…not covered, forcing them to pay the charges out-of-pocket, the complaint said. http://www.reuters.com/article/2014/05/15/us-usa-healthcare-blueshield-i… **** Recording seems to refute claims made by Anthem By David Lazarus Los Angeles Times, May 15,…
Enjoy health care deflators, or would you rather be a frog?
Medical cost trend: Behind the numbers 2019
…Providers’ capacity to engage in high-performance networks should continue to expand as hospitals and health systems consolidate and physicians increasingly are employed by hospitals and health systems. New combinations The…
“Narrow networks” take away choice
…HMO plans with narrow networks, but other insurance companies such as Aetna and UnitedHealth Group have also offered such plans. http://www.azcentral.com/business/articles/2011/11/01/20111101health-net-offer-discounted-insurance.html “Narrow networks” – sharply limiting the network of physicians…
Why are large employers unable to control their costs?
…The top strategies being used to control retiree health care costs are caps on company contributions (46%), increasing employee contributions (37%), and eliminating coverage for future retirees (33%). http://www.businessgrouphealth.org/pdfs/Plan%20Design%20Survey%20Report%20Public.pdf The…
How does the Affordable Care Act define ACOs?
…savings program will be provided in a Notice of Proposed Rulemaking which CMS expects to publish this fall. https://www.cms.gov/OfficeofLegislation/Downloads/AccountableCareOrganization.pdf Link to text of Sec. 1899 (under Sec. 3022) with a…
How does the Affordable Care Act define ACOs?
Medicare “Accountable Care Organizations”
…and summary of Sec. 2706 – Pediatric ACO Demonstration Project): http://www.iha.org/pdfs_documents/home/IHA_PPACAACOSummary.pdf Comment: By Don McCanne, MD Since enactment of the Patient Protection and Affordable Care Act (PPACA) there has been…
Why Taxing Health Care Plans is a Terrible Idea
The Myth of "Cadillac" Health Plans
…comes close to the “Cadillac” definition in the Senate’s legislation—while a policy with the same benefits in Phoenix costs less than $15,000, according to the actuarial consulting company Milliman. The…
Was the ACA ‘politically feasible’?
…in every previous instance in the past 100 years reflects the reality that there hadn’t been a reform designed to deal with the realities of American politics…. http://www.washingtonpost.com/blogs/wonkblog/wp/2014/01/05/the-group-that-got-health-reform-passed-is-declaring-victory-and-going-home/ **** Implementing…
Was the ACA ‘politically feasible’?
…in every previous instance in the past 100 years reflects the reality that there hadn’t been a reform designed to deal with the realities of American politics…. http://www.washingtonpost.com/blogs/wonkblog/wp/2014/01/05/the-group-tha… **** Implementing…
Disturbing PwC report on employer medical cost trends
…programs, contracting directly with centers of excellence, or even participating in private exchanges, may save employers money. Consumer behavior is also beginning to impact the spending growth rate. http://pwchealth.com/cgi-local/hregister.cgi/reg/pwc-hri-medical-cost-trend-2015.pdf ****…
Request for candidates for Green Mountain Care Board
…Search: http://humanresources.vermont.gov/GMCB_Search Green Mountain Care Board Member Job Description: http://humanresources.vermont.gov/sites/dhr/files/pdf/GMCB%20Job%20Description.pdf Application for Candidates for Green Mountain Care Board: http://humanresources.vermont.gov/sites/dhr/files/pdf/APPLICATION%20FOR%20GMCB%20CANDIDATES.pdf (Although this is not an official message from PNHP, it is…
Request for candidates for Green Mountain Care Board
…Green Mountain Care Board Member Search: http://humanresources.vermont.gov/GMCB_Search Green Mountain Care Board Member Job Description: http://humanresources.vermont.gov/sites/dhr/files/pdf/GMCB%20Job%20Description.pdf Application for Candidates for Green Mountain Care Board: http://humanresources.vermont.gov/sites/dhr/files/pdf/APPLICATION%20FOR%20GMCB%20CANDIDATES.pdf (Although this is not an official…
