Corporate Research Group's Weblog

United’s Slavitt Tapped for CMS Post

Carl Mercurio — Mon, 23 Jun 2014 15:03:09 +0000

According to CMS, he’ll be principal deputy administrator, overseeing day-to-day operations for Medicare, Medicaid, CHIP and exchanges. He was previously group executive vice president for United’s Optum, which was called in to help fix the troubled exchanges after the botched launch. CMS also said it would hire a permanent chief executive as well as a chief technology officer for the federal exchange. Republicans are warning of potential conflicts of interest in the Slavitt hiring. As for the CEO and CTO hires, it was sorely needed.

$82 for Health Insurance

Carl Mercurio — Wed, 18 Jun 2014 14:20:45 +0000

That’s how much the average subsidized person is paying monthly for health insurance on the exchanges, according to new HHS data covered on Vox by German Lopez. Taxpayers picked up an average of $264 of the tab:

The report, published Wednesday, is the most in-depth look available so far at the prices that federal marketplace shoppers will pay for private health coverage. It shows the vast majority of shoppers will use federal subsidies to pay for insurance, significantly reducing their monthly price tag.

Relative Value Health Insurance

Carl Mercurio — Mon, 16 Jun 2014 14:59:01 +0000

Interesting post in The New York Times blog The Upshot on the notion of relative value health insurance.

Consider the latest technology for treating prostate cancer: the proton beam….Per treatment, this therapy costs at least twice as much as alternative approaches, but is no more effective. Many health plans cover it and other therapies of low or uncertain value because they pay for anything that physicians deem medically necessary even when evidence suggests otherwise. And, without even knowing it, Americans pay for it in higher premiums.

It doesn’t have to be this way. If plans could compete on the basis of the therapies they cover, consumers could decide what they wish to pay for. This sounds complicated, but it need not be.

Health plans could define themselves at least in part by the value of technologies they cover, an idea proposed by Professor Russell Korobkin of the U.C.L.A. School of Law….

Someone who wanted proton-beam cancer treatment coverage could have it by selecting a platinum policy and paying its higher premiums. Someone who did not want to pay higher premiums for lower-value care, in turn, could choose a bronze or silver plan. This gives a different, but more useful, meaning to the terms “gold,” “silver” and “bronze” than they have in the new insurance exchanges today.

The Price of For-Profit Insurance

Carl Mercurio — Fri, 13 Jun 2014 14:15:57 +0000

Austin Frakt of The Incidental Economist highlights a study that suggests:

Sizeable [for-profit] insurers are more likely to exercise market power via price increases than are comparable NFP [not-for-profit] insurers. Second, pricing actions by dominant insurers have a ripple effect on rivals’ prices, further solidifying the evidence pointing towards oligopolistic conduct in many local insurance markets.

CRG Healthcare Update, June 12, 2014

Carl Mercurio — Thu, 12 Jun 2014 17:56:21 +0000

Managed Care Headlines

Aetna CEO Says 2015 Obamacare Rates to Rise Less Than 20 Pct

Centene Dodges Bullets In Changing Medicaid Landscape

Health Insurers Push for Change to ObamaCare

Health Law Helped Minnesota Uninsured Rate Drop 41 Percent

Blue Cross Blue Shield of Michigan and Blue Care Network Intend to Double Health Plan Product Offerings for the 2015 Individual Market

What’s Health Insurance Really Going to Cost?

Consumer-Directed Headlines

What To Do If Your Healthcare Records Are Compromised

Employer Headlines

Some Small-Business Employees to Have Only One Health-Plan Choice

Policy & Regulatory Headlines

Senate Health Plan for Veterans Costs May Top $35 Billion

Health Care Remains Drag for Democrats as 53% Oppose Law

Morning Plum: Republicans Still not Winning Argument Over Obamacare

Medicaid & Medicare Headlines

Federal Bungling Of ObamaCare Verification Creating Nationwide Chaos In Medicaid Departments

Virginia Governor May Try to Expand Medicaid on His Own

Medicare Costs Well Under Control So Far in 2014

Mercy Health Blames Lack Of Medicaid Expansion In Plan To Lay Off Hundreds

Pharmaceutical Headlines

Valeant Pharma’s Arguments About Drug Research Are Misleading And Wrong

What’s Going on in Virginia?

Carl Mercurio — Wed, 11 Jun 2014 14:38:42 +0000

First there’s the “insane” battle over the Medicaid expansion, as Sarah Kliff reports on Vox, and now House majority leader Eric Cantor has lost the Republican primary in his district to a Tea Party guy. As Phil Rizzuto would have said, “Holy Cow!”

What’s it all mean? Thomas Davis III, a Republican and former Virginia congressman, hit the nail on the head in this quote in The New York Times:

When Eric Cantor, a conservative and member of the leadership, is too moderate, it sends a chilling effect to other Republicans and makes it that much harder to cross over and work together.

CRG Healthcare Update, June 10, 2014

Carl Mercurio — Tue, 10 Jun 2014 17:21:20 +0000

Managed Care Headlines

Insurers Fill Gaps in Health-Law Plans

CareFirst Seeks Price Hikes for Individual Health Plans

Are Obamacare Premiums Really Plunging 21% in This State?

FL State Seeks to Dissolve Local Health Insurance Company

States Can Shed Light On Health Care Prices

Why the Obamacare Profit Surge Isn’t Over Yet

Employer Headlines

Trader Joe’s Proves That Obamacare Can Free Us From The Wrong Jobs

Employers Push Highmark, UPMC for Details of Transition Plan

Policy & Regulatory Headlines

The Nation’s Most Vicious Obamacare Fight Just Took A Wild Turn

Morning Plum: GOP’s Guerrilla Resistance to Obamacare Alive and Well

Obamacare’s Employer Mandate is Under Attack from Both Sides. Will It Survive?

Medicaid & Medicare Headlines

In Texarkana, Uninsured and on the Wrong Side of a State Line

More Than 1.7 Million Consumers Still Wait For Medicaid Decisions

Senator’s Resignation Complicates Medicaid Expansion Plan in Virginia

The Real Travesty of Virginia’s Medicaid Fight

Home Is Where The Money Is for Medicare Advantage Plans

Taxpayers Face Big Medicare Tab for Unusual Doctor Billings

Hospital Headlines

More Patients Flocking to ERs Under Obamacare

Physician Headlines

State Health Benefit Plan Can’t Seem to Escape Controversy

Healthcare Investing

Are 2 Million “Takers” Cheating Obamacare?

Healthcare Technology

Big Data’s Big Future in Health Care

3 Insurers Jumping on the Smartphone Health Care Revolution

Competition Growing on Exchanges

Carl Mercurio — Mon, 09 Jun 2014 14:18:54 +0000

And that’s good news. As Jason Millman of The Washington Post writes, increased competition is a sign that health plans are feeling confident about the exchanges. There’s more:

Recent research suggests that more competition in the exchanges could help temper premium increases. Other new analysis shows that exchange plans, on average, are cheaper than individual plans offered outside the insurance marketplaces. And given the narrow networks in exchange plans, more insurers could mean better access to providers.

Premiums Rose Before, Will Rise After ObamaCare

Carl Mercurio — Fri, 06 Jun 2014 16:57:54 +0000

CNBC’s coverage of a Commonwealth Fund study says:

Individual health insurance premiums in the years before President Barack Obama signed the Affordable Care Act into law had large average increases and a high variability in rate hikes across different states and insurers, a study released Thursday found.

It’s the kind of thing that absolutely true, but hard for people to fully appreciate when they’re being hit with hefty 2015 premiums increases.