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Insights & Analysis

There’s one constant in healthcare: change. Count on us to break down the trends so you can stay up to date. Follow our take on each piece of this deep, intertwined, and often perplexing industry to find opportunities and practical approaches to move healthcare forward.

CMS Codifies Enrollment Deadline Delay

On Dec. 12, CMS released an interim final rule (IFR) codifying recently announced changes that permit consumers to enroll in health insurance coverage through an exchange as late as Dec. 23 for coverage effective Jan. 1, 2014.

CMS and ONC Propose One-Year Meaningful Use Extension

On Dec. 6, CMS and the Office for the National Coordinator for Health Information Technology (ONC) proposed a one-year extension for Stage 2 of Meaningful Use for eligible providers who began attesting in 2011 or 2012.

Analysis: Dec. 23 Exchange Coverage Deadline Crucial For High-Need Enrollees

An analysis by Avalere Health addresses key issues faced by various high-need groups that must enroll in exchanges by Dec. 23 to secure coverage by Jan. 1, 2014, including those facing individual market cancellations, individuals in high-risk pools, some Medicaid beneficiaries and uninsured HIV/AIDS patients.

Analysis: Despite Subsidies, Chronically Ill Individuals Will Be Underinsured In Exchanges

NEWS RELEASE: An analysis from Avalere Health finds that most individuals in exchanges who reach their maximum out-of-pocket (OOP) cap will be underinsured, despite reduced OOP caps for those below 250 percent of poverty. The Commonwealth Fund[1] defines underinsurance as OOP costs[2] greater than 10 percent of income for those earning more than twice the poverty level and OOP costs greater than 5 percent of income for those earning less than twice the poverty level.

Notice of Benefit and Payment Parameters 2015 Proposed Rule

On Nov. 25, HHS released the Proposed Notice of Benefit and Payment Parameters for 2015 that provides technical details and policy parameters related to the advance payments of the premium tax credits (APTC), cost-sharing reductions (CSRs) and premium stabilization programs.

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