The Affordable Care Act (ACA) continues shaping the employer-sponsored medical plan landscape, through mandated coverage, the emergence of new options in both public and private exchanges, and the pending Cadillac tax in 2018.
While the government-sponsored health insurance marketplace continues to build enrollment despite the myriad early
technical challenges, private exchanges are redefining the relationship between payers, employers and a new secondary
market – the employee as benefits consumer.
Annual report about mid to large-sized organizations current and future compliance communication plans, processes, with a focus on Summary Plan Descriptions and the Summary of Benefits & Coverage.
Medicare Advantage is one of the fastest growing public sector programs in the country, presenting an opportunity for commercial payers. But with opportunity comes challenges, like meeting compliance requirements and securing a four-star rating. In this white paper, Leavitt Partners and HighRoads articulate why payers need to execute on a sound product and plan data management strategy to build or expand their Medicare Advantage business.
Centralized Product and Plan Management: A Health Care Payer’s Foundation for Success under Health Care Reform
The health insurance industry is experiencing a period of disruptive change driven by the consumerism of health care
and increasing momentum behind Health Care Reform (HCR). Health care payers face intense pressure to implement the
provisions of the Affordable Care Act (ACA) and must meet aggressive timelines to address reform mandates through 2014.
Payers are facing a litany of new challenges in other ACA requirements, including generation operationalization of new systems and data elements required for rate and form filings. Further, a future expansion of both products in the individual, small-group and self-insured markets as well as further revenue diversification by line of business will necessitate an end-to-end solution for payers.