Opinion Based List:

10 Strategic Considerations of SCOTUS upholding PPACA

Submitted by PayerFusion on Tue, 07/31/2012 - 15:59

  1. Adverse selection may still be a challenge.
  2. Medicaid expansion just became a far more complex and variable proposition.
  3. Employers grapple with new options and plan requirements.
  4. What is the effect on early retirees?
  5. Rate review scrutiny and no risk selection: Something’s got to give.
  6. Which states will get on the exchange bandwagon?
  7. Minimum loss ratios (MLR) pose an ongoing challenge for insurers.
  8. Risk adjustment is essential.
  9. Will cost shifting hold steady, increase or decrease?
  10. The cost problem persists. What can be done about it?

Notes: PayerFusion features Milliman's 10 Strategic Considerations. The Supreme Court ruling to uphold the PPACA will have major implications for healthcare stakeholders. Strategic considerations outlined in a report by Milliman are featured below. Concerns for those in the healthcare industry include adverse selection, strength of the individual mandate, new complexity surrounding Medicaid expansion and changes to employer-sponsored insurance. "Since 2009, Milliman has worked with its clients to prepare for and implement the healthcare reform law," said Clark Slipher, Milliman Health Practice Director. "With the law's constitutionality bound up in court, it's been an uncertain time for our clients, which include insurers, employers, providers, and state and Federal governments. This ruling clarifies the road ahead for American healthcare, and while it is reassuring to know where we are going, healthcare stakeholders face many strategic challenges that will require innovation and sound financial planning in the years ahead."

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  1. PayerFusion on Tue, 07/31/2012 - 16:00

    While PPACA being upheld makes bounding steps in the direction of beginning to solve problems in our healthcare system, there are several areas of concern that remain. Questions on how states’ decision to participate in the Medicaid expansion will affect employers to concerns about the cost of healthcare still linger unanswered. For more detailed information on these strategic considerations, visit insight.milliman.com/article.php?cntid=8113.