[…] Personally, I would be open to the idea of seeing a family practice doctor who doesn’t contract with health insurance carriers, and paying for routine care out of pocket, if there were some way to combine that with a discount on our health insurance premiums… If the DocTalker Family Medicine idea were to become more widespread and if insurers could account for this type of care when setting premiums, I can see it making a lot of sense for healthy families who want to use health insurance for large medical bills and budget for smaller bills themselves.
Healthcare.gov A Good Resource For Brokers
I spent some time on the Healthcare.gov website this morning, and found some great resources that could be particularly helpful for people with pre-existing conditions who are unable to obtain coverage in the individual market. The website was set up in conjunction with the PPACA and was designed to help people navigate the myriad of health insurance options available, along with the changes that will happen over the next few years as the provisions of the PPACA go into effect. […]
Health Wonk Review – Politics, Money and Health
Welcome to the Health Wonk Review. Health care costs, politics, and the economics of health care seemed to be the prevailing themes in the submissions this time, and there are some great ideas floating around here. Enjoy! […]
Access To Primary Care Is Only One Piece Of The Puzzle
[…] We need to make sure everyone has health insurance (first step in expanding access). We need to make sure there are enough primary care physicians (and other care providers) to go around. And then we need a systematic, coordinated effort between health care providers, hospitals, and health insurance carriers to make sure that everyone is on the same page. Expanding access to primary care is part of the solution, but it will only work in tandem with the other parts.
Colorado Hospitals Expanding
[…] I understand that each hospital needs to bring in enough money to pay staff, maintain the facilities, and – in the case of for-profit hospitals – make a profit for shareholders. But overall healthcare costs aren’t helped by duplication of facilities and high-tech medical gadgets. There has to be a balance between providing the excellent medical care, keeping things at least somewhat convenient for patients, and keeping medical costs under control. […]
Nothing Is Free
[…] For people with chronic health conditions who meet their deductibles every year, the savings with a high deductible health plan might be small or non-existent, and in those cases, more comprehensive coverage might make sense. But for people who are healthy, and insuring against potential future medical costs, it typically makes sense to minimize the amount that you’re guaranteed to pay (premiums) and accept a little bit higher exposure to amounts that you might have to pay (medical expenses that fall below the deductible). […]
Guaranteed Issue Policies For Children Happened Too Quickly
[…] Regardless of the practicalities involved, there’s no doubt that the headlines about insurers ceasing to issue child-only policies is generating some ill will and bad PR for insurance carriers. Either lawmakers knew that would happen, or else they put very little thought into considering the details of how insurers would go about making children’s coverage guaranteed issue a mere six months after the bill was signed into law, and just added the provision as a feel-good part of the bill.
More Americans Skipping Medical Care
[…] Copays and deductibles have risen for most families over the last few years, even those who don’t have policies that qualify as high deductible. And at the same time, economic stability has decreased for most families. This isn’t a good combination, and Joe’s right about the fact that when people skip necessary routine medical care, it will likely lead to increased medical costs (and declining health) in the future.
Money For Health Insurance Premium Increase Reviews
[…] Colorado will get $1 million to use for more extensive review of future rate increases, and the Division of Insurance has proposed hiring more analysts and actuaries to examine the data that is filed each year by the insurance carriers. The rate proposals will get more scrutiny, which is a good protective measure for consumers. But insureds could still see hefty rate increases thanks to the ever-increasing cost of health care. […]
Early Retiree Reinsurance Program Proving Very Popular
Earlier this summer, HHS announced that businesses could begin submitting applications to the newly-created Early Retiree Reinsurance Program in order to receive federal funding to help pay for retirees’ health insurance until they become eligible for Medicare. To date, 2000 businesses have been approved for the program, and HHS Secretary Kathleen Sebelius says that this is just the beginning. Businesses have shown great interest in the reinsurance program… […]
Amendment 63 On The Ballot In Colorado
Throughout this year, the Independence Institute has been working to get a measure on the ballot in Colorado to block the health care reform legislation that would require everyone to have health insurance starting in 2014. Yesterday, the Colorado Secretary of State confirmed that the amendment supporters have gathered enough signatures to get the measure on the ballot, so it will be up for a vote in November. […]
Deciphering Medical Loss Ratio Rules
Jaan Sidorov of the Disease Management Care Blog has started deciphering the specifics of the Medical Loss Ratio requirements, and it looks like the National Association of Insurance Commissioners (NAIC) is taking a rather inclusive view of medicine in their interpretation of the law. Ever since the MLR minimums were laid out in the PPACA, there has been much debate over what would be considered administrative costs. It’s heartening to see the NAIC giving so much leeway in terms of what will be considered medical expenses. […]
Why Medicare For All Might Not Be So Great
[…] most non-elderly Americans still get their health insurance through their employers. And in general, as long as people are somewhat satisfied with the status quo, most of us tend to be a bit resistant to change. Obviously, people who are currently uninsured are likely to support sweeping changes in the health care system. But most Americans do have health insurance, and those who have generous policies – that are at least partially funded by their employers – might find themselves with less coverage if we moved to a single payer plan.
Grandfathered Plans Will Be Rare By 2014
Several provisions in the new health care reform law will begin to take effect next month. More changes will take place over the next three years, leading up the biggest changes in 2014, when all individual policies will have to be guaranteed issue, and everyone will be required to have health insurance.
The only way an insurance policy will be able to avoid some of the changes implemented by the new law is to retain grandfathered status, basically by keeping the policy mostly unchanged from the way it was on March 23, 2010, when the law was passed. But it turns out that the benefits […]
Prescription Veggies
Colorado is the only state in the US with an adult obesity rate below 20%, but we’re just barely below that threshold. And according to the Colorado Health Report Card, our rate of obesity is rising faster than the rate for the whole country. I came across a NY Times article about a program that has been implemented in Mass recently, and I would love to see Colorado do the same thing. Maybe we could see our obesity percentage start to fall instead of continuing it’s upward climb. […]
Not Many Details Yet On Maternity Coverage In Colorado
[…] We still have several months left in 2009 for regulators and insurance companies to work out the details, and I’m sure we’ll know more by the end of the year. When you combine this with the new Colorado law banning gender rating on health insurance policies, and the myriad of reforms coming from the federal government, I’d say that health insurance regulators in Denver are going to have their hands full for a while.
Avoiding Adverse Selection
[…] Hopefully the fact that insurers can designate an open enrollment period for children to be accepted on a guaranteed issue basis will make it more likely that parents will keep their children continuously insured. The spirit of the law regarding coverage for children is good: It isn’t right that sick kids should be unable to get health insurance at any price. But with no requirement that all kids be insured, and without a designated open enrollment period, the new law would absolutely have encouraged adverse selection.
Eligible Does Not Mean Enrolled
[…] With budget cuts all over the county, now is probably not a good time for state agencies to add staff who focus on helping parents enroll their kids in public health insurance programs. But existing community based organizations could be a great resource for parents with uninsured kids. And this might also be an excellent position to fill with volunteers who are willing to work with parents in their own communities. […]
Open Enrollment Period For Children
[…] The Obama Administration had been clear in saying that health insurance companies would have to accept all children under age 19, without regard for pre-existing conditions. But last week that position was clarified with a bit of added leeway for insurers, allowing them to set open enrollment periods during which children can have access to health insurance regardless of pre-existing conditions. […]
Open Source Medical Records
[…] In general, I’m a fan of as much transparency as possible in health care. I think that patients, doctors, and payers (both public and private health insurance) should have access to information related to treatment, diagnoses, and cost – as quickly as possible and as clearly as possible. Open source medical records is one step towards transparency, and I like that. […]
Cavalcade Of Risk – Colorado Rocky Mountain High Edition
We’re in the midst of a beautiful Colorado summer, and the words to John Denver’s Rocky Mountain High (one of our official state songs) were running through my head over the weekend. So this week’s Cavalcade is a tribute to all the beauty that Colorado has to offer. I’m including a few photos we’ve taken over the years, so not only will you learn all sorts of new stuff about risk and risk management, but you’ll get a virtual tour of Colorado at the same time […]
Weeding Out The Worst Health Insurance Policies
[…] The new regulations won’t have much of an impact on good-quality policies from reputable health insurance carriers. Those plans already provide solid coverage for essential services. But removing the worst policies from the market – or forcing them to improve their coverage – will protect consumers who might otherwise have bought those plans thinking that they were as good as all the other options. And that’s a good thing.
If You Ever Get A Rock Stuck In Your Nose
[…] A lot has been said about over-utilization of health care lately, and the need to reduce both cost and utilization in order to make our health care system sustainable. But I have to wonder how many urgent care clinic front desk people would be willing to give out free advice like that, and how many would have just taken our insurance info and sent us in to see the doctor?
Sharing Instead Of Duplicating
[…] some doctors are nervous about such a system because they fear that they would earn less money overall. But he goes on to point out that earning a little less money might be well worth it if your job is easier and you get to spend far less time repeating tasks that someone else has already done. In addition, there would be less paperwork (electronic or otherwise) for health insurance companies to process, which should result in lower administrative expenses.
Standardizing Payments For Childbirth
[…] that could become the standard payment for all births, regardless of whether a c-section were performed or not. There would be no financial incentive for doctors to opt for c-sections, as they would no longer receive higher compensation for doing so. The tough medical malpractice environment that OBs practice in would likely provide more than enough motivation for them to continue to do c-sections when there was a true medical emergency, despite the fact that they would know there would be no additional compensation for the birth. […]