Expert Voices Essay – NIHCM Foundation
By Ann Miller RN MHA
The PP-ACA has introduced sweeping market changes that bring new uncertainty to the task of developing premiums for products to be offered in the health insurance exchanges beginning in 2014. The added complexity greatly increases the chances that these premiums will be off the mark.
In this essay, Alice Rosenblatt explains how actuaries set premiums, shows how key provisions of the ACA will affect their pricing for the October 2013 open enrollment period and describes what’s at stake if they don’t get it right.
Conclusion
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Filed under: Experts Invited, Health Insurance, Information Technology | Tagged: ACA, Alice F. Rosenblatt, Health Insurance Exchanges, HIE's |















Higher Hurdle to Deduct Medical Care is Near
http://online.wsj.com/article/SB10001424127887324851704578131394051135884.html
Rajesh
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Docs complain of lower pay by exchange plans
Did you know that some insurance companies have have reduced payment rates in some plans to keep premiums affordable.
http://www.medicalpracticeinsider.com/news/doctors-complain-they-will-be-paid-less-exchange-plans?email=MARCINKOADVISORS@MSN.COM&GroupID=90115
Apparently, physicians will make up for lower pay by seeing more patients, since the plans tend to have smaller networks of doctors!
Reasonable or not?
Ann Miller RN MHA
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Age Distribution of Health-Exchange Enrollees Compared to Age Distribution of Uninsured
Uninsured Population in 2012 Healthcare.gov Enrollees Through December 28th, 2013
<< 18 12% 6%
18-24 16% 9%
25-34 25% 15%
35-44 19% 15%
45-54 17% 22%
55-64 11% 33%
Source: The Wall Street Journal, Health Sign-Ups Skew Older, Raising Fears of Higher Costs, January 14, 2014
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