April 2011

Is It Even Possible For Patients To Be Consumers?

by Louise April 28, 2011

[...] Dr. Perednia makes some excellent points about the inability of patients to be true “consumers”, even in cases where they have their own money on the line. He notes that if you call your doctor’s office to find out the price of a procedure, they won’t be able to tell you because there are too many complexities in the health insurance system for the doctor to give you an accurate idea of what the cost will be. And if you call your health insurance carrier directly [...]

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Colorado House Approves Child-Only Health Insurance Bill

by Louise April 22, 2011

The language of the law was modified to include open-enrollment periods during which children could apply for coverage, and last September the Colorado Division of Insurance officially designated those open-enrollment periods as January and July each year. The idea was that with open-enrollment periods rather than constant access to new policies, parents would be less likely to wait until a child was sick to seek coverage. But even with the open-enrollment periods, only two carriers – Rocky Mountain Health Plans and [...]

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Facebook Poll: Will the health care reform bill (PPACA) get repealed before 2014?

by Jay April 21, 2011

Do you think health care reform will get repealed? Answer the Facebook poll here:

http://www.facebook.com/home.php?sk=question&id=10150229980216181

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SB200 Advances In the Colorado Senate

by Louise April 20, 2011

[...] Regardless of whether you support the federal healthcare reform laws, it’s hard to see how it would be better for Colorado to forgo creating a state-specific exchange. Doing so would mean that Colorado would have to participate in a federally-run exchange instead, and obviously such a program is not going to be geared to the specific needs of the people and businesses in Colorado. So although there are still likely to be plenty of legal battles over the Constitutionality and implementation of the federal healthcare reform law, it makes sense for states to move ahead in creating their own exchanges.

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Potential ACO Models

by Louise April 19, 2011

[...] The article delves into the Medicare savings that the government is hoping to realize as a result of ACOs, and also discusses several potential ACO models that are currently in use by various health plans around the country. If you’re curious about how ACOs might work, the ACP Internist article is a good primer.

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Differing Views On Paul Ryan’s Health Care Reform Proposal

by Louise April 18, 2011

Last week’s Health Wonk Review included several articles about Rep. Paul Ryan’s “Roadmap for America’s Future”, which includes significant changes in Medicare and Medicaid, and a repeal of the Affordable Care Act. This article from Avik Roy is particularly interesting, and raises some valid points in support of some aspects of the proposed budget reforms. But there are definitely problems with some of the radical changes being proposed. [...]

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Controversy Surrounding The Expansion Of Medicaid

by Louise April 14, 2011

[...] It’s true that we can’t just keep expanding Medicaid without figuring out ways to fund the expansion, but we also can’t ignore the needs of the uninsured population, many of whom are uninsured because of the cost of health insurance (even if they might not technically qualify for Medicaid under the current rules). Regardless of the future of the federal Medicaid mandates, hopefully the focus of the state leadership will be on finding additional ways to generate funds and increase efficiency in order to be able to provide real access to health care for as many Colorado residents as possible.

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MLRs – One Size Does Not Fit All

by Louise April 7, 2011

[...] A state with two functional insurance carriers offering individual policies is obviously going to have a very different marketplace than a state with ten major carriers competing for business. It will be interesting to see how things play out in the states that are granted temporary MLR waivers by CMS. Three years from now, will their insurance markets be able to provide adequate coverage and also comply with the 80/85% MLR guidelines? Or will the waivers morph into something that allows the impacted states to set their own guidelines? Time will tell.

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HHS To Stop Accepting Early Retiree Reinsurance Applications After May 5, 2011

by Louise April 4, 2011

[...] Although the program has proven quite popular – as of last month, HHS had approved approximately 5850 applications – one of the concerns from the beginning was that the $5 billion allocated to the ERRP might not be sufficient to last until 2014. HHS said from the start that they would only accept applications as long as they had enough available funding. They have now announced that they will not accept any new applications after May 5, 2011. [...]

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