September 9, 2020
Insurance Plans Piloting Primary Care Programs
Healthcare operations continue to stride forward in new directions; Forbes published an article this week detailing how BCBSGA, UHC and Aetna are running pilot programs where they are directly employing providers that circumnavigate the existing healthcare delivery systems. From the…
CMS to Increase Oversight of Medicaid Enrollment and Managed Care Plans
CMS announced that will be heightening audits to “confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees”. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees.
Physicians that receive poor reimbursement still don’t drop payers, survey says.
Physicians and Hospitals experienced over $68 billion in Medicare and Medicaid reimbursement shortfalls. The cost of care is out growing the reimbursement from Medicare and Medicaid. Yet few physicians are leaving their contract new survey shows.
Anthem/Cigna and Aetna/Humana Merger Update
Developments continue regarding the proposed mergers between Anthem/Cigna and Aetna/Humana. Yesterday, the Justice Department reported they will likely file lawsuits this month to halt both proposed mergers. If the Justice Department does take action, it may significantly delay any merger. …
Health Exchange Webinar
Strategic Healthcare Partners (SHP) continues our series on Health Exchanges and impact on providers. Please join us this Wed, 10/16 from 4pEST – 5pEST. Contact Jason Crosby at jcrosby@shpllc.com or 912-544-0421 with any questions. Space is limited, please reserve your seat…