Complimentary from the publisher

Complimentary from the publishers of Health Insurance Marketplace News October, 2014

“There are certainly some who are using 'narrow networks' for holding reimbursements to low levels, and these will not succeed, just as they haven't in the past. Docs will get frustrated, and patients will be impatient waiting for results. Narrow networks paid on quality outcomes will expand to include new practices that are willing to use the efficient methods of quality-based payments and EHRs/coordination care as foundational to their practices. That's what we've seen in Massachusetts. It's what is starting to happen across the US.”
- Cyndy Nayer, President, CyndyNayer.com; Founder/CEO of Center of Health Engagement.

"Covered California anticipates a total enrollment of 1.7 million Californians by the end of the coming open enrollment period -- 1.5 million in subsidized coverage and 230,000 in unsubsidized coverage. That forecast represents an increase of about 500,000 in total enrollment, or 43%."

Excerpted from: Health Insurance Marketplace News, Volume 2, Issue 10, October 2014, State Wrap-Up: "Covered California Announces Community Outreach Campaign for 2015"

Health Insurance Marketplace Forecasts 25% Growth In 2015
Health IT Outcomes, October 1, 2014

U.S. Cannot Subsidize Health Plans in States With No Marketplace, a Judge Rules
The New York Times, September 30, 2014

New Commonwealth Fund Report: Most People with ACA Marketplace Health Insurance Say They Can Afford Premiums; Lower-Income Adults Report Costs Similar to Employer Coverage
The Commonwealth Fund, September 18, 2014

Private exchanges gain ground in competitive health insurance marketplace
FierceHealthPayer, September 16, 2014

Washington, Wall Street Gauge HIX Performance as Open Enrollment Nears
HealthLeaders Media, September 11, 2014

The U.S. Health Insurance Marketplace: Are Premiums Truly Affordable?
Annals of Internal Medicine, abstract only, September 9, 2014

This Month in Health Insurance Marketplace News

Large Employers Must Carefully Watch the Evolution of the ACA Exchanges by Christopher E. Condeluci
Lawsuits Continue to Shape Exchanges
Thought Leaders' Corner: "Two researchers recently studied Massachusetts’ implementation of the Affordable Care Act and found that narrow network plans reduce costs by lowering per-visit prices and the incidence of some high-cost services, even though they result in an increase in primary care visits, thus shifting the site of care away from more expensive settings. There was not a shift, the researchers added, to lower-quality hospitals. So, what’s your take on those findings? Is that the impact of narrow networks in your experience?”
State Wrap-Up with briefs regarding California, Connecticut, Virginia and Oregon
Catching Up With... Cynthia C. Crone MNSc APRN

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