HealthLeadersMedia.com - Health Plan News & Analysis

AHIP: Hospital Consolidation is Driving Health Costs

Tue, 09 Feb 2010 17:01:00 GMT

When the Massachusetts Attorney General's Office released a recent report sharply critical of the state's healthcare costs, one of the office's most often used words was "driver"—referring to hidden forces steering potentially out of control expenses. What's to blame? Health insurers' major lobby in Washington is pointing to hospital consolidation as an often ignored reason for the soaring price of healthcare.

Health Insurers Need to Focus on Climate Change

Tue, 09 Feb 2010 13:22:00 GMT

Potential climate change litigation affecting insurers may be just beginning. A potential flood of lawsuits "will pose a challenge" especially because of demands for insurance carriers to cover defense costs or other liabilities, says attorney Stephen Rosenberg of Boston.

On health bill, GOP's road is a new map

Tue, 09 Feb 2010 13:10:00 GMT

If Congressional Republicans decide to participate in President Obama's bipartisan healthcare summit this month, they have laid out principles and alternatives that provide a road map to what a Republican healthcare bill would look like if they had the power to decide the outcome. The Republicans have a set of ideas intended to make health insurance more widely available and affordable, by emphasizing tax incentives and state innovations, with no new federal mandates and only a modest expansion of the federal safety net, the New York Times reports.

Leverage sought in health summit

Tue, 09 Feb 2010 13:08:00 GMT

Both the White House and congressional Republicans see opportunity in an upcoming bipartisan summit on healthcare, the Wall Street Journal reports. Republicans have rejected outright any health legislation that doesn't start from scratch, but the White House reiterated it has no intention of changing its fundamental approach. Still, the White House hopes the televised meeting will change the tone of the healthcare debate by showing Democrats are open to Republican ideas, many of which are already in their bills, the Journal reports.

Study: Health costs higher where hospital competition is lower

Tue, 09 Feb 2010 13:07:00 GMT

Spending by private insurers tends to be higher when the hospital market is less competitive, a new study finds. The study compared geographic patterns of Medicare spending, using the Dartmouth Atlas data, with spending by big employers that cover their workers. The researchers suggest that when a small market has just one or a few big hospital systems, employers spend more than they do in large cities where there's more competition, an issue that does not generally affect government health payers like Medicare.

Requests for medical data are questioned by CT doctors

Tue, 09 Feb 2010 13:06:00 GMT

Connecticut's largest physician organization wants answers after several doctors received faxed requests for patients' medical information from an insurer. UnitedHealthcare subsidiary Ingenix sent faxed requests to physicians, asking for information dating to Jan. 1, 2008. Medical society Executive Vice President Matthew Katz says while it is not uncommon for insurers to ask to review patients' charts, doctors don't generally receive requests for information by fax and they don't fax such sensitive information to third parties they don't know.

Tennessee hospitals push for tax to offset cuts to TennCare

Tue, 09 Feb 2010 12:56:00 GMT

The Tennessee Hospital Association's members will push for a temporary tax on their revenues to reduce cuts to the TennCare program proposed by Gov. Phil Bredesen. The association's board voted to approve a one-year "coverage fee" of 1%-2% that would raise money for hospital services scheduled to receive less funding from TennCare. The fee likely would go into effect July 1 and would not be passed along to patients, association officials said. The group also will lobby the state to dip further into reserves and to use any additional revenue that comes into the state to reduce TennCare cuts, The Tennessean reports.

Obama official very disturbed by Anthem Blue Cross rate hikes

Tue, 09 Feb 2010 12:51:00 GMT

California insurance regulators asked Anthem Blue Cross to delay controversial rate increases of as much as 39% for individual policies, hikes that have triggered widespread criticism. And in a rare step, the Obama administration called on Anthem to justify its rate hikes, saying the increases were alarming at a time when subscribers face skyrocketing healthcare costs. In a letter to Anthem's president, Health and Human Services Secretary Kathleen Sebelius voiced serious concern over the higher premiums, which go into effect March 1 for many of the insurer's estimated 800,000 individual policyholders, the Los Angeles Times reports.

Insurer plays judge on cancer care

Tue, 09 Feb 2010 12:40:00 GMT

UnitedHealthcare has started sending doctors individualized reports assessing their treatment of breast, lung, and colorectal cancer patients.

Sebelius Lashes Out at Anthem for Premium Increases

Mon, 08 Feb 2010 20:19:00 GMT

Health and Human Services Secretary Kathleen Sebelius is demanding that Anthem Blue Cross publicly justify its decision to raise member premiums by as much as 39%. In a letter to Leslie Margolin, president of Anthem Blue Cross, Sebelius bashed the premium increases at a time when WellPoint, Anthem's parent company, "earned $2.7 billion in the last quarter of 2009."

Obama Hopes to Recharge Health Reform with Public Meeting

Mon, 08 Feb 2010 13:17:00 GMT

President Obama announced Sunday that he will meet with congressional Republicans and Democrats on Feb. 25 to discuss ways to move forward with healthcare reform this year. Speaking with CBS anchor Katie Couric, he said he wants to "put their ideas on the table" during a half-day meeting that will focus on the stalled healthcare legislation.

Democrats ask, can healthcare bill be saved?

Mon, 08 Feb 2010 13:11:00 GMT

Democrats have been searching for a way to salvage the healthcare bill, after the legislation was thrown into limbo by the Republicans' upset victory in a special Senate election in Massachusetts on Jan. 19. President Obama suggested that Democrats and Republicans publicly debate the merits of their competing healthcare proposals, then hold a final vote. Some Senate Democrats have noted that they had already gone through such an exercise, debating the legislation for 25 straight days before they approved it, with no Republican support, on Christmas Eve, the New York Times reports.

Hospitals may ask TN to tax them

Mon, 08 Feb 2010 13:10:00 GMT

Some Tennessee hospitals are considering paying more taxes to head off steep cuts to TennCare that could take more than $1.5 billion from the state's medical system. Representatives for the hospital industry have suggested bringing back the hospital tax, which expired in 1994 when TennCare was created, to reduce or stave off cuts in state funding proposed by Gov. Phil Bredesen. Those cuts would save the state $380 million, according to one analysis. But they would cost Tennessee two to three times as much in federal aid, amplifying the effect on hospitals and other healthcare providers far beyond the state's savings, The Tennessean reports.

California targets discount health plans

Mon, 08 Feb 2010 13:09:00 GMT

California regulators are trying to rein in discount health and dental plans that officials say frequently overstate benefits, offer little if any savings, and promise access to doctors who aren't part of the system. Some of the discounters fraudulently market themselves as insurance, while preying on the poor, the elderly, and others who urgently need care, officials told the Los Angeles Times.

States look to forestall hypothetical health insurance mandate

Mon, 08 Feb 2010 12:52:00 GMT

Legislatures in more than two-thirds of the states are objecting to health reform requirements that everyone buy health insurance. Supporters of the mandate argue that requiring everyone to have health insurance is essential to making insurance affordable, even as the government provides some people with subsidies. But opponents say that people should not be forced to buy something they do not want or cannot afford, and that trying to make them do so would be unconstitutional, the New York Times reports.

Number of Minnesotans uninsured jumps by 100,000

Mon, 08 Feb 2010 12:47:00 GMT

More than 100,000 Minnesotans lost their health insurance between 2007 and 2009 as unemployment and the recession affected medical coverage, the state Department of Health reported. By last year, nearly 1 in 10 Minnesotans lacked health insurance, the highest share since the state began keeping records, in 1990. The number of uninsured Minnesotans rose from 374,000 to 480,000 between 2007 and 2009 and the uninsured rate rose from 7.2% to 9.1%, the Minneapolis Star Tribune reports.

Aetna reports profit drop, sees more declines in 2010

Mon, 08 Feb 2010 12:26:00 GMT

Hartford, CT-based Aetna Inc.'s fourth-quarter earnings fell 15%, despite prior-year investment losses, as the health insurer continued to feel the effects of inadequate pricing that battered its underwriting margins. Aetna also projected a decline in 2010 earnings. The outlook follows a 2009 in which Aetna's medical costs outpaced premium increases, and the health insurance industry felt pressures from the broad economic downturn, the Wall Street Journal reports.

President Obama maps a way forward for a health overhaul

Fri, 05 Feb 2010 13:15:00 GMT

Speaking to supporters at a fund-raiser, President Obama presented a plan to move forward with comprehensive healthcare legislation, the New York Times reports. President Obama said that he wanted to meet with Democrats, Republicans and independent experts, lay out the facts for the American people and then, he said, "I think that we have got to move forward on a vote." He also said that he would take the time to refute false statements and misunderstandings about the healthcare legislation and to hear alternate ideas from Republicans, the Times reports.

Anthem Blue Cross dramatically raising rates for Californians with individual health policies

Fri, 05 Feb 2010 13:11:00 GMT

Anthem Blue Cross, California's largest for-profit health insurer, is moving to dramatically raise rates for customers with individual policies, the Los Angeles Times reports. Anthem is telling many of its approximately 800,000 customers who buy individual coverage that its prices will go up March 1 and may be adjusted "more frequently" than its typical yearly increases. The insurer declined to say how high it is increasing rates, but brokers who sell these policies say they are fielding numerous calls from customers incensed over premium increases of 30% to 39%, reports the Times.

White House May Push Health Plans to Create Wellness Programs

Wed, 03 Feb 2010 15:05:00 GMT

Most health plans have wellness, fitness, and disease management programs, but those offerings could become mandatory as the nation searches for ways to reduce health costs.