Best Analysis of the two Medicare Proposals by Far

This article by Jonathan Cohn of the New Republic easily does the best job I have seen of comparing the two Medicare reform  initiatives of the two presidential candidates:

http://www.tnr.com/blog/plank/106298/guide-to-medicare-debate-romney-ryan-obama-voucher-premium-support#comment-377242

Supplemental Policies Sales Increase

With high deductible coverage becoing increasing popular due to its lower costs for employees, it appears that employees are buying supplemental policies to fill in the gap:

http://www.reuters.com/article/2012/08/02/us-insurance-supplementary-gaps-idUSBRE87111K20120802t

Maasachusetts Legislature Passes Bill to Rein in Health Care Costs

The Legislature in MA yesterday passed a bill that limits the cost of health care to the rate of economic growth in the state. This will be a challenge for providers and insurers as medical costs increased 6-7% in 2010 while the state economy grew by only 3.6%. More details in this Boston Globe article:

http://www.bostonglobe.com/lifestyle/health-wellness/2012/07/30/legislative-leaders-reach-compromise-plan-control-health-care-spending/nVM0gPAYznIo4Vc9YYlgyH/story.html?

Will this work? Hard to say but MA s the first state in the country to set such a target. More details to follow.

HCCI Report: Rising HC Costs Due to Children

According to a report from the Health Care Cost Institute, a Washington, DC-based research group, spending on healthcare costs for commercially insured children under age 18 grew faster than spending for adults from 2007 to 2010. HCCI had access to three billion health insurance claims from Aetna, Humana, and UnitedHealthcare.

Insurers and consumers spent nearly $88 billion on healthcare for children in 2010, up by 12% percent from 2007, according to the HCCI. Spending increased even though the number of children covered by employer-sponsored insurance dropped from 44 million in 2007 to 41.4 million in 2010.

By comparison, healthcare costs for adults increased by 8%. For  the full report please clink on the link below.
http://www.healthcostinstitute.org/childrensreport

Good Summary of What the SC Ruling Means for Medicaid Expansion

One of the key ways of expanding coverage in the ACA was raising Medicaid eligibility to 133% of the poverty level. 29 states opposed being compelled by the feds to do so and now given yesterday's ruling they now have the option not to do so. What does this mean?

If some states do reject the Medicaid expansion, consumers between 100% of poverty and 133% of poverty would become eligible for the private federally subsidized insurance in the exchanges since the subsidies start at 100% of poverty. That would mean more business for those offering private insurance in the exchanges.

It also means that the federal government’s cost of covering these people would increase—covering them under Medicaid would be cheaper than under the private plans in the exchanges.

For those between 100% of poverty and 133% of poverty, it would be a mixed bag. Instead of a Medicaid plan, they would get a mainstream private insurance plan from the exchange that could gain them access to the health care system beyond only the providers who accept Medicaid patients. But they would have to pay 2% of their income in premiums—$600 a year if they make $30,000 a year. And, unlike Medicaid, they would be subject to standard deductibles and copays—perhaps an upfront $1,000 deductible per person. The cheapest plan, the bronze plan, is intended to only cover about 60% of health care costs.

Governors even end up having an incentive to dump Medicaid people onto the exchange—the state has to pay 10% of any Medicaid extension starting in 2017 but none of the cost of subsidies in the private exchanges.

And, some states don't now provide Medicaid coverage for some poor people making less than 100% of the poverty level--leaving them caught in a gap before federal coverage starts at 100%.

So, it’s not an open and shut case for the states on what they should do.

Many States Will Not Have Their HIX Ready 2014

It made little sense to me to invent the wheel 50 times throughout the country but to appease conservatives and lessen the concern about the federal government takeover of health care, the ACA gave the power to the states to create their own HIXs. But in a true irony, given how few states will be ready come 2014, the feds will have to step in and play a minor to major role in approximately 40 states or more come 2014.

http://www.politico.com/news/stories/0512/76596.html

Under 65 HC Claims Data Study Reveals Interesting Results

The first report based on claims data for the under 65 insurance market was released last week. Some of the findings include:
--Prices for care outside the hospital grew faster (10.1%) than care for patients admitted to the hospital (5.5%), though the average price for outpatient care was a fraction of inpatient care. The average price for care provided to patients admitted to the hospital was $14,662, compared with $2,224 for outpatient care.

The researchers found that price was still the major driver of costs even after adjusting for intensity of service

Read more: Rising prices drove higher spending among commercially insured: study - Healthcare business news and research | Modern Healthcare http://www.modernhealthcare.com/article/20120521/NEWS/305219978#ixzz1vWFR0KUN
?trk=tynt

State HIXs Should Limit Plan Choices

Each state has the flexibility to create the HIX that it believes best serves its market. Right now only two states, Utah and Massachusetts, have established HIXs. Utah allows any insurer to market its product(s) while Massachusetts limits the number of products offered. My experience shows that the MA model makes the most sense. Health insurance is very confusing to the average consumer so limiting the amount of choices is best. Research has shown that the more choices a consumer has the more difficult it is for them to make a purchase decision. This is particularly true for health insurance.

http://thehill.com/blogs/healthwatch/health-reform-implementation/226085-study-states-should-limit-number-of-plans-in-exchanges

HHS Regulatory Review: All Bark No Bite

It is nice that HHS can call out insurers for "unreasonable" rate increases on their individual products but in the end the feds cannot stop them from doing it.
http://www.politico.com/news/stories/0512/76066.html

Commonwealth Study On US HC Costs Compared to 12 Other Countries

Good review of the topic. Same old story: we spend much more than anybody else with no improvement in quality and in some ways are way worse.

http://www.commonwealthfund.org/Publications/Issue-Briefs/2012/May/High-Health-Care-Spending.aspx

Good Review of the Promise of ACOs

I think this is a fair treatment of the ACO concept. But is the risk worth it? I think most providers will still say no.
http://www.kaiserhealthnews.org/Stories/2012/May/02/millenson-ACOs-muscle-to-transform-system.aspx

Aetna CEO: HIs are Dinosaurs

Aetna CEO says in a speech that health insurers need to shift to becoming  technology guides for future consumers that will make it more convenient for consumers to access health care:
http://www.healthdatamanagement.com/news/HIMSS12-Aetna-CEO-insurers-face-extinction-44041-1.html?zkPrintable=true&goback=.gde_3264333_member_97073975

So What is the Latest on Payment Reform in MA?

Interesting presentation on payment reform by Dr. Robert Galvin on what could go wrong in payment reform. Two of his biggest concerns: providers fighting the loss of their income and consumers being told they can no longer have it all.

http://commonhealth.wbur.org/2012/04/10-ways-payment-reform

Good Summary of the SC and the Mandate

I have read many accounts now of Tuesday's SC hearings. Many said that the mandate is likely to lose 5-4 based on what they heard during the oral arguments. This summary takes a more reasoned view:

http://healthaffairs.org/blog/2012/03/28/william-sage-on-the-supreme-court-aca-arguments-day-two-where-no-law-has-gone-before/

Employer Sponsored HI Coverage Drop

In 2001 it was at 69.8%. By 2010 it had dropped to 54%. Wow.

http://motherjones.com/kevin-drum/2012/03/employer-based-health-insurance-going-way-dodo

Consumers Still Not Satisfied w/ Health Insurers

JD Power's new survey shows that consumers still are not happy with their health insurers. Interesting to note that 41% of people who have coverage through their employers would be interested in using an exchange to obtain coverage. I think this speaks to their desire to have multiple options for coverage.

http://www.fiercehealthpayer.com/story/insurance-exchanges-entice-dissatisfied-consumers/2012-03-16?utm_medium=nl&utm_source=internal

CBO Analysis of ACA Impact on Employer Coverage

Estimates range from 3M more covered by employers to 20M less. But even if the 20M less happens the net cost to the federal gov't will be minimal as additional cost for subsidies will be offset by higher tax revenues from higher salaries paid in lieu of HI coverage.

http://www.cbo.gov/publication/43090?utm_source=feedblitz&utm_medium=FeedBlitzEmail&utm_content=812526&utm_campaign=On-Demand_2012-03-15%2016%3a08

So Much for "Skinny" Benefits

These MN employers pay full freight for employee coverage and make the trade-off in salaries:

http://www.startribune.com/lifestyle/wellness/141253433.html

5 Top Benefit Trends (According to Mercer)

February 27, 2012 | Categories: Infographics | Tags:

Health benefit cost management continues to be a dominant concern among US employers, according to the National Survey of Employer-Sponsored Health Plans. This nationally projectable survey, conducted annually by Mercer, includes public and private organizations with 10 or more employees; 2,844 employers responded in 2011.

“Our survey results show not only the actions employers are taking to manage their health benefit costs, but where they are having success,” says Beth Umland, Mercer’s director of research for health and benefits. “For example, last year the average growth in prescription drug benefit cost was the lowest in many years, helping to slow overall health plan cost growth.”

“As we typically see, larger employers are leading the way in exploring new cost-management measures,” she adds. “For example, they’ve been the first to adopt value-based plan design, which provides financial incentives to choose and adhere to courses of treatment with the best chance for success.”

Learn about five of today’s top health benefit trends.

(Click image to enlarge)

For more information about this survey, visit www.mercer.com/ushealthplansurvey.

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Looks Like It Will Be the Small Group Plan for Most States

Fron an AIS Newsletter:

Despite a cool reception from various consumer advocates and industry stakeholders on the Obama administration’s recent guidance giving flexibility to states in designing “essential health benefits,” HHS is unlikely to deviate from those benchmark options, sources tell HRW. And as states move forward in choosing benchmarks, most probably will select existing small-group plans in their states as the model, various industry insiders tell HRW. Rhode Island’s insurance commissioner told a Feb. 3 Capitol Hill briefing that he, too, sees this approach as most probable.

Separately, a formulary analysis released Jan. 26 by Avalere Health LLC concludes that states’ choices on benchmark plans for essential benefits could have “a profound effect” on the availability of drugs for individuals buying insurance through exchanges.

“My feeling is most states will go with small-group plans, but there will be exceptions,” actuary Jim Drennan, senior director at OptumInsight, a unit of UnitedHealth Group, tells HRW. “The logic is the federal employee plan covers more, which would run the [state’s] cost up…and state-mandated benefits may or may not be covered under the federal plan. But the small-group plan has to cover state mandates,” offers reasonable coverage and won’t force higher rates than what are now in the market.

Using the state-employee plan instead would have “pluses and minuses,” he says. It may have more generous coverage than small-group plans, and “doesn’t necessarily have to cover all the mandates but probably will,” he explains, and yet it also likely would cost more than the small-group plan option. (Drennan declines to identify his state clients, but describes most as being “smaller states without large actuarial staffs.”)

For 2014 and 2015, states must select a plan equal in scope to services covered by a typical employer group plan in their state, HHS said in a Dec. 16 “bulletin” (HRW 12/19/11, p. 1). A state may choose a benchmark from among the three largest small-group plans, three largest state-employee plans or three largest federal-employee plans in the state, or opt for the largest HMO offered in the state’s commercial market. HHS proposes giving states until third-quarter 2012 to select benchmarks and, if they fail to do so, would set a default benchmark of the small-group plan with the largest enrollment in the state. Under the guidance, plans may modify coverage as long as benefits are “substantially equal” to the benchmark in 10 benefit categories designated under the reform law.

Numerous groups voiced concerns to HHS about its essential-benefits guidance. The American Academy of Pediatrics, for example, joined with other children’s health groups in worrying that HHS’s benchmark options are built around working adults, and thus “may lack important benefits for children.” The Essential Health Benefits Coalition of employer groups recommends that the essential-benefits package should contain only benefits in effect as of March 1, 2012, and not add new state mandates retroactively.

In its comments, America’s Health Insurance Plans (AHIP) said HHS should review the cost and medical evidence for state mandates and develop a framework for excluding some of them from the essential-benefits package. AHIP also urged HHS to set a deadline of no later than June 30, 2012, by which states must choose a benchmark plan.

Janet Trautwein, CEO of the National Association of Health Underwriters, tells HRW that she has had “a lot of conversations” with HHS officials and would be “surprised if they deviated from those benchmarks.” The bigger question, she says, is what HHS will decide with respect to cost sharing (including deductibles and copayments) and whether it is affordable to employers. Also, she says, consumer groups are nervous about language in the guidance related to broad substitution and actuarial equivalence for essential benefits. And multistate small employers are wondering which benchmark plan they must use. As for large employers, she says, their lifetime and annual limits are tied to essential benefits.

HHS Clarifications Are Expected Soon

Since the common objective is to “keep employers in the game” of sponsoring health coverage, Trautwein says, HHS is expected to clarify such issues soon. “We’ve been told it’s coming in the next few weeks,” she said Feb. 8. As for the final rule on essential benefits, HHS officials told her during the week of Jan. 30 that they intend to pay close attention to public comments before issuing regulations. There has been speculation in the media that the regulations won’t come out before the fall elections.

Trautwein notes that if a state chooses a small-group plan, there is a downside in the form of affordability for individuals. Such a benchmark “would provide broad coverage and hopefully a large range of cost sharing,” she says, but it’s also much richer coverage than current individual-market offerings. Thus, it “definitely will cost more for individuals than what they are currently paying,” she says, and if small employers send their employees to the exchange, “even if coverage is subsidized, it starts from a higher place because it’s richer coverage.”

In Defense of the Medicare Advantage Program

The MA Program is under constant criticism for its relative high cost. This article makes the case that the cost criticism is unfair:
http://www.nejm.org/doi/full/10.1056/NEJMp1114019

Keeping Seniors Out of Nursing Homes

Good article in the NYT about the PACE program's growth and success in keeping seniors in the community and out of nursing homes. But does it actually save money? The article implies the program saves the gov't $1700 a month over nursing home care but the question is would these same people otherwise be in a nursing home?

http://www.nytimes.com/2012/02/24/nyregion/managed-care-keeps-the-frail-out-of-nursing-homes.html?_r=1&emc=tnt&tntemail1=y

Four Requirements for Value Driven Health Care

Easier written than done but these 4 things must be in place for ealth care to become value driven:

The First Cornerstone of value-driven healthcare is widespread adoption of interoperable HIT [health information technology] to facilitate, among other things, reducing medical errors, enhancing the provision of evidence-based healthcare, and increasing administrative efficiency in healthcare delivery. […]

The Second Cornerstone of value-driven healthcare is measuring and publishing information about healthcare quality. […]

The Third Cornerstone of value-driven healthcare is measuring and publishing information about prices. […]

The Fourth Cornerstone of value-driven healthcare is adopting incentives to promote high-quality and cost-effective care.

MA Leading the Way in Reducing HC Costs?

As I have blogged about numerous times, the state of Massachusetts is leading the way in health care reform. Given that it basically solved the problem of the uninsured, it then moved to tackle the issue of high rising health care costs. Recent premium increases only averaged 1.8%. So does this mean, the state has fixed this problem also? Not really. Read this interview w/4 experts from Kaiser Health News:

http://www.kaiserhealthnews.org/Stories/2012/February/22/massachusetts-health-cost-growth-slows.aspx

Customer Service Ranked Poorly

As the health insurance industry moves more and more to the individual market, customer service is going to become even more important to remain competitive. According to this survey, it has a long way to go at most companies:
http://www.fiercehealthpayer.com/story/survey-health-insurance-industry-has-worst-customer-service/2012-02-22?utm_medium=nl&utm_source=internal

Small Businessess and the ACA

Will more move to self-insure? If so, what will this do to premiums? Good questions.

http://www.healthleadersmedia.com/content/HEP-276833/What-if-Small-Businesses-Evade-ACA-Regs

State Exchanges: No Where Close to Being Ready

So this is why the Obama budget has a $750M request for a federal exchange:
From AIS's Newsletter

While HHS collectively has awarded $729 million to help states stand up an insurance exchange (see table, p. 4), many states will run out of time long before they run out of cash. As a result, HHS is expected to set the bar low when evaluating certification applications for state insurance exchanges, industry observers tell HEX.

The reform law requires HHS to certify state exchanges no later than Jan. 1, 2013. But with many states still waiting for their legislatures to act, or for the Supreme Court to rule on the constitutionality of the reform law, overall development of state exchanges is woefully behind schedule.

In November 2011, CMS issued a 14-page draft certification application, which states must submit this fall. But HHS has said little about what the certification process will look like. And given that a majority of states won’t be fully ready for certification — either by choice or circumstance — HHS is expected to help states make progress, rather than reject applications that fall short, according to a source who has worked with CMS’s Center for Consumer Information and Insurance Oversight (CCIIO) but asked not to be identified. HHS will most likely allow conditional approval with an action plan for states that don’t meet all of the certification requirements, she tells HEX.

Joel Ario, who headed HHS’s Office of Insurance Exchanges until last September, predicts that “substantially less than” half of the states that apply will receive full certification next January. Most of the others will need to rely on federal partnership options, which allow for “a certain amount of mixing and matching” of functions, he tells HEX. A state, for example, can focus on traditional functions such as insurer oversight and consumer assistance, while relying to varying degrees on the federal government for the front-end eligibility and enrollment system. “My hope would be that many states in this middle ground can move to a full state exchange over time, as the proposed rules allow.”

Frank Micciche, a senior advisor at the Washington, D.C., law firm McKenna Long & Aldridge LLP, says he’s not surprised at the approach. “Everything that CCIIO has done for the last few months now has been extremely solicitous of the states, doing everything possible to keep them from walking away from exchange establishment,” he says. The main motivation for such a strategy, he quips, is “complete terror” at HHS over the thought of having to run a large number of exchanges.

Deborah Chollet, a senior fellow at Mathematica Policy Research, agrees that HHS is likely to make the certification as “friendly” as possible, and notes that CMS would prefer that states operate their own exchange.

“States will be all over the map regarding their exchange progress…and a majority of them will be nowhere near ready by the Jan. 1, 2013, deadline. As such, HHS will need to issue ‘conditional approval’ based on different levels of progress,” predicts Dan Schuyler, who heads the health insurance exchange practice at the Utah-based consulting firm Leavitt Partners.

States that opt to build an exchange from the ground up will need between 24 and 36 months to develop the necessary information technology (IT). That means certification by next January will be virtually impossible for those states unless HHS is very flexible. Moreover, it’s unclear if the federal government will have enough time to create a federal program that can be plugged into states that can’t or won’t stand up their own exchange. And even if some form of a federal exchange model is operational early next year, Leavitt says it will be extremely costly for HHS to implement a federal exchange in states that have made progress but still lack a certifiable exchange. Prior to joining Leavitt, he helped define the technical goals and business processes for Utah’s insurance exchange.

Micciche anticipates that about 35 states will seek level one grants, but probably closer to 25 states will seek actual certification of an exchange this fall. “And if you get there, I think you’ll get the green light.” But he says HHS could face problems if states that received conditional approval aren’t ready to enroll people on Oct. 1, 2013.

‘Operational Readiness’ Will Be Challenging

The application is broken into three parts. The first section — Enabling Authority and Governance — requires a copy of the law or regulation granting the state authority to create an exchange. It notes that pending legislation won’t be enough. Applicants also must describe the entity’s governance structure and provide an overview of the board’s composition as well as details about how and why those members were selected.

Part 2, Exchange Functions, requires applicants to outline strategies for member outreach and education, call centers and the Web portal. States also must “provide evidence” that they have enough staff to process applications through a variety of channels, and ensure there are safeguards in place that will allow the exchange to receive federal tax information.

Part 3, Operational Readiness, will be difficult for many states to complete, says Micciche. “You have to have your act together from an IT perspective and that’s where most states will get caught up,” he predicts. “Most of the other requirements are pretty easy to meet as long as they have legislation and have started doing their work. It’s the operational readiness part that is going to mean everything. That will be what really determines if a state is ready to be certified.”

But it’s highly unlikely any state will have everything complete by Jan. 1, 2013, which means applicants need to demonstrate only future capabilities. And how HHS measures that is anyone’s guess, he adds.

States that receive conditional approval can enter into a partnership with HHS to provide some services until the state transitions to a fully state-based exchange, according to a prepared statement CMS supplied to HEX.

Editor’s note: Here’s a link to the CMS page that includes the exchange certification application: www.cms.gov/paperworkreductionactof1995/pral/itemdetail.asp?itemid=CMS12...

Cleveland Clinic Gets Serious About Participation in Health Promotion Program

Bottom Line: participate and meet goals--4% decrease in premiums; otherwise pay 21% more.

http://www.cleveland.com/healthfit/index.ssf/2012/02/join_or_pay_more_cleveland_cli.html

Ford Developing a Car that Can Check Your Health

I think this is pretty cool and useful given how much time we spend in our cars:

http://www.healthleadersmedia.com/print/TEC-276275/What-If-Your-Car-Cared-About-Your-Health

Wellpoint and Primary Care Reimbursement

$1B in increased reimbursement to primary care physicians hopefully will make a difference:
http://www.fiercehealthpayer.com/story/interview-behind-wellpoints-1b-primary-care-initiative/2012-02-06?utm_medium=nl&utm_source=internal

Should Medicare Move to Premium Supports?

Medicare premium supports are the mainstay of the recently proposed legislation sponsored by Sen. Ron Wyden and Rep. Paul Ryan. Is it a good idea? Read on:

http://www.nejm.org/doi/full/10.1056/NEJMp1200448

ACOs to Bring the End of Health Insurance Companies?

Well by 2020 this is what Ezekiel Emanuel predicts and I think he he is right, at least in their present form.

http://opinionator.blogs.nytimes.com/2012/01/30/the-end-of-health-insurance-companies/

Positive Impact of the ACA

So why did Obama not mention any of these achievements to date in his SOTU address from the passage of the Affordable Care Act? Good question:

http://www.washingtonmonthly.com/ten-miles-square/2012/01/a_quiet_triumph_of_obama_care035079.php

US Health Care System Is Already Socialized

Good article noting the way costs are shifted in our present system between public and private payors and high cost and low cost providers:

http://www.slate.com/articles/health_and_science/medical_examiner/2012/01/american_health_care_is_already_socialized_.html

Feds Being Tough on Individual MLR Waivers

With the rejection of Texas' MLR waiver request, nine states now have been denied:

http://www.modernhealthcare.com/article/20120127/NEWS/301279985/texas-bid-for-mlr-waiver-is-rejected

Will the States Be Exchange ready?

This report from the Urban Institute is not nearly as "sunny" as the one released the other day by the White House. What a surprise!

http://thehill.com/blogs/healthwatch/health-reform-implementation/205869-report-many-states-lag-in-implementing-healthcare-law

SOTU hardly Mentions Health Care Reform

2.5M young adults now with health care coverage? Risk pools available in states to those who can't get coverage elsewhere? Why did Obama not reference any of these things due to the ACA? Excellent question.

http://www.healthleadersmedia.com/page-1/HEP-275807/SOTU-Light-on-Healthcare-Industry-Reacts

Aetna Partners w/ Wellness Company to Offer Group Coverage

I would be curious to know if these are multi-yr. contracts since it takes more than a year to see the positive results of health promotion efforts.

http://www.businesswire.com/news/home/20120119006616/en/Aetna-Heartland-Health-Roll-Health-Plan

Will the Feds Be Ready to Step In?

States that do not have the capability to provide their own health insurance exchange by 1/1/14 will have to cede that responsibility to HHS. But will HHS be ready to do the job? This blogger soes not think so:

http://healthpolicyandmarket.blogspot.com/2012/01/will-feds-be-ready-with-fallback.html

Gov't Takeover of Health Care: Not At All

Good blog post from the Kaiser Foundation noting how private insurers through their Medicare Advantage and Medicaid managed care contracts are becoming MORE involved in health care:

http://healthreform.kff.org/notes-on-health-insurance-and-reform/2012/january/betting-on-private-insurers.aspx

Problem W/Tiered Networks

Good article on the problems with the movement towards tiered networks in MA. The biggest issue: different quality standards for docs used by the 3 major insurers:

http://www.kaiserhealthnews.org/Stories/2012/January/17/Mass-Tiered-Insurance.aspx

Top 15 HC Systems according to Thompson Reuters

Interesting that Mayo, Cleveland Clinic and UPMC on not on this list but Gesinger is.

Large Health Systems
More than $1.5 billion total operating expenses:

• Banner Health, Phoenix, AZ
• CareGroup Healthcare System, Boston, MA
• Jefferson Health System, Radnor, PA
• Memorial Hermann Healthcare System, Houston, TX
• St. Vincent Health, Indianapolis, IN

Medium Health Systems
Between $750 million-$1.5 billion total operating expenses:

• Baystate Health, Springfield, MA
• Geisinger Health System, Danville, PA
• HCA Central and West Texas Division, Austin, TX
• Mission Health System, Asheville, NC
• Prime Healthcare Services, Ontario, CA

Small Health Systems
Less than $750 million in total operating expenses:

• Baptist Health, Montgomery, AL
• Maury Regional Healthcare System, Columbia, TN
• Poudre Valley Health System, Fort Collins, CO
• Saint Joseph Regional Health System, Mishawaka, IN
• Tanner Health System, Carrolton, GA

http://www.healthleadersmedia.com/page-2/MAR-275452/Thomson-Reuters-IDs-15-Top-Health-Systems

CO High Risk Pool Experience Shows Why Mandate Is Needed

From the Denver Post:

Colorado's troubled high-risk health-insurance pool has asked the federal government for nearly $15 million more than planned after running up early claims that are twice the national average.

http://www.denverpost.com/news/ci_19750414

HBR Blog on the Downsides of Being an Informed Consumer

Good post on the problems w/putting consumers in the driver's seat. The real goal should be providing enough info so consumers can have an intelligent discussion w/their provider about the best course of action:

http://blogs.hbr.org/cs/2012/01/the_trouble_with_treating_pati.html?utm_source=twitterfeed&utm_medium=twitter

Technology Key to Being an Informed Consumer

Good report from CES on the latest apps to keep consumers informed and connected. But while having an app on your smartphone is nice, the content it provides is more critical. Until easily accessible and understandable data on cost and quality is out there, the dream of the informed medical consumer will continue to be just that.

http://www.fiercehealthit.com/story/technology-key-growing-consumerism-trend-healthcare/2012-01-12#disqus_thread

Update on Cigna's Venture into India

Entering a market of 1.2B makes sense to me. So where are the other major carriers?

Cigna and TTK said their joint venture will offer a new and innovative approach to India’s health service marketplace by offering consumers a portfolio of innovative products that help support and improve health and well being with high-quality care. “We have proven expertise in offering solutions that seek to improve customers’ health while managing cost,” said Cigna Chief Executive Officer David Cordani.

http://newsroom.cigna.com/NewsReleases/Cigna-and-TTK-Leaders-Outline-Details-of-New-Joint-Venture-to-Sell-Health-Insurance-Across-India.htm?view_id=3897

More Good Stuff from PWC Consumer Survey

These are the results of a consumer survey of 1,000 people.

http://www.pwc.com/us/en/health-industries/publications/change-the-channel.jhtml

Consumers to Health Insurers: We're Flexible But Still Not Perfect

From a PWC survey the six key results are:

1. Consumers want their health plans to link cost and effectiveness
2. Consumers put off care
3. Consumers think integrated healthcare is a good idea
4. Consumers are willing to share their medical data
5. Consumers are looking forward to health insurance exchanges
6. Consumers want to "friend" you.

http://www.healthleadersmedia.com/content/HEP-275227/6-Things-Customers-Want-Health-Plans-to-Know##

VA Dem View On Exchange Makes Sense

I have never understood why those opposed to the ACA think it is better for the Feds to come in an run the exchange vs. having control over it at the state level:

http://www.washingtonpost.com/blogs/virginia-politics/post/health-insurance-bill-would-keep-feds-at-bay-va-democrats-say/2012/01/10/gIQAHmPmoP_blog.html