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Editorials

For ACA marketplaces, the near-poor are the sweet spot

Andrew Sprung

Among the near-poor, the proportion of the newly insured who gain their insurance through the marketplace was likely to be particularly high.

The ACA's influence on the large employer market

Sue Hart, Milliman

While the modest impact continues in 2015, there are a number of influences that the ACA may have on costs in the large employer market over the next few years.

Re-evaluating QI evaluation and the process behind it

Jane Scott, Gorman Health Group

This is the time of year when most plans have either completed, or are in the process of completing, their annual evaluation of their Quality Improvement (QI) Program Description and Work Plan for operating year 2014. 

Do kids born by C-section have a higher risk of chronic disease?

Jan Blustein, MD, NYU

In many parts of the world, rates of cesarean delivery are too high, and growing. We need to understand the potential consequences.

Are hospitals the safest place for healthy women to have babies?

Neel Shah, MD, Harvard Medical School

There is a good chance that your grandparents were born at home. I am going to go ahead and assume they turned out fine, or at least fine enough, since you were eventually born too and are now reading this.

Gray areas in 'Making healthcare work'

Sam Toney, MD, Health Integrated

Nearly 4,000 healthcare professionals from across the U.S. convened in Nashville last week for America's Health Insurance Plans annual Institute, and the conference theme of "Making Healthcare Work" resonates.

The missed opportunity to unbundle Medicaid

Jay Sultan, Edifecs

While a significant overhaul of Medicaid is long overdue, the recent proposals fail to address one of the program's fundamental problems: the trifurcated nature of the program struggles to serve three very different needs.

Sorry Captain, there's no transparency in medical pricing

David Williams

Transparency isn't here yet and even then it will only be part of the answer.

Big rate increases are coming a year early

Robert Laszewski

The Obama administration has posted the 2016 rate increases in excess of 10 percent that the Obamacare health plans are requesting. There are a lot of them.

Reading between the lines in the 2016 MA Call Letter

Deb Mabari, Cody Consulting

Don't let errors that could have easily been avoided be the reason that CMS comes knocking on your door.

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