The policy analysis and guidance you need by the experts you trust, daily.
- After Hours
- Agent Oversight
- Brain Food
- Health Insurance Exchanges
- Part D
- Performance Optimization
- Policy & Health Reform
- Prospective Evaluations
- Provider Relations
- Risk Adjustment
- Sales & Marketing
- Star Ratings
- William on Will Trump and Price Pull Out the Scalpels for Star Ratings?
- Bobby on January Release of the Draft MMG – Perfect Timing
- Pam Lassila on Best Practices and Common Conditions of Audit Preparation
- Capitol Hill Healthcare Update | Gorman Health Group Blog on What Trump Could Actually Do to ObamaCare, Day One, Without Congress
- Are You Ready for the Medicare Advantage Advance Notice & Draft Call Letter? | Gorman Health Group Blog on 21st Century Cures Bill Slips in Some Changes to Medicare and Medicaid Programs
Topic: Brain Food
Now that applications are completed, it’s time to get started on developing bids for 2018. In our experience working with many health plans, we have seen a wide range of strategies for developing bids over the years. Some of the strategies have worked very well, but many times we are working to improve or develop a more robust system because something went wrong the year before. Whatever your scenario might be, here are three important tips to help your bid process run smoother this year:
With Trump’s picks of Tom Price to head the Department of Health & Human Services (HHS) and Seema Verma to head the Centers for Medicare & Medicaid Services (CMS), we now see the policy shift begin to take shape to align with the Republican Medicare and Medicaid platforms. Given Verma’s inexperience with Medicare, we will likely see Price’s physician background and the Trump administration’s desire for deregulation drive the agenda, while Verma applies her Medicaid expertise in establishing state reforms to push forward conservative changes in Medicaid and promote the move to state-based innovations. Some policy shifts we have noticed this month provide major hints of what’s to come.
On March 6, 2,540 days after the enactment of the Affordable Care Act (ACA), the House Ways & Means and Energy & Commerce committees finally released their proposed legislation to repeal and replace it. The American Health Care Act of 2017 is a toxic hot mess: Read more
Yesterday, as we wrote about Trump’s and Republican’s Affordable Care Act (ACA) proposals, a bizarre game of hide and seek took place at the Capitol. Congressmen, both left and right, and the media all frantically scurried about the buildings, seeking a hidden draft bill that contained new changes to the draft leaked last week. Today, Politico reported documents detailing the new draft were obtained. The changes, which are dated February 24, 2017, are sure to go through another round before the draft’s final release.
It’s only been four chaotic weeks into the Trump Administration, but the shapes in the fog in government health programs are slowly becoming clearer.
CMS Releases Widely Anticipated Proposed ACA regulation, the New Administration’s First Attempt at Market Stabilization
On February 15, 2017, the Centers for Medicare & Medicaid Services (CMS) released its widely anticipated proposed rule introducing new market health insurance market reforms. CMS is proposing changes for stricter Special Enrollment Period (SEP) verification, exceptions to guaranteed availability, updated network adequacy requirements, and a shorter Open Enrollment Period.