Insight, analysis & opinion from Joe Paduda
A group of docs in Texas has decided that two can play the ratings game. They are working on a project to rate insurers – on their “billing procedures and issues”.
It strikes me that these physicians may be engaging in the same type of behavior that infuriates them when exhibited by insurers – using an arbitrary, internally-developed methodology to evaluate payers solely on administrative indicators.
And the bad news just keeps on coming. The ranks of the uninsured increased for the sixth straight year, to 47 million. The increase this time was 2.2 million; 15.8% of Americans, or about one in seven, does not have health insurance.
This despite a slight decline in the national poverty rate and a leveling-off of health insurance premium increases.
So in a ‘best-case’ environment, 2.2 million Americans still lost their health insurance.
If the problems in the credit markets continue, they will likely drag down the economy, leading to even more becoming uninsured. And this will all happen just in time for the fall 2008 elections.
Carol Gentry of the Tampa Tribune has authored one of the more accessible pieces on the hows and whats of hospital price variation.
Carol’s piece illustrates two key issues – the data is available, and consumers aren’t using it.
Several sources indicate health care cost inflation is now running about 7%, with the latest coming from Towers Perrin. This jibes with other reports, and is consistent with last year’s final figures.
As always, the data underlying the overall result paint a more complete picture.
Continue reading Medical cost trends and consumer-directed health plans
CMS’ hospital reimbursement change is going to create winners and losers; among the biggest winners will be UnitedHealthcare.
Among the losers, their competitors.
Much has been made here and elsewhere of the issue of cost-shifting. Cost-shifting happens when a provider treats a patient, does not receive ‘full’ reimbursement, and then increases what s/he charges another patient to make up the difference.
There’s a lot of evidence that cost-shifting is pervasive, expensive, and results in a hidden tax of about $1000 for the average insured family.
But what forces providers to treat the uninsured?
In a word, EMTALA.
I’m covering the “Take Back America” conference in DC this week. It’s one of the leading progressive confabs, attended by everyone from subscribers to “the Weekly Worker” to green investment funds to Families USA to Sens. Edwards, Obama, Clinton, and Klobuchar to MoveOn.org. I’m here to hear what progressives are saying about health care and health reform.
So far, it appears the short answer is “not much”.
Continue reading Where’s the progressive movement on health care?
Ok, time to get back to examining Coventry. The second quarter earnings report is out, and things are looking good on the commercial side. I’ll look at that in detail later; for now, the work comp business is top of mind after the Concentra deal.
I don’t see how – because we’ll still have to pay for the uninsured. I’ve been mulling this over since reading a post on Health Care Policy and Marketplace Review. Bob’s post points out that a large enough group spreads risk well enough to help keep insurance affordable.
My take is coverage has to be mandated in order to prevent cost-shifting.
Continue reading Can we control cost without universal coverage?
The statistics are starting to come in and they aren’t pretty; Consumer directed health plans’ growth is all but stalled. Despite advocates claims to the contrary, employers are just not buying into CDHPs.
According to a study by the Kaiser Family Foundation, 19% of people with a choice of CDHPs or traditional forms of coverage choose CDHPs. And most of those folks (71% to be precise) don’t put any money into their accounts.
Continue reading Will consumer-directed health care make it?