Industry Insights

This is a little off topic from our other “analytics” postings, but a recent article (“The Operation of the Individual Tax Mandate” by Jeffrey H.Kahn) presents a fascinating analysis of the complexities of the tax consequences of not obtaining the health insurance coverage required under the health reform law.

A recent article in Becker's Hospital review linked to this article in the Corporate Counsel newsletter about the difficulties of complying with the ACO antitrust requirements, and the potential for disqualification from participation (with

As healthcare costs continue to increase, organizations that pay these costs are looking for opportunities to offload the risk of cost increases on to other organizations.  Many states have turned to capitation in the Medicaid programs, moving their utilization and price risk onto the Medicaid HMOs that participate in their programs.  In Massachusetts, insurance companies whose rates are forced down by state regulators are apparently also considering use of capitation to reduce a rate of increase of their costs.