Revenue Cycle and Payer News 8-16-2017

In the News…

Cigna Reports Strong Second Quarter 2017 Results, Raises Outlook
Cigna Corporation (@Cigna) reported second quarter 2017 results with strong performance across the company’s Global Health Care, Global Supplemental Benefits and Group Disability & Life segments. Total revenues in the quarter were $10.3 billion, an increase of 4% over second quarter 2016, driven by continued growth in Cigna’s targeted customer segments.

Leap Of Faith: Will Health Care Ministries Cover Your Costs?
Martin Estacio was shelling out $800 per month for a health plan that didn’t fit his two-state lifestyle. So Estacio dropped his plan this month and took a leap of faith. He joined Christian Healthcare Ministries (CHM), an alternative to health insurance that offers a religious approach to covering medical bills. Health care ministries such as CHM are essentially cost-sharing programs. Members’ monthly fees are applied directly to other members’ medical bills, no matter where they live in the U.S. Members also pray for each other, and often send notes of support and encouragement.

An Early Look at 2018 Premium Changes and Insurer Participation on ACA Exchanges
According to a recently released Kaiser Family Foundation report, insurers in this market face new uncertainty in the current political environment and in some cases have factored this into their premium increases for the coming year. Specifically, insurers have been unsure whether the individual mandate (which brings down premiums by compelling healthy people to buy coverage) will be repealed by Congress or to what degree it will be enforced by the Trump Administration. Additionally, insurers in this market do not know whether the Trump Administration will continue to make payments to compensate insurers for cost-sharing reductions (CSRs), which are the subject of a lawsuit, or whether Congress will appropriate these funds.

Here’s how much more your health insurance will cost next year
People who get health insurance through their jobs won’t see rate hikes in the double digits like those on the Obamacare exchanges, but they’ll still see the cost of health care go up. Large employers estimate that the employee share of health insurance costs next year will be $4,400, up from $4,200 this year, according to a new report from the National Business Group on Health.

MGMA Releases 2017 Regulatory Burden Survey: Medicare’s New MIPS Program Tops List
The results of the Medical Group Management Association (@mgma) 2017 Regulatory Burden Survey reveal there are no shortage of opportunities to reduce regulatory burdens on physician practices. At a time when medical groups are transforming the way they do business to improve the coordination of patient care and enhance operational efficiency, nearly half report spending more than $40,000 per FTE physician, per year, to comply with federal regulations.

Bankrupt ER operator Adeptus, based in D-FW, plans patient refunds to avoid ‘bad publicity’
A North Texas bankruptcy court has given the OK for the nation’s largest operator of freestanding emergency rooms to refund up to $250,000 to an undisclosed number of patients. Judge Stacey G.C. Jernigan this week authorized Adeptus to refund patients owed money before the bankruptcy. The company had asked for permission to refund eligible patients to avoid “bad publicity.”

First Settlement with an EHR Company Sends Important Message
The Department of Health and Human Services’ Office of the Inspector General (@OIGatHHS) recently released the following video addressing the settlement of eClinical Works (@eClinicalWorks) alleged violations of The False Claims Act. In the video HHS OIG Senior Counsel John O’Brien says that, “eClinicalWorks was causing healthcare providers who use its software to submit false claims to what is called the Medicare and Medicaid EHR Incentive Program, and it was doing this because its software actually didn’t meet the criteria required for a software to be certified in this program.”

In the Aftermath
In a Commonwealth Fund opinion piece, David Blumenthal and Sara Collins offer three key proposals they believe Congress should consider in order to ensure “a fair and sustainable approach to covering the uninsured and constraining our extraordinary health care costs to stabilize the health care market and gain forward traction.”

Snapshot on Stocks

In this roller coaster ride of just what will happen when it comes to health care these days, how are the health insurance stocks doing? We are not picking, just reporting.

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