Language and cultural issues, along with immigration concerns, could still pose major barriers to enrolling Asian-Americans, Native Hawaiians and Pacific Islanders in health insurance plans this fall, according to a report released Wednesday by Action for Health Justice, an advocacy coalition that aims to educate these populations about the health law.
Reported by Huffington Post 4 hours ago.
Difficulties Likely To Persist In Enrolling Asian-Americans, Pacific Islanders
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Katko jobs plan calls for reducing student debt, repealing health insurance taxes
Reported by syracuse.com 5 hours ago.
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Small Businesses Helping Workers Buy Health Plans
Trade-off: Small businesses drop health insurance, pay employees to buy own coverage
Reported by ABCNews.com 1 hour ago.
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CVS Caught Illegally Charging Women For Birth Control
CVS has been illegally charging women for birth control, violating an Obamacare provision that forces insurers to cover generic contraceptives at no cost to women.
Since learning of a price-coding error that erroneously charged approximately 11,000 women unlawful copays, CVS has moved to fix the problem and refund affected customers.
The issue was brought to public light by Rep. Jackie Speier (D-Calif.) after one of her staffers was charged a $20 copay when trying to buy generic birth control at a CVS in Washington, D.C. Such a copay is illegal under the Affordable Care Act. Speier wrote a letter to Larry Merlo, the CEO of CVS, earlier this month.
"Although my staff member's issue was eventually resolved a week and numerous phone calls and pharmacy visits later, I am concerned that most women who are likely not familiar with their rights under the ACA may go without this essential family planning service that is supposed to be guaranteed to them under law," Speier wrote in a letter dated September 9.
On September 19, Sol J. Ross, CVS's head of federal affairs, responded to Speier, saying that the company was handling the issue.
"Refund checks will be [sent] to affected plan members by September 26," Ross wrote. "In fact, refund checks have already started to go out and all should be received by October 1."
CVS told The Huffington Post Wednesday that it had identified the glitch before receiving Speier's letter.
"We are committed to assuring that our customers receive the pharmacy benefits that are available to them and apologize for any inconvenience this issue may have caused," a CVS spokesperson wrote in an email.
Thanks to the Affordable Care Act, millions of women no longer have to pay for preventative health services and screenings, like an annual check-up, pap-smears and generic birth control. According to a recent study from the Guttmacher Institute, the percentage of privately insured women who no longer have to pay out-of-pocket costs for birth control is growing quickly.
In fall 2012, before Obamacare went into affect, only 15 percent of insured women got free birth control pills. Today, that number is nearly 70 percent. The reason not all women today have health insurance that includes no-cost birth control is that some people are still covered by plans that are temporarily allowed to disregard this provision and other Obamacare rules. Eventually, virtually all health insurance will include no-cost contraceptives.
If you think you've been charged illegally for birth control at CVS, follow these instructions listed on Speier's website:
Customers with questions about an illegal co-pay charge, or those who want to make sure they are receiving a reimbursement and whose prescription drug benefits are covered through the Pharmacy Benefit Manager (PBM) CVS Caremark, are encouraged to call 1-800-704-6589 and ask to speak with a Tier 2 representative or supervisor about a generic birth control illegal co-pay charge to make sure that their call is immediately escalated to a staff member with override capabilities. Reported by Huffington Post 4 hours ago.
Since learning of a price-coding error that erroneously charged approximately 11,000 women unlawful copays, CVS has moved to fix the problem and refund affected customers.
The issue was brought to public light by Rep. Jackie Speier (D-Calif.) after one of her staffers was charged a $20 copay when trying to buy generic birth control at a CVS in Washington, D.C. Such a copay is illegal under the Affordable Care Act. Speier wrote a letter to Larry Merlo, the CEO of CVS, earlier this month.
"Although my staff member's issue was eventually resolved a week and numerous phone calls and pharmacy visits later, I am concerned that most women who are likely not familiar with their rights under the ACA may go without this essential family planning service that is supposed to be guaranteed to them under law," Speier wrote in a letter dated September 9.
On September 19, Sol J. Ross, CVS's head of federal affairs, responded to Speier, saying that the company was handling the issue.
"Refund checks will be [sent] to affected plan members by September 26," Ross wrote. "In fact, refund checks have already started to go out and all should be received by October 1."
CVS told The Huffington Post Wednesday that it had identified the glitch before receiving Speier's letter.
"We are committed to assuring that our customers receive the pharmacy benefits that are available to them and apologize for any inconvenience this issue may have caused," a CVS spokesperson wrote in an email.
Thanks to the Affordable Care Act, millions of women no longer have to pay for preventative health services and screenings, like an annual check-up, pap-smears and generic birth control. According to a recent study from the Guttmacher Institute, the percentage of privately insured women who no longer have to pay out-of-pocket costs for birth control is growing quickly.
In fall 2012, before Obamacare went into affect, only 15 percent of insured women got free birth control pills. Today, that number is nearly 70 percent. The reason not all women today have health insurance that includes no-cost birth control is that some people are still covered by plans that are temporarily allowed to disregard this provision and other Obamacare rules. Eventually, virtually all health insurance will include no-cost contraceptives.
If you think you've been charged illegally for birth control at CVS, follow these instructions listed on Speier's website:
Customers with questions about an illegal co-pay charge, or those who want to make sure they are receiving a reimbursement and whose prescription drug benefits are covered through the Pharmacy Benefit Manager (PBM) CVS Caremark, are encouraged to call 1-800-704-6589 and ask to speak with a Tier 2 representative or supervisor about a generic birth control illegal co-pay charge to make sure that their call is immediately escalated to a staff member with override capabilities. Reported by Huffington Post 4 hours ago.
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AlohaCare to drop Medicare Advantage plan in 2015
AlohaCare is dropping its Medicare Advantage plan in 2015, following losses of some $18.5 million since launching the health insurance plan for seniors eight years ago. The Honolulu Star-Advertiser reports the decision to discontinue the Medicare Advantage plan will affect 1,300 seniors; AlohaCare's other 60,000 members won't be affected. PBN previously reported that the Hawaii Medical Service Association plans to close its current line of Medicare plans, known as Akamai Advantage, and restart…
Reported by bizjournals 3 hours ago.
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Small businesses helping workers buy health plans
NEW YORK (AP) — When Monty Hagler learned his employee insurance premiums could rise as much as 38 percent, the small business owner decided he couldn't afford coverage that complies with the health care overhaul. Nearly 3 percent of 1,600 small businesses surveyed by the Society for Human Resource Management plan to give employees subsidies next year so they can buy their own coverage on private insurance exchanges. Insurance brokers are getting more inquiries about individual coverage, a sign to them that many people are losing coverage at work. If policy cancellations do rise this fall, it would likely be due to the fact many small businesses renewed their coverage before Jan. 1, 2014, when policies were required to comply with the health care law. [...] workers may get a better deal on government-run health insurance exchanges, especially if they qualify for government subsidies that will lower premium costs for individuals and families. Kim Sink, the company's director of projects and production, says she's grateful Hagler gives her a stipend that covers two-thirds of her $711 monthly premium. Giving workers extra compensation to help buy insurance can result in higher income tax for the employees, and it can also mean employers will owe payroll tax on the money. Some owners bring in insurance brokers or benefits consultants to help workers find new insurance.
Reported by SeattlePI.com 4 hours ago.
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Creative Tension: Hillary and the Progressive Movement
When I worked in the Clinton White House, our first big blowout of a fight was the 1993 budget battle. We ended winning every vote by the narrowest of margins, but in the end that budget was probably the most progressive budget passed since LBJ's heyday in the mid '60s, and arguably the most progressive passed since. We cut taxes on low-income folks and raised them on the wealthy, and we pumped a lot of new dollars into domestic programs. But there were a lot of things the could have been better, like there always are in politics, and I've always remembered Bill Clinton telling Bernie Sanders after we passed the budget that maybe if he and other progressives had raised more hell early about how the initial Clinton budget wasn't good enough, that maybe we could have gotten an even better budget deal.
I think about that conversation a lot when there are rocky moments between progressives and Democratic political leaders. We all need to understand that in the modern American political system, there is going to be a lot of tension between leaders of the progressive movement and Democratic politicians, but that in this era of crazy Koch-controlled Republicans, we also need each other. The wing of the Democratic Party closer to big business and Wall Street is wrong about a lot of things, but when you see the Koch philosophy of the world and understand how much they and their money controls the Republican Party, it couldn't be clearer that Democrats and progressives need to work together to stop the dystopia the Koch agenda would bring.
I say all this in part because we are in the fall of a huge election year, where the Republicans could well take over the Senate. If you want a taste of what McConnell is promising the Kochs he will do (said behind closed doors) if the Republicans get a majority, check this ugliness out. McConnell promised the Kochs and their billionaire friends that he will shut down the government through attaching riders to the budget that would stop companies like Koch Industries, Wall Street banks, and health insurance companies from getting any government oversight. And he said he would end debate on minimum wage, extending unemployment, and reforming student loans.
I also say all this because there was a ridiculously over-hyped article recently in The Hill by Alexandra Jaffe that quoted me and some other progressives from a private e-mail conversation we were having about Hillary Clinton. The article shamelessly linked some representatives of organizations on the private lists to an e-mail thread consisting entirely of individuals speaking for themselves, implying that all these groups were unhappy with her. Jaffe didn't include any of the positive comments a lot of us had expressed about Clinton because she wanted to do a melodramatic story on how progressives were unalterably opposed to her.
In these private e-mails, I expressed concern that Hillary is too close to Wall Street and too hawkish in her views on national security policy. Given that I have said those things in multiple blog posts published over the years, it wasn't a big surprise that I would have said them in a private e-mail chain as well. But what Jaffe chose not to quote was when I expressed my admiration for the toughness and passion I had seen Hillary show on the health care reform fight in the 1990s, or on numerous budget battles over children's programs, or for her high level of political skill. I told Jaffe that while progressives had plenty of concerns, that the Hillary Clinton I knew was smart enough to know she needed to court progressives in her campaign, and that if she were the nominee, most progressives would support her strongly given that the Republicans will nominate an extremist conservative for president.
That is the nature of politics in America right now. Progressive leaders are going to have disagreements with Democratic politicians, but to keep the Koch-controlled dystopians from office, we need the Democrats to win. And for the Democrats to win, they need to understand that they need us, too. Without the progressive movement's money, staff, and volunteer hours, without our being excited enough to convince our friends and get them out to vote, the Democrats cannot win.
So what happens to progressive causes when centrist Democrats win? Well, sometimes we will win and sometimes we will lose. Sometimes we will make progress, but only modest progress. But at least we will win some of the time, as opposed to being governed by Koch Republicans, where not only will we never make progress, but we could see truly horrible policies enacted.
Let me give you an example, from a fight I was deeply involved with, the battle to keep Obama from agreeing to a "grand bargain" with the Republicans that would involve cutting Social Security benefits. Obama was seriously considering this in the first term, and it came close to happening, but between tea party Republicans not wanting to agree to any deal with Obama and progressives strongly protesting any benefit cuts, the deal fell apart. It was a proud moment for those of us who had stood up to the White House when they were close to making that deal. If there had been a Republican president and Congress, though, the Ryan budget, which gutted Medicare, Medicaid, and most other domestic spending -- along with giving massive tax cuts to the wealthy -- would have become law. We would have had no leverage, no ability to stop anything. So even though it was frustrating and irritating to be fighting with Obama, and we had to fight him tooth and nail, it was far better to be fighting him than to have the Republicans be in charge of everything. As upset I have been with Obama at times over the last six years, I am so glad that I gave money and knocked on doors and did everything else in my power to help him win.
Having said all that, my friends in the Democratic establishment who have been sending me warning shots across the bow lately for saying these negative things about Hillary Clinton, or for criticizing the work of Emily's List to elect a conservative Democrat over a strong progressive incumbent in Hawaii in an article a couple of weeks back, need to understand a couple of things as well. One is the factor President Clinton highlighted in that conversation with Bernie Sanders: the tension between progressives and centrists in the Democratic party is a healthy thing. It gets us far more than Obama's compromising with himself before saying what he wants in a legislative package. Progressives should be loudly, annoyingly fighting with the powers that be for the best possible policy, or progress will never happen.
The other thing that the Democratic establishment needs to understand is what I learned while losing on health care reform in the Clinton White House, or when crafting a strategy that surprised party elders in taking back the House for Dems in 2006: passion trumps just about everything else in politics. You can't win an election or a legislative fight without it. Mark my words: No matter how much money she raises, no matter how many wise establishment operatives she has working for her, Hillary Clinton will need progressive passion to win in 2016. I do believe she understands that, and will run a campaign that reaches out to progressives just like Bill Clinton did in his campaigns and in his White House.
I am going to close with another story from that Social Security fight. There was a moment, when Obama decided he did want to push for Social Security benefit cuts and the White House started leaning on people to back off, when a lot of the liberal establishment in D.C. did look like they were starting to cave. I was having a ton of disturbing conversations with people telling me it was too bad, but the President had made his decision and it was time to stop fighting. Fortunately some major forces, led most strongly by the AFL-CIO and Moveon, refused to buckle and were rallying the troops. I wrote a blog post that my friends at MoveOn widely promoted, which, from the calls I got from the White House, really made the administration upset. It talked about an elderly woman I had met 30 years before who ended up freezing to death because she lived only on Social Security and couldn't afford her utility bills. I said in that post:
"But here's the deal: I didn't get into politics to help the Democratic party. I came to the Democratic party because they more often wanted to help the people I cared about helping -- the poor, the disabled, the middle class folks fighting for a decent life for them and their families. When forced to choose, as it looks like I will in this case, I will choose the people I got into this work to fight for.
My first loyalties are to my middle-class family, who will depend heavily on Social Security because they mostly won't have lots of savings or generous pensions; to the kids I grew up with in a working class part of Lincoln, NE, who are getting ready to retire and mostly don't have those savings or pensions either; to the people like my late brother Kevin who have lived with serious disabilities, who may or may not be taken care of depending on what is negotiated away next; and to the poor people and seniors who I got to know as a young organizer, like the elderly woman I made a promise to that I would keep fighting for her."
My first loyalties will always be those kinds of folks. What that means is that I have in the past, and will in the future, sometimes get into fights with Democratic politicians. I will always believe and continue to say that President Obama and the Clintons are too easy on Wall Street. I will never be a fan of a hawkish national security policy or permanent war. I will fight against every policy proposal that cuts benefits for the poor and elderly. But I also am keenly aware of how breathtakingly terrible the policies of the Kochs and their wholly owned subsidiary, the Republican party, are. I disagree with my old boss Hillary Clinton on some important things, but I also agree with her on a great many, and know there is much to admire in her. If she is the Democratic nominee, I won't have a moment's doubt about doing everything I know how to do to help her win, just as I am doing everything I know how to do to help the Democrats stay in control of the Senate. I think most progressives will end up in the same place, but they will need some show of respect from Clinton to get there. Reported by Huffington Post 3 hours ago.
I think about that conversation a lot when there are rocky moments between progressives and Democratic political leaders. We all need to understand that in the modern American political system, there is going to be a lot of tension between leaders of the progressive movement and Democratic politicians, but that in this era of crazy Koch-controlled Republicans, we also need each other. The wing of the Democratic Party closer to big business and Wall Street is wrong about a lot of things, but when you see the Koch philosophy of the world and understand how much they and their money controls the Republican Party, it couldn't be clearer that Democrats and progressives need to work together to stop the dystopia the Koch agenda would bring.
I say all this in part because we are in the fall of a huge election year, where the Republicans could well take over the Senate. If you want a taste of what McConnell is promising the Kochs he will do (said behind closed doors) if the Republicans get a majority, check this ugliness out. McConnell promised the Kochs and their billionaire friends that he will shut down the government through attaching riders to the budget that would stop companies like Koch Industries, Wall Street banks, and health insurance companies from getting any government oversight. And he said he would end debate on minimum wage, extending unemployment, and reforming student loans.
I also say all this because there was a ridiculously over-hyped article recently in The Hill by Alexandra Jaffe that quoted me and some other progressives from a private e-mail conversation we were having about Hillary Clinton. The article shamelessly linked some representatives of organizations on the private lists to an e-mail thread consisting entirely of individuals speaking for themselves, implying that all these groups were unhappy with her. Jaffe didn't include any of the positive comments a lot of us had expressed about Clinton because she wanted to do a melodramatic story on how progressives were unalterably opposed to her.
In these private e-mails, I expressed concern that Hillary is too close to Wall Street and too hawkish in her views on national security policy. Given that I have said those things in multiple blog posts published over the years, it wasn't a big surprise that I would have said them in a private e-mail chain as well. But what Jaffe chose not to quote was when I expressed my admiration for the toughness and passion I had seen Hillary show on the health care reform fight in the 1990s, or on numerous budget battles over children's programs, or for her high level of political skill. I told Jaffe that while progressives had plenty of concerns, that the Hillary Clinton I knew was smart enough to know she needed to court progressives in her campaign, and that if she were the nominee, most progressives would support her strongly given that the Republicans will nominate an extremist conservative for president.
That is the nature of politics in America right now. Progressive leaders are going to have disagreements with Democratic politicians, but to keep the Koch-controlled dystopians from office, we need the Democrats to win. And for the Democrats to win, they need to understand that they need us, too. Without the progressive movement's money, staff, and volunteer hours, without our being excited enough to convince our friends and get them out to vote, the Democrats cannot win.
So what happens to progressive causes when centrist Democrats win? Well, sometimes we will win and sometimes we will lose. Sometimes we will make progress, but only modest progress. But at least we will win some of the time, as opposed to being governed by Koch Republicans, where not only will we never make progress, but we could see truly horrible policies enacted.
Let me give you an example, from a fight I was deeply involved with, the battle to keep Obama from agreeing to a "grand bargain" with the Republicans that would involve cutting Social Security benefits. Obama was seriously considering this in the first term, and it came close to happening, but between tea party Republicans not wanting to agree to any deal with Obama and progressives strongly protesting any benefit cuts, the deal fell apart. It was a proud moment for those of us who had stood up to the White House when they were close to making that deal. If there had been a Republican president and Congress, though, the Ryan budget, which gutted Medicare, Medicaid, and most other domestic spending -- along with giving massive tax cuts to the wealthy -- would have become law. We would have had no leverage, no ability to stop anything. So even though it was frustrating and irritating to be fighting with Obama, and we had to fight him tooth and nail, it was far better to be fighting him than to have the Republicans be in charge of everything. As upset I have been with Obama at times over the last six years, I am so glad that I gave money and knocked on doors and did everything else in my power to help him win.
Having said all that, my friends in the Democratic establishment who have been sending me warning shots across the bow lately for saying these negative things about Hillary Clinton, or for criticizing the work of Emily's List to elect a conservative Democrat over a strong progressive incumbent in Hawaii in an article a couple of weeks back, need to understand a couple of things as well. One is the factor President Clinton highlighted in that conversation with Bernie Sanders: the tension between progressives and centrists in the Democratic party is a healthy thing. It gets us far more than Obama's compromising with himself before saying what he wants in a legislative package. Progressives should be loudly, annoyingly fighting with the powers that be for the best possible policy, or progress will never happen.
The other thing that the Democratic establishment needs to understand is what I learned while losing on health care reform in the Clinton White House, or when crafting a strategy that surprised party elders in taking back the House for Dems in 2006: passion trumps just about everything else in politics. You can't win an election or a legislative fight without it. Mark my words: No matter how much money she raises, no matter how many wise establishment operatives she has working for her, Hillary Clinton will need progressive passion to win in 2016. I do believe she understands that, and will run a campaign that reaches out to progressives just like Bill Clinton did in his campaigns and in his White House.
I am going to close with another story from that Social Security fight. There was a moment, when Obama decided he did want to push for Social Security benefit cuts and the White House started leaning on people to back off, when a lot of the liberal establishment in D.C. did look like they were starting to cave. I was having a ton of disturbing conversations with people telling me it was too bad, but the President had made his decision and it was time to stop fighting. Fortunately some major forces, led most strongly by the AFL-CIO and Moveon, refused to buckle and were rallying the troops. I wrote a blog post that my friends at MoveOn widely promoted, which, from the calls I got from the White House, really made the administration upset. It talked about an elderly woman I had met 30 years before who ended up freezing to death because she lived only on Social Security and couldn't afford her utility bills. I said in that post:
"But here's the deal: I didn't get into politics to help the Democratic party. I came to the Democratic party because they more often wanted to help the people I cared about helping -- the poor, the disabled, the middle class folks fighting for a decent life for them and their families. When forced to choose, as it looks like I will in this case, I will choose the people I got into this work to fight for.
My first loyalties are to my middle-class family, who will depend heavily on Social Security because they mostly won't have lots of savings or generous pensions; to the kids I grew up with in a working class part of Lincoln, NE, who are getting ready to retire and mostly don't have those savings or pensions either; to the people like my late brother Kevin who have lived with serious disabilities, who may or may not be taken care of depending on what is negotiated away next; and to the poor people and seniors who I got to know as a young organizer, like the elderly woman I made a promise to that I would keep fighting for her."
My first loyalties will always be those kinds of folks. What that means is that I have in the past, and will in the future, sometimes get into fights with Democratic politicians. I will always believe and continue to say that President Obama and the Clintons are too easy on Wall Street. I will never be a fan of a hawkish national security policy or permanent war. I will fight against every policy proposal that cuts benefits for the poor and elderly. But I also am keenly aware of how breathtakingly terrible the policies of the Kochs and their wholly owned subsidiary, the Republican party, are. I disagree with my old boss Hillary Clinton on some important things, but I also agree with her on a great many, and know there is much to admire in her. If she is the Democratic nominee, I won't have a moment's doubt about doing everything I know how to do to help her win, just as I am doing everything I know how to do to help the Democrats stay in control of the Senate. I think most progressives will end up in the same place, but they will need some show of respect from Clinton to get there. Reported by Huffington Post 3 hours ago.
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Insurance competition in ACA state marketplaces a positive sign
Nationwide, there will be 25 percent more insurers competing for business through the ACA state exchanges in their second year offering subsidized health insurance. In Virginia, there's been no increase in carriers, though one insurer that dropped out last year has returned. Open enrollment for 2015 coverage starts on Nov. 15.
Reported by dailypress.com 3 hours ago.
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A.M. Best Upgrades Ratings of Group Health Incorporated; Affirms Ratings of Other EmblemHealth, Inc. Subsidiaries
OLDWICK, N.J.--(BUSINESS WIRE)--A.M. Best has upgraded the financial strength rating (FSR) to B+ (Good) from C+ (Marginal) and the issuer credit rating (ICR) to “bbb-” from “b-” for Group Health Incorporated (GHI). Concurrently, A.M. Best has also affirmed the FSR of B+ (Good) and ICR of “bbb-” for Health Insurance Plan of Greater New York (HIP), HIP Insurance Company of New York and ConnectiCare, Inc. (Farmington, CT). The outlook for all ratings is stable. All companies are subsidiaries of Em
Reported by Business Wire 2 hours ago.
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Hospitals In States That Won't Expand Medicaid Left With More Unpaid Bills
States that refuse to accept Obamacare's Medicaid expansion aren't just leaving behind poor residents, they're also hurting hospitals' bottom lines.
Because the Affordable Care Act cut the number of people with no health insurance this year, hospitals across the country will see $5.7 billion less in unpaid bills, according to a report issued by the Department of Health and Human Services Wednesday.
But the difference in states that are expanding Medicaid versus those that aren't is stark, the report shows. Hospitals in the 25 states that already have made Medicaid available to more poor residents and the District of Columbia will see $4.2 billion less in unpaid bills and charity care, a decrease of one-quarter. In the other states, the decline will be just $1.5 billion, or 9 percent.
In other words, the reduction in the uninsured brought about by Obamacare has predictably led to a decrease in the number of people turning up at hospitals with no health insurance and no means to pay for their medical care. And that decrease is more substantial in states that allowed their poorest residents access to Medicaid coverage.
"It's actually showing that this provides benefits to states," Health and Human Services Secretary Sylvia Mathews Burwell said at a briefing with reporters prior to the report's release Wednesday.
The findings are a reflection of the fact that the uninsured rate, especially among low-income people, has fallen much more in states that expanded Medicaid than in states that didn't.
In a New England Journal of Medicine article published in July, HHS and the Harvard School of Public Health estimated 10.3 million fewer people are uninsured as a result of Obamacare. HHS also announced this month that 7.9 million more people are enrolled in Medicaid or a related benefit called the Children's Health Insurance Program than before Obamacare enrollment started last October. In addition, 7.3 million people have signed up for private health insurance via the law's exchange marketplaces, Burwell disclosed last week.
The Democrats who wrote the Affordable Care Act intended to expand Medicaid nationwide to anyone earning up to 133 percent of the poverty level, or about $15,300 for a single person. But the Supreme Court ruled in 2012 that states could opt out, enabling Republican governors and state legislators -- mostly in the South -- to refuse generous federal funding to cover low-income residents.
Via: The Advisory Board Company
The failure to expand Medicaid in those states has left 4.8 million people who would have been eligible without coverage, according to the Henry J. Kaiser Family Foundation.
The American Hospital Association, along with other national state hospital groups, endorsed the Affordable Care Act precisely because they wanted more people covered and fewer patients unable to pay for care. That's even though the law also cuts Medicare and Medicaid funding hospitals receive.
In states that haven't expanded Medicaid, hospitals are enduring the funding reductions without the increase in insured patients, though. When the Supreme Court ruling came down, hospital groups in states like Texas and Florida unsuccessfully lobbied in favor of the Medicaid expansion. The figures released by HHS show why they tried.
"Many of the hospitals in these communities feel it already, but I think the data and information will help them make their case more strongly with regard to the importance to their bottom line," Burwell said.
A growing number of states that initially didn't expand Medicaid are signing on, most recently Pennsylvania and New Hampshire, bringing the total up to 27 plus Washington, D.C. Burwell is in discussions with other states, including Utah, about bringing them aboard. "The more that we are able to attract conservative Republican governors, the more that those who have very strong feelings will perhaps listen," she said.
HHS based its analysis on financial reports from hospital chains such as HCA Holdings and LifePoint and on surveys by state-based hospital trade associations. The consulting firm PricewaterhouseCoopers published a similar report this month, and its findings are consistent with HHS's. Reported by Huffington Post 39 minutes ago.
Because the Affordable Care Act cut the number of people with no health insurance this year, hospitals across the country will see $5.7 billion less in unpaid bills, according to a report issued by the Department of Health and Human Services Wednesday.
But the difference in states that are expanding Medicaid versus those that aren't is stark, the report shows. Hospitals in the 25 states that already have made Medicaid available to more poor residents and the District of Columbia will see $4.2 billion less in unpaid bills and charity care, a decrease of one-quarter. In the other states, the decline will be just $1.5 billion, or 9 percent.
In other words, the reduction in the uninsured brought about by Obamacare has predictably led to a decrease in the number of people turning up at hospitals with no health insurance and no means to pay for their medical care. And that decrease is more substantial in states that allowed their poorest residents access to Medicaid coverage.
"It's actually showing that this provides benefits to states," Health and Human Services Secretary Sylvia Mathews Burwell said at a briefing with reporters prior to the report's release Wednesday.
The findings are a reflection of the fact that the uninsured rate, especially among low-income people, has fallen much more in states that expanded Medicaid than in states that didn't.
In a New England Journal of Medicine article published in July, HHS and the Harvard School of Public Health estimated 10.3 million fewer people are uninsured as a result of Obamacare. HHS also announced this month that 7.9 million more people are enrolled in Medicaid or a related benefit called the Children's Health Insurance Program than before Obamacare enrollment started last October. In addition, 7.3 million people have signed up for private health insurance via the law's exchange marketplaces, Burwell disclosed last week.
The Democrats who wrote the Affordable Care Act intended to expand Medicaid nationwide to anyone earning up to 133 percent of the poverty level, or about $15,300 for a single person. But the Supreme Court ruled in 2012 that states could opt out, enabling Republican governors and state legislators -- mostly in the South -- to refuse generous federal funding to cover low-income residents.
Via: The Advisory Board Company
The failure to expand Medicaid in those states has left 4.8 million people who would have been eligible without coverage, according to the Henry J. Kaiser Family Foundation.
The American Hospital Association, along with other national state hospital groups, endorsed the Affordable Care Act precisely because they wanted more people covered and fewer patients unable to pay for care. That's even though the law also cuts Medicare and Medicaid funding hospitals receive.
In states that haven't expanded Medicaid, hospitals are enduring the funding reductions without the increase in insured patients, though. When the Supreme Court ruling came down, hospital groups in states like Texas and Florida unsuccessfully lobbied in favor of the Medicaid expansion. The figures released by HHS show why they tried.
"Many of the hospitals in these communities feel it already, but I think the data and information will help them make their case more strongly with regard to the importance to their bottom line," Burwell said.
A growing number of states that initially didn't expand Medicaid are signing on, most recently Pennsylvania and New Hampshire, bringing the total up to 27 plus Washington, D.C. Burwell is in discussions with other states, including Utah, about bringing them aboard. "The more that we are able to attract conservative Republican governors, the more that those who have very strong feelings will perhaps listen," she said.
HHS based its analysis on financial reports from hospital chains such as HCA Holdings and LifePoint and on surveys by state-based hospital trade associations. The consulting firm PricewaterhouseCoopers published a similar report this month, and its findings are consistent with HHS's. Reported by Huffington Post 39 minutes ago.
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Latinos Get Insured by Obamacare in Droves
Enough young Latinos got health insurance under new Obamacare provisions to lower to uninsured rate by 20 points, researchers report.
Reported by msnbc.com 16 hours ago.
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Candidates for insurance commissioner: a clash of styles
For Democrat Dave Jones, who is seeking a second term, his job is making sure insurance companies play fair with their California customers by tightly regulating the rates they charge and the job they do. “I want to make sure we have a level playing field, a strong insurance market and good consumer protection,” said Jones, a 52-year-old Sacramento resident. Without regulations, insurance companies would take advantage of businesses and consumers. Jones’ “power-grabbing support for rate control over health insurance would choke off the supply of medical care,” Gaines told the group. Gaines is a critic of the Affordable Care Act and has sued Covered California, the state’s new health insurance exchange, for its efforts to implement President Obama’s signature legislationand what he says are excessive costs and a lack of transparency. Gaines also opposes apair of November ballot measures, Proposition 45, which would allow the insurance commissioner to regulate health insurance rates, and Proposition 46, which would raise the cap for noneconomic damages in malpractice suits and force some doctors to submit to random drug testing. Jones, a former assemblyman who began his career as a legal aid attorney, said Gaines’ objections show the candidates’ contrasting approaches to the insurance commissioner’s job. While Jones insists he doesn’t have an adversarial relationship with the insurance industry, he said health insurers have been charging excessive rates and that some have recently reduced premiumsfor purely political reasons.
Reported by SFGate 17 hours ago.
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India Network Visitor Health Insurance program announces extension of health insurance with pre-existing conditions coverage to travelers of all ages to United States
India Network Health Insurance is the only program in the United States that provides health insurance coverage with pre-existing conditions to all visitors from 0 to 99 years. The plans are available to any visitor coming to the United States for tourism, temporary work, business travel, or visit friends and family.
Orlando, FL (PRWEB) September 25, 2014
India Network Services, administrator of visitor health insurance in the USA, announced today that the comprehensive and scheduled benefit health insurance policies continue to be available to all ages till December 31, 2014. Earlier, the plans were restricted to renewals only and with immediate effects, new elderly visiting parents from India, or any country to the United States are welcome to take advantage of these plans. All community members are urged to enroll their visitors in health insurance coverage accorded by the plans before the December 31, 2014.
India Network visitor health insurance added several new features to the visitor health insurance program without any additional increases in premium. A centralized toll-free number, 1-855-428-3425 provides easy access to reach to customer service, police questions, coverage questions, claims office, Nurse Line assistance, and Europ Assistance services to handle medical evacuation, and repatriation benefits. India Network Program also offer $25,000 accidental death benefit to all program participants irrespective of their age. The online enrollment process process make it easy to anyone to apply from any where in the world with the help of internet and a major credit card.
Pre-existing condition coverage offered by India network plans protects the policy holders from any eventuality, whether a particular hospitalization is determined as a result of pre-existing condition, known or unknown to the policy holder or not. One may not necessarily have pre-existing conditions to choose for the policy cover since typical medical conditions such as heart attack, stroke, brain hemorrhage, etc are denied by all visitor plans under pre-existing condition exclusion clause. India Network Health Insurance is one of few plans that explicitly provide coverage for such catastrophic medical conditions when the visitor has chosen pre-existing condition coverage option.
Dr. KV Rao, Founder President said that the number of elderly visitors traveling to the United States has been increased many folds but awareness of the need to take good health insurance coverage is still low. A number of families call India Network office every week to seeking assistance with their medical bills. Unfortunately, India Network or any other organization can help these struggling families if they did not buy the right coverage.
India Network Foundation, established as a US non-profit organization, has been helping the Asian Indian community in North America with programs and grants to academics from India for more than two decades. India Network Foundation sponsors visitor health insurance to tourists, students, temporary workers (H1 visa holders) and their families. All insurance products are administered by India Network Services.
For more information visit http://www.indianetwork.org
About India Network Health Insurance
India Network Services, is a US based company that administers visitor health insurance to transition residents, tourists, students, temporary workers and their families. Visitor medical plans are offered for all age groups with both fixed coverage, comprehensive coverage and with pre-existing condition coverage. Reported by PRWeb 15 hours ago.
Orlando, FL (PRWEB) September 25, 2014
India Network Services, administrator of visitor health insurance in the USA, announced today that the comprehensive and scheduled benefit health insurance policies continue to be available to all ages till December 31, 2014. Earlier, the plans were restricted to renewals only and with immediate effects, new elderly visiting parents from India, or any country to the United States are welcome to take advantage of these plans. All community members are urged to enroll their visitors in health insurance coverage accorded by the plans before the December 31, 2014.
India Network visitor health insurance added several new features to the visitor health insurance program without any additional increases in premium. A centralized toll-free number, 1-855-428-3425 provides easy access to reach to customer service, police questions, coverage questions, claims office, Nurse Line assistance, and Europ Assistance services to handle medical evacuation, and repatriation benefits. India Network Program also offer $25,000 accidental death benefit to all program participants irrespective of their age. The online enrollment process process make it easy to anyone to apply from any where in the world with the help of internet and a major credit card.
Pre-existing condition coverage offered by India network plans protects the policy holders from any eventuality, whether a particular hospitalization is determined as a result of pre-existing condition, known or unknown to the policy holder or not. One may not necessarily have pre-existing conditions to choose for the policy cover since typical medical conditions such as heart attack, stroke, brain hemorrhage, etc are denied by all visitor plans under pre-existing condition exclusion clause. India Network Health Insurance is one of few plans that explicitly provide coverage for such catastrophic medical conditions when the visitor has chosen pre-existing condition coverage option.
Dr. KV Rao, Founder President said that the number of elderly visitors traveling to the United States has been increased many folds but awareness of the need to take good health insurance coverage is still low. A number of families call India Network office every week to seeking assistance with their medical bills. Unfortunately, India Network or any other organization can help these struggling families if they did not buy the right coverage.
India Network Foundation, established as a US non-profit organization, has been helping the Asian Indian community in North America with programs and grants to academics from India for more than two decades. India Network Foundation sponsors visitor health insurance to tourists, students, temporary workers (H1 visa holders) and their families. All insurance products are administered by India Network Services.
For more information visit http://www.indianetwork.org
About India Network Health Insurance
India Network Services, is a US based company that administers visitor health insurance to transition residents, tourists, students, temporary workers and their families. Visitor medical plans are offered for all age groups with both fixed coverage, comprehensive coverage and with pre-existing condition coverage. Reported by PRWeb 15 hours ago.
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Health insurance plans that help hold down costs
*Health insurance plans that help hold down costs*
A good health care plan should provide high overall quality and help members avoid unnecessary medical care. That can help cut health care costs and reduce the risks that come with all medical tests and treatments. (Read more about the outrageous costs of health care in this country).The PDF chart linked to here shows rankings for all private plans (those you buy on your own or get from your employer) in each state plus Puerto Rico and Washington, D.C, and also identifes plans that earned our check mark in Avoiding Overuse. The data come from the National Committee for Quality Assurance, a nonprofit quality measurement and accreditation organization. (See the full rankings of health insurance plans, including Medicare Advantage and Medicaid plans.)
To earn a check in Avoiding Overuse, plans must have sufficient data, score higher overall, and do better in at least three of these areas:
· *Avoiding inappropriate use of antibiotics. *Overuse of the drugs has undermined their effectiveness and has bred dangerous antibiotic-resistant strains of bacteria. Read more about the dangers of overusing antibiotics.
· *Limiting imaging tests for lower-back pain.* Getting an X-ray, CT scan, or MRI within the first month of back pain is rarely necessary because back pain almost always clears up on its own in that time. Read more about the best tests and treatments for back pain.
· *Reducing hospital readmissions.* Being readmitted to the hospital soon after discharge could mean, for example, that the hospital or doctor didn’t properly coordinate discharge or provide appropriate care when the patient was there. Read more about hospital readmissions.
· *Reducing overuse of invasive heart procedures. *It can be more cost-effective and better for patients when heart disease can be controlled with lifestyle changes and drugs. Read more about the best ways to treat heart disease.
· *Avoiding overuse of emergency rooms.* Good plans help patients stay out of the ER, in part by controlling chronic diseases.
Our analysis found that in general, preferred provider organizations (or PPOs, which allow you to see out-of-network providers, but at higher cost), did not perform as well in Avoiding Overuse as health maintenance organizations (HMOs, which only cover in-network providers and usually require you to get a referral from a primary-care doctor). We also looked at which health insurance companies had the most plans overall that did well in Avoiding Overuse, and where those plans tended to be situated in the U.S. (see below).*Which insurance companies are better at helping their members avoid unnecessary medical care?
*
We looked at large insurers that offer multiple health plans to see how they compare when it comes to avoiding overuse. The table shows the percentage of NCQA-ranked private plans for each insurer that earned a checkmark for Avoiding Overuse.
-Insurance company name-
-Percentage of plans with a check mark in Avoiding Overuse
-
Kaiser Foundation Health Plans, Inc.
67% (6 of 9)
Independents 30% (31 of 103)
Blue Cross and Blue Shield Association
27% (14 of 51)
CIGNA HealthCare, Inc. 21% (21 of 101)Coventry Health Care, Inc.
17% (3 of 18)
Aetna Health, Inc.
8% (5 of 65)
UnitedHealthcare Corporation
6% (6 of 108)Health Net, Inc.
0% (0 of 4)
Humana, Inc.
0% (0 of 26)
Wellpoint, Inc.
0% (0 of 22)
* *
*Where are the plans that do better in Avoiding Overuse?*
We looked at private health insurance plans across the country. In nearly half of the states, not a single plan received our checkmark for Avoiding Overuse, while in some states—notably Minnesota and Massachusetts—at least half earned that designation. Overall, plans in the Northeast outperformed those in the rest of the country.-Region-
-Percentage of plans with a check mark in Avoiding Overuse-
Northeast
33% (40 of 121)
West
13% (14 of 111)Midwest 12% (16 of 136)
South
10% (16 of 162)
*What else is in the health insurance rankings?*
*Overall score. *Each plan gets a score from 1 to 100, based on how well it provides preventive services, including cancer screenings and immunizations; how well it manages chronic diseases, such as heart disease; consumer satisfaction; and accreditation. The overall score is also used to determine a plan’s national rank, shown in the far left column of the chart.
*Consumer satisfaction. *This indicates how well a plan performed in a survey of members about such factors as getting timely doctors’ appointments, getting the care they need, and their overall assessment of their doctors and specialists.
*Prevention.* This measures the proportion of eligible members who received preventive services, such as prenatal and postpartum care, cancer screenings and immunizations. It also looks at access to primary- and preventive-care visits for children and adolescents.
*Treatment.* This measures the proportion of eligible members who received the recommended care for people with conditions such as asthma, diabetes, heart disease, alcohol and drug dependence, and mental illness.
*Accreditation.* Most plans in the rankings are accredited by the NCQA, which requires plans to consistently show high-quality care, strategies for improvement, and public disclosure. Plans pay fees to any organization that evaluates them, including NCQA.
Read more about how health insurance plans are ranked.Get health insurance rankings
Click on the image at right for rankings of health insurance plans nationwide. Use the tool to:
· Choose a plan category such as private HMO or PPO, or Medicare HMO or PPO.
· Choose a state.
· Customize your search to compare plans' scores and their performance in measures such as consumer satisfaction and providing preventive services.
· You can also download PDFs of complete rankings of all private plans, Medicare Advantage plans, and Medicaid plans, as well as a detailed description of how we rank plans on Avoiding Overuse.
This article also appeared in the November 2014 issue of Consumer Reports magazine.*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*
*Subscribe now!*
Subscribe to *ConsumerReports.org* for expert Ratings, buying advice and reliability on hundreds of products.
--------------------
Update your feed preferences Reported by Consumer Reports 10 hours ago.
A good health care plan should provide high overall quality and help members avoid unnecessary medical care. That can help cut health care costs and reduce the risks that come with all medical tests and treatments. (Read more about the outrageous costs of health care in this country).The PDF chart linked to here shows rankings for all private plans (those you buy on your own or get from your employer) in each state plus Puerto Rico and Washington, D.C, and also identifes plans that earned our check mark in Avoiding Overuse. The data come from the National Committee for Quality Assurance, a nonprofit quality measurement and accreditation organization. (See the full rankings of health insurance plans, including Medicare Advantage and Medicaid plans.)
To earn a check in Avoiding Overuse, plans must have sufficient data, score higher overall, and do better in at least three of these areas:
· *Avoiding inappropriate use of antibiotics. *Overuse of the drugs has undermined their effectiveness and has bred dangerous antibiotic-resistant strains of bacteria. Read more about the dangers of overusing antibiotics.
· *Limiting imaging tests for lower-back pain.* Getting an X-ray, CT scan, or MRI within the first month of back pain is rarely necessary because back pain almost always clears up on its own in that time. Read more about the best tests and treatments for back pain.
· *Reducing hospital readmissions.* Being readmitted to the hospital soon after discharge could mean, for example, that the hospital or doctor didn’t properly coordinate discharge or provide appropriate care when the patient was there. Read more about hospital readmissions.
· *Reducing overuse of invasive heart procedures. *It can be more cost-effective and better for patients when heart disease can be controlled with lifestyle changes and drugs. Read more about the best ways to treat heart disease.
· *Avoiding overuse of emergency rooms.* Good plans help patients stay out of the ER, in part by controlling chronic diseases.
Our analysis found that in general, preferred provider organizations (or PPOs, which allow you to see out-of-network providers, but at higher cost), did not perform as well in Avoiding Overuse as health maintenance organizations (HMOs, which only cover in-network providers and usually require you to get a referral from a primary-care doctor). We also looked at which health insurance companies had the most plans overall that did well in Avoiding Overuse, and where those plans tended to be situated in the U.S. (see below).*Which insurance companies are better at helping their members avoid unnecessary medical care?
*
We looked at large insurers that offer multiple health plans to see how they compare when it comes to avoiding overuse. The table shows the percentage of NCQA-ranked private plans for each insurer that earned a checkmark for Avoiding Overuse.
-Insurance company name-
-Percentage of plans with a check mark in Avoiding Overuse
-
Kaiser Foundation Health Plans, Inc.
67% (6 of 9)
Independents 30% (31 of 103)
Blue Cross and Blue Shield Association
27% (14 of 51)
CIGNA HealthCare, Inc. 21% (21 of 101)Coventry Health Care, Inc.
17% (3 of 18)
Aetna Health, Inc.
8% (5 of 65)
UnitedHealthcare Corporation
6% (6 of 108)Health Net, Inc.
0% (0 of 4)
Humana, Inc.
0% (0 of 26)
Wellpoint, Inc.
0% (0 of 22)
* *
*Where are the plans that do better in Avoiding Overuse?*
We looked at private health insurance plans across the country. In nearly half of the states, not a single plan received our checkmark for Avoiding Overuse, while in some states—notably Minnesota and Massachusetts—at least half earned that designation. Overall, plans in the Northeast outperformed those in the rest of the country.-Region-
-Percentage of plans with a check mark in Avoiding Overuse-
Northeast
33% (40 of 121)
West
13% (14 of 111)Midwest 12% (16 of 136)
South
10% (16 of 162)
*What else is in the health insurance rankings?*
*Overall score. *Each plan gets a score from 1 to 100, based on how well it provides preventive services, including cancer screenings and immunizations; how well it manages chronic diseases, such as heart disease; consumer satisfaction; and accreditation. The overall score is also used to determine a plan’s national rank, shown in the far left column of the chart.
*Consumer satisfaction. *This indicates how well a plan performed in a survey of members about such factors as getting timely doctors’ appointments, getting the care they need, and their overall assessment of their doctors and specialists.
*Prevention.* This measures the proportion of eligible members who received preventive services, such as prenatal and postpartum care, cancer screenings and immunizations. It also looks at access to primary- and preventive-care visits for children and adolescents.
*Treatment.* This measures the proportion of eligible members who received the recommended care for people with conditions such as asthma, diabetes, heart disease, alcohol and drug dependence, and mental illness.
*Accreditation.* Most plans in the rankings are accredited by the NCQA, which requires plans to consistently show high-quality care, strategies for improvement, and public disclosure. Plans pay fees to any organization that evaluates them, including NCQA.
Read more about how health insurance plans are ranked.Get health insurance rankings
Click on the image at right for rankings of health insurance plans nationwide. Use the tool to:
· Choose a plan category such as private HMO or PPO, or Medicare HMO or PPO.
· Choose a state.
· Customize your search to compare plans' scores and their performance in measures such as consumer satisfaction and providing preventive services.
· You can also download PDFs of complete rankings of all private plans, Medicare Advantage plans, and Medicaid plans, as well as a detailed description of how we rank plans on Avoiding Overuse.
This article also appeared in the November 2014 issue of Consumer Reports magazine.*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*
*Subscribe now!*
Subscribe to *ConsumerReports.org* for expert Ratings, buying advice and reliability on hundreds of products.
--------------------
Update your feed preferences Reported by Consumer Reports 10 hours ago.
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It's time to get mad about the outrageous cost of health care
*It's time to get mad about the outrageous cost of health care*
Person for person, health care in the U.S. costs about twice as much as it does in the rest of the developed world. In fact, if our $3 trillion health care sector were its own country, it would be the world’s fifth-largest economy.
If you have health insurance, you may think it doesn’t matter because someone else is paying the bill. You’d be wrong. This country’s exorbitant medical costs mean that we all pay too much for health insurance. Overpriced care also translates into fewer raises for American workers. And to top it off, we’re not even getting the best care for our money.
First, be aware that even if you have insurance, it doesn’t always fully protect you. Four years ago, Joclyn Krevat, a 32-year-old occupational therapist from New York City, collapsed with a rare heart condition and ended up needing an emergency heart transplant. She had it done at a hospital in her health plan’s network, but no one bothered to tell her that her transplant surgeons didn’t take her insurance. They billed her $70,000 and sent collection agencies and lawyers after her while she was still home recuperating. In studying the problem, Consumer Reports has heard dozens of similar tales about surprise out-of-network bills. (If you have one, consider sharing it with us).Second, higher health care costs mean higher health insurance premiums for everyone. It’s Health Insurance 101: Insurance is about pooling risk. That’s a good thing because it protects you against unexpected costs—but companies have to collect enough in premiums to pay for members’ health expenses. The higher the expenses for the risk pool, the higher the premiums for everyone—even if you received little or none of that care.
And if you’re wondering why you can’t get ahead financially, blame it on the fact that health care is eating your raises. Since 2000, incomes have barely kept up with inflation and insurance premiums have more than doubled. The average employer family health plan that cost companies $6,438 per staffer in 2000 shot up to $16,351 by 2013. That’s money that could have gone into your paycheck but didn’t because your employer had to spend it on your health insurance instead.
The kicker: We don’t get much for our money. In a 2013 Commonwealth Fund study of 11 developed countries’ health care systems, the U.S. ranked fifth in quality and worst for infant mortality. We also did the worst job of preventing deaths from treatable conditions, such as strokes, diabetes, high blood pressure, and certain treatable cancers. (See graph, below).
No wonder that when Consumer Reports surveyed a representative sample of 1,079 American adults, we found considerable distress about high costs. Twelve percent said they had spent more than $5,000 of their own money on medical bills (not counting prescriptions or insurance premiums) in the previous year, and 11 percent said they had medical bills they had trouble paying. Large majorities said they wanted better information about cost and quality of their health care (see the box, below).
All of which brings us to the big question: Why exactly is our health care so expensive?
Health care works nothing like other market transactions. As a consumer, you are a bystander to the real action, which takes place between providers—hospitals, doctors, labs, drug companies, and device manufacturers—and the private and governmental entities that pay them. Those same providers are also pushing Americans into newer and more expensive treatments, even when there’s no evidence they’re any better.
“There is no such thing as a legitimate price for anything in health care,” says George Halvorson, former chairman of Kaiser Permanente, the giant health maintenance organization based in California. “Prices are made up depending on who the payer is.”
When Medicare is paying the bills, prices tend to be lower. That agency is by far the largest single source of revenue for most health care providers, which gives it more leverage to set prices. Private insurance companies and providers, on the other hand, bargain head-to-head over prices, often savagely. (If you see headlines in your area about such-and-such hospital leaving an insurer network, that’s what’s going on.)
In regions with many competing providers, insurers can play them against each other to hold down prices. But where there are few providers, not so much. Providers know that, and are busily consolidating into larger groups to get more bargaining power. In your own community, you may have noticed new outpatient medical clinics sprouting up emblazoned with the name of a local hospital; that is hospitals buying up private medical practices to get more clout with insurers.
But the providers with the most clout are the brand-name medical centers, which hold special cachet for patients and are thus “must have” hospitals for many insurers. “In some markets the prestigious medical institutions can name their price,” says Andrea Caballero, program director for Catalyst for Payment Reform, a national nonprofit trying to get a grip on health costs on behalf of large employers. “They may have brand names of high prestige but not necessarily deliver higher-quality care.”
There are small but hopeful signs that health costs aren’t growing quite as fast as they used to. Medicare’s costs are stabilizing, for instance. It’s too soon to tell whether that is a permanent trend.
But the “medical industrial complex” continues going for as much gold as it can, as the following examples show all too clearly.
Americans usually pay for health care by the piece: so much for each office visit, X-ray, outpatient procedure, etc. That approach leads to one thing: waste. Up to 30 percent of the care provided in this country is unnecessary, according to the Congressional Budget Office. “If you have a treatment that requires three CT scans and re-engineer it to require only one, it won’t happen because two CT scan places will lose a source of revenue,” says George Halvorson of Kaiser Permanente. “Piecework also rewards bad outcomes. It pays a lot if you have a heart attack but very little for preventing it.”
Some insurance companies are making headway against overtreatment—which is why Consumer Reports has prepared a list of them in collaboration with the National Committee for Quality Assurance (NCQA), a nonprofit quality measurement and accreditation organization. (Read more about health plans that help members avoid unnecessary medical care.)Here’s a prime example of big pharma’s we-charge-what-we-want syndrome: A new pill for hepatitis C has hit the market that, if taken by everyone who should take it, would cost Americans more per year than all other brand-name drugs combined. No one—not individuals, not private insurers, not Medicare—can do a thing about it. That’s because here in the U.S., as long as the drug, Sovaldi, remains under patent, its owner, Gilead Sciences, can charge whatever it wants. At the moment that’s $1,000 per pill, or $84,000 to $150,000 for a course of treatment.
“Drug companies charge what the market will bear, and in the United States the market will bear a lot,” says Matt Salo, executive director of the National Association of Medicaid Directors, a policy group based in Washington, D.C.
Hepatitis C affects 3.2 million mostly boomer-aged Americans who got it through tainted blood transfusions (no longer a serious risk thanks to new screening tests) and intravenous drug use. Left untreated, it can lead to liver failure and is the leading reason for liver transplants in the U.S. Older treatments were uncomfortable, took forever, came with unpleasant side effects, and didn’t always work. With Sovaldi, you take the pill for a few months; it has a cure rate of about 90 percent in clinical trials.
The industry defends the price on the grounds that it’s cheaper than a $500,000 liver transplant. But most people with untreated Hepatitis C never need a transplant; even after 20 years, the savings from not having to treat the disease’s worst effects would offset only about 75 percent of Sovaldi’s up-front costs, research suggests. Meanwhile, it would add $600 per person to the annual cost of a group health plan.
One way for hospitals and medical practices to make gobs of money is to push a new, trendy procedure—even if it’s no better than an older one. Prime example: prostate cancer surgery. Medical science still has little idea which treatments work best for the disease, or even who really needs to be treated, because many patients have cancer so indolent that they will die of something else long before it kills them.
None of that has stopped medical marketers from persuading hospitals to spend ever larger sums of money on so-called cutting-edge prostate cancer treatments to lure patients away from competitors.
The poster child for the phenomenon is robotic surgery, which your local hospital has probably bragged about.
First introduced for prostate cancer surgery in 2001, the $2 million machine—a collection of laparoscopic instruments operated remotely—went from being used for 6 percent of prostatectomies in 2004 to 83 percent in 2014, despite little evidence that it is better than other types of surgery even though it comes with a higher price tag.
“There’s marketing value in a very expensive piece of technology, such as a robot, even if it doesn’t work better,” says Jeffrey C. Lerner, president of the ECRI Institute, a nonprofit health technology evaluation organization. “Nobody’s ever going to put up a billboard about having the best bandage.”
-1. Find out the real cost of your treatment-
More and more insurers are disclosing at least some negotiated prices to members who register with their websites. Take advantage of that feature if your health plan offers it, especially for things you can plan in advance, such as imaging tests. In a recent experiment, people scheduled for CT scans or MRIs were called and told about cheaper alternatives of equal quality; they ended up saving participating insurers an average of $220 per scan—and prompted more expensive providers to cut their prices.
-2. If you want the celeb doctor, pay extra-
“Reference pricing” is when an insurer analyzes its past claims to set a reasonable price for a good-quality routine test or procedure and tells its customers that if they want to go to a higher-cost in-network provider, they can—but will be responsible for the difference between the reference price and the provider’s price.
CalPERS, which buys health insurance for 1.3 million California state employees and retirees, set a reference price of $30,000 for routine hip and knee replacements after discovering it was paying as much as $110,000 for those procedures. In the first year, savings averaged $7,000 per patient—and several high-cost hospitals suddenly discovered that they, too, could offer $30,000 joint replacements. One caveat: This fix needs to be done carefully to make sure that quality stays high and consumers aren’t caught by surprise.
-3. Seek out a smaller medical network-
You can save about 20 percent on premiums by signing up with a plan that has fewer providers than customary. Providers give the insurer a price break in exchange for fewer competitors. But before signing on, make sure that the network includes the doctors, hospitals, labs, and other services you need within a reasonable distance from your home and that they accept new patients. Subscribers to our website can see how hospitals compare in quality.
-Get health insurance rankings-
Click on the image at right for rankings of health insurance plans nationwide. Use the tool to:
· Choose a plan category such as private HMO or PPO, Medicare HMO or PPO, or Medicaid.
· Choose a state.
· Customize your search to compare plans' scores and their performance in measures such as consumer satisfaction and providing preventive services.
This article also appeared in the November 2014 issue of Consumer Reports magazine.
*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*
*Subscribe now!*
Subscribe to *ConsumerReports.org* for expert Ratings, buying advice and reliability on hundreds of products.
--------------------
Update your feed preferences
Reported by Consumer Reports 10 hours ago.
Person for person, health care in the U.S. costs about twice as much as it does in the rest of the developed world. In fact, if our $3 trillion health care sector were its own country, it would be the world’s fifth-largest economy.
If you have health insurance, you may think it doesn’t matter because someone else is paying the bill. You’d be wrong. This country’s exorbitant medical costs mean that we all pay too much for health insurance. Overpriced care also translates into fewer raises for American workers. And to top it off, we’re not even getting the best care for our money.
First, be aware that even if you have insurance, it doesn’t always fully protect you. Four years ago, Joclyn Krevat, a 32-year-old occupational therapist from New York City, collapsed with a rare heart condition and ended up needing an emergency heart transplant. She had it done at a hospital in her health plan’s network, but no one bothered to tell her that her transplant surgeons didn’t take her insurance. They billed her $70,000 and sent collection agencies and lawyers after her while she was still home recuperating. In studying the problem, Consumer Reports has heard dozens of similar tales about surprise out-of-network bills. (If you have one, consider sharing it with us).Second, higher health care costs mean higher health insurance premiums for everyone. It’s Health Insurance 101: Insurance is about pooling risk. That’s a good thing because it protects you against unexpected costs—but companies have to collect enough in premiums to pay for members’ health expenses. The higher the expenses for the risk pool, the higher the premiums for everyone—even if you received little or none of that care.
And if you’re wondering why you can’t get ahead financially, blame it on the fact that health care is eating your raises. Since 2000, incomes have barely kept up with inflation and insurance premiums have more than doubled. The average employer family health plan that cost companies $6,438 per staffer in 2000 shot up to $16,351 by 2013. That’s money that could have gone into your paycheck but didn’t because your employer had to spend it on your health insurance instead.
The kicker: We don’t get much for our money. In a 2013 Commonwealth Fund study of 11 developed countries’ health care systems, the U.S. ranked fifth in quality and worst for infant mortality. We also did the worst job of preventing deaths from treatable conditions, such as strokes, diabetes, high blood pressure, and certain treatable cancers. (See graph, below).
No wonder that when Consumer Reports surveyed a representative sample of 1,079 American adults, we found considerable distress about high costs. Twelve percent said they had spent more than $5,000 of their own money on medical bills (not counting prescriptions or insurance premiums) in the previous year, and 11 percent said they had medical bills they had trouble paying. Large majorities said they wanted better information about cost and quality of their health care (see the box, below).
All of which brings us to the big question: Why exactly is our health care so expensive?
Health care works nothing like other market transactions. As a consumer, you are a bystander to the real action, which takes place between providers—hospitals, doctors, labs, drug companies, and device manufacturers—and the private and governmental entities that pay them. Those same providers are also pushing Americans into newer and more expensive treatments, even when there’s no evidence they’re any better.
“There is no such thing as a legitimate price for anything in health care,” says George Halvorson, former chairman of Kaiser Permanente, the giant health maintenance organization based in California. “Prices are made up depending on who the payer is.”
When Medicare is paying the bills, prices tend to be lower. That agency is by far the largest single source of revenue for most health care providers, which gives it more leverage to set prices. Private insurance companies and providers, on the other hand, bargain head-to-head over prices, often savagely. (If you see headlines in your area about such-and-such hospital leaving an insurer network, that’s what’s going on.)
In regions with many competing providers, insurers can play them against each other to hold down prices. But where there are few providers, not so much. Providers know that, and are busily consolidating into larger groups to get more bargaining power. In your own community, you may have noticed new outpatient medical clinics sprouting up emblazoned with the name of a local hospital; that is hospitals buying up private medical practices to get more clout with insurers.
But the providers with the most clout are the brand-name medical centers, which hold special cachet for patients and are thus “must have” hospitals for many insurers. “In some markets the prestigious medical institutions can name their price,” says Andrea Caballero, program director for Catalyst for Payment Reform, a national nonprofit trying to get a grip on health costs on behalf of large employers. “They may have brand names of high prestige but not necessarily deliver higher-quality care.”
There are small but hopeful signs that health costs aren’t growing quite as fast as they used to. Medicare’s costs are stabilizing, for instance. It’s too soon to tell whether that is a permanent trend.
But the “medical industrial complex” continues going for as much gold as it can, as the following examples show all too clearly.
Americans usually pay for health care by the piece: so much for each office visit, X-ray, outpatient procedure, etc. That approach leads to one thing: waste. Up to 30 percent of the care provided in this country is unnecessary, according to the Congressional Budget Office. “If you have a treatment that requires three CT scans and re-engineer it to require only one, it won’t happen because two CT scan places will lose a source of revenue,” says George Halvorson of Kaiser Permanente. “Piecework also rewards bad outcomes. It pays a lot if you have a heart attack but very little for preventing it.”
Some insurance companies are making headway against overtreatment—which is why Consumer Reports has prepared a list of them in collaboration with the National Committee for Quality Assurance (NCQA), a nonprofit quality measurement and accreditation organization. (Read more about health plans that help members avoid unnecessary medical care.)Here’s a prime example of big pharma’s we-charge-what-we-want syndrome: A new pill for hepatitis C has hit the market that, if taken by everyone who should take it, would cost Americans more per year than all other brand-name drugs combined. No one—not individuals, not private insurers, not Medicare—can do a thing about it. That’s because here in the U.S., as long as the drug, Sovaldi, remains under patent, its owner, Gilead Sciences, can charge whatever it wants. At the moment that’s $1,000 per pill, or $84,000 to $150,000 for a course of treatment.
“Drug companies charge what the market will bear, and in the United States the market will bear a lot,” says Matt Salo, executive director of the National Association of Medicaid Directors, a policy group based in Washington, D.C.
Hepatitis C affects 3.2 million mostly boomer-aged Americans who got it through tainted blood transfusions (no longer a serious risk thanks to new screening tests) and intravenous drug use. Left untreated, it can lead to liver failure and is the leading reason for liver transplants in the U.S. Older treatments were uncomfortable, took forever, came with unpleasant side effects, and didn’t always work. With Sovaldi, you take the pill for a few months; it has a cure rate of about 90 percent in clinical trials.
The industry defends the price on the grounds that it’s cheaper than a $500,000 liver transplant. But most people with untreated Hepatitis C never need a transplant; even after 20 years, the savings from not having to treat the disease’s worst effects would offset only about 75 percent of Sovaldi’s up-front costs, research suggests. Meanwhile, it would add $600 per person to the annual cost of a group health plan.
One way for hospitals and medical practices to make gobs of money is to push a new, trendy procedure—even if it’s no better than an older one. Prime example: prostate cancer surgery. Medical science still has little idea which treatments work best for the disease, or even who really needs to be treated, because many patients have cancer so indolent that they will die of something else long before it kills them.
None of that has stopped medical marketers from persuading hospitals to spend ever larger sums of money on so-called cutting-edge prostate cancer treatments to lure patients away from competitors.
The poster child for the phenomenon is robotic surgery, which your local hospital has probably bragged about.
First introduced for prostate cancer surgery in 2001, the $2 million machine—a collection of laparoscopic instruments operated remotely—went from being used for 6 percent of prostatectomies in 2004 to 83 percent in 2014, despite little evidence that it is better than other types of surgery even though it comes with a higher price tag.
“There’s marketing value in a very expensive piece of technology, such as a robot, even if it doesn’t work better,” says Jeffrey C. Lerner, president of the ECRI Institute, a nonprofit health technology evaluation organization. “Nobody’s ever going to put up a billboard about having the best bandage.”
-1. Find out the real cost of your treatment-
More and more insurers are disclosing at least some negotiated prices to members who register with their websites. Take advantage of that feature if your health plan offers it, especially for things you can plan in advance, such as imaging tests. In a recent experiment, people scheduled for CT scans or MRIs were called and told about cheaper alternatives of equal quality; they ended up saving participating insurers an average of $220 per scan—and prompted more expensive providers to cut their prices.
-2. If you want the celeb doctor, pay extra-
“Reference pricing” is when an insurer analyzes its past claims to set a reasonable price for a good-quality routine test or procedure and tells its customers that if they want to go to a higher-cost in-network provider, they can—but will be responsible for the difference between the reference price and the provider’s price.
CalPERS, which buys health insurance for 1.3 million California state employees and retirees, set a reference price of $30,000 for routine hip and knee replacements after discovering it was paying as much as $110,000 for those procedures. In the first year, savings averaged $7,000 per patient—and several high-cost hospitals suddenly discovered that they, too, could offer $30,000 joint replacements. One caveat: This fix needs to be done carefully to make sure that quality stays high and consumers aren’t caught by surprise.
-3. Seek out a smaller medical network-
You can save about 20 percent on premiums by signing up with a plan that has fewer providers than customary. Providers give the insurer a price break in exchange for fewer competitors. But before signing on, make sure that the network includes the doctors, hospitals, labs, and other services you need within a reasonable distance from your home and that they accept new patients. Subscribers to our website can see how hospitals compare in quality.
-Get health insurance rankings-
Click on the image at right for rankings of health insurance plans nationwide. Use the tool to:
· Choose a plan category such as private HMO or PPO, Medicare HMO or PPO, or Medicaid.
· Choose a state.
· Customize your search to compare plans' scores and their performance in measures such as consumer satisfaction and providing preventive services.
This article also appeared in the November 2014 issue of Consumer Reports magazine.
*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*
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Reported by Consumer Reports 10 hours ago.
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More Americans Are Seeking Long Term Care Insurance through Their Employers, ACSIA Partners Reports
KIRKLAND, Wash., Sept. 25, 2014 /PRNewswire/ -- Why isn't long term care insurance, like health insurance, available at the workplace? Well, increasingly it is -- and more Americans should take advantage of that fact, according to ACSIA Partners, a leader in long term care...
Reported by PR Newswire 11 hours ago.
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Health Insurance in Australia Industry Market Research Report Now Updated by IBISWorld
Over the past five years, growth in revenue has been propelled by higher private health insurance prices and membership numbers. For this reason, industry research firm IBISWorld has updated its report on the Health Insurance industry in Australia.
Melbourne, Australia (PRWEB) September 25, 2014
The Health Insurance industry is an integral part of the Australian health system, providing coverage to almost 47.0% of the population. Health insurers generate revenue from the sale of health insurance policies (premium income) and the investment of premium reserves (investment income). Premium income generally accounts for more than 95.0% of revenue, though this changes from year to year. Industry revenue is forecast to grow by 3.8% in 2014-15, to reach $20.6 billion, on the back of strong growth in premium income. Over the five years through 2014-15, industry revenue is expected to grow at an annualised 4.9%. According to IBISWorld industry analyst Andrei Ivanov, “over the past five years, growth in premium income has been propelled by higher private health insurance prices and membership numbers.” This has led to premium income growth estimated at 3.3% annualised over the five years through 2014-15, to reach $20.0 billion. Investment income has also contributed to the industry's solid performance, as local markets have posted strong increases despite global economic uncertainty.
Healthy revenue growth will translate into a stronger bottom line for the industry. The industry's largest expense, benefit payments, is expected to grow as a proportion of revenue, as benefit costs and utilisation rates increase, and the membership profile ages. Premium prices have been steadily growing by over 5.0% per annum, to counterbalance these increases. “The industry will work to limit the effect of these rising costs by minimising growth in management expenses, through investment in online service platforms and other labour-saving technologies,” says Ivanov. In 2015-16, revenue is expected to grow, as health insurers continue to benefit from a rebounding economy, growing investor confidence and continued strengthening in the premium cycle. Profit is expected to increase marginally over the next five years, in line with the industry winning approval for larger price rises, thereby offsetting the profit-eroding effects of increasing benefit expenses.
IBISWorld classifies the Health Insurance industry as having a high level of market share concentration. In the last couple of years, smaller major players NIB, HCF and HBF have managed to gain some ground on the much larger BUPA and Medibank, while the total market share between the five major players has not significantly changed. Consolidation is expected to occur over the next five years, due to the pressures the industry faces relating to competitiveness and profitability, partly brought on by the increase in the Medicare Levy Surcharge threshold and changes in the PHI Rebate. Some of the industry's larger players are expected to acquire struggling smaller players, resulting in a decline in the number of industry enterprises.
For more information, visit IBISWorld’s Health Insurance industry in Australia report page.
This industry includes businesses that primarily underwrite insurance policies relating to health and medical risks. Underwriting insurance policies involves assuming risks and assigning premiums. The type of insurance cover provided by businesses operating in the industry is for hospital, medical, dental, pharmaceutical and funeral expenses or costs. Businesses within the industry generate revenue not only through insurance underwriting but also by investing premiums.
Follow IBISWorld on Twitter: http://twitter.com/#!/ibisworldau
IBISWorld industry Report Key Topics
Industry Performance
Executive Summary
Key External Drivers
Current Performance
Industry Outlook
Industry Life Cycle
Products & Markets
Supply Chain
Products & Services
Major Markets
International Trade
Business Locations
Competitive Landscape
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Basis of Competition
Barriers to Entry
Industry Globalisation
Major Companies
Operating Conditions
Capital Intensity
Technology & Systems
Revenue Volatility
Regulation & Policy
Industry Assistance
Key Statistics
Industry Data
Annual Change
Key Ratios
About IBISWorld Inc.
Recognised as the nation’s most trusted independent source of industry and market research, IBISWorld offers a comprehensive database of unique information and analysis on every Australian industry. With an extensive online portfolio, valued for its depth and scope, the company equips clients with the insight necessary to make better business decisions. Headquartered in Melbourne, IBISWorld serves a range of business, professional service and government organisations through more than 10 locations worldwide. For more information, visit http://www.ibisworld.com.au or call (03) 9655 3886. Reported by PRWeb 9 hours ago.
Melbourne, Australia (PRWEB) September 25, 2014
The Health Insurance industry is an integral part of the Australian health system, providing coverage to almost 47.0% of the population. Health insurers generate revenue from the sale of health insurance policies (premium income) and the investment of premium reserves (investment income). Premium income generally accounts for more than 95.0% of revenue, though this changes from year to year. Industry revenue is forecast to grow by 3.8% in 2014-15, to reach $20.6 billion, on the back of strong growth in premium income. Over the five years through 2014-15, industry revenue is expected to grow at an annualised 4.9%. According to IBISWorld industry analyst Andrei Ivanov, “over the past five years, growth in premium income has been propelled by higher private health insurance prices and membership numbers.” This has led to premium income growth estimated at 3.3% annualised over the five years through 2014-15, to reach $20.0 billion. Investment income has also contributed to the industry's solid performance, as local markets have posted strong increases despite global economic uncertainty.
Healthy revenue growth will translate into a stronger bottom line for the industry. The industry's largest expense, benefit payments, is expected to grow as a proportion of revenue, as benefit costs and utilisation rates increase, and the membership profile ages. Premium prices have been steadily growing by over 5.0% per annum, to counterbalance these increases. “The industry will work to limit the effect of these rising costs by minimising growth in management expenses, through investment in online service platforms and other labour-saving technologies,” says Ivanov. In 2015-16, revenue is expected to grow, as health insurers continue to benefit from a rebounding economy, growing investor confidence and continued strengthening in the premium cycle. Profit is expected to increase marginally over the next five years, in line with the industry winning approval for larger price rises, thereby offsetting the profit-eroding effects of increasing benefit expenses.
IBISWorld classifies the Health Insurance industry as having a high level of market share concentration. In the last couple of years, smaller major players NIB, HCF and HBF have managed to gain some ground on the much larger BUPA and Medibank, while the total market share between the five major players has not significantly changed. Consolidation is expected to occur over the next five years, due to the pressures the industry faces relating to competitiveness and profitability, partly brought on by the increase in the Medicare Levy Surcharge threshold and changes in the PHI Rebate. Some of the industry's larger players are expected to acquire struggling smaller players, resulting in a decline in the number of industry enterprises.
For more information, visit IBISWorld’s Health Insurance industry in Australia report page.
This industry includes businesses that primarily underwrite insurance policies relating to health and medical risks. Underwriting insurance policies involves assuming risks and assigning premiums. The type of insurance cover provided by businesses operating in the industry is for hospital, medical, dental, pharmaceutical and funeral expenses or costs. Businesses within the industry generate revenue not only through insurance underwriting but also by investing premiums.
Follow IBISWorld on Twitter: http://twitter.com/#!/ibisworldau
IBISWorld industry Report Key Topics
Industry Performance
Executive Summary
Key External Drivers
Current Performance
Industry Outlook
Industry Life Cycle
Products & Markets
Supply Chain
Products & Services
Major Markets
International Trade
Business Locations
Competitive Landscape
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Basis of Competition
Barriers to Entry
Industry Globalisation
Major Companies
Operating Conditions
Capital Intensity
Technology & Systems
Revenue Volatility
Regulation & Policy
Industry Assistance
Key Statistics
Industry Data
Annual Change
Key Ratios
About IBISWorld Inc.
Recognised as the nation’s most trusted independent source of industry and market research, IBISWorld offers a comprehensive database of unique information and analysis on every Australian industry. With an extensive online portfolio, valued for its depth and scope, the company equips clients with the insight necessary to make better business decisions. Headquartered in Melbourne, IBISWorld serves a range of business, professional service and government organisations through more than 10 locations worldwide. For more information, visit http://www.ibisworld.com.au or call (03) 9655 3886. Reported by PRWeb 9 hours ago.
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Nearly One in Four Employers Say Private Health Insurance Exchanges Could Provide a Viable Alternative for Full-Time Active Employees in 2016
ARLINGTON, Va.--(BUSINESS WIRE)--Results of a July 2014 survey of midsize to large employers by global professional services company Towers Watson (NYSE, NASDAQ:TW) showed that 28% said they had already extensively evaluated the viability of private exchanges. Nearly one in four (24%) said private exchanges could provide a viable alternative for their active full-time employees as soon as 2016. The results are from the 2014 Towers Watson Health Care Changes Ahead Survey, which was completed by
Reported by Business Wire 9 hours ago.
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Two Horizon BCBSNJ Directors Named Among DiversityMBA Magazine's Top 100 Under 50 Executives and Emerging Leaders
Two directors for Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) have been recognized as DiversityMBA Magazine’s 2014 Top 100 Under 50 Diverse Executives & Emerging Leaders.
Newark, NJ (PRWEB) September 25, 2014
Two directors for Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) have been recognized as DiversityMBA Magazine’s 2014 Top 100 Under 50 Diverse Executives & Emerging Leaders. This year, Maureen Martin, Director, Service Operations, and Vincenza Cruz, Director, Talent Acquisition, were honored by DiversityMBA Magazine at their Executive Leaders Conference and Awards Gala. The event was held last week at the DoubleTree by Hilton in Oak Brook, IL. Both recipients will be featured in the 2014 fall issue of DiversityMBA Magazine.
“Horizon is proud that DiversityMBA Magazine has honored two of its talented directors, and congratulates Maureen and Vincenza for this well-deserved recognition,” said Alison Banks-Moore, Chief Diversity Officer for Horizon BCBSNJ.
As Director, Talent Acquisition, Vincenza Cruz, of Oakridge, Ms. Cruz leads Horizon BCBSNJ’s overall recruiting efforts and works to maintain the company’s position as the employer of choice among top talent in the competitive health insurance industry. Ms. Cruz has also led collaborations with local and national military organizations to recruit, train and hire veterans of the armed forces. Ms. Cruz is an active member of Women’s LEAD, Horizon BCBSNJ’s Women Leadership Affinity Group, which fosters career development for women employees.
As Director, Service Operations, Maureen Martin, of Westfield, is responsible for managing service delivery to more than 28,000 participating providers, 100 hospitals and other ancillary providers. Under Ms. Martin’s leadership, Horizon BCBSNJ has improved the quality, speed and cost efficiency of its service operations to better respond to customers’ needs. Ms. Martin is also active in Horizon BCBSNJ’s Women’s LEAD group.
Also at the awards ceremony, Horizon BCBSNJ was honored as one of the DiversityMBA Magazine’s 2014 50 Out Front Companies for Diversity Leadership. The award recognizes companies that not only demonstrate their strong commitment to diversity, but also work hard to help support external programs that enhance leadership and retention within their organizations.
###
About Horizon BCBSNJ’s Diversity programs
Horizon BCBSNJ has instituted many programs aimed at promoting diversity within the company including: paid minority internships and manager development programs, as well as a Diversity Council and minority leadership programs. To learn more about Horizon BCBSNJ and its diversity efforts, visit: http://www.HorizonBlue.com/diversity
About Horizon Blue Cross Blue Shield of New Jersey
Horizon Blue Cross Blue Shield of New Jersey, the state’s oldest and largest health insurer, is a tax-paying, not-for-profit health services corporation, providing a wide array of medical, dental, and prescription insurance products and services. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association, serving 3.7 million members with headquarters in Newark and offices in Wall, Mt. Laurel, and West Trenton. Learn more at http://www.HorizonBlue.com
About Diversity MBA Magazine
DiversityMBA Magazine provides research reports on diversity benchmarks for talent retention, industry diversity programs, and performance in the diversity arena through its partnership with DePaul University. The magazines distributed at newsstands, top business schools, professional and business associations domestically, and 30 countries worldwide through QS Top MBA World Tour. Reported by PRWeb 9 hours ago.
Newark, NJ (PRWEB) September 25, 2014
Two directors for Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) have been recognized as DiversityMBA Magazine’s 2014 Top 100 Under 50 Diverse Executives & Emerging Leaders. This year, Maureen Martin, Director, Service Operations, and Vincenza Cruz, Director, Talent Acquisition, were honored by DiversityMBA Magazine at their Executive Leaders Conference and Awards Gala. The event was held last week at the DoubleTree by Hilton in Oak Brook, IL. Both recipients will be featured in the 2014 fall issue of DiversityMBA Magazine.
“Horizon is proud that DiversityMBA Magazine has honored two of its talented directors, and congratulates Maureen and Vincenza for this well-deserved recognition,” said Alison Banks-Moore, Chief Diversity Officer for Horizon BCBSNJ.
As Director, Talent Acquisition, Vincenza Cruz, of Oakridge, Ms. Cruz leads Horizon BCBSNJ’s overall recruiting efforts and works to maintain the company’s position as the employer of choice among top talent in the competitive health insurance industry. Ms. Cruz has also led collaborations with local and national military organizations to recruit, train and hire veterans of the armed forces. Ms. Cruz is an active member of Women’s LEAD, Horizon BCBSNJ’s Women Leadership Affinity Group, which fosters career development for women employees.
As Director, Service Operations, Maureen Martin, of Westfield, is responsible for managing service delivery to more than 28,000 participating providers, 100 hospitals and other ancillary providers. Under Ms. Martin’s leadership, Horizon BCBSNJ has improved the quality, speed and cost efficiency of its service operations to better respond to customers’ needs. Ms. Martin is also active in Horizon BCBSNJ’s Women’s LEAD group.
Also at the awards ceremony, Horizon BCBSNJ was honored as one of the DiversityMBA Magazine’s 2014 50 Out Front Companies for Diversity Leadership. The award recognizes companies that not only demonstrate their strong commitment to diversity, but also work hard to help support external programs that enhance leadership and retention within their organizations.
###
About Horizon BCBSNJ’s Diversity programs
Horizon BCBSNJ has instituted many programs aimed at promoting diversity within the company including: paid minority internships and manager development programs, as well as a Diversity Council and minority leadership programs. To learn more about Horizon BCBSNJ and its diversity efforts, visit: http://www.HorizonBlue.com/diversity
About Horizon Blue Cross Blue Shield of New Jersey
Horizon Blue Cross Blue Shield of New Jersey, the state’s oldest and largest health insurer, is a tax-paying, not-for-profit health services corporation, providing a wide array of medical, dental, and prescription insurance products and services. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association, serving 3.7 million members with headquarters in Newark and offices in Wall, Mt. Laurel, and West Trenton. Learn more at http://www.HorizonBlue.com
About Diversity MBA Magazine
DiversityMBA Magazine provides research reports on diversity benchmarks for talent retention, industry diversity programs, and performance in the diversity arena through its partnership with DePaul University. The magazines distributed at newsstands, top business schools, professional and business associations domestically, and 30 countries worldwide through QS Top MBA World Tour. Reported by PRWeb 9 hours ago.
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Cigna Plans Are Top-Ranked in North Carolina in PPO Category, According to NCQA’s Private Health Insurance Plan Rankings
BLOOMFIELD, Conn.--(BUSINESS WIRE)--Cigna’s Preferred Provider Organization-type (PPO-type) plans are the top-ranked among similar plans in North Carolina.
Reported by Business Wire 9 hours ago.
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