Becker's Healthcare April 29, 2024
There are now more than 20 million Americans enrolled through the individual health insurance exchange marketplace (HIX) and growing. A product originally designed to provide coverage for the uninsured and those caught between having too much to qualify for Medicaid, but not quite enough to afford commercial coverage, is now setting its sights on the small group commercial market through ICHRA, or an individual coverage health reimbursement arrangement. This has the potential to be incredibly disruptive to providers given the negative impact this shift could have on overall reimbursement and provider margins.
Payers have effectively negotiated discounts off commercial rates for the past decade from providers for their HIX products — arguing that it was not commercial business — it...
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