1. ACA health plans limit access to specialists: 7 findings
Health insurance plans through the Affordable Care Act should be making enrollees pay additional money for specialist care, according to a study published in JAMA.
2. Lawsuit settlement forces Anthem Blue Cross to refund $8.3 million to Calif. consumers
After agreeing to a class-action lawsuit settlement, one of California’s largest health insurers, Anthem Blue Cross, will refund $8.3 million to approximately 50,000 policyholders, according to the San Francisco Business Times.
3. Utah shuts down nonprofit insurance co-op
A tenth nonprofit insurance cooperative formed under the Affordable Care Act, Utah’s Arches Health Plan, is going to close, according to The Salt Lake Tribune.
4. Aetna signs on ACOs with Mercy Health, Quality Health Alliance
Aetna has signed on to launch accountable care organizations with two members of Livonia, Mich.-based Trinity Health: Mercy Accountable Care, part of Conshohoken, Pa.-based Mercy Health, and Quality Health Alliance, part of Langhorne, Pa.-based St. Mary Medical Center.
5. Customers call foul on Blue Shield of California’s decision to dump Stanford
In early October, Blue Shield of California said it is booting Stanford (Calif.) Hospital and Palo Alto, Calif.-based Lucile Packard Children’s Hospital out of its individual and family plan networks next year due to high costs. The decision isn’t sitting well with some customers, who say the insurer is raising premiums while decreasing their access to quality healthcare, according to a San Francisco Business Times report.
6. Legacy Health buys 50% stake in PacificSource Health Plans
The six-hospital system Legacy Health and Springfield, Ore.-based PacificSource Health Plans signed a letter of intent to create a new partnership in which Legacy Health will purchase a 50 percent stake in the payer.
7. Anthem pulls out of health exchange in parts of Wis.
Anthem, the Blue Cross and Blue Shield licensee in Wisconsin, will stop offering individual plans on the health exchange marketplace in three Wisconsin counties beginning in January, according to WAOW.com.
8. Cigna, Elliot Physician Network team up on ACO-like model
Cigna and Manchester, N.H.-based Elliot Physician Network launched an initiative Oct. 1 to improve access to care, care coordination, health outcomes, affordability and patient experience.
9. Health Net, Centene merger approved by stockholders
Stockholders in both Los Angeles-based Health Net and St. Louis-based Centene voted to approve the proposed merger between the two organizations.
10. Horizon BCBSNJ, Meridian Health plan ACO for OMNIA members
Horizon Blue Cross Blue Shield of New Jersey and Neptune, N.J.-based Meridian Health are collaborating to launch an accountable care organization for OMNIA health plan members.
11. 10 Medicare Advantage plans ranked by member satisfaction
Medicare Advantage members on average are more satisfied with their health plans than commercial plan members, according to a survey from J.D. Power.
12. South Carolina insurer to shut down, blames drop in risk corridor payments
South Carolina-based Consumers’ Choice Health Insurance, a nonprofit cooperative, agreed to a voluntary “run-off” and will not sell policies for 2016, according to The Post and Courier.
13. Wyoming health insurer to close
Cheyenne, Wyo.-based WINhealth, the second-largest health insurer in Wyoming, is shutting down, according to the Casper Star Tribune.
More articles on payer issues:
Health insurers in the news: Week in review Oct. 15-22
Vanderbilt, BCBST in Medicare Advantage standoff
Hillary Clinton has ‘serious concerns’ about health insurer mega-mergers
