Georgia’s ACA exchange enrollment for 2018 may fall short of the current year totals. The final number of Georgians who actually started exchange coverage in 2017 was 404,000. This year 246,270 have signed up for coverage in the state’s exchange.…
St. Louis-based Ascension Health are in talks to merge with Renton, Washington’s Providence St. Joseph Health, which would create the largest hospital chain in America. The companies are the top two Catholic health systems in the nation. If the two…
CVS Health announced Sunday that it agreed to buy Aetna for a whopping $69 billion. The deal would be considered one of the largest transactions of the year, combining the drugstore giant and one of the biggest health insurers in…
The Centers for Medicare & Medicaid Services (CMS) proposed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) in late April, 2016. This release announced a fundamental overhaul of physician payment methodologies from a model reimbursing each individual service…
As The Department of Justice (DOJ) recently filed Antitrust lawsuits against both the Connecticut-based Aetna and Indianapolis-based Anthem “Mega-Mergers,” the DOJ is suggests a February start date to the trial. With Aetna aiming to complete a $37 billion acquisition of Humana…
The Office of the National Coordinator for Health IT recently released defined interoperability measures as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). These measures intend to clarify what exactly it means to, “achieve widespread exchange…
If the proposed Anthem/Cigna and Aetna/Humana mergers are allowed to proceed, the combined entities will control roughly 90 percent of both Georgia’s individual health insurance market. Additionally, these entities will subsequently control 90 percent of both the Medicare Title XVIII…
In an interesting turn for political support, there now exists a desire by a small number of Georgia Republicans that are now open to the idea of expanding Medicaid. However, they will face significant hurdles to do so. The conservative…
The Merit-Based Incentive Payment System (MIPS) is the future value-based program for Medicare Part B Providers that should be considered the default Medicare payment program beginning January 1, 2019 with a two-year look-back, therefore truly beginning in 2017. This program…
The Center for Medicare and Medicaid Services (CMS) released the first set of “Core Quality Measures” this Tuesday, in which CMS and private payers agree to utilize in value-based payments. The collaborative includes members from America’s Health Insurance Plans (AHIP),…