States Are Behind in HI Exchange Development

This is not surprising:

http://www.kaiserhealthnews.org/Stories/2011/June/24/Leavitt-Says-States-Not-On-Track-On-Exchanges-Deadline.aspx

At the same time Leavitt is now a consultant helping states form exchanges so his "concern" should be taken with a grain of salt.

MA AG Report: Global Payments NOT Saving Money

1 yr. into the new payment plan finds that doc costs are still up 10% vs. 1.9% for docs not participating in global payments. I really can't believe the 1.9% figure:

http://www.boston.com/lifestyle/health/articles/2011/06/23/mass_finds_new_payment_system_not_cutting_health_care_costs/?p1=Well_MostPop_Emailed2

Health Insurance Exchanges Just Too Complicated

This article reviews all the issues involved in setting up an HI exchange:

http://www.kaiserhealthnews.org/Columns/2011/June/061511howardparente.aspx

BS of CA 2% Profit Cap: " A Good PR Gimmick"

BS of CA has garnered a great deal of good press for its voluntary move to limit profitd to 2% of revenue. But is this positive publicity deserved? Not according to this interview:

http://www.healthleadersmedia.com/page-1/HEP-267432/Behind-BSCAs-2-Solution##

Costs in MA Continue to Outpace the Nation

Providers continue to drive costs in our country's health care laboratory:

http://commonhealth.wbur.org/2011/06/state-health-spending-outpaces-nation/

Messing w/Medicare and Medicaid

As this article points out, more than just the recipients of the two programs are involved:

http://www.kff.org/pullingittogether/medicaid_medicare_multiplier.cfm

Oregon Ready to Establish HI Exchange

I looks like OR is moving forward. The more a state stalls, the more under the gun it will be.

Oregon's legislature this week passed bipartisan exchange legislation and the governor is expected to sign it. "I look forward to signing this key piece of our health care improvement agenda," Gov. John Kitzhaber, a Democrat, said in a statement. The Oregonian newspaper reported that the bill gained a large majority in the state's House despite opposition from the left and the right. Conservatives in the tea party movement viewed any action on the health care law implementation as an endorsement of the overhaul, while unions protested that the setup of the exchange gives too much clout to the insurance industry. The exchange won't have the power to extract lower rates from insurance plans.

Care Management: We Have a Long Way to Go

PCPs just are not yet set up to handle this new role:

http://blog.healthintegrated.com/index.php/2011/06/09/care-management-a-patients-view/?utm_content=0000-00-00%2000%3A00%3A00&utm_source=VerticalResponse&utm_medium=Email&utm_term=&utm_campaign=Care%20Management%20%E2%80%93%20A%20Patient%E2%80%99s%20Viewcontent

ACO Regs Not Attracting Many Takers

Why? The financial incentives are just not there:

http://www.kaiserhealthnews.org/Columns/2011/June/060311cannon.aspx?utm_source=khn&utm_medium=internal&utm_campaign=viewed

BS of CA Agrees to Cap Profits

This is a major advantage of being a non-profit vs. a publicly traded company:
http://www.kaiserhealthnews.org/Stories/2011/June/09/blue-shield-california-profit-cap.aspx

Broler Commissions Issue Find Friends in Congress

Proposed federal legislation removes commissions from admin costs. So where would they go?

http://www.commonwealthfund.org/Content/Newsletters/Washington-Health-Policy-in-Review/2011/Jun/June-6-2011/Brokers-Push-for-Review-of-Broker-Rule.aspx

Update on State Health Insurance Exchange Activity

Surprisingly Alabama is moving forward while my home state of PA sits on its hands:

http://www.washingtonpost.com/politics/health-care/states-slow-to-adopt-health-care-transition/2011/06/03/AGbZbjJH_story.html

Agents Do Not Want Commissions to be part of MLR Calculations

So they want it to be part of admin expenses?

http://www.kaiserhealthnews.org/Columns/2011/May/052611Besesparis.aspx

Agents Still Not Liking MLR Requirements

From Capitol Hill testimony:

The cost and quality of healthcare will get worse because of healthcare reform rules that let the federal government review rates and set limits on how insurance companies spend their money, small businesses and insurance agents said Thursday.

Employers and agents are particularly concerned about rules that say insurers can only put 20 percent of their revenues toward profit and administrative expenses. Agents and brokers want their commissions to be carved out of the definition of administrative costs. Without that change, they fear insurers will squeeze broker commissions in order to free up money for other uses.

Agents and brokers are facing a “desperate economic situation” because of the requirements, said Janet Trautwein, chief executive of the National Association of Health Underwriters. She testified Thursday before the House Energy and Commerce Health Subcommittee.

Witnesses said the restrictions on spending — known as the medical loss ratio — will ultimately raise costs and reduce options for consumers. The MLR represents a “significant move toward government micromanagement of health insurance,” University of Pennsylvania professor Scott Harrington said.

ACA's Impact in Oregon

This is a good summary of what two major players in OR's health care market see where things are going in the next few years:

http://www.thelundreport.org/resource/health_reform_should_drive_down_insurance_rate_increases

Commonwealth Fund Report on CA HI Exchange

This is a good review of what CA has been up to:

http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/May/1507_Weinberg_california_hlt_benefit_exchange_ib.pdf

Wake Up Call to Hospitals: Medicaid No Long to Pay for Never Events

Given Medicaid's budget problems this new policy makes total sense:

http://www.shrm.org/hrdisciplines/benefits/Articles/Pages/WHCC2011.aspx

Employee Incentives Gaining Popularity

Employee incentives for healthier behaviors and high performing networks are becoming more popular:

http://www.shrm.org/hrdisciplines/benefits/Articles/Pages/WHCC2011.aspx