Big Health Plan Formularies Do Provide ‘Fair Access’ To Treatments: Study
An investigation into how some of the largest health plans' formularies provide access to 18 treatments for some serious diseases showed positive results, but did note that transparent coverage info was sometimes lacking. Meanwhile, this year's ACA enrollment, freshly open, has an easier sign-up.
Stat:
Analysis: Health Plan Formularies Lowered Barriers To Fair Access To Some Drugs
Most of the formularies run by some of the largest health plans in the U.S. generally provide “fair access” to 18 treatments for a handful of serious diseases, although transparent coverage information is often lacking for some medicines, a new analysis has found. (Silverman, 11/3)
More on open enrollment —
The Hill:
This Year’s Affordable Care Act Enrollment Is Different: What You Need To Know
Open enrollment for plans available through the Affordable Care Act (ACA) Marketplace has officially begun, and this year’s sign-up period will have some new factors that may make it easier for more people to sign up for coverage. Prospective customers now have until Jan. 15 to sign up for ACA insurance plans, though those who want coverage at the start of the calendar year should sign up by Dec. 15. Last year’s enrollment reached record numbers — 15.7 million — and this year’s is expected to exceed that rate. (Choi, 11/5)
Health News Florida:
Jacksonville Launches Program To Help The City's Uninsured Get Coverage
Jacksonville is launching an initiative aimed at helping uninsured people get coverage, just as the season to enroll in health plans opens. About 120,000 residents under age 65 don’t have affordable private health care, the city said Thursday in launching “Get Covered Jax.” The program will help residents navigate the Florida Health Insurance Marketplace at Healthcare.gov to find affordable or even no-cost options, Mayor Donna Deegan said in announcing the plan. (Scanlan, 11/3)
Fierce Healthcare:
Independence Blue Cross Unveils Three New Health Plans For Small Businesses
Among a rush of new changes in 2024, Independence Blue Cross is introducing new health plans, increased access to virtual care and in-network dental plans. The company said its plans meet the needs of small businesses and are compliant with the Affordable Care Act. (Tong, 11/3)
St. Louis Post-Dispatch:
What Patients Need To Know About BJC's Deal With Aetna
BJC HealthCare has reached a much-anticipated agreement for a new Affordable Care Act insurance plan under Aetna, beginning Jan. 1. The deal will come as a relief to BJC patients who are signing up for ACA plans as the federal open enrollment period kicks off this week. The previous carrier of individual marketplace plans covering BJC — Cigna, which offered them under the brand “Cigna Connect” — is exiting Missouri’s ACA marketplace in 2024. (Merrilees, 11/3)
The Wall Street Journal:
Should You Buy Disability Insurance Through Work?
Don’t let the complexity of disability insurance keep you from buying it. Disability insurance involves confusing paperwork and more than a little bit of math. It is designed to soften the financial fallout for employees who can’t work for some time as a result of illness, injury or another qualifying condition. For a regular fee, you get income back for a predetermined amount of time. But understanding how it works is only part of the equation. You also have to understand the cost. (Carpenter, 11/5)
In other health care industry news —
CBS News:
Cook County Health Warns Of Data Breach For 1.2 Million Patients
More than 1 million patients of the Cook County hospital system could have had their personal information exposed in a data breach earlier this year. Cook County Health said Perry Johnson & Associates (PJ&A), which once provided medical transportation services for its hospitals and clinics, informed the county of a data breach in July. PJ&A said an unauthorized individual accessed systems where patient data was stored in April, and personal information of Cook County Health patients might have been affected, according to the county. (Feurer, 11/3)
Fierce Healthcare:
Walmart Health Partners With Health System, Insurer In Florida
Walmart Health is making a move to better coordinate patient care between its health centers in Florida and a major health system. The retail giant announced a partnership with Orlando Health, a private, not-for-profit network of community and specialty hospitals across Florida, that will initially focus on improving referral management, care coordination and patient engagement. (Landi, 11/3)
Minnesota Public Radio:
Fairview Health Services Announces Plans To Cut 250 Jobs
Minneapolis-based Fairview Health Services says it’s cutting 250 jobs across its hospitals and clinics. Fairview says the jobs will be cut before the end of the year, and most of the affected jobs are not full-time positions. In a statement, the organization says health care is facing “tremendous pressures,” including increased labor costs and reimbursement rates that it says are not keeping up with inflation. (Cox, 11/3)
KFF Health News:
Nursing Homes Say They Can’t Afford Higher Staffing. But Their Finances Are Often Opaque.
Perhaps the biggest mystery, as the Biden administration moves to force nursing homes to boost staffing, is this: how much extra money do the nation’s 15,000 homes actually have to hire and retain more nurses and aides? Public comments are due Monday on the most sweeping regulatory changes to hit the industry in decades. The proposal has provoked a fierce lobbying battle between nursing homes and patient advocates, with more than 22,000 comments filed already to the Centers for Medicare and Medicaid Services. (Rau, 11/3)
