Dive Brief:
- Federal officials have released market standards and regulations for health exchanges for the next year, and the new rule includes some meaningful changes.
- The final 2015 rule includes risk program adjustments designed to lower upward pressure on premiums, more comprehensive collection of quality information from health plans and tougher standards for the "navigators" who help people choose health plans.
- The new rule also includes changes to the risk corridors program which include raising the ceiling on administrative costs and the floor on profits by 2% each.
Dive Insight:
With most health plans still seeing the health exchange program as a sea of unknowns, this is one of the instances in which the industry might appreciate the structure that the final rule offers. Right now, health plan executives have been saying that they still see the exchanges as a bit of a Wild West atmosphere, but as CMS spells out its intentions — and the health plans continue to figure out how to operate in the HIX environment — things should settle down.