Maine Medicine Weekly Update - 06/05/2017  (Plain Text Version)

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In this issue:
•  Physicians' Day a Success!
•  MMA, Lown Institute and Colleagues Present "Challenges to Professionalism in a Time of Change" in Portsmouth, June 17
•  MMA Board of Directors to Meet on Wednesday, June 7
•  Harvard Pilgrim Seeks 39.7% Premium Increase in the ACA Marketplace, Smaller Increases Sought by Anthem and CHO
•  Physician-Owned Practices Dip Below 50 Percent
•  U.S. Senate Deliberates on Health-System Reform Legislation
•  CMS Releases New Resources to Help Clinicians Successfully Participate in QPP
•  Weekly MMA Legislative Committee Conference Call Information
•  Legislative Highlights of the Week
•  Call Your Legislators: L.D. 46 Eliminating Physician Exemption from Jury Duty Poses Threat to Physician Practices
•  Online Learning Opportunities Offering CME Credits - from the Northern New England Practice Transformation Network
•  Time is Running Out...Will You Be Compliant on July 1st With The New E-Prescribing Mandate? Free Webinars on June 7 & June 14
•  How Can I Choose Wisely? A Community Conversation on Healthcare Changes and Rising Costs June 8
•  June 20 Webinar: Recognizing When Patients Have Concerns About the Cost of Their Health Care
•  National Medicare Education Program June 28
•  Family Medicine Physician - Pittsfield, ME
•  Family Medicine Physician - Maine Medical Partners Primary Care - Standish, ME
•  Primary Care Physician - Eastern Maine Medical Center
•  Outpatient Only - Internal Medicine with Loan Repayment & Sign-on Bonus
•  Part-time Clinical & Part-time Research Position in Central Maine
•  Family Medicine Physician - Winthrop, ME
•  DO or MD Physician - Augusta, ME
•  Family Medicine Physician - Waterville, ME
•  Family Medicine Physician/Clinician Leader - Portland, ME
•  Family Medicine - Windham, ME
•  Family Nurse Practitioner/Physician Assistant Wanted
•  Physician - Lubec, ME
•  Nurse Practitioner - Swift River Family Medicine - Rumford, ME
•  Physician Assistant/Nurse Practitioner - Bridgton, ME
•  UNE Graduates First Class of Dentists


Harvard Pilgrim Seeks 39.7% Premium Increase in the ACA Marketplace, Smaller Increases Sought by Anthem and CHO

Harvard Pilgrim Health Care announced Friday (June 2) that it would be requesting an average premium increase of 39.7% for individual plans in the ACA Marketplace for 2018. Anthem Blue Cross and Blue Shield is seeking a 21.2% increase, and Community Health Options is looking for a 19.6% increase.

Republican efforts in Washington to replace the ACA has resulted in uncertainly about the future of the subsidies and the large increases are partially a result of this uncertainly. Nearly 90 percent of the 86,000 Mainers who receive coverage in individual plans through the exchange receive a subsidy to help with the cost of the premium. The subsidies are available to individuals earning between 100 percent and 400 percent of the federal poverty level.

Community Health Options stated 15 percent of its requested premium increase is due to individual plans issued to “an anticipated smaller, and sicker, pool of insureds.” CHO has approximately 42,000 policyholders in Maine. It said its need for this level of rate increase is basically driven by the lack of an insurance mandate and the resulting impact of higher premiums. The CHO small group rate increase (for those plans continued from 2017 into 2018) is 7.8%.

Harvard Pilgrim and Anthem cited higher costs and market instability as reasons for their rate increases, and Harvard Pilgrim also suggested it may leave the Maine marketplace completely. A Harvard Pilgrim spokesperson said, “While we remain committed to the principle of everyone having access to affordable coverage, we can only continue to participate in the exchanges if there is stability in this market, and that will only come with immediate action from Washington.”

In prior years federal subsidies based on income have largely offset increases in out-of-pocket costs for low- to moderate-income policyholders. Those subsidies are now in doubt based on recent efforts in Congress to repeal the ACA and its associated subsidies.