| Complimentary from the publishers of HealthExecWeek | September 2024 |
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How Narrow or Broad Are ACA Marketplace Physician
Networks? This brief examines the share of doctors participating in the provider networks of Qualified Health Plans (QHPs) offered in the individual market in the federal and state Marketplaces in 2021, and how network breadth affected costs for enrollees. KFF, August 26, 2024 4 Ways to Prep for Where Health Care Will Be Delivered in 2035 Big changes are coming to health care over the next decade, with technology innovation supporting significant shifts that will necessitate operational changes for providers. American Hospital Association, August 2024 Report: Decades of Underfunding Has Limited the Public Health System's Capacity to Protect Americans' Health Insufficient funding has left the nation's public health system without the necessary resources to meet the public health challenges of the 21st century, according to a report, The Impact of Chronic Underfunding on America's Public Health System 2024: Trends, Risks, and Recommendations, released today by Trust for America's Health. PRNewswire, August 21, 2024 New Lines of Attack Form Against the Affordable Care Act The Affordable Care Act is back under attack. Not as in the repeal-and-replace debates of yore, but in a fresher take from Republican lawmakers who say key parts of the ACA cost taxpayers too much and provide incentive for fraud. KFF Health News, August 15, 2024 The Impact of Enhanced Premium Tax Credits on Coverage by Race and Ethnicity Congress passed enhanced premium tax credits (PTCs) in March 2021 as part of the American Rescue Plan Act (ARPA) and extended them through 2025 by the Inflation Reduction Act (IRA) of 2022. The enhanced PTCs substantially increased the subsidies available to buy insurance in the Marketplace, making coverage more affordable for eligible people. Urban Institute, August 12, 2024 Why Primary Care Practitioners Aren’t Joining Value-Based Payment Models: Reasons and Potential Solutions Report: PCPs’ enthusiasm for VBP models is tempered by financial barriers, the PCP workforce shortage, and imperfect performance measures. Commonwealth Fund, July 17, 2024 |
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Distribution of Proposed 2025
Rate Changes Among 324 Reviewed ACA Marketplace Insurers 1. Decrease of -10% to -15%: 3 2. Decrease of -5% to -10%: 9 3. Decrease of -5% to 0%: 38 4. Increase of 0% to 5%: 76 5. Increase of 5% to 10%: 113 6. Increase of 10% to 15%: 54 7. Increase of 15% to 20%: 20 8. Increase of 20% to 25%: 5 9. Increase of greater than 25%: 6 Note: Median increase is 7% Source: KFF Health System Tracker, August 2024 |
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Biden administration finalizes rules to ensure insurers
pay for mental health care The Biden administration announced it would finalize a highly anticipated proposal meant to force health insurers to cover mental health care on the same basis as physical health conditions. STAT, September 9, 2024 States are making it easier for physician assistants to work across state lines By 2028, the nation as a whole will be short some 100,000 critical health care workers — doctors, nurses and home health aides. The looming shortage is one reason why 13 states have joined the PA Licensure Compact, a multistate agreement that allows PAs to practice in any participating state, without having to get an additional license. Stateline, September 6, 2024 Mercer Projects a Deficit of Over 100,000 Healthcare Workers in the US by 2028, Worsening Health Disparities and Impacting Patient Care Mercer released new research, Future of the U.S. Healthcare Industry: Labor Market Projections by 2028. The report projects a nationwide healthcare worker shortage of 100,000 by 2028. Even before COVID-19, the US healthcare labor market faced challenges with the demand for professionals in healthcare occupations outpacing supply. Business Wire, August 29, 2024 Biden-Harris Administration Awards $100 Million to Navigators Who Will Help Millions of Americans Sign Up for Health Coverage The Biden-Harris Administration continued its investment in health care coverage and the Affordable Care Act (ACA) by awarding a new round of $100 million to organizations vital to helping underserved communities, consumers, and small businesses find and enroll in quality, affordable health coverage through HealthCare.gov, the Health Insurance Marketplace. CMS, August 26, 2024 10 states tackling prior authorization Since January, 10 states have passed laws reforming prior authorization rules in an effort to reduce care delays and save time for physicians and patients, according to a report from the American Medical Association. Beckers, August 19, 2024 Aon: U.S. Employer Health Care Costs Projected to Increase 9 Percent Next Year The average cost of employer-sponsored health care coverage in the U.S. is expected to increase 9.0 percent, surpassing $16,000 per employee in 2025, according to Aon plc. PRNewswire, August 15, 2024 In a first, Medicare has set prices for 10 drugs, saving billions The Biden administration released the results of the first Medicare drug price negotiations, a milestone in Democrats’ decades-long quest to have the nation’s largest payer use its leverage to lower prescription drug prices. Politico, August 15, 2024 Actuaries See Relatively Mild Pressures on ACA Health Insurance Premiums for 2025, With Most Coming from Higher Prescription Costs The American Academy of Actuaries is shedding light on the factors and trends likely to affect the health insurance premiums that millions of Americans will pay in 2025 versus 2024 in a new issue brief, Drivers of 2025 Health Insurance Premium Changes. PRNewswire, August 14, 2024 ACA Marketplace Enrollees Will See Steep Increases in Premium Payments in 2026 if Enhanced Subsidies Expire Without the enhanced subsidies in the Inflation Reduction Act (IRA), Affordable Care Act (ACA) Marketplace enrollees in 12 of the states that use HealthCare.gov would see their annual premium payments at least double on average, according to a KFF analysis. KFF, July 26, 2024 |
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