Archive for January 8th, 2014

Transparency In Health Care Can Be Illusory

Wednesday, January 8th, 2014

cockroachhttp://www.youtube.com/watch?v=Q1xLY15uSQY&app=desktop

 

What You Need To Know About Provider Networks Under ACA

Wednesday, January 8th, 2014

By   – January 6, 2014 •

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“PPACA started to phase in limits on how insurers could use annual benefits limits, medical underwriting and plan benefits choices to hold rates down. Insurers reacted by creating narrow, ultra-low-cost networks; narrow networks made up of providers with high quality scores (LOW FEES); and big networks (High Fees) aimed at the Cadillac plan market.”

Editor’s Note: Translation – ACA limits insurers to pre-defined “metal” plans that leave no room for cost shifting. So, how do carriers compete now? By paying providers less. Narrow networks are  SBPPO’s – composed of providers who charge less than others – (type in “sbppo” in search box on this blog for information on SBPPO’s).

ACA provides  high octane fuel for Cost Plus / Reference Based Pricing schemes.

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