health insurance

When it comes to health insurance, "in-network" means a provider or facility that's contracted with your insurer to provide services at an agreed-upon rate. "Out-of-network" means a provider or facility that doesn't have an agreement with your insurer. Whether in-network or out-of-network providers and facilities are covered, and to what extent, depends on your particular health insurance plan.

Kristin Gourlay / RIPR

The public comment period has ended and now the Rhode Island health department must decide whether United Healthcare can cut Landmark Medical Center from its insurance network. The decision could affect thousands of patients.

Aaron Read / RIPR

You may have gotten a letter in the mail recently from your health insurance company asking whether you wanted to opt out of something called an “all payer claims database.”

It's pretty basic: in order to save a little money, most people have to stick to a budget. But before you can sketch out that spending plan, you need to know where your money's been going and how much you've been spending on everything. Then you can look for places to trim and skimp.

So too goes the theory with health care spending. Or at least, that's the idea behind several new efforts:

Aaron Read / RIPR

New rules for Medicare Advantage plan members give seniors more flexibility to opt out of plans that drop their doctors from the network.

The Centers for Medicare and Medicaid Services has announced that Medicare Advantage plan members will be able to switch plans if those plans drop doctors mid-year without cause. These are Medicare plans offered by private insurance companies and often operate like HMOs.

As you may know, today is the deadline for individuals and families to sign up for health insurance coverage through HealthSource RI, if you don't already have coverage. But what happens tomorrow?

Well, if you're an individual or a family without coverage now, and you can't get it through your employer or via Medicaid, you'll have to wait until the next open enrollment period, November 15, 2014. Also, you might face a tax penalty.

Monday is the deadline to enroll in a health insurance plan through HealthSource RI, the state’s online insurance marketplace. That’s the last chance to enroll until November.

The push is on to attract as many eligible Rhode Islanders to HealthSource RI to sign up for a health insurance plan. March 31st is the deadline to enroll in coverage in order to avoid a tax penalty for the year. And the next open enrollment period doesn’t start until mid-November for coverage that begins the following January. So if you were waiting until the last minute, now’s the time.

Another study seems to suggest that, contrary to previous assumptions, it does.

Researchers from Beth Israel Deaconess Medical Center in Boston have just published the results of a study in the Annals of Emergency Medicine that looked at all emergency department visits at 69 hospitals between the fall of 2006 and the fall of 2009. In 2006, Massachusetts expanded access to health insurance to nearly everyone in the state.

Providence Business News Editor Mark Murphy joins Rhode Island Public Radio's Dave Fallon for our weekly business segment called The Bottom Line.

This week, HealthSource RI director Christine Ferguson joins Dave and Mark to talk about the approaching deadline for open enrollment, how to attract more small businesses, young 'invincibles,' and Latinos to the health insurance exchange, and funding the exchange into the future.

When to Listen
You can hear The Bottom Line each Friday at 5:50pm.

Rhode Island took advantage of millions in federal dollars to build and launch its own health insurance exchange. Now as that federal money is about to run out, HealthSource RI director Christine Ferguson says she’s got a plan for the 2015 fiscal year, which starts this July.

The Commonwealth Fund

Looks like a mixed bag. Check out this interactive map from the Commonwealth Fund. Of the states with their own, state-run marketplaces, some plan to raise revenue for their exchanges with taxes or "assessments" on health insurance premiums, for instance. Others, like Rhode Island, seem to be still undecided.

Rhode Island’s health insurance exchange is opening a temporary walk in center in Warwick today. Open enrollment on HealthSource RI ends this month.

Kristin Gourlay / RIPR

Rhode Island hospitals posted a nearly $59 million dollar operating loss in 2013. That’s just one aspect of a troubling economic picture emerging in a new report on the state of the state’s hospitals.

A new analysis out from the US Health and Human Services agency estimates that about 17,000 uninsured Latinos in Rhode Island may qualify for assistance buying a health insurance plan on HealthSource RI or for Medicaid. That's out of RI's total Latino population of about 112,000. Both seem like sizeable numbers for a state of only about a million.

file / RIPR

Rhode Island’s online health insurance exchange has nearly doubled enrollment numbers since January. The news comes as the deadline for individuals to get covered is less than two weeks away.

More than 16,000 Rhode Islanders have enrolled in health insurance plans on HealthSource RI as of this past weekend. That’s up from 9800 at the beginning of January.  HealthSource RI says most enrollees have qualified for some kind of help paying for those plans – a reduced monthly premium and assistance with co-pays and deductibles.