Archive for November 26th, 2011

South Texas Employer To Drop PPO Plan – But Will They Save Money?

Saturday, November 26th, 2011

A South Texas employer group has made the decison to drop their PPO network and pay physicians  U&C. Facilities will be paid using Medicare as a benchmark.

The rationale?: Why pay PPO access fees, (disclosed and undisclosed)  when instead  you can just pay providers what they get anyway? Seems to make sense.

Editor’s Note: There are two species of medical providers – doctors and hospitals. Doctors  want to be paid fairly and promptly. Most hate PPO networks, insurance companies and other intermediaries who “manage” health care. They sign PPO contracts only because they want to be advertised as “preferred.” Doctors would like nothing better than to be left alone to practice medicine. Hospitals, are different. They consider PPO networks as their outside salesmen and partners. They dictate pricing while PPO intermediaries demand ” discounts” to justify their fees. Inflated and arbitrary pricing accomplishes both objectives.

 

The Best Way To Get Referrals Is to Own The Referrer – Patient Steerage On Steroids

Saturday, November 26th, 2011

 

The largest hospital system in Georgia, Emory Healthcare, entered into a clinical affiliation with CVS Caremark’s MinuteClinic, opening up the door to convenient care for consumers, the latter announced yesterday.

(more…)

United HealthCare to Acquire XL Health

Saturday, November 26th, 2011

With ObamaCare looming, and the expected death and planned extermination of private health insurance carriers in this country  by 2014, insurance companies are positioning for continued profits by supplementing government health care programs such as Medicare and Medicaid through niche products. Transitioning strategies include acquisition of urgent care centers (Humana- Concentra), Medicare supplement business, entry into foreign markets (Aetna – China) or a  total exit from health insurance to other lines.

(more…)