Health Insurance Exchange

September 17, 2014 | Anthony Brino

Call it managed care 2.0. The latest idea in affordable networks is bringing together a large insurer and disparate providers to create a simplified, integrated care system.

September 17, 2014 | Anthony Brino

What happens when an insurer with the bulk of a state's public exchange membership pulls out?

September 16, 2014 | Anthony Brino

Before the next open enrollment begins, verification issues are lingering for several hundred thousand consumers on existing exchange plans, leaving insurers and providers facing a range of potential problems.

September 16, 2014 | Anthony Brino

Narrow networks sparked consumer angst and new government oversight after the Affordable Care Act's first open enrollment period. But now, there's evidence that limited networks can be a win-win, albeit with one primary caveat.

September 15, 2014 | Anthony Brino

In the latest development of private health insurance exchanges, one large Blue Cross company is betting on the single-carrier model as a way to keep group business, or hopefully expand it.

September 11, 2014 | Anthony Brino

In branding, sometimes it's worth giving up old ideas and trying new ones, or at least transitioning to new messages when it seems they're not resonating.

September 10, 2014 | Anthony Brino

What happens when the insurers who flooded exchanges and garnered the bulk of the membership increase their rates?

September 8, 2014 | Shefali Luthra

Americans living in rural areas will be a key target as insurers, states and nonprofit groups strategize how to enroll more people in exchange plans this fall.

September 5, 2014 | Anthony Brino

Many insurers setting premiums for the upcoming exchange season seem to be banking on consumer price sensitivity. Some are also poised to draw the most cost-conscious enrollees away from competitors.

September 3, 2014 | Marissa Evans

Signing people up for health insurance is the easy part of Rawha Abouarabi's job ministering to immigrants and Arab Americans in this manufacturing hub along the Rouge River in Dearborn, Michigan.

September 2, 2014 | Anthony Brino

Forty years after the creation of a national regulatory framework for workplace benefits at large employers, employee health benefits are in the midst of another evolution.

September 2, 2014 | Anthony Brino

Another state is being offered a federal waiver to expand Medicaid on its own terms, hoping to bring the efficiency of private insurance and new value incentives to the public payer program.

September 10, 2014 | White Papers
With the September 22, 2014 deadline to renew existing Business Associate Agreements and comply with updated HIPAA requirements, it’s important that you have the information and tools to take action. View this fact sheet and learn: Key changes from the HIPAA Omnibus final rule, steps you need to take to comply and how DocuSign can help your organization meet the deadline and stay ahead of the curve with HIPAA compliance.

August 27, 2014 | White Papers
New Bedford Corporation was expending too much time and staff manually entering medical charges generated by 50 of its healthcare provider customers into its practice management application. The back-office services provider deployed EnableSoft's Foxtrot to automate the billing data entry process, which resulted in the reduction of data entry time by 5.6 hours per 1,000 records and a savings in human resources equal to two FTEs.

August 27, 2014 | White Papers
Care1st Health Plan experienced a 20,000-member increase as a result of county expansion and the potential for even more members as the new third-party administrator for Arizona's insurance cooperative. In order to automate and expedite burdensome data-entry processes, the health plan implemented EnableSoft's Foxtrot software, which ultimately saved valuable and human resources.

August 27, 2014 | White Papers
Scott & White Health Plan and Insurance Company foresaw increased manual data-entry processes required to accommodate an influx of new members under the Affordable Care Act. The nationally rated health plan's implementation of EnableSoft's Foxtrot software helped to reduce new network set-up time and time to establish new pay classes, while at the same time increasing productivity and scaling operations without increasing staff.

May 19, 2014 | White Papers
If your organization enters or changes data manually, or is using a series of macros cobbled together to automate enrollment, claims reprocessing, or panel updates, you’re probably losing time, money, and risking data quality. This study explores the causes, prevalence, and repercussions of these traditional data practices for payers, then shares innovative ways to conquer inefficiency with automation technology.

March 11, 2014 | White Papers
For health insurers, data integrity and visibility are key to successful integration with the Federal Marketplace. However, complex processes and trivial errors can lead to data gaps that impact revenue, profitability and member satisfaction. Adopting a standarized approach to data integrity early in the process is critical to succesfully adapting to the technologies and processes of the Affordable Care Act.

October 30, 2013 | White Papers
This visual industry primer answers key questions about health insurance exchanges and includes data points from leading consulting firms. Read this piece to get grounded on the new world of health insurance marketplaces, and gets answers to some basic industry questions including: 1) How will people buy health insurance in the post-reform landscape? 2) What’s the difference between defined contribution and defined benefit? 3)How do public and private exchanges differ? 4) How does a single-insurer private exchange work?

October 30, 2013 | White Papers
This summer with the October 1 launch of public health exchanges looming, Array Health surveyed health insurance executives to get their perspective on the changing marketplace. Read this report to discover their opinions on key questions surrounding exchanges including: 1) What percentage of insurers will participate in both private and public exchanges? 2) How aware are employers of the defined contribution funding model? 3) How many “young invincibles” will comply with the ACA individual coverage mandate?

October 17, 2013 | White Papers
For a company that provides medical, dental, and vision coverage to more than 25 million people nationwide and processes over 50 million claims every year ensuring call resolution is key to organizational performance. Thanks to healthcare reform and an anticipated increase in calls from both members and providers, this organization needed to streamline the cost of new customer service representatives. See how training helped streamline the onboarding process by 30% and save over $500,000 annually.

October 9, 2013 | On Demand Webinars
The healthcare sector is going through massive transformation. Payers have to invest in readiness around data delivery to federal and state or multiple health insurance exchanges before Jan 1, 2014 deadline. While the ICD-10 adoption deadline has been pushed back due to industry pressures on regulator - it is still a huge undertaking for any healthcare entity that touches diagnostic or procedural codes. These are just some of the projects that are converging on healthcare IT teams this year. For healthcare CIOs and IT teams and especially application development teams this project overload translates into a cascading capital and operational cost burden. Learn how Presbyterian reduced storage, operational costs and realized significant productivity benefits around critical business processes.

October 9, 2013 | White Papers
Healthcare reform is transforming the US medical insurance sector - creating a dynamic and competitive new market with compelling opportunities for growth. But do you have the necessary responsiveness to capitalize on these opportunities? Here are the five compelling ways technology investment delivers agility you need - and how.

July 1, 2013 | White Papers
The launch of new Health Insurance Marketplaces in all 50 states on October 1 accelerates an ongoing transition from the employer-driven payer model of U.S. healthcare toward a new era of consumerism. Health plans will be required to treat customers as individuals and use multiple channels to take their products to market. This paper will explore how Dell’s proven expertise in building and managing Health Insurances Exchanges can help you succeed in this new world.


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