The AMA recently released a special analyses of commercial health insurance markets that found the "combined impact of proposed mergers among four of the nation's largest health insurance companies would exceed federal antitrust guidelines designed to preserve competition in as many as 97 metropolitan areas within 17 states," and that "all told, the two mergers would diminish competition in up to 154 metropolitan areas within 23 states."

CMS this week released performance data for the Pioneer and Shared Savings Medicare ACO programs. Two healthsprocket lists just posted provide a summary of this information: 7 Things to Know about 2014 Pioneer ACO Performance and 6 Things to Know about 2014 MSSP ACO Performance.

This list – Seven Things to Know About Medicaid Going Forward, was recently posted in MCOLBlog, with nearly all items too lengthy to be presented in the standard HealthSprocket format, so we thought we’d share this snapshot with you of key Medicaid data that sets the stage for Medicaid going forward:

Vitals this week released survey results finding that "over 80 percent of doctors monitor their reviews and ratings." Vitals current survey also found that "75 percent of doctors check more than one online rating site. Nearly 12 percent of physicians said they check reviews at least once per week. Another 33 percent said they monitor reviews monthly, while 42 percent check a few times per year.

Much has been made of the recent milestone marking the fiftieth anniversary of the Medicare and Medicaid programs. In the political arena, and elsewhere, Medicare seems to get have received top billing in discussion of the two programs during the past fifty years.

But that may change going forward, even with aging baby boomers reaching their Medicare years. Going into 2016, Medicaid will be covering a record 71.6 million people with total spending coming close to $500 billion dollars. Enrollment has grown 22% from pre-ACA levels.

Speaking of Anthem and Cigna....

Fri, 07/24/2015 - 17:20

Lots is already being said about the latest mega health plan merger, with Anthem and Cigna tying the knot. Three lists on this topic have been posted in healthsprocket already, including the light=hearted New Names for Merged Health Plans Left on The Cutting Room Floor.

Earlier this month, the CMS Innovation Center (CMMI) announced a new proposed model to test bundled payments for a selected episode of care: lower extremity joint replacements or LEJR. A new healthsprocket list details the main points of the new model: 16 Things to Know About the New CMMI Comprehensive Care for Joint Replacement Model.

Mega Health Plans By the Numbers

Thu, 07/09/2015 - 16:11

Three new healthsprocket lists examine Mega Health Plan world. Two present the seven largest national plans with respect to revenues and medical membership (with UnitedHealth and Anthem finishing #1 and #2 respectively in both categories):
Mega Health Plans 1st Quarter 2015 Medical Membership in 1,000s (Pre-Merger)
Mega Health Plans 1st Quarter 2015 Revenues (Pre-Merger)

A Becker's Hospital Review list details major points on the Aetna-Humana merger:

What’s next in the land of public health insurance exchanges in this post King vs. Burwell world? Some recent healthsprocket lists attempt to tackle that very question. First, for context, you might want to check out Seven Numbers to Consider After The SCOTUS King v Burwell Decision, which takes us from 6.4 million (people with coverage at stake) down to 3 (SCOTUS dissenters.)