“You probably won’t be keeping it. That’s a prediction from Joel Ario, who oversees these health exchanges for the Department of Health and Human Services.
Archive for March, 2011
Dr. Garrison Bliss has found a way to decrease the role of insurance companies in day-to-day medical care that leaves both doctors and patients with more money.
The U.S. Supreme Court on April 15 will convene a private conference to consider an appeal by Virginia Attorney General Ken Cuccinelli (R) for an expedited review of a federal judge’s ruling in the state’s lawsuit against the federal health reform law, CQ HealthBeat reports (Norman, CQ HealthBeat, 3/23).
Balance Billing… it happens. With health care reform in effect and costs of providing benefits soaring, our industry has become increasingly careful with their claims dollars. Plan Administrators, seeking to cut costs and enforce their plan documents, are combating provider overcharges with a new vigor.
Some risk managers want more transparency from their third-party administrators on the financial arrangements they have in place with vendors………………………………..
Rather than moving toward a competitive world, we seem to be moving toward the opposite extreme: monopoly. Major consolidation is underway both on the provider and insurer sides of the market. And while this trend was already underway before Barack Obama became president, without doubt it is accelerating because of ObamaCare.
The graph below shows what things look like in the market for commercial insurance in major Texas cities:
Blue Cross already has 70% of the market in three of the nine largest metropolitan areas. In all of them, and for the state as a whole, more than 60% of all customers buy from only two insurers.
The health care reform law could threaten the ability of employers that self-fund their health care plans to design those plans, benefit experts say. The level of some of those threats could be known in just a few weeks.
Insurance Brokerage Exchange (IBX) is a software package designed to assist employers in seeking competitive proposals on group life and disability plans. Rights to the system are delegated to select brokers/distributors.
Financing and administering health care through a self-funded employee welfare plan takes many forms. Financing is accomplished through mix of employee and employer contributions – determining the money value of the plan, current and projected is easy. Determining the actual value is not as easy. Determining who shares in the money sometimes takes a path of convoluted twists and turns.