Health Care Delivery

A coverage gap in the Affordable Care Act (ACA) means that many children will not be eligible for dental coverage, which was mandated as one of the 10 essential health benefits for adequate health insurance.

Hospitals and medical practices across the United States are bracing for confusion and administrative hassles as new insurance plans under President Barack Obama's healthcare law take effect.

Over two million people have enrolled in health insurance plans through the federally run HealthCare.gov and state healthcare enrollment websites, a US administration official said on Tuesday. HealthCare.gov covers 36 states, and another 14 states have their own websites.

A look back at some of the InFocus blog highlights of 2013.

Insurance companies aren't crazy about their share of the health law's taxes, but mostly they've complained to politicians and regulators.

Healthcare reform is already presenting new challenges and opportunities for endocrinology, a specialty that is under significant stress in the United States. A critical workforce shortage has drained the pool of practicing endocrinologists, just as the Affordable Care Act (ACA) is expected to send millions of newly insured people into the system.

Len Nichols, director of the Center for Health Policy Research and Ethics (CHPRE) and a professor of Health Policy at George Mason University, discusses how hospitals can achieve the triple aim.

The Centers for Medicare & Medicaid Services announced Friday that it is seeking a second round of applicants to the Pioneer ACO Model. It is also soliciting suggestions for new accountable care organization models that encourage greater provider integration and financial accountability.

The business of treating patients via telehealth in the U.S. will dramatically increase to nearly $2 billion in revenue within five years due to a confluence of events in the health care industry from doctor shortages to provider payment changes under the Affordable Care Act.

Millions of people facing the cancellation of health insurance policies will be allowed to buy catastrophic coverage and will be exempt from penalties if they go without insurance next year, the White House said Thursday night.

The director of Minnesota's health insurance exchange, April Todd-Malmlov, abruptly resigned this week, making the exchange the fourth state program to see a leadership change in the midst of mounting criticism over the rollout of President Obama's new health care law.

In an effort to avoid a coverage gap in health insurance, those covered under the Pre-existing Condition Insurance Plan (PCIP) will get until January 2014 to enroll into a new plan through the state or federal healthcare exchange website.

To keep premium prices down for individuals and small businesses buying coverage through new online marketplaces, insurers have created smaller networks of hospitals. But consumers and policy experts have wondered, just how small?

Access is an important component of the Triple Aim (cost, quality, access), and it has also been stressed as a significant factor in health reform initiatives. As the influx of uninsured increasingly seeks care, and if the number of providers available to provide primary care decreases as projected, achieving access to quality and cost-effective care may become more problematic.

Enrollment in new Obamacare exchanges may be lagging, but experts said Thursday that the health law's massive expansion of Medicaid could place more than 8 million low-income people in the program before the first year is up.

About 85,000 people with a history of serious illnesses, who are enrolled in high-risk insurance pools created under the health care law, will get a month's reprieve before they lose that coverage.

The US health system has undergone notable transformations over the last 2 decades. Independent community hospitals haveconsolidated horizontally with others to form hospital healthcare systems, with many of the larger ones covering wide-ranging geographies, generating billions of dollars in operating revenues.

The Medicare, Medicaid, and Dual Eligibles programs are on the verge of a significant transition under the Affordable Care Act. Coordinating care and improving population health outcomes will require these federal programs to move away from outdated fee-for-service models to ones that incent better quality and more cost-effective delivery methods. At America's Health Insurance Plans (AHIP) Medicare, Medicaid, and Dual Eligibles conference held on September 23-26 in Washington, DC, the sessions featured discussions that highlighted the role health insurance plans will play as these federal programs continue to evolve under healthcare reform.

We are in the midst of exchange implementation-the centerpiece of the affordable care act-and it seems a good time to take stock of where we are and need to go. The ACA has validated and spurred on existing efforts. We are making progress on many fronts but fundamental changes are still needed to deliver on the promise of better value.

Hackensack Alliance ACO integrates pharmacists and adopts new technology as it joins in the bold experiment to lower costs and improve quality under health reform.

Horizon Blue Cross Blue Shield of New Jersey said Tuesday it won't renew any of its 2013 policies for individuals and small-business owners after the end of the year because it would be next to impossible to undo the work it has put in preparing for Obamacare.

More than 100,000 individuals selected a private insurance plan through the federal online marketplace in November, HHS announced Wednesday. That's roughly four times the enrollment total during October, when the HealthCare.gov website was largely dysfunctional. But it was far short of the levels needed to meet the Obama administration's projection of 3.3 million enrollees by Dec. 31.

Richard Umdenstock, president and chief executive officer, American Hospital Association (AHA), says hospitals have been preparing themselves for the influx of newly insured since 2010.

States' refusal to expand their Medicaid programs could cost billions of dollars over the next 10 years, and those costs are staggering.

The downward trend in preventable hospital readmissions that began in 2012 has continued well into this year, according to data published Friday on the CMS' blog. Quality experts were impressed but had questions.

Reference prices, a health benefit strategy that requires patients to pay costs above a set price, may save employers and patients money, but their potential may be limited-perhaps even more so under the Patient Protection and Affordable Care Act.

The Affordable Care Act has dramatically increased the cost of buying a health insurance plan on the individual market in California, Texas, Florida, New York, Illinois, Georgia, and North Carolina, states that account for more than half of America's uninsured adults.

About 29,000 people successfully navigated HealthCare.gov and selected an insurance plan on Sunday and Monday, more than the entire number of people who were able to enroll through the federal exchange during the month of October, according to a person familiar with the project.