Daily Insurance Report    Walt Bernard Podgurski
Daily Insurance Report  
Walt Bernard Podgurski,  Editor,  440-773-1108, 

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Editorial Mission Statement: The goal of this publication is to provide readers a broad selection of what is being written about the insurance industry and related issues. Some articles may have a “tilt” towards a particular perspective one way or another. Inclusion in this newsletter is not an endorsement of any views or content; but report the various and differing views appearing in media.
  Daily Insurance ReportThursday, 08/16/18

How to help clients create association health plans
By Alex Tolbert
New rules from President Trump and the Department of Labor expand the scope of association health plans, thereby creating a key opportunity for brokers to help clients who may benefit from the updated regulations.
The new rule expands who can participate in AHPs. This will allow more people to benefit from economies of scale in health insurance. Groups in the same metropolitan area no longer have to have a common business interest in order to form an association, and self-employed individuals will now also be able to participate in AHPs.
Offering coverage through an AHP can produce significant cost savings for your clients or prospects, but the group or sole proprietor will first have to join or form an association. It’s important that your groups get the regulatory and compliance aspects of AHPs right, which is why some of your current or prospective clients may already be asking you for advice on this.
To support these clients, partnering with an attorney will provide much-needed assistance.
Vetting a labor or ERISA attorney will allow you to provide another layer of support to clients interested in AHPs, but it will require some research. You will likely want to first interview at least two or three attorneys in your market, and ultimately form an alliance with one to assist clients who wish to create associations and ensure compliance.
Here’s how some brokerages are thinking about going about this, and a few steps to consider.

Amazon, Alphabet, Microsoft and other tech giants want to fix one of the most broken things about health care
It's difficult for patients to share medical records, especially between hospitals.
Despite years of efforts to make it easier, there are strong economic incentives that keep health tech incumbents and care providers from fixing the problem.
On Monday, a bunch of traditional tech giants, including Alphabet, Amazon, IBM, Microsoft, and Salesforce, proposed a common set of standards and pledged to make products that support them.
Christina Farr / CNBC.com
On Monday, Alphabet, Amazon, IBM, Microsoft and Salesforce spoke out at an event in Washington D.C. called the Blue Button 2.0 Developer conference. These companies are rivals in some important ways, so it's a strong signal that they came together on this issue.
Here's the joint statement:
We are jointly committed to removing barriers for the adoption of technologies for healthcare interoperability, particularly those that are enabled through the cloud and AI. We share the common quest to unlock the potential in healthcare data, to deliver better outcomes at lower costs.
To address the problem, these tech companies are proposing to build tools for the health community around a set of common standards for exchanging health information electronically, called "FHIR."

Digital Health: Who's Really Gaining Traction?
Ben Brown, HCIT Leader | Value Creator | M&A Advisor | Mentor
Who are healthcare organizations betting on in today's healthcare environment for digital health solutions? With tens of billions invested in new and evolving digital health technologies, payers and providers are searching for solutions that improve patient care, cut costs, add value, assist clinicians and deliver tangible outcomes. Our KLAS team reached out and asked 200 providers and payers what innovations, technologies and companies had recently caught their attention. While not all had an answer we uncovered some exciting and innovative companies.
So which companies were healthcare organizations most excited to tell us about? healthfinch, Augmedix, AgileMD, CrossChx, Phreesia, Simplee and Zebra Medical are growing digital health companies that bubbled up to the top and most often mentioned.
A few trends were extremely clear. Healthcare organizations are actively looking for patient engagement tools that will improve the patient experience. There are still many providers looking for population health systems. Doctors and nurses need better technology to enhance the clinician experience. Artificial intelligence, BI and machine learning are more than just buzzwords. Both payers and providers are investigating how AI can make a difference.

How You Can Redefine Your Practice to Succeed in the Value-based Ecosystem
Sachin Saxena, Manager Marketing at Innovaccer - World's fastest growing Health Tech Company.
The value-based reimbursement model is fundamentally changing healthcare and we can observe a different dynamic in physician-patient relationship. There is now increased focus on enhancing collaborations to culminate the entire care process into a better experience.
In light of these goals, the need and opportunity for value-based care has probably never been greater than it is right now. In January 2015, the Department of Health and Human Services (HHS) announced its intentions to link 50% of all traditional Medicare payments to a value-based reimbursement model by the end of 2018.
Every organization has its own unique set of challenges as well as opportunities. Recognizing the right opportunities that can result in favorable outcomes for the organization is the first step in realizing the potential of savings. The challenge is to be realistic about what impact value-based activities can create and what is targeted.
Most organizations might have the resources to succeed in value-based care, but perhaps not the right strategic road map.
Value-based journey is a step-by-step process, one cannot hope for higher savings without getting the preliminary steps right. It’s like working on a high-rise building project, you need to have a strong foundation for it.
1) Opportunity Identification
Target the lowest hanging fruits first, and then aim for the tougher ones.
The most effective method to attract better financial and clinical outcomes is to strategically approach them. Before you start working towards a value-based transformation, find the direction to start with. Locate the areas where most opportunities lie for your organization to have a substantial impact on quality of care and savings.

Key Obamacare lawsuit to be argued just ahead of midterm elections
by Kimberly Leonard / Washington Examiner
The Trump administration will be asking a federal court to strike down key Obamacare regulations protecting patients with pre-existing illnesses just two months before the midterm elections.
A judge has set the oral argument for Sept. 10 for the case, filed in the U.S. District Court for the Northern District of Texas. The date is also roughly six weeks before Obamacare’s Nov. 1 open enrollment, during which certain customers can sign up for coverage that is subsidized by the federal government while others are expected to learn they will be facing stiff premium hikes.
Democrats have made the Obamacare lawsuit a centerpiece of their attacks against Republicans and President Trump. They argue that the party is intent on "sabotaging" Obamacare, including the more popular parts of the law.

White House Will Ask Judge to Scrap Obamacare’s Protections This September
By Eric Levitz / Daily Intelligencer
It isn’t hard to see why Democrats have chosen to put health care at the center of both their midterm campaign and opposition to Kavanugh’s confirmation. The GOP’s proposed Obamacare replacement, the American Health Care Act, ended up being the most unpopular piece of major legislation in our nation’s modern history. Shortly after the bill’s introduction last spring, the Democratic Party opened a double-digit lead in polls of the 2018 generic ballot, while President Trump’s job approval rating dipped. Subsequent surveys showed the public favoring the Democrats over the Republicans on health-care policy by wide margins.
Thus, it is difficult to understand why the Trump administration decided to revive its crusade against Obamacare or, more precisely, against the law’s single most popular provision — its protections for people with preexisting conditions — this summer.

Anthem to offer health insurance in 42 more Virginia markets
By The Associated Press
A health insurance carrier is re-entering the markets of 42 Virginia localities next year.
The Richmond Times-Dispatch reports roughly 70 percent of Virginia’s 132 cities and counties have only one carrier, and the re-entry by Anthem Healthkeepers will decrease the amount to 45 percent. All but seven of the localities Anthem is returning to have one carrier.

The Health 202: Health-care competition in Charlottesville a dramatic example of Obamacare's resilience
By Colby Itkowitz / The Washington Post
Residents in the small university town who didn't qualify for government subsidies paid monthly premiums that were two to even three times higher than they had the year before. Insurers had pulled out of the area ahead of 2018, as was true in markets all over the country. After some cajoling from the state, Optima agreed to cover Charlottesville and its surrounding county, but with no competition priced its plans exorbitantly.
Consumers were furious and formed a 700-person-strong alliance. Since fall 2017 they've been relentless in their pursuit of more affordable care, hiring lawyers and educating themselves on the intricacies of health law.
Then Friday they received some welcome news: Anthem, which had left the market last year, was re-entering the individual market for 2019 at significantly lower rates than Optima.
Even as President Trump claims the ACA is dead, it actually seems to be bouncing back after years of uncertainty -- and Charlottesville is one of the most dramatic examples of the law’s resilience.

Alphabet Invests $375 Million in Healthcare Startup Oscar
Alphabet Inc., Google’s expansive parent company, is investing $375 million in the 6-year-old healthcare startup Oscar Health.
Co-founded by CEO Mario Schlosser and Josh Kushner (brother of Jared Kushner, the son-in-law and a top adviser to President Donald Trump), Oscar was valued at $3.2 billion before this latest investment, Bloomberg reports.
At Oscar’s start, Alphabet invested through its venture capital fund Capital G and its health sciences company, Verily. With Tuesday’s additional investment, the startup has more funding to expand and update infrastructure as they focus on the release of a new product, Medicare Advantage, in 2020. Salar Kamangar, the former CEO of YouTube, will also be joining Oscar’s board with this investment.

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