S&S Benefits.....Opinion,
Hearsay & News Review
Coventry Health Care has signed an agreement to purchase
Florida Health Plan Administrators which owns Vista Healthplans. Vista has about
295,000 HMO health plan members, mostly in south
Florida
.
In
Texas
in 2003, lawmakers and voters implemented a $250,000 cap on non-economic
damages in medical malpractice cases. Malpractice insurance premiums in
Texas
have fallen by an average of 21.3% since that time. Now doctor applications to
practice in
Texas
are skyrocketing, with over 4,000 applications for licenses in 2006, up from
2,992 the previous year. The Texas Medical Board is having trouble keeping up
with the applications.
According to a recent Watson Wyatt survey, 49% of workers
have trouble understanding their health coverage and admit confusion when it
comes to basic terms. Seventy percent of workers prefer to receive health
information in print, followed closely by 64% who prefer the information be
accessible online. Only 52% or workers read their information cover to cover and
many admit only scanning what is needed to enroll or make changes to their
existing plan. Just less than half of workers feel comfortable explaining such
terms as “copay” and “deductible.”
The New York Attorney General’s office has asked
UnitedHealth Group to cease implementation of a program which ranks doctors
according to quality and cost effectiveness. The attorney general’s office is
concerned that consumers may be steered to doctors based on “faulty data and
criteria” and may be encouraged to choose doctors based on price rather than
quality.
An Express Scripts study found that plans with a generic
vs. brand copayment differential of $21 or more used generic drugs at a rate
5.2% higher than plans with a $0 to $5 differential. A 1% generic use increase
results in an estimated 1.6% decrease in total drug plan costs. Compared to
plans with the lowest differential between generic and brand copayments, plans
with $11-$15 and $16 to $20 differentials used generic drugs at rates that were
1.9% and 2.9% higher, respectively.
Another study by
Carnegie
Mellon
University
outlined in the Pittsburg Post- Gazette says that savings from prescription
drug copays being raised are offset by other health plan increases such as ER
visits and outpatient care. The study says 35% of any savings realized are
offset by other medical cost increases that occur when people stop taking their
prescriptions. The study covered 9 employers and 500,000 employees.