ACA open enrollment for 2015 causing anxiety for plans, providers

During the 2014 open enrollment for Obamacare coverage, Mary Denson, 21, a student at Columbia (Mo.) College, qualified for a federal premium subsidy that reduced her premium contribution for buying health insurance to less than $20 a month. But she fears that when she renews her coverage for 2015, she won’t have enough income from her nanny job to reach the subsidy income threshold of 100% of the federal poverty level and continue qualifying for premium tax credits. She isn’t eligible for Medicaid because Missouri hasn’t expanded that program for low-income adults. Denson says she’s considering looking for another job to reach the $11,670 income threshold but worries she may have to drop classes. Without the subsidy, her coverage would cost nearly $400 a month, far more than she can afford. “I’m just going to have to re-apply and pretty much hope that I make the cut again,” Denson said.

Consumers may not realize that unless they update their income data, they won’t have accurate information about how much they are eligible for in premium tax credits and what their out-of-pocket premium contribution for a plan actually is.
The sole focus during the 2014 open enrollment period was on signing up […]

By |September 19th, 2014|Health Reform|Comments Off

ACO’s Save Medicare $372 Million

Medicare’s voluntary clinical alliances of providers have produced $372 million for the program to date and provided participants $445 million in bonuses, the agency reported this week.

The results for two models of accountable care organizations (ACOs) came from preliminary quality and financial results from the second year of 23 pioneer ACOs, and from the first year of 220 Medicare Shared Savings Program (MSSP) ACOs. Only 64 ACOs earned at total of $445 million in bonuses for their efforts to reduce the costs of care while improving clinical outcomes for Medicare beneficiaries enrolled in them.

The Obama administration hailed the results as early successes in its efforts to use the Affordable Care Act as a way to move healthcare delivery from a quantity- to a quality-focused approach.

“As we announced today, they are already seeing success,” a release from the U.S. Department of Health and Human Services (HHS) said. “By working with state and private partners, we can drive more improvement through supporting payment models that reward higher quality care.”

A healthcare finance expert said the latest ACO results reflected the effort of the participating providers.

“In addition to the savings attributed to these new payment models, quality and patient experience scores improved as […]

By |September 18th, 2014|Medicare/Medicaid|Comments Off

Administration threatens to cut off ObamaCare subsidies to 360,000

The Obama administration announced Monday it will cut off tax subsidies to about 360,000 people if they do not offer proof of their income in the next two weeks.

Officials will send final notices this week to individuals who signed up for ObamaCare with income levels that didn’t match government records. The announcement marks the administration’s first move to tackle the politically charged issue of income verification, which has remained a key GOP argument against the healthcare reform law.

Those who don’t confirm their income levels could lose their tax credit and face higher premiums and higher deductibles.

Nearly 90 percent of the 8 million people who signed up for ObamaCare have received government subsidies. The average consumer pays $82 per month for a $346 plan, receiving an average subsidy of $264.

The administration had already warned that it would end coverage for the 966,000 individuals whose immigration status could not be confirmed by the government.

About 115,000 people will lose coverage this month if they do not submit their paperwork, Andy Slavitt, principal deputy administrator at the Centers for Medicare and Medicaid Services, told reporters Monday.

A total of 1.2 million people have had income inconsistencies since the launch of ObamaCare last year. About 800,000 people […]

By |September 16th, 2014|Health Reform|Comments Off

 

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