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Editorial

Keeping your wind in the final AEP laps

Debbie R. Mabari

Debbie R. Mabari's picture

Medicare plans are mid-way through the process of creating Annual Election Period (AEP) materials that are due to members by the end of September. At this stage of the game, tension is running high and time is running out.

Patient engagement as a route to better star ratings

Mariza Hardin, Alere Health

Mariza Hardin's picture

Not only are older Americans living longer than in past generations, they also have multiple health problems. If Medicare Advantage plans focus on effective engagement strategies that address these issues, they can improve member satisfaction and outcomes, scores for which are weighted three times more heavily than operation measures.

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President Obama acknowledges the technical issues with HealthCare.gov, pledging his Administration will resolve them soon and asserting that the distressed web portal is not the only way to shop for affordable health insurance available through the ACA.

 

Three years after launching a 750-patient Medicare Advantage collaborative care pilot, Portland, Maine-based independent physician practice NovaHealth and insurer Aetna have shown concrete results in improving care quality and reducing costs. Technology and provider-payer cooperation played a large part in the program's success.

Well, here we are. The revised compliance date for providers, payers and clearinghouses to transition to ICD-10 has been finalized by the Department of Health and Human Services.

Utah's start-up health plan is offering a new service that could prove attractive to employers and individuals in a state with a growing tech hub, while also putting pressure on established players.

More and more, insurers are trying to help members get fit, slim down, and eat better. But for one of this century's most pernicious health problems, some find they need data-driven frameworks to target interventions and gauge their effectiveness.

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The San Francisco Bay area is getting a new accountable care organization courtesy of the formation of a new company by two healthcare powerhouses in the region.

A new portrait of the uninsured and newly-insured is emerging, with a confluence of factors shaping who is and isn't enrolling in Medicaid or private plans.

Among the many challenges in year two of federal exchanges, the process of auto re-enrollment is bringing the potential of convenience and disruption, for both consumers and insurers.

Lawmakers, taxpayers and health organizations concerned about Medicare's sustainability can breathe a small sigh of relief, if not hold their breath.

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