Healthcare Economy

The very mention of the word "Exchange" today, in the United States is associated with Health reform and the PPACA act which was implemented by President Obama in March 2010 and why not? It is probably one of the most discussed topics today.  The Exchange which is supposed to make insurance purchase a simple yet effective tool for the majority of uninsured population, has long been in controversy, sometimes due to actual reasons and concerns; like the cost of implementing an exchange or how to actually make the Exchange self-sufficient by 2015, both at the state level or sometimes only because of political conflict. The general public for a very long has been in a dilemma about what is in it, for them.

Continue reading "THE COMMON MAN'S EXCHANGE" »

Posted by Kaustubh Sathe at 6:52 AM | Permalink | Comments (0) | TrackBacks (0)

Shopping for an insurance plan is a tedious job. And when you are an individual and have bought insurance plan, then re-shopping for coverage benefits after experiencing life event is laborious.

Life events or qualifying life events (QLE) are the events which after experiencing, an individual has to change the coverage as the eligibility changes. These events include Marriage, Pregnancy, childbirth and adoption, when your child is no longer dependent, Death, Legal separation and divorce, Death of a dependent or change in the number of tax dependents or Change in employment status (for employee, spouse, or employee's dependent).

Continue reading "Re-shopping in Health Benefit Exchange" »

Posted by Dr. Poonam Upadhyay at 1:38 PM | Permalink | Comments (0) | TrackBacks (0)

The Health Care Reform was launched with the idea of transforming the healthcare scenario in the entire United States, but how far will it actually serve the main purpose is the doubt I have in mind.

The main agenda of the much talked about Health Reform legislation is being able to make healthcare affordable for all the citizens of US as the act typically says "Affordable Care Act". But in the struggle for fulfilling the Reform's motive of care for all the policy makers are making provisions that in a way  contradict each other. The irony is that PPACA's act 1331 talks about establishing Basic Health Program, the implementation of which might lead to be a threat to the its own state established exchanges. BHP and Exchange can cut lines for each other. The ultimate decision with the BHP still awaits but it has the potential of affecting the successful running of Health Benefit Exchange, though both have their own pros and con's.

Continue reading "Basic Health Program vs. Health Benefit Exchange" »

Posted by Aarti Rau at 1:23 PM | Permalink | Comments (0) | TrackBacks (0)

It is quite amazing to see the reaction to the health insurance/benefit exchanges that have been mandated by the health reform bill, to be created and maintained by each state to manage its uninsured population. There were 7 states/coalitions that had received the early innovator grants, ranging from just above 6 million to MD, all the way in excess of 50 million to OK. Now that is some range of innovation, I must say. But I deviate. The point is that two of the top 3 grantees have since returned the grants, OK and KS. And by the looks of the conversations we have been hearing in the corridors of power, there may be others who are contemplating a similar response. On the other hand, the second round of grants provided additional funding to the smallest grantee MD, in excess of 20 million dollars.

Read the complete post at my blog space in Health Data Management.

The link below:

http://www.healthdatamanagement.com/blogs/health_care_technology_news-43121-1.html

Posted by Rajiv Sabharwal at 8:33 AM | Permalink | Comments (0) | TrackBacks (0)

How many times have you got lost looking for the right information in a web site? How many times did you go "phew, not another form!" or "Why are they asking all these questions over and over again?

Starting in 2014, the state health benefit exchanges are required to setup a new marketplace where insurance can be bought the 'Travelocity' style. The health benefit exchange for small employers, un/under insured population will have a platform to view comparable and obtain clear information on benefits and costs of insurance plans.

Continue reading "Health Insurance Exchanges - Get your site right" »

Posted by Aishwarya Srikanth at 8:01 AM | Permalink | Comments (0) | TrackBacks (0)

Lately, I have been reading a lot and of course, simultaneously thinking a lot, about the whole business of HIX. The more I think about it the more I start believing that the HIX and subsequently the move towards the individual market could be the ultimate catalyst to bring that major change in US healthcare industry that everybody is looking for. But it could simply be wishful, a bit misty, thinking on part of an increasingly frustrated middle-aged healthcare industry professional. I guess I included half of the healthcare industry professionals out there, along with myself. Anyways, I am going to throw out a bit of what I have been thinking over the next few blogs and would love to hear back from you guys if it makes sense or is just a day-dream.

Read the entire article in Health Data Management Blog :

Insurance Exchanges: Why Do States Have To Pay For Them?

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The HHS has defined what, at a minimum, the HBEs will offer in terms of benefits provided to the members. They have also hinted upon a basic set of functionality that will be offered. But does anybody actually believe that exchanges will stick to only the prescribed structure. And here I am not even talking about later generations of the exchanges. I am talking about the very first set of exchanges that will hit the market.

Continue reading "Health Benefit Exchange (HBE) - The different generations" »

Posted by Rajiv Sabharwal at 9:52 AM | Permalink | Comments (0) | TrackBacks (0)

Health benefit exchanges will take different designs from state to state. The requirements in each state will be different from the requirements in other. It is extremely important that each state studies its population and their healthcare needs before deciding which way to go. Take the case of the existing exchanges in Utah and Massachussetts. The Utah model is an open model which is open to all insurers and encourages unfettered competition and choices, whereas the MA model is more controlled and focuses on leveraging purchasing power and emphasising managed competion. Utah realised that their exchange needs to focus on small businesses instead of the individual customer and that is exactly what they did. Massachussetts as all of us know did the exact opposite by focusing on individuals as that is what they needed in that state. For the other states, probably both these models will not work and they might want to go for a hybrid model which suits them. Or like connecticut, try out a private exchange. Most of the staes except MN and Alaska have asked for federal funding to setup exchanges. With the density of population in Alaska, the exchange might not be financially viable.

Continue reading "My thoughts on the Health Benefit Exchange..." »

Posted by Shinju Damodaran at 11:10 AM | Permalink | Comments (1) | TrackBacks (0)

Health Benefit Exchanges (HBE) or simply individual market - what to focus on? I believe this is the most talked about topic these days. I had very recently attended the AHIP Exchange Conference (NOv 8-10, 2010,Chicago), and somebody mentioned that the volume of the state-sponsored Health Benefit Exchanges is still unknown. But what everyone is sure of - is the fact that quite a significant portion of American population will be either purchasing healthcare insurance from HBEs or through some kind of a similar off-exchange model, by 2016.

Continue reading "Health Benefit Exchange Vs Individual Market" »

Posted by Rajiv Sabharwal at 5:40 AM | Permalink | Comments (0) | TrackBacks (0)