Release, March 23, 2021 11 Years On, the Affordable Care Act Defies Opponents and Keeps Expanding More than 200,000 Americans flocked to the Affordable Care Act’s online marketplace to sign up for health insurance during the first two weeks of an open enrollment period created by President Biden — a sign that those who lost insurance during the pandemic remain in desperate need of coverage. At the same time, a provision in the president’s $1.9 trillion stimulus law to make Medicaid expansion more fiscally appealing has prompted deeply conservative Alabama and Wyoming to consider expanding the government health program to residents who are too rich to qualify now but too poor to afford private health plans. New York Times, March 22, 2021 |
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