A South Texas political subdivision decided this month to eliminate their PPO plan and instead pay claims using 2008 RBRVS as a benchmark for physician claims. Facility charges will be paid on a cost plus basis. A special feature of the plan prevents any balance billing to the plan participant. To our knowledge, this is the first Texas political subdivision to take this approach to controling run away health care costs.
Out of the box strategies to control health care costs
In response to criticism from federal workers and members of Congress, the Blue Cross and Blue Shield Association has announced that it will revise its 2009 fee structure for out-of-network, non-emergency surgeries under its standard plan for federal employees. BCBS — the largest provider of federal employee health insurance plans previously had said members of the plan in 2009 would be responsible for 100% of the cost of an out-of-network surgery, up to a maximum of $7,500 per surgeon, per surgical day. According to the Post, the change “outraged” federal workers and “troubled” many members of Congress.
Under the revised fee structure for 2009, BCBS will cover 70% of the cost and members will pay the remaining 30%, as well as any difference between the allowed amount and the actual bill.
Investments and catastrophic losses affected property/casualty insurance industry earnings for the first nine months this year as net income dropped 92%. Net income for the industry after taxes was $4.1 billion for the first nine months of 2008, compared with $50 billion during the first nine months in 2007.
December 19, 2008 – Agents from the Federal Bureau of Investigation have seized files from Brooke Corp. and are combing through the bankrupt insurance agency franchiser’s financial records, the special master appointed to oversee the bankruptcy confirmed.
Editor’s Note: What will be the immediate future of the Brooke Insurance Agencies in Texas?
Aetna is offering traditional medical policies for pets as it branches out for the first time from humans to cats and dogs.
The Hartford-based health insurer began underwriting the policies last week in six states, mostly in the West, and in the District of Columbia. Aetna eventually expects to sell in all 50 states.
