BCBS of Georgia’s Solution to Non-Emergency ER Visits?

BCBS of Georgia held a webinar last week. From what we have been told, BCBS and Anthem are cancelling Emergency Room benefit payments that are not “emergencies.” We have done the same with some of our self-funded clients. Significant savings have been achieved. No longer will Mommy take little Johnny to the ER for a fever and pay a low co-pay. Now when Little Johnny’s mommy gets the bill, her co-pay for non-emergency ER visits will be 100%……………….

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To Promote Health Care Excellence, Let’s Recognize Approaches That Assure Value

Aug 28, 2017

BY BRIAN KLEPPER

A challenge for health care purchasers is choosing vendors whose performance matches their cost and outcomes claims. A 2015 Mercer surveyfound that only 41 percent of worksite clinic sponsors think that they’re saving money. As Al Lewis and Tom Emerick have detailed, many wellness and disease management companies simply overstate their results. In many cases employers may not realize that they, not the vendor, take the risk for results.

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Why A Pennsylvania Insurer’s Collapse Could Whack Californians In the Wallet

Penn Treaty’s liquidation poses a “potential shock to the health marketplace” as the losses pile up, according to the A.M. Best credit rating firm. Industry analysts estimate the parent company has long-term claims liabilities approaching $4 billion, but only about $700 million in assets.

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Smoke & Mirrors – Comparing PPO “Discounts”

Many independent fee based insurance consultants are sucked into the PPO “discount” vortex……………..

The carriers are very good at playing this game and my belief is that most consultants don’t get it or pretend not to get it, thus doing a great dis-service to their client.”   – PHO Sales Representative

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