Posts filed under ‘Insurance Design’

ACA to Greatly Benefit those with Pre-existing Conditions

Under the Affordable Care Act, those with pre-existing medical conditions cannot be denied health insurance, nor experience higher premiums just because of their conditions. This is likely to cause an increase in market size for healthcare device and therapy manufactures who target patients with pre-existing conditions.

Continue Reading July 2, 2013 at 10:07 AM 2 comments

Your Customers are Living in the Wrong State!

The number of health insurance plans to be offered in the new online health insurance exchange will widely vary from state to state. This can negatively impact drug and device manufacturers if their customers live in states that don’t offer a large number of plans. Read on to learn why.

Continue Reading June 20, 2013 at 9:53 AM 2 comments

Do You Know Which Type of Health Insurance Exchange Your State Will Have?

With the new Health Insurance Exchange to go into effect in a few months, each state has decided which type of exchange they will use. Depending on the method chosen, there can be a significant difference in the requirements of each state’s exchange.

Continue Reading May 30, 2013 at 2:25 PM 1 comment

Specialty Pharmaceuticals: Reimbursement Moves Toward ASP

In a survey we recently conducted, we discovered some significant trends regarding the use of specialty pharmaceuticals. One of these trends includes a shift towards ASP-based reimbursement for specialty pharmaceuticals.

Continue Reading July 23, 2012 at 2:55 PM Leave a comment

Romney’s Approach to U.S. Health Reform

Mitt Romney has continuously received criticism on his position related to healthcare reform. Many believe the plan he instituted as governor of Massachusetts is similar to ObamaCare and others say his ideas on national health reform are more “revolutionary” than President Obama’s. Recently, Romney has released some of the main points of his plans should he be elected into office. These include block grants for Medicaid and other payments to states, the privatization of Medicare, and the promotion of free markets and competition within the health insurance industry.

An article in the LA Times discusses what some experts believe could result from these changes. Some argue that Romney’s plan would incentivize employers to stop providing coverage to their employees, resulting in an increase in the number of uninsured Americans. Conservative experts state the plan will bring benefits of competition to healthcare and would give consumers more power to choose their plans for themselves. Also, although Romney has said that President Obama’s legislation is a “budget-busting entitlement” as referred to in a Huffington Post article, some say his current ideas could similarly swell the federal deficit. Finally, some have stated Romney’s plan for national healthcare reform is contradictory to what he instituted in Massachusetts.

Regardless of whether you support RomneyCare or ObamaCare, it is clear that the healthcare industry will need to prepare for some serious adjustments resulting from governmental action. The continuing news about rising costs and questions over the sustainability of government programs like Medicare and Medicaid, and legislative reform is evidence of this. It is highly unlikely that anyone will devise a plan that pleases everyone when it comes to healthcare, but it will be interesting to see how this year’s election unfolds and what changes in regards to health reform will actually be instituted.


Author: Jamie Notaro

Editor: Ken Chiang


May 11, 2012 at 10:45 AM Leave a comment

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