Hearsay & News Review
cost hikes slowed to a 0.8% increase between March and June in the private
sector according to the Labor Department’s Employment Cost index. The previous
quarter was a 1.1% increase. A Hewitt survey of HMOs shows rate increases are
going to average 12.6% more in 2006. A WSJ online poll says that 61% of
2299 adults surveyed would choose no pay increase and the ability to maintain
their current health benefits if they had to choose. Nationally, Blues plans
reported that their 40 companies saved $228 million in 2004 through
coordinated antifraud efforts.
changed to Assurant and is now changing their name to Union Security Insurance
Company. They for got to add the word “Blanket” after Security and will
change again next year. Just what the market demanded is more idiotic and costly
name changes. Concentra has acquired Beech
Street Corporation. Beech Street will continue to operate as a separate
brand, but opens the market for Concentra in group health.
a lawsuit against Union Pacific Railroad, the court ruled that not allowing
contraceptive coverage to prevent pregnancy was a violation of the Pregnancy
Healthcare has announced that Provena Health has terminated its hospital
contracts effective 11/30/2005. This affects Mercy in
and St.Mary’s in
suffering from post-traumatic stress disorder are now required to be
covered by insured health plans in the state. Also,
the state has passed the Illinois Family
Military Leave Act which entitles qualified employees to take leave to visit
with a spouse or child who has been called into military service for a period
lasting longer than 30 days. In addition, the Governor of Illinois has signed
into law a medical malpractice reform bill
that caps noneconomic damages at $1M for hospitals and $500K for physicians or
other health care professionals. The law also requires that the Dept. of
Financial and Professional Regulation establish a web site containing physician
profiles that includes history of disciplinary actions and malpractice
judgments. That will be a nice change.
Reports says that HMOs are slightly more palatable than PPOs to consumers. They
surveyed 35,000 readers. The major differences were: HMO users had more trouble
getting appointments and needed medical care, but the PPO users had more billing
error problems. People make their choices, but if in need of medical care,
wouldn’t one rather have an appointment and fight about the bill later?
of all employers surveyed by the ERISA Industry Committee have decided
not to offer the FSA extended grace period.
reports that plan sponsor AutoNation claims that United Healthcare overpaid
their claims by $10M! The overpayments involved payments for terminated
employees, out of network services paid as in-network and paying claims that
exceeded maximum benefits. This suit would seem to indicate that the implied
quality of carriers is no better, and maybe worse, than the TPAs they compete
against in the quality and discount arena.
study of 44 DM programs by
and Thomson Medstat gives mixed reviews on the programs. Congestive heart
failure was a DM winner, delivering $2.78 in savings for every dollar spent.
Only two of 44 DM programs produced any return on investment for asthma.
Diabetes results were inconclusive. DM programs targeting depression
consistently cost more than they saved. Programs managing patients with
multiple diseases have the most success.
EBN survey shows that employers favor wellness programs and employee incentives
for healthy behavior, but place little value on worksite health clinics and
hospital performance data for obtaining improvement in controlling costs and
J. Gallagher clients can expect to receive their settlement offer in October for
the $27 million settlement that AJG reached with the state.
CMMS is extending the application deadline for employers to receive the Medicare
Part D subsidy to October 31st.