CMS Proposes Standards for Nonprofit Health Insurance Plans | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

CMS Proposes Standards for Nonprofit Health Insurance Plans

July 19, 2011
by root
| Reprints

The Centers for Medicare & Medicare Services (CMS) took steps to encourage the creation of Consumer Operated and Oriented Plans (CO-OPs), new private non-profit, consumer-governed health insurance plans that will help increase competition and give consumers and small businesses additional affordable health insurance choices. CMS is proposing standards for CO-OPs, and for qualifying for $3.8 billion in repayable loans to help start-up and capitalize these new health plans. All CO-OP loans must be repaid with interest and loans will only be made to private, nonprofit entities that demonstrate a high probability of becoming financially viable.

CO-OPs are designed to give consumers and small businesses control over their own health insurance. CO-OPs are private, non-profit insurers governed by their members and offering affordable, consumer-friendly health insurance options. CO-OPs will use any profits to benefit its members, including actions to lower premiums, improve health benefits, improve the quality of members’ health care, expand enrollment, or otherwise contribute to the stability of coverage for members.

Working from the recommendations of the public advisory committee, the rules proposing the framework were developed with significant input from many stakeholders, including testimony at public meetings from consumers, small businesses and health care providers. The proposed rule is only a first step. CMS is taking public comment on the proposal and expects to release a Funding Opportunity Announcement regarding the availability of loans to start up CO-OPs soon.

For more information on this announcement, read the fact sheet at www.HealthCare.gov/news/factsheets/coops07182011a.html.

Topics

News

Anthem to Create Tech Center in Downtown Atlanta

Anthem has announced that its local Atlanta affiliate will build a new technology center downtown where 3,000 multidisciplinary IT professionals will work on innovative projects to help improve the consumer experience.

Healthcare Associations to Congress: Extend MACRA Flexibilities by Three More Years

Several prominent healthcare associations and medical societies have written a letter to leading members of the Committee on Energy and Commerce, proposing to continue current MACRA flexibilities for an additional three years.

HIMSS Issues “Call to Action” on Nationwide Interoperability

The Chicago-based Healthcare Information and Management Systems Society (HIMSS) has issued a “call to action” for the Department of Health and Human Services (HHS) and others to achieve nationwide interoperability.

Delaware’s Nemours Hospital Receives Stage 7 Designation

Nemours Alfred I duPont Hospital for Children, a pediatric hospital located in Wilmington, Del., has been recognized by HIMSS Analytics as a Stage 7 patient care organization.

Survey: Broad Usage of AI in Healthcare Still Two to Five Years Out

Roughly 48 percent of healthcare organizations currently use clinical intelligence solutions, but most healthcare organizations predict broad usage of artificial intelligence won’t happen for another two to five years, according to a HIMSS Analytics 2017 Essentials Brief.

KLAS: Providers’ Needs for Advanced Pop Health Solutions Ramp Up

Provider organizations’ needs in managing population health are as varied as the capabilities of the IT solutions designed to assist them, according to KLAS researchers following a new report.