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Administration recommends Medicare enrollees drop exchange plans
The federal government is encouraging older Americans who have a marketplace plan and are on Medicare to drop insurance they have purchased on the exchanges. Medicare often overlaps with private insurance coverage, meaning most consumers do not need both plans, writes Susan Jaffe for The Washington Post.
Insurers’ reluctance to adopt value-based models frustrates providers
Health care providers believe commercial insurers have been too slow in implementing value-based payment models. A survey conduct by the quality consulting firm Premier finds many hospitals are considering establishing provider-owned health plans as an alternative to working with commercial insurers, writes Shelby Livingston of Modern Healthcare.
Minnesota Governor calls for ACA adjustments
Minnesota Governor Mark Dayton believes the Affordable Care Act has made health care “no longer affordable” to many Americans. Several insurers have withdrawn from Minnesota’s exchange and average cost of premiums in the state will rise by more than 50 percent in 2016. Dayton argues the law has important features, but is calling on Congress to make adjustments that will alleviate health care costs. Rachana Pradhan of Politico has the story.
Humana ratings, shares fall
The Centers for Medicare and Medicaid Services (CMS) Medicare Star Quality Ratings reports Humana’s membership in 4-star plans has been nearly halved for the 2018 plan year. Shares of Humana are on the decline following the CMS ratings release. Berkeley Lovelace Jr. at CNBC shares Humana attributes the decrease in membership to a closed CMS program audit and plans to file for reconsideration of certain ratings.
Insurers take different approaches to mergers
Aetna, Humana, Cigna and Anthem are all discussing mergers, but the companies diverge on how they are going about striking deals. Anthem and Cigna have been at odds over possible violations of the merger agreement, creating discord that could affect the plausibility of a deal. Aetna and Humana have been working together, agreeing to sell Medicare Advantage assets in counties the Justice Department finds problematic. The willingness of the insurers to cooperate makes a government negotiation for a merger more likely to succeed. Charley Grant at The Wall Street Journal has the story (subscriber’s content).
Studies of Note
In this feature, the Media Monitoring Report shares a selection of notable research studies within the health care industry.
Doctors vs. Algorithms
Comparison of Physician and Computer Diagnostic Accuracy
JAMA Internal Medicine
October 10, 2016
Researchers from Harvard Medical School, Brigham and Women’s Hospital and the Human Diagnosis Project find doctors are more accurate in their predictions of diagnoses than online symptom checkers, such as websites or apps offered by WebMD and the Mayo Clinic. Computer algorithms were more successful at correctly identifying common ailments than serious illnesses (subscriber’s content).
Blood Pressure Affects the Brain
High Blood Pressure Linked with Brain Disease Expectancy
October 11, 2016
The American Heart Association (AHA) has reviewed several studies describing the link between high blood pressure and brain diseases. The studies find high blood pressure, especially in middle age, puts individuals at a greater risk for cognitive impairment, explains reporter Kristi King. The AHA published the results in its journal Hypertension.
Wellness at Work
Study Links Workplace Wellness Programs and Mental Health
A study conducted by UCLA staff and students suggests wellness programs promoting physical activity may lead to improved mental health. Researchers led by UCLA Semel Institute Research Statistician Prabha Siddarth, PhD, asked volunteers to complete surveys rating stress levels. The data show the average participant has a better handle on stress, a calmer outlook and an improved sense of well-being, reports Associate Editor Stefanie Valentic.
Association between the 2014 Medicaid Expansion and U.S. Hospital Finances
Journal of American Medical Association
Hospitals in states that expanded Medicaid under the Affordable Care Act receive more Medicaid revenue, have lower uncompensated care costs and tend to show higher profitability. The study compares revenue and profitability data from two surveys on hospital revenue and profitability. Urban Institute Health Policy Center Senior Research Associate Frederic Blavin, PhD, conducted the study (subscriber’s content).