Was Aetna the catalyst behind the ACA exchange departures?

Aetna's exit from many Affordable Care Act exchanges may have led other payers to follow suit, according to Louisville Business First.

Here are four notes:

1. Earlier this month, The Huffington Post accessed a letter in which Aetna CEO Mark Bertolini told federal officials in July that the company would exit the ACA exchanges if officials made moves to block the Aetna-Humana million-dollar deal. Mr. Bertolini wrote the letter 16 days before the DOJ filed suits against the Aetna-Humana and Anthem-Cigna mergers.

2. After news broke about Aetna, leading payer Humana also said it would be exiting several ACA exchanges going forth into 2017. Utah Department of Insurance confirmed Humana will stop offering plans on the state's individual insurance marketplace next year  With Humana's exit, Utah residents will only have three payers to choose from — Molina, SelectHealth and University of Utah Health Plans.

3. This month, Cigna also announced it will no longer offer ACA plans in Georgia.  Aetna and UnitedHealthcare are also not offering plans in the state's ACA exchange in 2017.

4. These payer moves could have huge impacts on options for consumers next year. A Kaiser Family Foundation survey found 31 percent of U.S. counties will have only one payer on the exchange next year. This figure is significantly up from 7 percent of counties this year.

More articles on coding & billing:
ACA enrollment hits 11.1M Americans, falls 12.9M short of CBO predictions: 5 things to know
52% of coders assign codes based on documentation, regardless of physician query: 5 things to know
6 ways payers and providers can reduce claim denials

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers

Featured Podcast