Insight, analysis & opinion from Joe Paduda
Several of the larger workers’ comp payers are strongly considering using group health provider networks for their claimant population. And, some have already inked deals with these entities (Hartford-Aetna; Hartford-Horizon NJ). This marks a shift in strategy, and the reasoning … Continue reading The problem with Workers Comp provider networks
Read More...One of the newer ideas to hit employee benefit health plan design is tiering copayments according to the quality of the provider accessed by the insured. United Healthcare and Medica are two of the health plans that have introduced these … Continue reading Provider quality-based plan design
Read More...California HealthLine has an excellent roundup of Medicare news. Most significant is their take on physician reimbursement, which is slated to be cut by 4% on 1/1/2006. Lawmakers appear to be interested in rescinding the cut, which would be consistent … Continue reading Medicare cuts in MD reimbursement
Read More...Interesting notes from their analyst’s call, focusing on their First Health acquisition… They are “achieving synergies” by reducing headcount and consolidating purchasing. On the pink-slip front, the combined First Health-Coventry operations will shrink by about 450 positions by year end. … Continue reading Coventry
Read More...This is Cover the Uninsured Week, a national program to bring awareness of and discussion of solutions to the US’ 45 million non-elderly without health insurance. While this elicits a big yawn from many with health insurance, that is a … Continue reading Cover the Uninsured Week
Read More...The Hartford announced this week that they will be using Aetna’s Workers Comp PPO network in Pennsylvania, effective 6/1/05. This is a big step for Aetna, which has been struggling to achieve traction in the WC network business since starting … Continue reading Hartford and Aetna
Read More...Dr. Paul Ginsburg of the Center for the Study of Health System Change has stated that technology and the increasing income of the US population are the top drivers of health care costs. The two are interrelated, as health care … Continue reading Medical technology facts and impact
Read More...For consumers, managed care is a choice between limited access to providers and premium costs; the greater the access, the higher the premium; the more limited the choice of providers, the lower the premium. In the late nineties, the so-called … Continue reading Access v. Cost
Read More...It appears that Medicaid is safe, at least in the Senate, from Pres. Bush’s attempt to cut $14 billion over five years. Smith, Republican Sen. of Oregon, claimed to have enough votes to pass an amendment restoring the dollars, and … Continue reading Medicaid, Round three
Read More...In what may prove to be a critical indicator of the future of Medicaid funding, a bipartisan group of senators has introduced an amendment that would restore the $14 billion in Medicaid funding cuts in the President’s budget proposal. The … Continue reading Medicaid Round Two
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