Archive for March 16th, 2014

Insurance Companies As We Know Them Are About to Die And Here’s What’s Going To Replace Them

Sunday, March 16th, 2014


“More health systems are seeking to contract directly with employers with deals to bundle the price for certain services or serve as exclusive contractor for all healthcare services for a company’s employees….”
Editor’s Note: We believe this article provides an accurate prediction of the evolution or our health care delivery system. We are already seeing the movement begin here in Texas.

“Reimbursements Based on a Medicare Allowable Not Legally Appropriate”

Sunday, March 16th, 2014


Another short-term, cheap and faddish solution is making benefit reimbursement determinations based on a Medicare allowable.”

Editor’s Note: This article will be in every salesman’s briefcase tomorrow morning. You can hear the Xerox machines warming up right now. Pro-Cost Plus Health Care Revolutionaries who sell fear  (   will use this article to justify higher fees for legal indemnification, while BUCA sales representatives will use it to sell against Cost Plus Insurance…………..


From a TPA:

At the root of this article is the fact that DCC is a Dialysis Cost Containment company whose lifeblood is “negotiated” reductions from providers of that service.  The successful use of reference based pricing combined with use of the laws related to dialysis service facilities not being able to balance bill Medicare eligible plan members would eliminate DCC from the market.  The article is built from a self-serving perspective.