Sep
25

California Blue Cross gets hit and concedes.

The PR and financial fallout from the recent reports of inappropriate retroactive denial of coverage is starting to take its toll on California’s Blue Cross plan. From Fierce Healthcare comes the latest news; the State of CA has levied a $200,000 fine against BX for their actions in one specific case.
And that’s just one case. Reports indicate there are as many as 19 more.
What does this mean for you?
If David is doing battle with Goliath and the venue is the court of public opinion, you’d best bet on the little guy.


Sep
24

Zurich – St Paul merger. Not.

OK, for the last and final time, Zurich and StPaul-Travelers are not merging, one is not acquiring the other, there are no due diligence conversations going on, books have not been exchanged, and whatever else I can say to convince the rumour hounds that this one has no basis in fact.
Could they merge at some point in the future? Perhaps. But there are no substantive discussions going on today, and there would be if the two companies were thinking about doing a deal.
How do I know? And do I know with 100% certainty? No to the latter, but 95% yes. As to sources, colleagues in both organizations have been denying this for months, and StPaul-Travelers went so far as to issue a denial. And a pretty firm one at that.
Sheesh. I wonder if Oliver Stone is behind all this nonsense…


Sep
21

Blue Cross – Brand v. Underwriting

The Blues have decided to get smart. Perhaps not smart, but at least smarter. Blue Cross of California’s much-publicized PR disaster arose when the LATimes published an article decrying the plan’s policy of trying creative ways to cancel policies for individuals who had the nerve to ask BX to pay for their medical problems.
Actually, the problem arose when the State of CA took legal action against BX.

Continue reading Blue Cross – Brand v. Underwriting


Sep
20

BWC – now it’s getting really disgusting

If you have yet to shower, you may well need one after reading this.
Just in time for election season, another chapter in Ohio Bureau of Workers’ Comp scandal is heading for court. The latest news comes from the Toledo Blade, which reported last week that the BWC’s CFO is alleged to have accepted bribes from brokers for investment firms eager to invest the Bureau’s funds.

Continue reading BWC – now it’s getting really disgusting


Sep
18

Site updates

We’ve made two changes to Managed Care Matters.
Least obvious to most will be the change in color of hypertext links; we are now using blue, which is more easily read by folks w certain types of color blindness. Thanks to friend Terry Reardon for the suggestion. (he’s a color blind orthopedic surgeon, who assures me that is not an occupational limitation…)
We’ve also added another step in the commenting process, asking submitters to enter a bit of text to verify they are a human and not a @#$%^&*&^%$^&**))*%%$## spam bot. Sorry for the extra step, but I can’t go thru 200 spams a day looking for your pearls.


Sep
18

Why HSAs won’t help the uninsured

One of the oft-cited rationales for Health Savings Accounts and Consumer Directed Health Plans (HSAs and CDHPs) is their potential to reduce the number of individuals without health insurance (or, as my neighbor says, the “individually self-insured). While HSAs may have some benefits in terms of increasing consumer awareness of costs, for two rather obvious reasons, HSAs will not help reduce the number of uninsured in the US.

Continue reading Why HSAs won’t help the uninsured


Sep
14

National Consumer Directed Healthcare Summit – report from the scene

I went to the National Consumer Directed Healthcare Summit in DC yesterday skeptical but with an open mind. And after Paul Ginsburg’s opening talk, I was thinking there may well be a pony in here somewhere. Unfortunately, I left after three more presentations still searching for the pony.

Continue reading National Consumer Directed Healthcare Summit – report from the scene