Day: January 10, 2023

Texas Legislature To Consider Shared Savings Strategy for Managed Care Plans

88(R) SB 358 – Introduced Version – Bill Text

  Sec. 1276.054.  SHARED SAVINGS PAYMENT. (a) Except as 
 provided by Subsection (b), if an enrollee who requests a
 disclosure under Section 1276.052 elects and receives a health care
 service or supply the actual cost of which is less than the amount
 disclosed under Section 1276.052, the health benefit plan issuer or
 administrator shall pay to the enrollee 50 percent of the
 difference between the amount disclosed under Section 1276.052 and
 the actual cost, minus any applicable deductible, copayment, or
 coinsurance.

Texas Considers Risk Pool Funded By Federal Tax Dollars

Sec. 1511.0052.  PURPOSE OF POOL. The purpose of the pool is
 to provide a reinsurance mechanism to:
              (1)  meaningfully reduce health benefit plan premiums
 in the individual market by mitigating the impact of high-risk
 individuals on rates;
              (2)  maximize available federal money to assist
 residents of this state to obtain guaranteed issue health benefit
 coverage without increasing the federal deficit; and
              (3)  increase enrollment in guaranteed issue,
 individual market health benefit plans that provide benefits and
 coverage and cost-sharing protections against out-of-pocket costs
 comparable to and as comprehensive as health benefit plans that
 would be available without the pool.
Continue reading Texas Considers Risk Pool Funded By Federal Tax Dollars

NEW BCBS MASSACHUSETTS HEALTHCARE MODEL: If You’re (Pick a color, gender, sexual preference) You Get Priority Over One Who Is (Pick a color, gender, sexual preference)

BCBS of Massachusetts announces first-in-state value-based contracts with incentives tied to equity

The plan says the move is the first in the state and among the first in the nation to create a financial payment model rewarding providers for eliminating racial and ethnic inequities in care. 

Continue reading NEW BCBS MASSACHUSETTS HEALTHCARE MODEL: If You’re (Pick a color, gender, sexual preference) You Get Priority Over One Who Is (Pick a color, gender, sexual preference)