HCPro Health Plan Insider - December 9, 2009 | Reform Should Create Transparencies Throughout Healthcare View as a Webpage | Subscribe for Free
Reform Should Create Transparencies Throughout Healthcare
Les Masterson, Senior Editor-Managed Care

Provisions in health reform legislation being discussed on Capitol Hill would open up claims and payment data to consumers; require insurers to provide detailed information about policies, such as out-of-pocket costs and claims denial rates; and offer information about how premium dollars are spent. Yes, greater health insurance transparency is needed, but I would go beyond that. Hospital and physician pricing and quality information should at the same time become more accessible to consumers so they can make informed healthcare decisions in aspects beyond insurance purchases. [Read More]
  December 9, 2009

Editor's Picks
Aetna overstated spending on patient-care category
Here is another talking point for health reform advocates: Aetna announced it overstated the amount of money spent on patient care for small business by $4.9 billion. As a result, Aetna's medical loss ratio for small businesses is actually 79% and not 82% as originally reported. The insurer said the error was a simple mistake and they have filed an amended report to the National Association of Insurance Commissioners on December 2 to correct the error, but private insurance foes will likely use this often when they promote the need for health insurance reform. [Read More]
Senators: Congress, President Should Get Health Insurance Through Public Option
This was bound to happen. Republican Senators, who are against a public insurance option, want the White House and Congress to sign up for the public plan if Congress includes it in health reform. Senator Tom Coburn (R-OK) floated the idea during the summer and it's back as the Senate heads into the final days of this year's health reform debate. Will the idea actually make it into the final health reform plan? No, but I do like the senators' thinking: If it's good enough for the American people, then you sign up for it. [Read More]
Report Finds Significant Geographic Quality Differences in Medicare Advantage Plans
Though nearly one-quarter of Medicare Advantage enrollees are in health plans with four or more stars, beneficiaries in many states don't have that luxury. Kaiser Family Foundation reported that less than 2% of beneficiaries in 25 states are in highly-rated plans, while more than half of Medicare Advantage enrollees in other states—Massachusetts, Oregon, and Hawaii—are in highly-rated plans. The researchers found that the average Medicare Advantage plan receives 3.27 stars on the CMS quality scale. The researchers wrote that the findings show that quality ratings are closely tied to plan type, plan experience, and whether they are nonprofit. [Read More]
Connecticut AG says Health Net hard drive was stolen
The Connecticut attorney general is reporting that another health insurer's hard drive with member information was stolen. This time, someone allegedly stole a portable, external hard drive from Health Net. While the state said the hard drive was stolen in May from the insurer's Northeast headquarters in Shelton, CT, Health Net said they are not sure whether it was lost or stolen. The drive contained the medical claims and financial information of as many as 1.5 million members. This is the second reported hard drive theft involving a health insurer in as many weeks. BlueCross BlueShield of Tennessee last week sent a mass mailing to some of its 3.1 million customers in the Volunteer State who may have had their Social Security numbers and other private data compromised after an Oct. 2 hard drive theft at a remote training facility in Chattanooga. [Read More]
Managed Care Headlines
Judge Gives Preliminary OK to $350 Million UnitedHealth Settlement
Les Masterson, for HealthLeaders Media, December 4, 2009
UnitedHealthCare's acquisition of Health Net approved
Hartford Courant, December 7, 2009
Senate Amendments Feature Insurer Exec Pay Limits, Malpractice Award Caps
Janice Simmons, for HealthLeaders Media, December 7, 2009
Senate Democrats Bash Blue Cross' Health Reform Report
John Commins, for HealthLeaders Media, December 4, 2009
Stimulus Money Protected Medicaid/CHIP, Says Kaiser Survey
John Commins, for HealthLeaders Media, December 9, 2009
Survey: Health Costs, Reform a Source of Stress for Americans
Ben Cole, for HealthLeaders Media, December 8, 2009
Massachusetts seeks better student healthcare
Boston Globe, December 3, 2009

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Listen Up
Retail Clinics a Disruptive Innovation

Paul Keckley, director of Deloitte's Center for Health Solutions, discusses the latest business developments in retail clinics. [Listen Now]
From HealthLeaders Media
Highmark Leads On-Site Clinic Movement

Highmark Inc., has opened on-site healthcare clinics and pharmacies for its 10,000 or so employees at its two main operations centers. [Read More]
From HealthLeaders Magazine
Blocking the One-Two Punch

Health insurance companies are rightfully concerned about how healthcare reform will affect their companies and offerings, but there is a more immediate threat to their future: the loss of the employer-based health insurance market. Here are ways to survive the fading employer-based insurance market. [Read More]
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