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Health Reform

‘Narrow’ networks are the exchange norm here

Georgia had the highest percentage of “narrow’’ insurance networks in the 2014 health exchanges, a new report says.

Healthcare CostFive of six Georgia “Silver” exchange plans last year had medical provider networks with a limited choice of doctors, the report said.

The 83 percent of Georgia plans having narrow networks surpassed that of all other states, according to University of Pennsylvania researchers.

The report, released Monday, said health insurers are using narrow networks to keep premiums down as consumers shop for coverage on the exchanges, created under the Affordable Care Act. full story

‘Special’ exchange enrollment surpasses 55,000

More than 55,000 Georgians signed up for health insurance exchange coverage during a “special” four-month period through the end of June.

This period came after regular open enrollment ended in February.

healthcaregovThe signups during the special period included people who lost job-based coverage, got married or had a baby since late February.

Overall, more than 940,000 Americans took advantage of these changes in circumstances to obtain coverage in 37 states that use the federal exchange, part of the Affordable Care Act.

Georgia’s enrollment of 55,581 was the third highest total in these states, after those of Florida and Texas.   full story

Former state insurance chief wary of big mergers

The giant health insurance mergers now on the table would reduce the number of major national insurers from five to three.

John Oxendine, Georgia’s former insurance commissioner, believes that a Big Three is not enough for a competitive balance.

John Oxendine

John Oxendine

“Three is not competitive,’’ Oxendine told GHN last week in an interview. “My personal opinion is that it would be very bad for consumers.”

The two deals – Aetna buying Humana and Anthem buying Cigna – were each announced in July.  The former would double Aetna’s size in Georgia, while the latter would add to Blue Cross and Blue Shield of Georgia’s big membership lead over other insurers in the state. Anthem is Blue Cross’ parent company.

If both deals ultimately are approved by regulators and shareholders, the two combined companies, Aetna and Anthem, would be part of the new Big Three, with UnitedHealthcare being the other giant national player. full story

Mega-merger would bolster Blue Cross here

Anthem’s agreement to buy Cigna for $48 billion, if consummated, would cement the dominant position of Georgia’s leading health insurer.

The insurer deal, announced Friday, follows the merger agreement announced earlier this month between two other insurance heavyweights, Aetna and Humana. And both fit into the picture of fast-paced consolidation across the health care industry, partly driven by changes from the Affordable Care Act.

clipboardIf both consolidations are approved by regulators and shareholders, the national effect would be huge, with the number of large, for-profit health insurers shrinking from five to three.

Indianapolis-based Anthem is the parent company of Blue Cross and Blue Shield of Georgia, which is the big player in the Peach State, with about 3 million members here.

Cigna officials here could not be reached for comment, but one industry estimate put that insurer’s health plan and Medicare membership in Georgia at roughly 600,000. full story

WellStar in talks to buy Tenet’s hospitals in state

(Updated at 2:15 p.m.)

WellStar Health System, fresh from abandoning a proposed deal with Emory Healthcare, has now landed a new potential partner.

The Marietta-based WellStar is beginning negotiations with Tenet Healthcare to buy Tenet’s five hospitals in Georgia — all in greater metro Atlanta.

North Fulton Hospital

North Fulton Hospital

The two organizations issued a statement Thursday confirming the start of “exclusive, non-binding discussions’’ about a potential sale of Tenet’s Atlanta-area hospitals and other facilities to WellStar.

“This is to ensure that these hospitals and facilities are best positioned to meet the needs of their communities and continue delivering high-quality health care for many years to come,’’ said the statement.

WellStar and Tenet declined further comment about the potential deal.

The wave of consolidation in the health care business was also evident elsewhere Thursday, with reports on a looming deal by Anthem to acquire fellow insurer Cigna. full story

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