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Milliman Survey: Even with New Contracting Approaches Rates Increase 11.7% in 2011

Milliman's 2010 Group Health Insurance Survey  found insurers estimated a 10.2% and 11.7% increase for HMOs and PPOs respectively for 2011. The survey also found that the most frequent contracting and cost control steps insurers are taking in 2011 include: Quality incentive programs Shared risk with provider networks Increased price transparency with members More aggressively tiered providers networks Reduced broker commissions Almost all of the insurers... Read More
Posted by Cristie Travis at Thursday, October 28, 2010

Tennessee Starts to Evaluate Health Insurance Exchanges

Should the state of Tennessee establish its own health insurance exchange or tap into the national, federal exchange? That is the question being considered by the State of Tennessee under a $1 million grant from the federal government. I attended the "kick-off" meeting on October 22, 2010 for Tennessee's evaluation of the whole health insurance exchange issue. About 200 of us gathered in the central Nashville library to hear about the proposal TN had made for planning grant funds from the... Read More
Posted by Cristie Travis at Saturday, October 23, 2010

Commercial Per Capita Costs Increase 8.7%, Far Outpacing Medicare Costs

From Business Insurance , S&P Healthcare Indices reports that for the 12-month period ending August 2010, per capita health care costs for commercial plans,including self-insured, increased 8.66% compared to an increase in Medicare per capita cost of only 5.08%. Hospital services accounted for the greatest difference between commercial & Medicare with commercial experiencing a 9.66% increase and Medicare having a 4.48% increase. Read More
Posted by Cristie Travis at Friday, October 22, 2010

Sentara Healthcare Saves $3.4 Million & Improves Employee Health

A 3-year, incentive-based wellness program for the employees of Sentara Healthcare had a 6:1 return on investment, saved approximately $3.4 million in healthcare costs, and resulted in health improvement for nearly 80% of the employees that participated in the program. Major program components included: Completion of a voluntary personal health profile to identify risk factors Employees with low risk factors were awarded a $500 annual premium reduction Employees with... Read More
Posted by Cristie Travis at Wednesday, October 20, 2010

Glad You Have "Most Favored Nation" Pricing? You Should Read This

Most favored nation pricing means that you (or your health plan) have the best pricing a hospital or physician practice gives any plan.On the surface, this looks good; after all, all other payors will pay more than you. However, all may not be good at all. If the price you have as the floor is a high price, then you and everyone else pays more than you really should be paying, leading to higher overall health care costs in your market. This is just one of the issues being litigated in the... Read More
Posted by Cristie Travis at Tuesday, October 19, 2010

Stunning Medical Mistakes Still Happen 6 Years After Introducing Universal Protocol

According to a report published in the October issue of the Archives of Surgery, introducing the universal protocol endorsed by the Joint Commission in 2004 has NOT reduced the frequency of such medical errors as wrong site surgery or wrong patient surgery, Read a summary of the report. The protocol requires 3 steps: Pre-procedure verification Marking the correct surgical site Taking a "time-out" for the surgical team just before surgery. Diagnostic... Read More
Posted by Cristie Travis at Tuesday, October 19, 2010

What is your premium increase for 2011?

Tell us what your premium (or premium equivalent if you are self-insured) increase is for 2011 .Approximately what is the amount of this increase that is due to changes required by health reform? Did you make some benefit design changes to reduce your premium increase? If so, what changes did you make and what do you think the impact of those changes were on your final premium increase?  Be sure to tell us if you are fully-insured or self-insured. Read More
Posted by Cristie Travis at Wednesday, October 13, 2010

New Over the Counter Rules Can Be Confusing

Effective January 1, 2011, employees must have a "prescription" to purchase over-the-counter medicines and drugs if they are to be categorized as "medical care" for purposes of the employer health plan and health savings accounts. Click here to read this concise summary from Alston & Bird and published in Employee Benefit News of the recently released IRS notice which provides clarifications around: What is a medication or drug? When is a medicine or drug considered prescribed?... Read More
Posted by Cristie Travis at Friday, October 1, 2010

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