Health Insurance Experts

5 Things You Need to Know About ACA in 2015

2017-04-02T13:28:27-04:00By |Health Care Reform, Health Insurance, Health Insurance Exchange, Healthcare Preventitive Care, Services|

Five years into the Affordable Care Act, the healthcare climate of the United States has continued to evolve and improve. While there are some long term changes required that have just begun to take shape, many changes brought about by the ACA are immediate gratification. Changes to Medicare and Medicaid have helped many Americans gain coverage that they previously wouldn’t have had access to. While the system is imperfect, there’s plenty of positivity to consider since it launched in 2010.

Open Enrollment 2015 | Enrolling in the Marketplace

2017-04-02T13:28:28-04:00By |Health Care Reform, Health Insurance, Health Insurance Exchange|

Open enrollment doesn’t start for a couple more days, but if you’re shopping around the health insurance marketplace, you know that the “window shopping” phase of enrollment has already begun. If you remember the marketplace 1.0 fiasco from last year, and are hesitant to give the new and improved page a go, here’s a rundown of what you can expect when you head over to sign up.

Managed Care Trends | Where Are We Headed?

2017-04-02T13:28:32-04:00By |Accountable Care Organizations, Health Insurance, Managed Care|

Many people who talk about managed care don’t realize that it has actually been undergoing a bit of a renaissance since the late 1980s - and has existed conceptually since the ‘30s. Since the late ‘80s, MCOs have progressed through several phases: Phase 1: Using utilization review and pre-admission certification to manage access to care. Phase 2: The addition of fee-for-service networks and managing benefits. Phase 3: Shift from utilization review to utilization management with an emphasis on the ‘appropriateness’ of care as well as the care setting. Phase 4: The current phase of MCO development, which has only started in the last couple of years, looks at establishing a continuum of services, lessening the tendency for providers to operate in ‘silos’ which has been the dominant structure of healthcare in the U.S. for years.

Are ACOs Just HMOs in Disguise?

2017-04-02T13:28:32-04:00By |Accountable Care Organizations, Care Coordination, Financial, Health Insurance, Services|

When we talk about Accountable Care Organizations (ACOs) , a lot of people think that they are nothing more than a second try at the ol’ Health Maintenance Organizations (HMOs) of the late 80s. ACOs may have some things in common with HMOs, but when you look a little bit closer you’ll see that there are a few very distinct elements that differentiate them.

Studies Show ACOs Are Succeeding in 2014

2017-04-02T13:28:33-04:00By |Accountable Care Organizations, Financial Analysis, Health Care Reform, Health Insurance, Physician Compensation, Services|

Accountable Care Organizations are cropping up nationwide. With over 10 million patients covered by Obamacare, the pressure is on for hospitals to acquire ACO status. Accountable Care Organizations were a hot topic of conversation at the beginning of the year, 15 million patients had coverage under an ACO in the U.S. Now, midyear, a new report shows that the number has jumped up to over 20.5 million.

Top 8 ACA Delays |Blatantly Illegal or Temporary Courses of Action?

2017-04-02T13:28:34-04:00By |Compliance, Health Care Reform, Health Insurance, Health Insurance Exchange, Services|

With so many ACA delays thus far, is the ACA really what we bargained for? Should the President have the authority to delay ACA provisions at his discretion or is it his duty to uphold the law as written? The Affordable Care Act was enacted in 2010 with provisions becoming effective over several years, many of which have been delayed. Why the ACA delays? •Limited resources for implementing the law •The need to prioritize limited resources •Technological limitations, such as the “glitches” in the computer systems as they related to the healthcare exchanges •Complaints from various quite vocal groups, both political and non •Undue hardships placed on employers and / or employees •Additional time and / or funding required to comply •Tax and reporting requirements •Political reasons

Millennials: Obamacare Costs Less Than Your Cell Phone Bill

2017-04-02T13:28:34-04:00By |Health Care Reform, Health Insurance, Health Insurance Exchange|

Americans were a little wary of the healthcare marketplace when it debuted this past year, but now, some are beginning to see the benefits - of the benefits. New data released this week from the Department of Health and Human Services reports that new Obamacare customers are paying, on average, about $82 in monthly premiums for their coverage. For many, that’s less than many of their utility bills, such as internet, cable and smartphones.

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