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3 Groups Payers Will Watch Closely in 2013

Jacqueline Fellows, for HealthLeaders Media, January 2, 2013

3.Other payers
The variance between what the country's largest health insurance companies will cover is fairly small. With Medicare reimbursement rates as the benchmark for coverage decisions, payers first look to the federal agency, then to each other.

Yes, they're competing for their own share of healthcare dollars, but AHIP has illustrated the fine point on the issue that all payers are facing and that is how to cover an influx of new beneficiaries without additional cost sharing and without raising premiums?

The uncertainty hovering over how health insurance exchanges will work once up and running, and how many people will actually participate sets up payers to enter as late arrivals. Consumers, who are also confused about how exchanges will work, are likely waiting for the company name they recognize on their EOB statements to explain it to them.


Jacqueline Fellows is an editor for HealthLeaders Media.
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