Aetna, UC Clash Over Contract Terms
Why it may disrupt care for thousands of patients
UC Davis Health alerted roughly 6,900 of its patients on Friday that they will likely have to pay substantially higher fees to see its physicians starting April 22 because it has not negotiated a new contract with health insurance giant Aetna. This bargaining stalemate will affect not only UC Davis Health but also UC San Francisco, UC Los Angeles and all other University of California health systems, meaning tens of thousand of Aetna members will be affected around California.
MEDICARE
Sponsored by AGA
Medicare go-broke date pushed back to 2031
The date Medicare’s hospital trust fund is expected to run dry has been extended by three years, but stakeholders continue to urge action from Washington to address Medicare’s long-term solvency
The go-broke date for a pivotal trust fund that props up Medicare has been pushed back three years, giving additional wiggle room for Washington to address looming insolvency for a program that currently covers 65 million senior and disabled Americans.
CMS proposes nearly 3% bump to inpatient pay in fiscal 2024 and installs equity requirements
The Biden administration is proposing a 2.8% bump to inpatient payments to eligible hospitals in the next fiscal year, a $3.3 billion boost for facilities.
The Centers for Medicare & Medicaid Services (CMS) released the proposed Inpatient Prospective Payment Systems (IPPS) rule and the Long-Term Care Hospital pay rule. In addition to changes to payment rates, the agency is proposing to measure hospitals on how they tackle health equity.
New Final Medicare Marketing Rules Curb Event-Based Marketing
New Medicare plan marketing rules could lead to big changes for Medicare plan marketers that have used educational events to generate leads.
The rules could also impose new advertising and disclosure requirements on Medicare plan marketers — and give agents who serve clients who walk in off the street a new edge over agents who set appoints with prospects in advance.
The Centers for Medicare and Medicaid Services, the agency that oversees Medicare, include the regulations in a new final rule for Medicare program operations for the 2024 coverage year released Wednesday.
GROUP BENEFITS
Sponsored by Word&Brown
ERBI FINDS ONGOING EMPLOYER SUPPORT FOR EMPLOYEE BENEFITS
A recent study by the Employee Benefits Research Institute (ERBI) found continuing enthusiasm among employers concerning sponsorship of worker health insurance. According to the ERBI, contrary to predictions envisioning an offload of health benefits, employers do not want to give up control. They view themselves as “paternalistic” and health benefits as advantageous for recruitment and retention.
The Big Squeeze: More Enrollees and Smaller Networks Plague Some ACA Plans
The Affordable Care Act may be struggling with its own success.
Record enrollment over the last two years brought more consumers into the market. At the same time, many insurers began offering smaller networks of doctors and hospitals, partly to be price-competitive.
That combination left some patients scrambling to find an available in-network physician or medical facility. That can be a challenge, especially when enrollees must rely on inaccurate provider lists from their insurance company.
Small, mid-sized businesses offer employee benefits at record levels
Even in the face of a possible recession and continued market volatility, small and midsized businesses are providing employee benefits at record levels, according to a survey by Principal.
Business owners are offering benefits at the highest levels seen since 2008, said Nate Schelhaas, senior vice president for benefits and protection, and head of business owner segment at Principal. Health and wellness offerings have grown significantly, added Schelhaas. These include comprehensive health, health savings accounts (HSAs), employee-assistance programs (EAPs) and emotional/mental wellness programs.
EXIT PLANNING
Sponsored by Strazzeri/Mancini
Southern California Institute (SCI.)
2023 Thursday Insights
Every Thursday, the Institute presents training sessions for independent attorneys, CPAs, bankers, financial planners, investment advisors, and individuals working in the real estate and insurance industries.
Learn from independent CPAs, bankers, financial planners, insurance experts, real estate agents, and attorneys who conduct training courses every week. Attend this event to find out more about business succession planning.
Southern California Institute meeting (SCI.)
Weekly Thursday Insights Schedule and Registration:
www.SCInstitute.org/ThursdayInsights
For additional information call:
Shelley Lightfoot
Executive Director
Email: sl@scinstitute.org
858-200-1900
“Special Offer for California Broker Magazine Readers”
The SCI Academy is the digital extension of SCI’s Thought Leader Community providing resources, education, and advice via collaborative think tanks, events, programs, online content, and introductions.
As a Basic Member you will have special alerts and access to live events such as Thursday Insights, Community Insights, and select recordings. You will also enjoy discounts for select conferences, programs and products. Additionally, you will have access to Thought Leader Connections and Monday Practice Builders. For increased discounts and access to other areas of the system, we encourage you to explore Premium Membership. We look forward to helping you grow your practice. Thank you for being a member!
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COMMISSION COACH
Sponsored by Commission Solutions
Looking for a way to exit the business?
Find out what a fair payout is and how to transfer your clients to the right health insurance professional who will advocate for clients as you have for years.
INFOTECH
AgencyBloc Launches Quote+, an AgencyBloc Solution
AgencyBloc Launches Quote+ Group Quoting and Proposal Tool
Quote+ gives brokers one central place to compare all types of health insurance offerings.
AgencyBloc, the leading management platform for independent life and health insurance agencies, announced the launch of the new digital workflow tool for small group business, Quote+.
With Quote+, brokers can compare multiple types of health insurance offerings, including community rated, medically underwritten and ancillary, in one central place with more valuable tools to manage the various time-consuming processes involved in quoting, product comparison and proposal generation. Quote+ is the only solution on the market that allows brokers to easily access and compare medically underwritten products alongside community rated.
The debut of this new quote-to-close solution follows AgencyBloc’s recent acquisition of FormFire, a leading small group quoting tool, and aligns with AgencyBloc’s strategy and commitment to being the leading solution provider for life and health insurance agents.
For more information about Quote+ and other AgencyBloc solutions, visit www.agencybloc.com.
Majority of healthcare leaders struggle with inefficient data, report finds
An overwhelming 90% of healthcare leaders reported losing revenue due to inefficient data use, according to a new survey and report from healthcare data company Intelligent Medical Objects and market researcher PureSpectrum.
Of 300 surveyed healthcare leaders responsible for purchasing and implementing technology at provider organizations, 84% of respondents reported using more than 20 individual healthcare software vendors, contributing to data silos and “management nightmares,” according to the report.
FEATURED EVENT:
LAAHU’S ANNUAL SYMPOSIUM is one of the largest in the state. attracting well over 500 attendees.
Professionals working in the Southern California health insurance sector have access to the best networking and educational opportunities.
Come to connect with others and gain knowledge from renowned speakers.
REGISTRATION NOW OPEN :
LAAHU 2023 Annual Symposium –
April 25, 7am to 5pm PST
Pasadena Convention Center
Info: 800-676-1628
INDUSTRY CALENDAR
- April 18 @ 1:30-2:30 pm PST, CAHIP Medicare 101. Register
- April 13 @ 10 am PST, NABIP ACA and Beyond Certification Primer. Register.
NABIP offers ongoing virtual trainings. More info: www.nabip.org. - May 4 @ 6:00 pm – 8:00 pm, NAIFA Los Angeles, LET’S PLAY POOL! Billiards Night in Pasadena. Register
- May 16 @11 am-1:45pm CAHIP-OC Anti-Fraud CE Presentation Register
CONFERENCES
- April 21/23 @ 2:00-6:00 pm PST, Dancing With the CAHIP-SD Stars, Four Points by Sheraton San Diego. Register
- April 25 @ 7 am-5 pm PST, LAAHU 2023 Annual Symposium, Pasadena Convention Center. Info: 800-676-1628. Register
- May 8-10, CAHIP Capitol Summit, Sacramento. Register
- May 16 @ 8:00 am-3:00 pm PST, 32nd Annual IEAHU Sales Symposium E3: EARN; ELEVATE; EVOLVE. Register
- May 18 @ 7:30 am-2 pm PST, CAHIP Desert Cities Health Care Summit, Palm Valley Country Club Palm Desert, CA. Register
