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