Tag Archives: Health Plans

Them, Not Us

Brian Klepper Posted 1/7/13 on Medscape Connect’s Care and Cost Blog “How many businesses do you know that want to cut their revenue in half? That’s why the healthcare system won’t change the healthcare system.” Rick Scott, Governor of Florida Former … Continue reading

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Posted in Analytics, Benefits, Brian Klepper, Conflicts of Interest, Health Care Cost, Medical Management | Tagged , , , , , | 2 Comments

A Thousand Dollars Says Dr. Ezekiel Emanuel Is Wrong About ACO’s Long Term Prospects

Jaan Sidorov Posted 2/1/12 on the Disease Management Care Blog Approximately 15 years ago, the Disease Management Care Blog was a speaker at a conference with an audience mostly made up of managed care leaders. It boldly argued the nation’s … Continue reading

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Posted in Analytics, Health Care Cost, Market Dynamics, Medical Management, Physicians, Policy/Law/Regulation, Politics, Quality | Tagged , , , , , , | 1 Comment

Working for Health Care: What $15,000 Will Buy An American Worker

Jane Sarasohn-Kahn   What could $15,000 get you? – The value of the proposed Home Buyers Tax Incentive initiative being discussed in Congress – A Kia Rio automobile – The cost of an NFL fine. $15,404 was the average annual cost of health insurance for a family … Continue reading

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Health Plans Enter A New World of Retail

Jane Sarasohn-Kahn First posted 8/26/11 on Health Populi Health plans are more aggressively managing medical costs, leaning out administrative inefficiencies, and looking for new customers. Plans are undertaking these strategies as they face uncertainties over the next couple of years leading … Continue reading

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Posted in Analytics, Market Dynamics, Medical Management, Physicians, Policy/Law/Regulation, Quality, Reform, Tools | Tagged , , | Leave a comment

The 100 Year Shift? Introduction and Overview

Vince Kuraitis and Jaan Sidorov First posted 7/5/11 on the eCareManagement Blog Gazing at the horizon, we foresee the potential for a tectonic realignment among physicians, hospitals and payers. Here’s a quick visual representation: This essay is the first of a … Continue reading

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Posted in Analytics, Innovation, Medical Management, Physicians, Policy/Law/Regulation, Quality, Reform | Tagged , , , , , , | 1 Comment

Average Annual Health Costs for a US Family of Four Approach $20,000, With Employees Bearing 40%

Jane Sarasohn-Kahn First published 5/11/11 on Health Populi Health care costs have doubled in less than nine years for the typical American family of four covered by a preferred provider health plan (PPO). In 2011, that health cost is nearly $20,000; … Continue reading

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Can Health Plans Explain Why They Aren’t Re-Empowering Primary Care?

Brian Klepper and David C. Kibbe First published 10/30/2008 on The Health Care Blog Brian’s Note: Recently I received a note from a New Jersey primary care physician who argued that, even more than Medicare, the health plans are killing primary care through extraordinarily … Continue reading

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Posted in Analytics, General, Innovation, Market Dynamics, Medical Management, Physicians, Policy/Law/Regulation, Quality, Recycled But Relevant | Tagged , , , | 1 Comment

Medical Loss Ratios – Again

Roger Collier First published 4/4/11 on Health Reform Update A new study, reported in the American Journal of Managed Care, seems likely to add more heat to the continuing medical loss ratio controversy. The Accountable Care Act effectively mandates that … Continue reading

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Posted in Analytics, Market Dynamics, Policy/Law/Regulation, Reform | Tagged , , , , | 1 Comment

Tire Kickers Need Not Apply – 8 First Impressions of the Medicare ACO Rule

Vince Kuraitis First published 4/1/11 on e-Care Management On March 31, CMS released the long-awaited “Medicare Shared Savings Program: Accountable Care Organizations” document (ACO Rule). Read the details here (strong suggestion: unless you’re working on your PhD in ACOs, start with … Continue reading

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Posted in Benefits, Market Dynamics, Medical Management, Physicians, Policy/Law/Regulation, Quality, Reform | Tagged , , , , , , , | 1 Comment

The “Post Health Plan” Health Plan

Jane Sarasohn-Kahn First published 3/8/11 on Health Populi “If nothing else, the health reform bill has signaled the beginning of the end of the health plan as we know and love it,” David Brailer, once health IT czar under President GW … Continue reading

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Power – Er, No, Risk – To The People

Paul Levy First published 3/2/11 on [Not] Running A Hospital What will be the biggest trend in the health insurance business over the coming years? A tendency to shift risk from the insurance companies to the public. How fitting for … Continue reading

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Accountable Care Organizations: The Emperor Has No Clothes, Or, Jeff Goldsmith’s Plan B

DAVID HARLOW Originally published 1/06/11 on HealthBlawg The current all-ACO issue of Health Affairs includes a piece by Jeff Goldsmith entitled: Accountable Care Organizations: The Case For Flexible Partnerships Between Health Plans And Providers.  It is a proposal for how private sector … Continue reading

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Posted in General, Market Dynamics, Medical Management, Physicians, Policy/Law/Regulation, Quality, Reform | Tagged , , , , , | Leave a comment

International Federation of Health Plans 2010 Comparative Price Report: Medical and Hospital Fees by Country

BRIAN KLEPPER This sobering report arrived on my desk today. The International Federation of Health Plans is comprised of “the leading global network of the industry, with one hundred member companies in 30 countries.” Each year they prepare a report that compares pricing … Continue reading

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