News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Anthem and Aurora Healthcare Create Joint Venture; Trends for Health Systems Entering Insurance Markets Continue to Grow

As health systems accept increased risk under healthcare reform, partnerships and provider insurance plans may also lead to greater rewards for hospitals and doctors

Even as pathologists, clinical laboratories, and other medical service providers adapt to value-based care initiatives and bundled payment plans, health systems are looking for ways to optimize both quality of care and treatment costs. In some cases this is the reason behind new joint ventures between provider and payer organizations.

Once such joint venture involves Anthem Blue Cross and Blue Shield and Aurora Healthcare. It was announced in an April press release.

The two partners created a newly licensed insurer called the Wisconsin Collaborative Insurance Company (WCIC). With both Anthem and Aurora Healthcare investing $5-million in the new insurance company, they will split equally any profits and losses derived from their new commercial health plan—Well Priority.

The plan includes services with 15 Aurora Healthcare hospitals as well as choice providers throughout the state. The first commercial plan will be available to fully insured and self-insured employers, with service starting January 1, 2017. (more…)

How the ACA and Medicaid Expansion Are Affecting Patient Bad Debt at Hospitals, Pathology Groups, and Clinical Laboratories

The amount of patient debt healthcare providers face depends on multiple, complex factors, including whether they engaged in Medicaid Expansion

Often the challenges facing hospitals and medical pathology laboratories are similar. So it is with patient debt. Blame that on two trends. One is the increase in the number of patients with high-deductible health plans. The other is the increase in the number of people enrolled via the Affordable Care Act (ACA) health insurance exchanges with similar high-deductible health plans.

These two factors are contributing to increased levels of bad debt that confront the nation’s hospitals, clinical laboratories, and anatomic pathology groups. However, in some states where Medicaid programs have been expanded, hospitals have reported declines in the level of patient bad debt.

When President Obama signed the Affordable Care Act into law in 2010, many people thought that fewer uninsured people would mean less bad debt for hospitals. Now, six years later, the reality is not so clear-cut.

Hospitals, clinical laboratories, and other entities within the healthcare system are seeing different levels of bad debt depending on what part of the country they are in, what kinds of policies they have enacted, and probably most importantly, whether or not the state in which they are located has expanded Medicaid(more…)

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