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Amount of refund declines, but insurers still owe $2.4 billion in exchange rebates


Consumers have received more than $2.4 billion in Affordable Care Act premium rebates since 2011, but the number of people owed refunds by insurers decreased by more than a million this year compared to last, according to a report released Thursday by the Centers for Medicare and Medicaid Services. Read more »

More than 1 million sign up on HealthCare.gov during first two weeks of open enrollment


Week two of open enrollment saw another 500,000-plus consumers select plans in the federal marketplace, bringing the total for the first two weeks to over 1 million, according to the Centers for Medicare and Medicaid Services. Read more »

Humana gives $77 million bonus to physicians participating in value-based care


The goal is to increase the approximately 59 percent of Humana individual Medicare Advantage members who have primary care physicians participating in value-based relationships, to 75 percent by the end of 2017. Read more »

Obamacare open enrollment challenge leads advocates to seek out uninsured


To encourage more people to sign up in Florida, Obamacare assisters are handing out flyers at food truck festivals, farmers' markets and health fairs. Read more »

CMS invests $32 million to drive down number of uninsured children


The Centers for Medicare and Medicaid Services on Monday announced a $32 million initiative to drive down the number of uninsured children by supporting outreach to get families with children eligible for Medicaid and the Children's Health Insurance Program enrolled. Read more »

Bundled payments for knee and hip replacement to launch this spring


Under the model, hospitals in 67 geographic areas will receive additional payments if quality and spending performance are strong, or if not, have to potentially repay Medicare for a portion of the spending for care for a lower extremity joint replacement procedure. Read more »

McKesson's new rate pricing tool automates value-based reimbursement


The news comes as more health plans move from broad networks and straightforward reimbursement approaches to narrow networks and value-based payments. Read more »

CMS releases slight rise in Medicare Part A rates while keeping Part B unchanged


The Medicare Part A annual deductible that beneficiaries pay when admitted to the hospital will be $1,288.00 in 2016, a small increase from $1,260.00 in 2015. Read more »

First week of open enrollment sees 500,000 new plan applications


Over 1.1 million applications were submitted to HealthCare.gov from Nov. 1 through 7, CMS reported. Read more »

Health Republic Insurance co-op ordered to close by end of month as debt mounts


The nonprofit co-op Health Republic Insurance of New York owes hospitals within the Greater New York Hospital Association more than $150 million, according to a November 11 letter from President Kenneth Raske to member CEOs. Read more »

Horizon Blue Cross Blue Shield sued by St. Peter's for exclusion from OMNIA health plan


A judge in New Jersey is expected to hear a complaint by Saint Peter's University Hospital that it was illegally excluded from a new discounted health plan offered by the state's largest health insurer because it and other independent, Catholic hospitals serve low income residents, according to the health system. Read more »

AIDS and HIV patients get limited access to drugs on Marketplace silver plans, study says


In 31 states and the District of Columbia, silver-level plans cover fewer than seven of the 10 most common drug treatment options or charge consumers more than $200 a month in cost sharing, according to an analysis of 2015 silver plans by consultant group Avalere Health. Read more »

Senate committee and Justice Department scrutinizing dramatic drug price increases


The investigation is spurred by dramatic drug price increases, often on older, off-patent drugs, after the acquisition or merger of pharmaceutical companies. Read more »

Analysts take a wait and see approach to the long-term viability of provider-led insurance plans


Though healthcare systems can gain insurance know-how by partnering with or acquiring an insurer or third party administrator to handle claims, compliance and customer service, putting it all together can be challenging. Read more »

Cancer patients insured by California's Medi-Cal have lower survival rates, report says


Cancer patients insured by California's health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by University of California-Davis researchers. Read more »

CMS is developing a new model to pay dual-eligible plans it admits to underpaying


The Centers for Medicare and Medicaid Services is developing a new model for how it pays dual-eligible health plans after an analysis showed it was underpaying these plans. Read more »

Health plans that offer coverage outside of network are hard to find on the marketplaces


Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, and those cutbacks will affect customers in 37 states, according to the foundation. Read more »

Spending increase in employer-sponsored private insurance due to rise in brand-name drugs


Healthcare spending grew by 3.4 percent in 2014, a new report by the Health Care Cost Institute found, even though overall utilization declined. Read more »

Two Massachusetts health systems latest to exit Pioneer ACO program


The Massachusetts hospitals follow the exit of Dartmouth-Hitchcock Medical Center in New Hampshire last month. Read more »

CMS to pay for end-of-life care, adding advanced planning service


The Centers for Medicare and Medicaid Services will pay for end-of-life services, bringing to a close a debate that started with false "death panel" claims during negotiations over the Affordable Care Act and is ending with coverage for families so they can discuss the care patients receive when they are dying. Read more »

Residents and insurers grapple with high price of claims in Alaska


The average 2016 premium for a 40-year-old in Anchorage is $719 a month - more than double the national average, according to an analysis by the Kaiser Family Foundation. Read more »

Montana expands Medicaid; names Blue Cross Blue Shield as administrator


Montana has become the 30th state to expand Medicaid, with federal officials on Monday signing off on a plan to expand coverage to low-income residents through a federal waiver that requires beneficiaries to pay premiums of up to 2 percent of their income. Read more »

Health Alliance merger boosts competition against BCBS, Spectrum Health in Michigan


HealthPlus of Michigan is merging with Health Alliance Plan, forming a larger, competitive plan while bailing out the struggling HealthPlus business. Read more »

Certain marketplace services are available without paying a high deductible


As the open enrollment period for health insurance through the state and federal marketplaces got underway on Nov. 1, Kaiser answers plan questions. Read more »

Budget deal eliminates employer mandate for health plan enrollment


The budget eliminates a mandate of the Affordable Care Act requiring large employers to automatically enroll new employees in health plans. Read more »

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