[…] I can see how awareness is a good thing if it encourages people (men and women) to be in tune with their health and current on the screening exams that they and their doctor feel they need. And it’s a reminder to all of us to do whatever we can to provide support to those who have cancer. But what about the people who know that their cancer is terminal? What about those with metastatic breast cancer? Or with another form of advanced cancer like my friend? The people who know that there is almost no chance they will beat the disease, and that their life will almost certainly be cut short by it? Do all the pink ribbons trivialize their deaths? […]
Conflicting Data Regarding Medical Costs
[…] These numbers are much more in line with the rise in health insurance premiums that we’ve seen over the past few years. I have no explanation for why the data from the two sources is so dramatically different in terms of medical trend in 2010, but if the trend was really closer to 7.5% rather than 1.7%, the health insurance premium increases would be a lot easier to understand. […] In addition to the MLR rules, some states (including Colorado) have implemented strict review processes for rate hikes. The ACA now calls for insurers who propose a rate hike of 10% or more […]
The Opposite Of Transparent
[…] David also points out that the amounts allowed by his Blue Cross Blue Shield carrier don’t seem to have anything to do with the amounts billed by his physical therapies – the lowest allowed amount on his EOB was for the service that was billed with the highest price tag. We’ve also seen little rhyme or reason (that we can detect, anyway) in terms of how billed amounts and allowed amount correlate. […]
Stuck In A Mini-Med
[…] So he applied for an individual policy with Anthem Blue Cross for his family, and was approved. But then when he tried to cancel his mini-med plan, his employer told him that he couldn’t cancel it until the open enrollment period next April. It would seem that trapping enrollees into a year-long contract with a mini-med plan is not in line with the spirit of the HHS guidelines that call for full disclosure regarding the waivers and directives to steer enrollees towards healthcare dot gov if they are interested in getting a policy that does comply with the ACA rules regarding annual policy limits. […]
Grand Rounds – Colorado Fall Colors Edition
Henry Stern of InsureBlog brings us an interview with the whistleblower who has brought a lawsuit against LabCorp for allegedly charging a lower price to United HealthCare than to Medicare. The post is particularly interesting because Hank adds his own thoughts after the interview, and he sees things a little differently than Andrew Baker (the whistleblower). Hank agrees that it does look like LabCorp lowered their fees for UHC […]
Increased Medicare Cost Sharing Might Not Be The Best Plan
[…] The healthcare providers make recommendations, order tests, perform surgeries… and in general, the patient does what the doctor recommends. And really, isn’t that the way it probably ought to be? Most of us have not been to medical school. When something seems amiss with our health, we need to feel that we can rely on our doctors to tell us the best course of action. Increased cost-sharing tends to increase the number of people who skip healthcare in general – including very necessary care like keeping diabetes and blood pressure under control.
Colorado Legislators Delay Health Benefits Exchange Grant Application
[…] That issue again appears to be a sticking point, with Colorado House Republicans blocking the health insurance exchange board from applying for a $22 million grant because the application mentioned changing Colorado regulations to “conform to federal requirements”. The grant application is due at HHS on Friday, and the exchange board will not be able to meet that deadline. They are hoping, however, to address the legislator’s concerns and be able to get the application submitted by the end of the year, to be considered in the second round of funding. […]
Colorado Health Insurance Exchange Board Hires Attorney General’s Office
[…] I’m confident that the Colorado Attorney General’s office will be able to provide competent legal advice to the exchange board. In addition, it appears that the board is getting an excellent value, since they’ll be paying less than $79/hour for a lawyer. But I assume that John Suthers is hoping to prevail in the lawsuit challenging the individual mandate, and I am a bit skeptical about whether the rest of the ACA (including the health insurance exchanges) could survive without the individual mandate.
A Great Cavalcade And Some Good Advice About Life Insurance
[…] a good one for people considering such a product – or really, most any very specific life insurance policy that only covers a particular debt, like your car loan, mortgage, or credit card balance. A regular term life insurance policy will likely be a much better value and can be used by your dependents to pay off whatever debts you may have and cover their own cost of living.
Transferring Costs From Medicaid To Emergency Departments
[…] Denying arbitrary “non-emergent” ED claims for Medicaid patients doesn’t seem like a way to actually reduce ED overutilization. Instead, it seems like a way to cut Medicaid costs by increasing the number of unpaid claims that EDs have to write off each year. In order to cover their costs, hospitals will have to further increase prices for privately insured patients. That in turn causes health insurance premium hikes, which leads to calls for negotiations to artificially lower premiums. Where does it end?
A Good Trend In Medicare Spending
[…] She specifically addresses Medicare costs, but it stands to reason that the same cost-saving strategies and paradigm shifts will also help to lower healthcare costs that are being reimbursed by private health insurance carriers. Not only do private carriers tend to follow Medicare’s lead, but the focus on value over volume from a provider perspective will benefit everyone, as it’s unlikely to be applied only to Medicare patients.
Negotiating Premiums Doesn’t Lower The Cost Of Healthcare
[…] How would it help to have health insurance exchange boards negotiating with health insurance carriers to try to lower premiums – without addressing the root problem, which is the ever-increasing cost of healthcare? […] Much of the focus of the healthcare reform rhetoric has been on health insurance (availability, premiums, etc.), and some important issues have been addressed in the process. But we cannot continue to focus primarily on the cost of health insurance (or try to artificially lower it) without reducing the cost of healthcare.
Decline And Rate Up Statistics – Interesting But Confusing
[…] Your policy will cost the same amount regardless of whether you use a broker, but an experienced broker will be able to help you make sense of the plan comparison information, including the underwriting statistics. A policy or carrier’s statistical likelihood of declining or rating up any one application isn’t really relevant to each specific client… what is relevant however, is each carrier’s underwriting guidelines for the particular pre-existing condition the applicant has. […]
Runaway Health Care Spending, But Do Families Really Earn Nearly $100K?
[…] Although I’m a bit perplexed by the $99,000 median household income figure cited in the Rand study, I think that the gist of the study – basically the fact that health care is eating up a huge portion of family and government income in America – is important for people to understand. We can’t tackle a problem without first knowing what the problem is. And one of the obstacles in the way of curtailing health care costs in the US is that our current system is so convoluted and complex that it’s nearly impossible to see all the areas where health care spending is impacting us – at the federal, state, and household levels.
Colorado DOI Improving Transparency Of Rate Review Process
[…] This should help boost public participation in the rate review discussion, and add to the general understanding of how the rate review process works. The DOI is obviously working hard to create as much transparency as possible with regards to rate increases. Rates will continue to increase as long as the cost of health care continues to climb (and as long as we continue to increase our utilization of health care) but at least the logic behind the rate increases will be more clear.
Low Enrollment And Adverse Selection In High Risk Pools
[…]CoverColorado – the high risk pool that Colorado has had in place since the early 90s – instead allows eligible applicants to enroll as soon as they are without another coverage option, but makes them wait to receive coverage for pre-existing conditions if they have been uninsured prior to applying. That system encourages people to sign up as soon as they are eligible rather than waiting until they need care. It would seem that the federally-funded high risk pools might be able to boost their enrollment and also avoid adverse selection by switching to a similar eligibility model.
ACOs in the Health Wonk News
my favorites had to do with accountable care organizations (ACOs). Much like health insurance exchanges, ACOs are a bit of a buzz word these days, but are often misunderstood. Of course things like that tend to lend themselves well to consulting gigs, and Paul Hsieh of Pajamas Media points out that the initial phases of development and implementation of ACOs has already created a consulting niche that is raking in huge amounts of money from hospitals and doctors who want to figure out the best way to design their ACOs. $25,000 a day for […]
Federal Requirements For State Exchanges
[…] The guidelines that HHS set forth were designed to make sure that state-specific exchanges meet basic minimum standards, while still allowing the states to accomplish many of those standards however they see fit. And although some would criticize HHS for being too restrictive, others have said that the agency did all they could to keep things as simple and flexible as possible. […]
Health Insurance For Everyone Is Just The Beginning
[…] Insuring the entire population isn’t going to solve all of our healthcare woes. For starters, even with health insurance, healthcare can still be unaffordable. And even if we were to make health insurance more comprehensive than it is now, with lower out-of-pocket costs (not likely, as the trend over the last decade has been towards higher out-of-pocket costs in order to keep premiums from increasing even faster than they already do), there would still be more than one in five people without realistic access to care – for reasons that aren’t directly related to paying for care. […]
COBRA Subsidies Coming To An End
[…] The subsidy program was extended to help people who were involuntarily terminated on or before May 31, 2010, and allowed them to receive up to 15 months of COBRA premium assistance. For most people who qualified for the subsidies, the 15 months has already ended. But for the last people who qualified – those who were laid off in the final days of May, 2010 – the 15 months of premium assistance will come to an end next week. […]
Balancing Interests In The Colorado Health Insurance Exchange
[…] The Colorado exchange has received some early criticism based on the make-up of the board, as several board members have ties – direct and indirect – to the health insurance industry. I’ve noted that my own opinion is that it would tough to implement a successful exchange without the knowledge of the health insurance industry that those board members bring to the table. But I think that the board’s election of Hammer to lead them does help to balance things out and make sure that the consumer voice is heard alongside that of the health insurance industry. […]
Thoughts On Direct-Pay PCPs
[…] Those are a few of the thoughts that come to mind when I think about direct-pay medical care. I can see pros and cons to the idea, and I’m sure that there are many PCPs who would love the chance to focus more on medicine and less on administration/payer issues. But I think that most PCPs also want to make sure that everyone – regardless of financial status – has realistic access to medical care. And I’m just not sure that would be the case if more PCPs started pulling out of the health insurance networks – especially the networks that serve low income populations.
Seeking Certainty
[…] And finally, if the Supreme Court is going to hand down a ruling like the one we got from the Appeals Court last week, we need to know that as soon as possible too. If the individual mandate does indeed end up being tossed out, the health care reform law will need an awful lot of compromises and revisions in order to make it tenable. Perhaps I’m being overly pessimistic, but given the level of compromise we’ve seen from the political system over the last decade or so, I have a hard time seeing how the PPACA could go on with one of its major provisions deleted. […]
Standardized Policy Descriptions Coming Soon
The Colorado Health Plan Description Form isn’t exactly the same as the forms that HHS will require carriers to make available next year, but it’s similar in many ways, and carriers in Colorado have been issuing these standardized plan summaries for nearly 14 years. As well as outlining the coverage provided, the new forms will include “coverage examples” that will show potential customers how the plan would cover three common medical scenarios: breast cancer, maternity care, and diabetes. […]
August Open Enrollment Period For Child Only Policies In Colorado
For parents looking for child-only policies in Colorado, we are in the middle of the 2011 open enrollment period, which will end August 31st. All carriers that offer individual health insurance policies for adults must also offer (during open enrollment periods only) at least one plan option for a child applying without an adult on the policy. This is pursuant to Colorado Senate Bill 128, which was signed into law earlier this year. Following the passage of SB128, the Colorado Division of Insurance stepped in to clarify the issue with emergency regulation E-11-03, which has specific details about the implementation of the law. […]