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Health Insurance

Humana pulling out of many Obamacare markets

The Hill: Humana To Leave ‘Substantially All’ ObamaCare Markets Humana, one of the nation’s top health insurers, is pulling out of ObamaCare plans in all but a handful of states after a year of nearly $1 billion in losses. The company plans to exit nearly half of the markets next year, it announced during an earnings report Thursday. It will take part in “no more” than 11 state marketplaces, down from 19 states this year, the company said. (Ferris, 7/21)

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Aetna to quit most Obamacare markets, including Florida

BY ZACHARY TRACER Bloomberg LINKEDIN GOOGLE+ PINTEREST REDDIT Health insurer Aetna Inc. will stop selling individual Obamacare plans next year in 11 of the 15 states where it had been participating in the program, joining other major insurers who’ve pulled out of the government-run markets in the face of mounting losses. It will exit markets including Florida, North Carolina and Pennsylvania, and keep selling plans in Iowa, Delaware, Nebraska and Virginia, Aetna said in a statement Monday. In most areas

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Mark on Medicare ACOs

By LISA BARI Recently, Anish Koka, MD, a Cardiologist from Pennsylvania, posted his anti-Accountable Care Organization (ACO) manifesto here on The Health Care Blog. [1] Koka argues that ACOs don’t work and are doomed to fail because they were designed by non-practicing physician policymakers and academics in ivory towers. He appears to be basing his judgment on a commercial ACO contract that only pays him $4 per month extra for care coordination and requires that he meet specific quality measures. He

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Confessions of a Health Plan CEO

By JIM PURCELL The fact that I was once the CEO of a health insurer may cause you to read this with some skepticism. I invite and challenge your skepticism.  And I will do my very best to keep this piece strictly factual and not stray into the ambiguities that necessarily accompany complicated matters. So bear with me. Health insurers are not popular.  No one wants to go to the prom with us.  We have been vilified by no less

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Inequality Helps the Medicine go Down

By SAURABH JHA, MD The conventional wisdom in the circles I hang out in – pro-Hillary, morally conscious,happy bunnies who pretend to enjoy French wine and opera – is that the greatest scourgeon humanity after the bubonic plague is inequality of wealth. They worship Pope St. John Paul Pikettyand canonize Archbishop Paul Krugman. Not only is inequality bad for its own sake, they say, it makes people ill, like medically ill. Their premise always struck me as specious. I once

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Health Care Debate

With no apology offered, I will be venturing into a very subjective realm, namely, a characterization of today’s healthcare dialogue and what, in my opinion, might be an improvement. I would suggest we have fallen into the trap that was partly enhanced by email and blogs, namely, that we can say outrageous things impolitely and without consequence.  With email we tend to be much blunter and impolite than we would be face to face.  On blogs, we can be positively

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What Medicare Just Did on Patient Engagement!

Sure, I’ve always wanted to write a clickbait headline that sounds like a promo for the bastard child of Buzzfeed and the Federal Register. But, seriously: you will not believe what Medicare just did about patient engagement in a draft new rule dramatically changing how doctors are paid. And, depending upon the reaction of the patient community, you definitely won’t believe what happens next. By way of background, the Centers for Medicare & Medicaid Services (CMS) just issued long-awaited regulations for implementation of a

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The Angry Physician

I think I speak for most physicians when I say that we did not choose to go into medicine to shape health care policy.  Medicine is a calling, and I treated it as such.  I immersed myself with taking care of patients, and keeping up with the ever changing knowledge landscape that is medicine. I left the policy making to the folks I voted for the last 8 years. These were the adults, the intellectuals –  they would take care of

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Health Insurance Trends

It seems like as soon as Americans become accustomed to healthcare reform laws, a new one is introduced. Ever since The Affordable Care Act (ACA) became law in 2010, and continued to charge forward amid partisan controversy, the health insurance industry has been dealing with widespread change. And now that President Obama has started his second term in office, the prospect of overturning the law has become a thing of the past How has the phase-in of Obamacare affected the

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Health Insurance Options for Short-Term Unemployed and Self-Employed Individuals

Are you in straddling two health insurance policies – one that just ended from your old job and another that is yet to begin in your new job? Perhaps you are waiting for that new health insurance policy to take effect and your old company was too small to offer COBRA. If you’re young and healthy, it is tempting to wait it out and hope nothing goes wrong with your health during that period. But industry analysts say this type

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