-
The GHG Blog is just the tip of the iceberg. Check out the Point for complete access to all content from GHG experts. -
- ACOs
- After Hours
- Agent Oversight
- Brain Food
- Compliance
- Health Insurance Exchanges
- Medicaid
- Part D
- Performance Optimization
- Policy & Health Reform
- Prospective Evaluations
- Provider Relations
- Risk Adjustment
- Sales & Marketing
- Star Ratings
- Strategy
- Kristina on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Curt Black on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Margaret on What Sequestration Could Mean to Medicare Advantage Claims Payment
- Jane Wall Medicare Health Benefits Inc on Strange Bedfellows Come to Medicare Advantage’s Rescue
- Barb Housewright on What Happens to Medicare/Medicaid If There’s a Government Shutdown?
-
-
Tag Archives: Health Reform
Election Gives Health Reform the Kiss of Life
It’s hard to argue this wasn’t a decisive victory for the President and Democrats in the Senate. What remains to be seen is whether intractable Congressional Republicans will come to the table to get stuff done.
The Impact of the Election On Medicare Private Plans
Now that President Obama has been re-elected, the Affordable Care Act (ACA) will not be repealed and the ACA provisions impacting Medicare Advantage (MA) plans and Prescription Drug Plans (PDPs) will continue to be implemented.
Public and Private Exchanges
It appears that Medicare beneficiaries who use the most health care services and are often considered the least able to shop over the internet for health insurance may have been the trailblazers for how health insurance will be purchased in the future. Medicare took a first step in the 1990s when it created a voluntary online marketplace where Medicare beneficiaries could select a Medicare Advantage private plan from the government run internet site “Medicare Compare”. Medicare expanded the experiment when it implemented the Part D prescription drug plan benefit in 2006. At that time, all seniors and disabled beneficiaries who were not covered by an employer drug plan were required to shop and select from an online menu of new prescription drug plans during a short open enrollment period.
Open Enrollment and Star Ratings for 2013
Open enrollment season has started and CMS has posted the star ratings for each Medicare Advantage (MA) plan and Prescription Drug Plan (PDP) on the Medicare.gov website, which is the official site beneficiaries use to get information on their plan choices. Five star plans get a special gold star icon and have special enrollment periods. Higher performing MA plans also receive higher bonuses. Low performing plans are also designated by a special icon on the Medicare website. Most MA plans whose rating fell will see a decrease in their payments in 2014.
With Presidential Election Static, Senate Slips from GOP’s Grip
The most frequent question I get is “what will the elections mean to Medicare and Medicaid?” We’ve said here the Republicans’ only hope of repealing the Affordable Care Act and enacting entitlement reform comes from making President Obama a one-termer, maintaining their majority in the House, and retaking the Senate. At the moment the Presidential race remains largely unchanged, with Mitt Romney getting a disappointing bounce from the GOP convention; Republicans will likely hold the House, but their grip on retaking the US Senate is slipping — and with it, any chance of ObamaCare repeal or major changes to Medicare and Medicaid.
GOP’s “Reform Repeal Theatre” Costs Taxpayers $48 Million. WTF?
The House of Representatives again voted to repeal the Accountable Care Act (ACA) last Wednesday, marking the 33rd time Republicans have tried. All 32 previous attempts died in the Senate, as this one will. But the GOP’s “Repeal Theatre” comes with a sick price tag: about $48 million and counting, according to a report by CBS News.
If Mandate Survives SCOTUS, Will GOP States Be Caught Flat-Footed on Exchanges?
I keynoted the Opal Events Medicare Executive Forum last week and stated there — as I have here – that I think there’s slightly more than an even chance that SCOTUS will overturn the individual mandate in its ACA ruling later this month. The presentation raised an interesting question: if the mandate survives the Court, will the 26 GOP governors who filed suit be caught flat-footed on exchanges, and have a Federal fallback exchange jammed down their throats in 2014 for their inaction? Remember that the states must demonstrate to HHS this fall that they’ll be ready to launch their exchanges by January 1, 2014, and that there are dozens of states waiting to see what the Court will decide before taking any action. Politico held a policy briefing Friday with a couple influential state regulators that argued at least a few of those red states are moving forward on exchanges.
