[…] 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. […]
health insurance
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 […]
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. […]
Resurrecting House Calls
[…] Private health insurance companies tend to take some of their cues from Medicare in terms of what they cover, so if Medicare eventually makes home visits more available, it stands to reason that people with private health insurance might also have access to house calls from doctors, even if they can’t afford to pay full price to a non-network provider.
Too Much Medical Care
[…] Much has been said about how we need to reign in health care costs in order for health insurance to be universally affordable. But we also need to figure out how to just use less medical care all around. We need to find ways to support health rather than react to illness (diet is a good place to start). And we need to question just how much we want our lives to revolve around medical intervention, pharmaceutical concoctions, and beeping machines. As Dr. Welch noted, some medical interventions are absolutely essential and worthwhile. But that is not the case for all medical care, and a “less is more” approach might create a healthier population and lower health care costs.
Public Opinion Of Health Care Reform Improving
[…] It will be interesting to watch public opinion of health care reform over the next few years. I imagine a lot of it will depend on what happens to premiums. If health insurance carriers can comply with the requirements of the new law without substantial premiums increases, we’ll probably see even more favorable public opinion of the law, especially once government subsidies kick in to help people pay for health insurance.
Information About Medical Cost Sharing Programs
[…] But the reason I have health insurance is to protect our family in the event of a catastrophic illness or injury. If that were to happen, I want to know that I have a real health insurance company paying my bills, and legal recourse in the event of a dispute. I like knowing that my health insurance policy is regulated by Colorado’s Division of Insurance, and I like the fact that it doesn’t say “this is not health insurance” anywhere on my policy information. […]
New High Risk Pool Unveiled Today In Colorado
[…] It’s nice to see Colorado leading the way in terms of using the federal high risk pool money to set up a new program for people with pre-existing conditions. Whether the money will hold out until 2014 remains to be seen, but at least we are now well on our way to having one more option for people in Colorado who can’t qualify for private health insurance.
Some Confusion Around New Colorado High Risk Pool
The new Colorado health insurance program for people with pre-existing conditions is supposed to become available next week, but there seems to still be a lot of confusion about how it’s going to work. Since Colorado already has a policy available for people with pre-existing conditions (Cover Colorado), we are one of the states that is opting to use the federal money to set up another risk pool for applicants who cannot qualify for medically underwritten individual policies […]
Colorado Ranks Highly In Women’s Health
Colorado is the only state in a recent report by HealthGrades to rank in the top ten for all three aspects of women’s care studied (see appendix D on page 15 of the report). Although only three hospitals in Colorado received the HealthGrades 2009/2010 Women’s Health Excellence Award: North Colorado Medical Center in Greeley, Poudre Valley Hospital in Fort Collins, and Centura Health-Penrose Saint Francis Health Services in Colorado Springs. […]
Instant Billing Long Overdue
I have often thought that an instant billing/payment system for medical offices (sort of a Visa/Mastercard type of setup between providers and health insurance carriers) was long-overdue. This New York Times article details exactly how such a system could work, but also addresses some of the problems it would face. The main issue is the complicated nature of health insurance billing, with thousands of medical codes that the doctor’s office has to sort through in order to correctly submit a bill. […]
Colorado Delaying Medicaid Payments
[…] And that means that Medicaid claims submitted over the last couple weeks won’t be paid until July 9th – providers will miss out on payments that were scheduled for last week and later this week. The 2011 fiscal year begins in July, and the state is planning to push Medicaid reimbursements out in order to contain the budget for this year. The money will eventually be paid to the providers, but for book-keeping purposes it will be in a different fiscal year, and it also amounts to an interest-free short term loan from the providers to the state. […]