Hank Stern of InsureBlog has posted the latest from the world of risk management and related topics. There’s interesting and wide-ranging stuff from car insurance to physician credentialing.
Dec
19
Insight, analysis & opinion from Joe Paduda
Dec
18
I’ve been virtually talking with other interested parties and staff from Sen. Ron Wyden’s (D OR) office about his Healthy Americans Act and how it deals with pricing. Here’s my preliminary take.
There are two core concepts central to HAA’s viability. First, universal coverage. If everyone has coverage, than there is no (or at least a lot less) need for providers to charge folks with insurance more to cover their losses incurred when they treat people without insurance. Cost-shifting drives up health insurance costs for those folks fortunate and employed enough to have coverage.
Dec
18
You’re better off getting treated at a not-for-profit hospital. Unless you qualify for treatment at a VA hospital, in which case you’re the luckiest of all. At least that’s the conclusion drawn by researchers at Harvard who evaluated care for three common conditions at over 4000 hospitals.
Dec
15
Here’s a synopsis of the initial reactions from the health blogosphere to Sen. Ron Wyden’s (D OR) Healthy Americans Act.
Ezra Klein notes that insurance companies will have to compete on quality and low cost instead of medical underwriting and risk selection. I’d agree but note that HAA should push health plans to take all those dollars they have been investing in risk selection and broker commissions and invest them in care management. Health plans talk a lot about managing care, but few are really doing anything innovative or productive.
Continue reading UPDATE – Other thoughts on Wyden’s Health plan
Dec
14
Sen. Ron Wyden (D OR) has come up with a plan for health care that just might work. Wyden’s plan requires all Americans to purchase health insurance, prohibits medical underwriting, replaces Medicaid with private insurance, and funds the program by a combination of employer contributions, individual payments, and recaptured funds from the mishmash of programs that attempt to address cost-shifting and indigent care.
Those folks making less than the poverty level will not pay anything for their coverage, with graduated subsidies for those making from 1x the poverty level to 4x. There’s a lot more detail to the plan, which you can peruse at your leisure at Wyden’s site.
Dec
14
A well-done and tip of the cup, er, cap to Rita Schwab of MSSP Nexus. Rita has done and exemplary job hosting the latest edition of Health Wonk Review, wherein the best of the biweekly blogosphere are brung to you.
Dec
14
The pharma industry is still in a bit of a tizzy about the lawsuits alleging improprieties in pricing, with some saying there will be wholesale changes (pun intended) while others ho-hum the notion. But, as more information comes out regarding the McKesson – First DataBank suits, there appears to be more to the notion that changes are in the wind.
This is not just an item of passing interest; the plaintiffs in the suit alleged that these pricing practices have cost payers upwards of $6 billion over a three-year period.
Dec
12
Third party billers WorkingRx and Third Party Solutions may be for sale. The two pharmacy factoring companies together own the work comp script factoring business, a sector that has been under some pressure lately. According to several industry sources, the owners of both entities (Fiserv for TPS and investment firm Arcapita for WorkingRx) have engaged investment bankers to shop their respective companies.
Dec
12
The body of knowledge concerning consumer directed health plans is increasing steadily, and unfortunately for advocates, it does not appear to include much in the way of good news.
Continue reading What’s really happening with consumer-directed health care
Dec
11
In what will come as no surprise to anyone, Congress will eliminate the pending cut in Medicare physician reimbursement. Not only that, but docs who agree to report certain data to CMS will actually get a 1.5% increase in reimbursement from the Feds.
If you listen very closely, you can almost hear the medical community’s resounding “yippee”.
The reasons docs are not exactly ecstatic about the news are two-fold.
