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Texas Prepares to Shutter High-Risk Insurance Pool
At year's end, Texas will shut down its high-risk insurance pool for some of the state's sickest residents, pushing participants to find private coverage in the federal health insurance marketplace created under the federal Affordable Care Act.
At year's end, Texas will shut down its high-risk insurance pool for some of the state’s sickest residents, pushing participants to find private coverage in the federal health insurance marketplace created under the federal Affordable Care Act. And patient advocates say those participants should focus on making the transition sooner rather than later to ensure that they don't experience a lapse in coverage or lose access to current health care providers and services.
"Pool policyholders who are in the middle of treatment will especially need to be sure the network offered by their replacement health plan includes their treatment team," Steven Browning, executive director of the
, said in an email.
The high-risk pool is financed mainly by patient premiums and assessments paid by health insurance companies and HMOs, along with some funding from federal grant programs.
Read the full story here: http://bit.ly/1hZ4bSL
Source: The Texas Tribune
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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Integrated CKD Care Model Cuts ED Visits by 30%, Boosts Specialized Treatment
April 21st 2025An analysis of an interdisciplinary care model for managing chronic kidney disease (CKD) shows hospital admissions dropped by 26% and emergency department (ED) visits decreased by 30% after clinic initiation.
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