http://thinkrevivehealth.com/topic/trust/
During the course of calendar year 2016, what percentage of your total commercial revenues will be based on volume versus value?
During the course of calendar year 2016, what percentage of your the total claims you pay for commercially insured patients will be based on volume versus value?
Are Blues’ Plans Benefiting Unfairly From Program To Offset Cost Of Sicker Patients?
Some health insurers say they’re paying too much to rival Blue Cross Blue Shield plans under a key pillar of the federal health law designed to compensate insurers that take on sicker and more expensive patients.
The critics’ chief complaint is that the Affordable Care Act’s risk-adjustment program unfairly rewards health plans — including Blue Shield of California — that have excess administrative costs and higher premiums. That comes at the expense of more efficient, lower-priced plans in the individual market, they say.
Lawyers for the U.S. Department of Justice say Aetna Inc. and Humana Inc are trying to derail the government’s antitrust challenge of Aetna’s proposed $37 billion acquisition of Louisville-based Humana.
This comes after lawyers for the companies accused the DOJ with “serious delay and misconduct” last week. The companies requested sanctions, claiming that the government withheld about 1 million documents and that this had “gravely undermined” the companies’ ability to mount a defense against claims that the acquisition would hurt competition.
The National Law Journal reports that the government’s response came Saturday in a court filing, in which it said the DOJ has tried to accommodate the “broad and extremely burdensome discovery demand” from Aetna (NYSE: AET) and Humana (NYSE: HUM) on the U.S. Department of Health and Human Services.
The government called the request for sanctions “a transparent attempt to derail the United States’ merger challenge before the district court ever hears from a single witness or reviews any evidence,” the law journal reported.
At issue is how much market share the combined company would control in Medicare Advantage, a type of Medicare plan offered by a private insurer. A court date is set for Dec. 5, 2016, and the judge says a decision isn’t likely until mid-January 2017 — past the companies’ end-of-year deadline to close the deal.
http://www.ama-assn.org/ama/pub/news/news/2016/2016-09-21-ama-analyses-support-blocking-mergers.page
http://www.usatoday.com/story/news/2016/09/15/progressives-push-public-option-health-plan/90375964/
Progressive senators and activists are launching a campaign Thursday calling for every American to have the choice of a public health insurance option.
http://www.courant.com/news/connecticut/hc-bertolini-senators-20160912-story.html
Jan Kern was bitten by a stray dog while traveling abroad and ended up with a jaw-dropping illustration of why the U.S. healthcare industry is completely sick.
That’s because she underwent a series of rabies shots in three countries at four medical facilities. What that revealed, and which will surprise no one, is that Americans pay way more for the exact same treatment than people in other nations.
Moreover, her experience highlights the lack of uniformity for drug prices, including commonly used medications. One facility might charge a few bucks for the same drug that costs thousands of dollars at a U.S. hospital.
“There’s no rhyme or reason to our medical system,” said Rick Kern, 61, who contacted me about his 62-year-old wife’s global healthcare adventure after reading my recent column on drug prices.
What’s great about his story as well is that, after I shared it with about a dozen healthcare experts, the consistent reaction was one of utter disbelief. We’re accustomed to shaking our heads at U.S. healthcare costs. Things become significantly more absurd when a couple of overseas medical facilities are stirred into the mix.
“It’s obvious that our system is unlike any other health system,” said Uwe Reinhardt, a healthcare economist at Princeton University. “Other systems were set up to care for patients. Ours was set up by the providers — the hospitals and drug companies — for their own benefit.”
HENRY KOTULA 