Practice Management
Last week we told you about Humana’s plans to drop out of Affordable Care Act (ACA, or “Obamacare”) insurance exchanges in certain states. Now the company has revealed that one of those states is Alabama—leaving just one ACA exchange in the entire state, effective Dec. 31, 2016. The other states (so far) are Kansas, Wisconsin, and Virginia, though news regarding more states may still be ahead. The company first said it would consider exiting certain …
Read More
URGENT MESSAGE: Although the Affordable Care Act has made some progress in reducing the number of Americans without any health insurance, many of the newly insured are still unable to afford routine healthcare due to plan designs that include high deductibles, copays and coinsurance. Alan A. Ayers, MBA, MAcc is Practice Management Editor of JUCM—The Journal of Urgent Care Medicine, a former member of the Board of Directors of the Urgent Care Association of America, …
Read More
In advance of formal approval of its merger with Aetna, Humana plans to stop participating in some state insurance exchanges constructed under the Affordable Care Act (ACA, or “Obamacare”). The company says its member base dropped 21% compared with the first quarter of 2015. That includes those who bought policies under the ACA exchanges, which many insurers say are hard on their bottom lines to begin with. UnitedHealth Group was the first major insurer to …
Read More
No longer satisfied with revealing states in which it plans to stop offering insurance under the Affordable Care Act (ACA, or “Obamacare”) a few at a time, UnitedHealth Group has acknowledged it will drop out of all but a “handful” of states by the end of this year. Right now, it participates in exchanges in 34 states; the dawn of 2017 will see it offering health coverage in just 12, as now planned. The market …
Read More
The growing ranks of older U.S. citizens and the Affordable Care Act (APA, or “Obamacare”) add up to a need for more and more physicians as time goes by, but a new study says the number of qualified physicians is not keeping pace. The research from the Association of American Medical Colleges (AAMC) points to shortages among specialties, in particular. The portion of the U.S. population over the age of 65 is expected to grow …
Read More
An influx of newly insured patients is just one reason emergency room traffic continues to go up in the age of the Affordable Care Act (ACA, or “Obamacare”), according to new data from the Centers for Disease Control and Prevention. Lack of access to primary care providers in general is especially problematic among Medicaid patients; often, they find access to be untimely, at a median wait time of 2 weeks for an appointment—if a conveniently …
Read More
Just a week after revealing it will no longer participate in Affordable Care Act plans in Arkansas and Georgia, UnitedHealth Group says it is bowing out of Michigan plans backed by the ACA (or “Obamacare”), as well. The company, which started warning that low profitability associated with ACA exchanges made doing business through them untenable months ago, will cease to carry such plans in the three states at the end of this year. Anyone currently …
Read More
UnitedHealth Group has been saying for months that it may opt to not participate in insurance exchange programs set up under the Affordable Care Act (ACA, or “Obamacare”). Apparently it was no idle threat, as the biggest insurer in the country says it will not sell plans in Arkansas or Georgia next year. The company has said the ACA plans are not profitable enough to justify their participation. UnitedHealth and Aetna both saw losses on …
Read More
A new report from Blue Cross Blue Shield reveals that its Affordable Care Act enrollees are sicker and more expensive than its other plan members, as a whole. In fact, they’re nearly twice as likely to be admitted to hospitals. One reason will come as no surprise to critics of the ACA, or “Obamacare:” People who were uninsured and less healthy in the first place have signed up in droves. The act requires participating insurers …
Read More
UnitedHealthcare (UHC) is testing a no-cost primary care model to see if it equates to greater use of preventive care and, ultimately, lower costs for the company. It farmed out the program to Harken Health, which gives members unlimited no-fee access to primary care services and a 24-hour helpline, a personal health coach, psychological counseling, and classes in fitness and nutrition. Access is limited at this point, however, as Harken has just six clinics in …
Read More