Day: March 25, 2016

“Self-funded employers have been forced to rely on PPOs to give a percent off billed charges from these providers.  This has done nothing to curb the rising cost of care as most PPOs are taking a portion of ‘savings’ as an additional revenue stream.  It benefits them if the billed charge is excessive.  In additional to the PPO, many more layers between the patient and the provider further add to the cost. “

Continue reading Free Market Medical Association – TPA Call To Action

Continue reading David Returns To Rome – To Start Wellness Initiative

“In Dallas, Texas Blue Cross, in its Exchange plan, is paying 10 percent less than what Medicaid pays. So these are low rates. They take all the doctors who accept that fee—and that typically doesn’t include the best doctors, by the way—and that’s how they get their premiums down. They’re convinced that healthy people buy on price.” – John Goodman

Editor’s Note: Nothing in the ACA mandates the reimbursement levels paid to medical care givers. In this case BCBSTX is paying less than Medicaid on their narrow network If BCBSTX can pay an arbitrary number which is less than Medicaid reimbursement rates, what prevents an employer doing the same thing? The employer could build a Base Plan with reimbursement rates half of Medicaid’s and thus limit risk while complying with the ACA. The employer could then offer a Buy Up Plan for those who want “real” insurance

Continue reading Repeal-Obsessed Republicans Don’t Understand Obamacare Is Kind Of A Gift