As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and could have tax liability implications.
As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and tax liability implications.
The State Network hosted a Small Group Convening in Boston, MA on July 10-11, 2014, bringing together state officials and technical experts to discuss QHP and IAP renewals in advance of the upcoming open enrollment period. The meeting provided officials from several states within and outside of State Network an opportunity to discuss strategies for confronting potential issues related to the renewals process.
All-payer claims databases (APCDs) collect and compile medical, pharmacy, and sometimes dental claims, eligibility, and provider files from public and private payers. APCDs are currently being used for a variety of functions, including population health analysis, comparative analysis of provider and facility quality, cost management for Medicaid and other public programs, support for provider payment reform initiatives, and consumer transparency tools.
The final webinar in a three-part series on payment reform, this presentation by Bailit Health Purchasing addresses special topics in payment reform including using state levers to implement payment reform, multi-payer strategies, and measuring delivery system performance.
Under the Affordable Care Act (ACA), individuals seeking health insurance coverage through a Marketplace are assessed for eligibility for an advance payment of the premium tax credit (APTC) based on projected annual income. When eligible individuals file federal income taxes at the end of the year, the Internal Revenue Service (IRS) will reconcile the premium tax credit received based on estimated annual income with what should have been received based on actual income.
he Affordable Care Act (ACA) is already greatly expanding individual health insurance coverage, particularly among lower-income uninsured individuals. However, this is neither easy nor inexpensive to sustain, and it will require ongoing, effective public-private partnerships on multiple levels. One potential partnership opportunity is with “web brokers” who sell individual health insurance online, functioning as private distribution channels in a fashion similar to the new Marketplaces and offering a choice of health plans from multiple insurers, while relying primarily on websites and call centers for customer service.
With full implementation of the health insurance coverage provisions of the Affordable Care Act (ACA) on January 1, 2014, there has been great interest in assessing the law’s early impact on health insurance coverage in Minnesota.
The second webinar in a three-part series on payment reform, this presentation by Bailit Health Purchasing describes payment reform models being used by state purchasers, including how they work and their strengths and challenges.
The first webinar in a three-part series on payment reform, this presentation by Bailit Health Purchasing addresses how traditional fee-for-service payment impedes state efforts to purchase value and describes the relationship between payment and delivery system reform.