Kip Piper's Health Care Blog
Medicare, Medicaid, Health Reform

Home Health Plans Qualified Health Plans

Qualified Health Plans

As part of the Affordable Care Act (ACA), Medicaid coverage could be expanded to cover nearly 400,000 currently uninsured American Indians and Alaska Natives (AI/AN). This population, particularly sensitive to health disparities, suffers from elevated disease burdens and poorer overall health than that of the general population. The AI/AN...
A new report examines individual eligibility for federal premium subsidies in Health Insurance Exchanges when employer-sponsored or public coverage is not available to them.  Both federal premium subsidies and state or federally-run Health Insurance Exchanges are features starting in 2014 under the Affordable Care Act (ACA). While most individuals will be required to...
The Patient Protection and Affordable Care Act (ACA) requires benefit plans offer a minimum set of essential health benefits. Those include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitation and habilitative services and devices, and laboratory services. The...
In previous research, Milliman, one of the nation's top actuarial firms, provided an overview of the impact made by guaranteed issue and community rating reforms on the health insurance markets within eight states in the 1990s. Retained by America’s Health Insurance Plans (AHIP), Milliman has published an update to this...
As part of the Health Reform Toolkit Series, the Blue Cross Blue Shield of Massachusetts Foundation, the Robert Wood Johnson Foundation, and the Commonwealth Health Insurance Connector Authority have published Effective Education, Outreach, and Enrollment Approaches for Populations Newly Eligible for Health Coverage. The series offers resources for health...
A new report outlines the key principles and various options for funding the operating costs of Health Insurance Exchanges mandated under the Affordable Care Act.  Nevada’s Silver State Health Insurance Exchange describes methods other states are using or may use to finance day-to-day operations of a Health Insurance Exchange...
The Affordable Care Act (ACA) requires the Centers for Medicare and Medicaid Services (CMS) issue employer group health plan quality improvement reporting requirements. Reports shall cover specified quality improvement activities regarding plan or coverage benefit and provider reimbursement structures. Those requirements shall include efforts to improve health outcomes, ensure...
Health insurance plans are required to report their administrative expenses.  For health plans in the for the large group, small group, and individual insured markets, an new report from Milliman details insurers’ administrative expenses in five categories: Expenses for improving healthcare quality Claims adjustment expenses Agents and brokers fees and commissions Direct sales...
The Affordable Care Act (ACA) requires that most Americans have health insurance that meets minimum federal requirements.  Under the controversial mandate, starting in 2014, most individuals under 65 must purchase minimum essential health insurance coverage or pay a penalty to the IRS.  One practical concern is that healthy individuals...
Under the Affordable Care Act (ACA), states are responsible for implementing a complex array of health reforms, most notably Health Insurance Exchanges, Medicaid expansion, and health insurance market regulations.  ACA presents states, particularly state Medicaid agencies and insurance departments, with unprecedented policy, fiscal, programmatic, operational, and systems challenges. A helpful new...

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