2021 is almost in the books. The US inaugurated a new President, rolled out three vaccines and boosters to stem the COVID-19 pandemic and the world awakened a bit from its COVID slumber. Yet, near the end of the year a new, fast-spreading variant emerged that dampened enthusiasm.
Our top blog posts from 2021 paint the picture of what’s happening regulatorily for carriers. They also discuss how the ACA health insurance exchanges have become more stable with more health insurance plans and more stable pricing year-over-year. They detail how the end of the COVID public health emergency may impact Medicaid. Learn more about Certifi’s most popular content in 2021 below.
Certifi’s Top 5 Blog Posts in 2021
Published in April, this post summarized CMS’ final rule on price transparency for payers. The rule was designed to help patients know how much their health will cost in advance of treatment. The rule required payers to disclose cost-sharing information upon request, including providing an estimate before service is performed. Plans were also required to make in-network negotiated rates available through machine-readable files available on a website.
Published in August, this post examined some little-discussed aspects of the No Surprises Act signed into law late in 2020, Advanced Explanation of Benefits, and Member ID requirements. The Act requires health plans to send members an Advanced Explanation of Benefits (EOB) in specific instances, including when requested by a member. That Advanced Explanation of Benefits is also required to have specific information, as outlined in the post.
Additionally, the Act required specific information on member ID cards so members understand in-network and out-of-network costs.
The Top 3
In September, we examined preliminary rates in the ACA federal and state exchanges to see what consumers should expect. Most states saw modest increases or declines in rates. We also examined the effect of COVID-19 on those preliminary rates. Most insurers didn’t address COVID-19 in their filings, though a few indicated that COVID-19 costs may slightly increase overall plan costs.
We tackled the mind-bending idea of quantum computing and its applications for health insurers in September. In addition to outlining the benefits, we examined some practical applications for quantum computing in a payer. We also looked at some vendors in the space as well as Anthem’s use of quantum computing to potentially personalize member treatment.
In October, we examined what will likely happen early in 2022: The end of the COVID-19 public health emergency and the beginning of Medicaid redeterminations. What’s the connection? As part of the public health emergency, Medicaid agencies received enhanced funding. To qualify for that funding, they had to pause Medicaid redeterminations during the emergency. Though there were some limited reasons for which an agency could disenroll Medicaid beneficiaries, generally speaking, when the public health emergency ends, Medicaid agencies will face a significant backlog of redeterminations to process.
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We also publish external articles frequently to our Twitter and LinkedIn accounts. Here are the most-clicked articles from 2021:
Telehealth exploded during the COVID-19 pandemic. A report produced by researchers at HHS’s Office of the Assistant Secretary for Planning and Evaluation found massive increases in telehealth. Medicare visits went from 840,000 in 2019 to a remarkable 52.7 million in 2020.
Like many states with state-based health insurance exchanges, New Mexico scheduled a special open enrollment period as a result of the COVID-19 pandemic.
The Top 3
Nearly nine out of every ten American seniors had not changed Medicare plans with less than a month left in the 2022 open enrollment season, according to a MedicareGuide.com survey.
MedicareGuide.com surveyed over 2,280 seniors over the age of 65 from November 15 through November 17, 2021. At the time of the survey, there were three weeks left in the 2022 Medicare open enrollment season.
HealthItAnalytics published this article in June. It explained how researchers had developed a machine learning tool that can predict a COVID-19 patient’s risk of death or dialysis treatment. If successful, the tool would enable providers to make more informed decisions when allocating resources to treat COVID-19 patients.
To encourage enrollment in their state health insurance exchange, the Washington Healthplan Finder put together this great resource debunking common health insurance myths. Among them, that health insurance is too expensive. Learn why it might not be for most enrollees.
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