Despite the elimination of mandatory bundled payments by the Centers for Medicare and Medicaid (CMS), commercial insurers are investing in this model based upon the positive results they’ve seen from the CMS demonstration models and their own trial experiences.
Payer
Nearly three-fourths (74 percent) of individuals who purchase insurance through the ACA's marketplace think $200 premiums would be an unfair price to pay each month, according to a recent eHealth survey.
Texas physicians are raising concerns about a new BlueCross BlueShield of Texas policy that may require members who access nonemergent care at out-of-network emergency departments to pay their bills in full, according to Spectrum News Austin.
UnitedHealthcare's bundled payment program for knee, hip and spine procedures has generated about $18 million in employer savings across 115 employers.
The CEO of Nashville, Tenn.-based Envision Healthcare blamed payers for much of patients' confusion about health insurance coverage and billing processes, the Nashville Business Journal reports.
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New Hampshire is the latest state to win federal approval for its request to implement Medicaid work requirements, according to The Hill.
CMS rejected Kansas' proposal to cap Medicaid benefits to three years in a lifetime, according to The Hill.
Health insurers selling policies on the ACA's marketplace proposed to raise premiums by an average 30 percent for 2019, according to The Washington Post.
A patient's journey through the American healthcare system is difficult to map. However, there is one experience most patients will certainly face: a disconnected and often oppositional relationship between their health insurer and provider.