Health Plans Leading the Way on Delivery System Reform

Health plans have pioneered accountable care arrangements and are partnering with providers all across the country to change payment models and move away from the outdated fee-for-service system to one that pays for value, quality, and better health outcomes. Continue reading

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Posted in: In Case You Missed It

The FACTS about Medicare Advantage

Medicare beneficiaries continue to choose Medicare Advantage coverage because these plans have lower out-of-pocket costs and offer innovative services, such as care coordination, that improve the quality and safety of patient care. Continue reading

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Posted in: Fact Check

Health Affairs Policy Brief on ACOs

Health Affairs’ policy brief on ACOs provides some important background information on the impact of ACOs on prices and competitive issues. Continue reading

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Posted in: ACA, Issue Alert

AHIP’s Letter to HHS on the Essential Health Benefits’ Bulletin

Earlier today, AHIP submitted a comment letter to HHS in response to the Essential Health Benefits Bulletin released on December 16, 2011. AHIP’s comments strongly emphasize the need to assure an affordable EHB benefit package that promotes access to high-quality and cost-effective care for patients and consumers. Continue reading

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Posted in: ACA, AHIP, AHIP Letters, Issue Alert

What Role Do Specialist Referrals Play in Increasing Health Care Costs?

The New York Times reports on a new study from the Archives of Internal Medicine that examines referral patterns among primary care physicians. Continue reading

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Posted in: Cost Alert, Health Care Costs

Cost Spotlight: New Cancer Drugs

The Fiscal Times examines the rising cost of new cancer treatments and the impact on health care spending. Continue reading

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Posted in: Cost Alert, Health Care Costs

Forbes Columnists Wonders: Are We Just Playing Around Edge of Health Care Costs?

Dan Munro, a columnist for Forbes, examines the issue of health care costs in relation to the ACA.  He says that despite the implementation of ACA and all of the talk about various provisions that will supposedly bend the cost curve, Munro wonders if it’s enough.  Munro examines eight issues that he says shows costs are still the major issue in the health care arena. Of particular interest he writes about the MLR provision and whether it will really “bend” [...]

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Posted in: ACA, AHIP, AHIP Studies and Reports, Health Care Costs, Issue Alert

Cost Spotlight: Another example of self-referrals leading to higher health care spending

The Baltimore Sun’s Jay Hancock is a man on mission. His mission — shine a glowing spotlight on the practice of physician self-referrals and the impact on health care costs. Continue reading

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Posted in: Health Care Costs

Competition Improves Quality: The Case of Medicare Advantage

A new report released by the Heritage Foundation, “How Competition Improves Quality: The Case of Medicare Advantage,” reinforces recent studies and research by Niall Brennan and Mark Shepard and AHIP published in The American Journal of Managed Care that shows Medicare Advantage outperforming traditional Medicare fee-for-service on quality of care. Continue reading

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Posted in: AHIP Studies and Reports

THE FACTS: PREMIUMS AND UNDERLYING MEDICAL COSTS

This latest fact check provides important information on health care costs and premiums. The focus of the fact check is on three areas: premiums track directly with the underlying cost of care; the need to focus on all factor driving premium increases; provisions in the law that are driving up costs; and what health plans are doing to improve quality and safety. Continue reading

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Posted in: AHIP, Fact Check, Health Care Costs