CHI to exit health insurance business

Catholic Health Initiatives has decided to divest its health insurance business, according to recent financial documents from the Englewood, Colo.-based system.

CHI's insurance subsidiary QualChoice Health, formerly known as Prominence Health, offers Medicare Advantage and commercial insurance products to members in six states. The health insurance business lost nearly $97 million from operations in the first nine months of fiscal year 2016, which ended March 31. In the same period of fiscal 2015, QualChoice recorded an operating loss of nearly $19 million.

Due to those losses, CHI cut staff at QualChoice in March. In May, CHI executives decided to "exit the health insurance business" and are currently "exploring options to sell" QualChoice, according to the financial documents.

CHI is one of many systems across the nation that has launched a health plan in recent years. Between 2010 and 2014, the most recent year for which data is available, the number of providers offering health plans steadily increased from 94 to 106, according to a report by McKinsey & Co. However, financial performance of provider-led plans remains mixed. Of the 89 plans analyzed for the McKinsey & Co. report, more than 40 had negative margins in some or all of the past three years.

CHI ended the first nine months of fiscal 2016 with an operating loss of $265.6 million on revenue of $12.2 billion. In April, S&P and Moody's Investors Service lowered their ratings on CHI's debt due to the system's persistent losses.

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Medicaid, private insurers embrace pacts with telemedicine providers

Partnerships between health insurers and telemedicine providers are on the rise as more private and public plans provide at least some reimbursement for telehealth services, according to a Healthcare Dive article.

Teladoc and RelayHealth are among the telemedicine providers partnering with private insurers, according to the article. Here are some other signs telemedicine is gaining acceptance as a way to cover gaps in traditional coverage:

  • Only two states don’t provide any Medicaid reimbursement for telehealth services.
  • Telemedicine parity laws for private payers are in place in 29 states and the District of Columbia, including 22 states that place no restrictions on providers or technology.
  • Thirty-two states and D.C. offer some kind of private insurance coverage for telemedicine.

Another successful partnership cited by the article is the case of CirrusMD, which works with Rocky Mountain Health Plans to offer a telemedicine platform called MyDigitalMD to schedule video visits and text messaging to privately insured patients along with 140,000 Medicaid patients in 22 Colorado counties. Text messaging accounted for 85 percent of patient encounters.

The partnership saved $435 per encounter by diverting visits to the emergency department, urgent care and primary care offices, the article adds.

Insurers both large and small are increasingly warming up to the concept of telemedicine, though they sometimes face barriers in the form of restrictive regulations.

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Louisiana, the U.S. incarceration capital, prepares for expanded Medicaid

Here in the state that imprisons more of its citizens per capita than any other, the long-awaited July 1 launch of expanded Medicaid coverage will give those leaving prison a chance to at least continue what many describe as spotty treatment for the conditions that plagued them while behind bars.

These include Dolfinette Martin, who has been out of prison for four years with no health coverage or medications to control her bipolar disorder, and Maryam Henderson-Uloho, who spent more than 12 years in prison, and who says she and other inmates seldom sought medical treatment because prison officials would write them up for "malingering" when they did.

Both women and other formerly incarcerated Louisiana residents describe prison and reentry as psychologically crushing for most people. Without access to health care when they leave prison, it's often only a matter of time until many prisoners return. The imminent expansion at least gives many hope they can get some help for problems that helped send them to prison in the first place.

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