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9Sep, 2016

On Obamacare, Senators Demand Answers From Aetna

By Kimberly Leonard | Staff Writer Sept. 8, 2016, at 3:26 p.m. | USNEWS.com

Five Democratic Senators sent a letter to Aetna’s chairman and CEO Thursday saying that they were troubled by the possibility that the company was pulling its participation from health insurance exchanges in retaliation for a Department of Justice lawsuit blocking its proposed multibillion-dollar merger.

Senators including Elizabeth Warren, D-Mass., and Bernie Sanders, I-Vt., urged Aetna CEO Mark Bertolini to “answer both to your shareholders and to the thousands of Americans who trusted Aetna with their health coverage.” Among their questions: how much money the company would lose if […]

6Sep, 2016

‘Simple Choice Plans’ To Debut In 2017 Marketplace Enrollment

By Michelle Andrews September 2, 2016 | Kaiser Health News

Despite much hand-wringing about health insurers exiting the marketplaces where people buy individual coverage, in many areas consumers will likely still have a choice of plans when the 2017 open enrollment starts in November. Aiming to make picking a plan easier, the federal government, which runs the marketplaces in roughly two-thirds of states, is encouraging insurers to offer “simple choice plans” as an option this fall.

The six new standardized plan designs will eliminate many of the moving parts that have bedeviled consumers trying to make apples-to-apples comparisons between plans. The government is providing guidelines for a simple […]

2Sep, 2016

Insurers Move to Limit Options in Health-Care Exchange Plans


A spokesman for the Department of Health and Human Services said that many surveys have shown exchange enrollees are satisfied with the array of health-care providers in their plans, and insurers are adjusting their offerings based on consumer demand. Photo: Getty Images

By Anna Wilde Mathews | Updated Aug. 31, 2016 2:41 p.m. ET | The Wall Street Journal

Under intense pressure to curb costs that have led to losses on the Affordable Care Act exchanges, insurers are accelerating their move toward plans that offer limited choices of doctors and hospitals.

A new McKinsey & Co. analysis of regulatory filings for […]

2Sep, 2016

St. Luke’s, Geisinger to collaborate, offer new Medicare health plan

The Daily Item | August 31, 2016

BETHLEHEM — Officials at St. Luke’s University Health Network, Geisinger Health System and Geisinger Health Plan today announced the signing of a Master Collaboration Agreement.

The collaboration will take advantage of the collective strengths of the organizations to further improve access to affordable and high quality healthcare to persons living in nearly 50 counties in Pennsylvania, a spokesman for Geisinger said.

Geisinger sought to team up with St. Luke’s based on its reputation for exceptional quality, strategic vision and willingness to implement new and innovative models of care in collaboration with physicians. When executive leadership from […]

29Aug, 2016

UPMC’s health plan swells in aftermath of Highmark spat

By Bob Herman  | August 26, 2016 | modernhealthcare.com

Membership in UPMC’s health insurance division grew 8% in the past year, according to financial documents released Friday, giving UPMC a bigger foothold as it tries to operate peacefully with its rival Highmark Health.

UPMC and Highmark, both not-for-profit organizations that sit as corporate giants in Pittsburgh, have been operating under a “continuity of care” consent decree since this past January. The two hospital and health insurance systems have been fighting for the past several years over rates, networks and turf in the area, which prompted policymakers to step in and hammer out an […]

22Aug, 2016

Popular ‘Obamacare’ provision gives young adults coverage

Geoff Mulvihill, Associated Press | Saturday, August 20, 2016 | Chron.com
Mina Schultz figured she’d be OK without health insurance during the months between finishing graduate school and joining the Peace Corps.

But a few weeks after graduation, she was diagnosed with osteosarcoma, a bone cancer more common in children.

All her plans changed. Instead of working for several months on a Montana ranch, she was living at age 25 with her father and stepmother in Columbia, Missouri, and going through a year of chemotherapy plus a knee replacement.

Her father, Jack Schultz, a professor at the University of Missouri, recalls a scramble not […]

22Aug, 2016

Highmark Blue Shield and Lehigh Valley Health Network announce joint effort to reduce health care cost trends, improve coordination of care

August 15, 2016 | By Sheila Caballero | Lehigh Valley Health Network

Two local health industry organizations have announced plans to work together to create long-term health improvements in the community – improvements that can lower future health care cost trends for both employers and individuals.

Highmark Blue Shield (Highmark) has launched a new health insurance product* – Lehigh Valley Flex Blue – in Lehigh, Northampton and Schuylkill counties enabling Lehigh Valley Health Network (LVHN) and other aligned providers to better manage the care members and patients receive, improving outcomes and lowering future health care costs.

Employers and individuals can enroll in Lehigh Valley […]

22Aug, 2016

How to rescue Obamacare as insurers drop out

By Henry J. Aaron | August 19 | The Washington Post

Henry J. Aaron is the Bruce and Virginia MacLaury senior fellow at the Brookings Institution and the vice chair of the DC Health Benefit Exchange Authority.

According to an old bit of folk wisdom, if one person says you are drunk, you can wave him off. If two people tell you, go home.
When UnitedHealth Group announced a few months back that it was going to stop selling individual health insurance in most Obamacare exchanges, informed observers were not alarmed. They noted that nearly all exchange customers still had at least […]

18Aug, 2016

Doctors not taught to discuss diet, nutrition with patients

Barbara Sadick | Chicago Tribune

Good diet and nutrition can put you on a path to health and wellness, but it’s unusual to find doctors who are trained well enough and can spend the time required to have this conversation with patients.

In the United States, the traditional medical approach has been to focus on treatment rather than prevention of disease and illness. Jennifer Trilk, assistant professor in the department of biomedical science at the University of South Carolina School of Medicine at Greenville and a leader in the new lifestyle medicine movement, says that as we’ve developed more and more ways […]

17Aug, 2016

Obamacare hikes: Average rate request of 24 percent

By Dan Diamond | 08/15/16 10:00 AM EDT | politico.com

A new study raises questions about orphan drugs, and the decision to declare a “public health emergency” in Puerto Rico over Zika is sparking another round of political fights. But first: More evidence of Obamacare’s pending double-digit rate hikes.

OBAMACARE HIKES — Average rate request of 24 percent this year. That’s according to findings from independent analyst Charles Gaba, who has crunched the numbers for insurers participating in the ACA exchanges in all 50 states, including a handful of recent updates.

For instance, Cigna and Humana recently revised their rate requests in Tennessee, […]