ACA RA Transfer Report – 2020 Benefit Year

CLICK TO VIEW INTERACTIVE VISUALIZATION According to the U.S. Department of Health and Human Services (HHS), the risk adjustment program operated smoothly for the 2020 benefit year. The risk adjustment program is working as intended by more evenly spreading the financial risk carried by issuers that enrolled higher-risk individuals in a particular state market risk…

Read More

Government Healthcare: Strategizing Today for Success Tomorrow

The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) both underwent a leadership change in 2021. Xavier Becerra was confirmed as HHS’ Secretary in March and Chiquita Brooks-LaSure as CMS’ Administrator in May.   CMS, an Operating Division of HHS, has oversight for what Brooks-LaSure calls “the…

Read More

Weathering the Storm of Climate Change and Its Impact on Health Equity

News Flash! January through June 2021 was the eighth warmest such period on record according to the National Oceanic and Atmospheric Administration (NOAA). The other day my Amazon Show informed me about the melting ice in Greenland. The red tide algae bloom in Florida was hard to miss as the news reported disturbing images of…

Read More

Medicaid Before, During, and After the COVID-19 Public Health Emergency

Remember when there wasn’t a pandemic? COVID-19 has rocked our world and has left its mark on a new generation. It has also shape-shifted the Medicaid program. States will need to figure out how to return Medicaid to the pre-COVID-19 program it was. What does that mean for payors, providers, and beneficiaries? This article takes…

Read More

Emergency Declarations and Their Medicaid Impacts

A few state Governors are ending the public health emergency (PHE) declaration for their state, with more to follow. This is causing concern and confusion in the Medicaid provider and health plan communities. Providers are concerned about a sudden increase in the uninsured while Medicaid managed care plans are concerned about a sudden drop in…

Read More

Affordable Care Act Anniversary: There’s Still More Work To Do

What year was it? The number of non-elderly uninsured Americans was 48.2 million (18.2%) Uninsured children under the age of 18 was 9.8% Employer-sponsored insurance covered 55.3% of the population 5% of the population was covered by Medicare 9% of the population was covered by Medicaid with some individuals covered by Medicare and Medicaid Medicaid…

Read More

Riding Off Into the RAPS Sunset

“Every sunset is an opportunity to reset.” – Richie Norton “Sunsets are proof that no matter what happens, every day can end beautifully.” – Kristen Butler “Beautiful sunsets need cloudy skies.” – Paulo Coelho Most of us can appreciate the beauty and splendor of a beautiful sunset and all that it represents, such as the…

Read More

Understanding the Differences Between Medicare and Medicaid

Medicare and Medicaid are two separate and commonly misunderstood programs, even among healthcare professionals. Centauri Health Solutions wants to help clarify the differences. Medicare was designed to protect people in retirement. Originally, it included Part A, which is hospital insurance, and Part B, which covers medical care outside of a hospital admission. Medicare pays the…

Read More

Federal Poverty Guidelines 2021 Release

The 2021 Poverty Guidelines were posted today at https://aspe.hhs.gov/poverty-guidelines and in effect as of January 13, 2021. The Federal Register notice for the 2021 Poverty Guidelines will be published the week of January 18 through January 22, 2021. Payers and Providers wait for the release of the poverty guidelines each year to update patient financial…

Read More

Hospital Price Transparency

Effective January 1, 2021, hospitals are required to post standard charges in a machine-readable file and post their negotiated rates online for 300 “shoppable” services, 70 of which are pre-selected by the Centers for Medicare and Medicaid Services (CMS). “Standard charges” include the gross charges, payer-specific negotiated charges, the amount the hospital is willing to…

Read More