The end of PPO’s may be coming to an end sooner than we thought…………..

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A large Texas school district recently approved an across the board 4- 4.78% pay raise. Or is that number really 1% before taxes? The difference goes to area medical providers in the form of higher health care costs memorialized within secretive managed care contracts crafted by third party intermediaries. If the district had taken better advice, they could have lowered their health care costs 15-25% without a reduction in benefits, thus giving their employees a significant raise this year. Other Texas school districts are doing just that………………..

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“The hospital opened in 1997 and has recently become a force to be reckoned with”…………..Much has changed since the following article was written in 2009 and it hasn’t been an erosion of influence…..

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“Hospital systems are seen as the evil empire, and facility costs are seen as driving healthcare expenses,” Dickerson says. “So we tried to keep people from going to hospital system.”

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The Brownsville Independent School District recently went out for Request for Proposals for TPA services for the district’s self-funded employee health plan. The four finalists include Aetna, Blue Cross, United HealthCare and one independent TPA.

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Mission Impossible Assignment for Plan Sponsors

Nothing is secret about health care costs although many third party intermediaries wish it so. Piecing all the data towards responsible stewardship of an employer sponsored health plan is not impossible. Reviewing managed care contracts is not impossible either. Once I was told I would never get my hands on a Blue Cross hospital contract. I did. – Bill Rusteberg

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“If Congress cannot address even obvious market failures in private health care, a federal takeover of our entire health-care sector will become that much more attractive.”

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Each investment would be $15 million, with an estimated 30 percent return on investment each year for a decade……………..

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“It doesn’t look like a hospital, and it doesn’t feel like a hospital,” Kristy Nations said on a recent visit to pick up medications at the pharmacy. “It actually feels good to be here.”

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American Health Care: If you’re poor it’s free, if you’re rich it’s affordable, but if you’re a middle class American you’re screwed.

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A quick read of the minimum requirements knocks out all TPA’s except the BUCAs. This will be a bidding war between Aetna (incumbent), Blue Cross and United HealthCare. Smart money is on Blue Cross. Sadly though, changing the logo on the I.D. card won’t solve the problem of runaway health care costs………….

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The TRS ActiveCare program is a ticking time bomb for Texas conservatives and a point of light for Texas liberals. Unless it’s fixed quickly Texas will become a Blue State faster than a melting raspa in deep South Texas on an August afternoon.

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With the stroke of his pen, Gov. Greg Abbott signed into law some of the strongest patient protection laws in the nation to shield Texans from the financial pain and misleading practices of free standing emergency rooms, where patients face a more than 80% risk of being balanced billed.

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In Texas, it’s almost impossible to bribe a public official as long as you report it.” That’s what political scientists call “legal corruption,” and it’s the rule by which Texas operates.”

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A retiree health plan is when ex-employees are provided for or allowed to purchase health care through their former employer.

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“Nola’s commitment to excellence and her dogged approach to problem solving fits in perfectly with our culture here”

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When Mike Dendy is involved, it’s golden. Introducing CarynHealth……………

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Mention Reference Based Pricing to a hospital official anywhere and you may experience first hand a human meltdown unfold before your very own eyes……………….

“Burn in hell, you sorry SOBs. Your plan to cut payments to hospitals could possibly be the most moronic idea I have ever seen come out of state government, and since you retardicians have taken power, and that’s saying a lot………….poor people generally don’t vote for your party, so you want them to die.”

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We’re going to start paying you less, are you in or out……..”

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The ACA is a naked command to buy an insurance product the government deems suitable,” Texas Solicitor General Kyle Hawkins argued in court papers.

“Bereft of penalties, the mandate now raises no revenue and therefore cannot by any conceivable definition be considered a tax,” he added. “Stripped of its tax status, the individual mandate is nothing more than an unconstitutional congressional mandate to purchase health insurance.”

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North Korea’s “first” insurance, reinsurance broker launches new website

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A federal judge has rejected the Trump administration’s rules for association plans………….

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Since the passage of the ACA un-elected bureaucrats in Washington have been issuing regulations faster than a melting raspa on a deep South Texas afternoon in August. Now the focus is on whorehouse high prescription drug costs…………

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Ruling will fundamentally change the way employers provide employee health care benefits……..

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Managed Care Castle Under Siege

If current proposals come to fruition, the issue of narrow networks or surprise billing will no longer be the consumers’ problem………providers could be left holding the bag if their ability to negotiate is undermined by disclosing rates to managed care entities …….the need to contract could conceivably be impacted and the foundational concept of managed care could break down.

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Is there a single soul who is surprised that an engineer came up with this?  The 10,535 pages of the Obama Care legislation reduced to 4 short sentences.

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bill that some insurers lobbied quietly to quash made its way through the Legislature and was signed by Gov. Phil Murphy on Sunday.

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“The French are on vacation more than they’re at work.” “They can’t wait to get laid off so they can live off generous unemployment.” “They have no ambition.”  – (secretsofparis.com) (more…)