“A provision of Obamacare requires health insurers to spend roughly 80 percent of premiums on medical costs. This was supposed to help control insurance costs.”
Perverse Incentives Adopted By Clueless Politicians
“However, now the only way insurers can increase profits is by paying more for medical bills. A doubling of underlying medical bills permits a doubling of premiums and, therefore, a doubling of the 20% amount that can go towards insurer profits.” (See PPACA – Game Changer For Health Care Financing)
Cash Pay Health Plans Save More Than Insurance Plans
“This policy which creates conflicts for insurance companies explains why patients have been reporting they can negotiate cash prices far below what their healthcare providers would be paid by their own health insurance.”
SOURCE: Quotes shown above are excerpts from: Memo To Congress When Replacing ObamaCare – Health Insurance Is Not Health Care, By Scot Vorse (see previous blog posting)
Editor’s Note: Cash Pay health plans are the future of health care financing. Hospitals are paid quickly and efficiently. No pre-certification, no claims to file, no need to chase patient share. Doctors too are paid fairly and quickly through electronic fund transfer. A self-funded employer would be wise to implement a voluntary Cash Pay Plan Option as a good first step in finally controlling health care costs.
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The shared vision of RiskManagers.us and clients who retain our services is to establish and maintain a comprehensive employee health and welfare plan, identify cost areas that may be improved without cost shifting to any significant degree, and ensure a superior and sustained partnership with a claim administrator responsive to members needs on a level consistent with prudent business practices.
Plan costs, in all areas including fixed expenses and claims are open for review on a continuing basis. Cost effective plan administration and equitable benefit payment to providers are paramount to fulfilling our mutual fiduciary duties. As we proactively monitor and manage an entire benefit program we are open to any suggestions members may make or the dynamic health benefit market may warrant in order to accomplish these goals.
Duty of loyalty to our clients, transparency and accountability are essential to the foundation of our services. To that end, we expect our clients to realize a substantial savings based upon the services that we will deliver.
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FROM A TPA NATIONAL SALES DIRECTOR
Good article…….this nails the idea I try to explain to agents all the time….that the way the system works is that the the higher the claim cost the more money the insurance companies make under the ACA…since the ACA effective;ly removed and underwriting profit motivation….their profit motivation is now tied directly to increasing claim costs….how dumb can you be!
Also the driving factor behind maintaining networks is that “network access fees” are not part of the MLR calculation. In Iowa doe example Wellmark collects $30M annually in just network access fees…..no one has been able to explain what value they offer to the consumer?