The Solution To Texas’ Dental Medicaid Problems

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Grandma’s Self-Insured Dental Plan 

By Darrell Pruitt, DDS

As I read your political call for dentists to help expand Medicaid/Medicare dentalcare, currently administered by DentaQuest, it occurred to me that taxpayers deserve more transparency concerning DentaQuest – an increasingly popular but secretive destiny for tax dollars.”

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K&K Launches Student Accident Coverage Website


K&K Insurance Group, Inc., a subsidiary of Aon plc, has launched a new website at offering K-12 student accident coverage. The website is designed for private, non-boarding K-12 schools and offers the ability to quote and purchase insurance online and receive coverage documents immediately via email.

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Anthem-Cigna Deal Creates Opportunity, Risk for Brokers


Stressed Heath Insurance Broker Contemplates Future

“Brokers that are comfortable working on a fee-basis will be fine, but the majority of small and mid-size brokers still work on a commission basis, so this could be a real risk for them if they do not have the skill set or culture in their organization to engage clients on a fee-basis,” O’Connor says.

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The Employer-Led Health Care Revolution


Intel was rigorously managing its equipment suppliers but not its health care suppliers…….Intel decided it  could use its purchasing power in markets where it had operations to influence health care players—care providers, health plan administrators or insurers, and other employers—to rise above their competing self-interests and work together to redesign the local health care system….

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Assuring Hospital Emergency Care Without Crippling Competition


“Emergency departments are often more profitable than hospitals admit, as they are the source for roughly half of inpatient admissions. Patients admitted in emergency situations are rarely price-conscious, and revenue from ED admissions is often counted as part of subsequent inpatient stays. Furthermore, as non-urgent cases presenting in the ED are often relatively cheap to treat and well-covered by ED reimbursement rates, hospitals lack the incentive to redirect them to cheaper sites of service.”

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Insurance Companies Blame Actuarys


Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected.

Upon hearing the news, hordes of actuarys flock to liquor stores throughout the fruited plane seeking solace……………..“An actuary is a person who passes as an expert on the basis of a prolific ability to produce an infinite variety of incomprehensible figures calculated with micro-metric precision from the vaguest of assumptions based on debatable evidence drawn from inclusive data derived by persons of questionable reliability for the sole purpose of confusing an already hopelessly befuddled group of persons who never read the statistics anyway.”    

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High-Deductible Plans – Hospital Bad Debt & 75% Lower Utilization

chasingdollarsHigh deductible plans are creating new headaches for hospitals, including more unpaid bills and seasonal demand for some healthcare services as patients wait to hit their deductibles before seeking non-urgent care.

The bulk of the savings through high deductible plans, up to 75%, come from lower utilization. It’s not the value of the increased deductible per se, it’s the change in behavior. When it’s other people’s money it doesn’t matter, but when it’s your money it’s a completely different dynamic.

Instead of jacking up prices, hospitals should work with local health plans to achieve equitable solutions – lower reimbursement rates for lower deductibles and co-insurance. Is 250% of Medicare and chasing dollars better than 100% of Medicare and not chasing dollars?

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