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Colorado Health Insurance Insider

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prescription drugs

Grand Rounds – Colorado Fall Colors Edition

October 4, 2011 By Louise Norris

Henry Stern of InsureBlog brings us an interview with the whistleblower who has brought a lawsuit against LabCorp for allegedly charging a lower price to United HealthCare than to Medicare. The post is particularly interesting because Hank adds his own thoughts after the interview, and he sees things a little differently than Andrew Baker (the whistleblower). Hank agrees that it does look like LabCorp lowered their fees for UHC […]

Filed Under: Health Care Goodies, Health Care Reform, Health Insurance Reform, Medicare, Medigap, Policy, Providers, United Healthcare

A Good Trend In Medicare Spending

September 16, 2011 By Louise Norris

[…] She specifically addresses Medicare costs, but it stands to reason that the same cost-saving strategies and paradigm shifts will also help to lower healthcare costs that are being reimbursed by private health insurance carriers. Not only do private carriers tend to follow Medicare’s lead, but the focus on value over volume from a provider perspective will benefit everyone, as it’s unlikely to be applied only to Medicare patients.

Filed Under: Accountable Care Organizations, Health Care Goodies, Health Care Reform, HSA, Providers

Health Insurance Does Not Always Prevent Medical Debt

July 6, 2011 By Louise Norris

[…] Chances are, if you have a claim on your home or auto policy, it will be because of a one-time incident like a fire or a car accident. That can be the case with a health claim too, of course, but many times a large claim on a health insurance policy can be the result of a chronic condition or one that will need extensive long-term treatment. A person might have health insurance at the start of the ordeal, but may lose coverage as time goes on […]

Filed Under: Group Health, HSA, Individual/Family Health

Grand Rounds Vol. 7 No. 40

June 28, 2011 By Louise Norris

Welcome to Grand Rounds! It’s the third time we’ve hosted Grand Rounds at the Colorado Health Insurance Insider and we’re honored to be hosting again. It was a pleasure to read so many great articles for this edition. Since our blog tends to focus on health care policy and reform, I’m starting things off with the posts that pertain to that topic. Enjoy!

Filed Under: Health Care Reform, Medicare, Medigap

Medicare Trustees Report Not So Gloomy

May 27, 2011 By Louise Norris

[…] One way or another, we need to seek solutions that will enable Medicare to pay the 10% shortfall that is currently predicted for a decade from now. That can be accomplished by cutting costs, increasing revenues, or both. But we don’t need to start from scratch and overhaul the entire system, especially with the improvements that the PPACA has already created.

Filed Under: Health Care Goodies, Health Care Reform, Health Insurance Reform, Medicare

Medicare and Prescription Coverage

May 25, 2011 By Louise Norris

[…] If the government can tell the health insurance carriers that no more than 15 – 20% of premium dollars can be spent on administrative expenses, including profits, why can’t similar guidelines be enacted for the pharmaceutical industry? Perhaps then we wouldn’t need to worry as much about who is going to pay the cost of prescription drugs for seniors. And maybe individual health insurance policies could start covering prescriptions with basic copays again.

Filed Under: Anthem Blue Cross, Health Care Goodies, Health Care Reform, Health Insurance Reform, Medicare

Makena – No Good Options For Health Insurers

March 17, 2011 By Louise Norris

[…] Over the last several years, most of the major health insurance carriers in Colorado have increased the out of pocket portion that an insured has to pay for prescriptions. Most individual policies now have prescription deductibles, and a lot of carriers have designated very expensive drugs as a separate tier that requires a percentage copay from the insured, rather than a flat amount. And of course, premiums continue to climb. The Makena story is an example of why this happens, and it has nothing to do with health insurance carrier profits. When insureds see their health insurance premiums skyrocket again, where do you think they will point their finger?

Filed Under: Health Care Goodies, Insurance Companies, Maternity/Pregnancy

Looking For Ulterior Motives

January 5, 2011 By Louise Norris

Health care costs are rising at a dizzying pace. For most Americans, this translates into increasing health insurance premiums, which are driven mostly by the cost of health care. Getting health care costs under control is a necessary step, and one that politicians generally say is important. But what is said and what is done are not always in line with each other. This outstanding article on Emergency Physicians Monthly is a perfect example of health care costs run amok. […]

Filed Under: Health Care Goodies, Providers

Standardized Language For Health Insurance

December 15, 2010 By Louise Norris

[…] In Colorado, all policies have long been required to have a standardized plan description form (separate from the carrier-created marketing brochure), and House Bill 1166 passed earlier this year, requiring that all policy information be written at no more than a 10th grade reading level. But I think that most consumers tend to look at brochures, mailers, online advertising, and other marketing materials designed by each insurance carrier. […]

Filed Under: Health Care Goodies, HSA

Doctors Contracting Directly With Patients

September 19, 2010 By Louise Norris

[…] Personally, I would be open to the idea of seeing a family practice doctor who doesn’t contract with health insurance carriers, and paying for routine care out of pocket, if there were some way to combine that with a discount on our health insurance premiums… If the DocTalker Family Medicine idea were to become more widespread and if insurers could account for this type of care when setting premiums, I can see it making a lot of sense for healthy families who want to use health insurance for large medical bills and budget for smaller bills themselves.

Filed Under: HSA, Individual/Family Health, Providers

More Americans Skipping Medical Care

September 2, 2010 By Louise Norris

[…] Copays and deductibles have risen for most families over the last few years, even those who don’t have policies that qualify as high deductible. And at the same time, economic stability has decreased for most families. This isn’t a good combination, and Joe’s right about the fact that when people skip necessary routine medical care, it will likely lead to increased medical costs (and declining health) in the future.

Filed Under: Group Health, HSA, Individual/Family Health

Prescription Veggies

August 17, 2010 By Louise Norris

Colorado is the only state in the US with an adult obesity rate below 20%, but we’re just barely below that threshold. And according to the Colorado Health Report Card, our rate of obesity is rising faster than the rate for the whole country. I came across a NY Times article about a program that has been implemented in Mass recently, and I would love to see Colorado do the same thing. Maybe we could see our obesity percentage start to fall instead of continuing it’s upward climb. […]

Filed Under: Health Care Goodies

Spiraling Prescription Drug Use In Kids

June 3, 2010 By Louise Norris

[…] The thought of 30 percent of adolescents being on medication for chronic conditions should make us all sit up and take notice. Hopefully it will fuel the cry for better school lunches and increased attention to prevention of obesity and mental health problems in kids. As a society, we simply cannot afford to continue to increase our utilization of prescription drugs.

Filed Under: Health Care Goodies, Individual/Family Health

Another Way Exercise Could Lower Health Care Costs

May 21, 2010 By Louise Norris

[…] Maybe if doctors and patients were all aware of the fact that exercise is more beneficial in the long term than anti-depressants, we could start to cut down on the number of anti-depressant prescriptions being written. Lower utilization of pharmaceutical products would be helpful in terms of limiting the overall cost of medical claims and thus the price of health insurance as time goes on. […]

Filed Under: Health Care Goodies, Individual/Family Health

Dentists Overprescribing Antibiotics and Avoiding Health Care Reform

May 20, 2010 By Jay Norris

[…] MD Whistleblower had a couple good observations:
– Dentists prescribe prophylactic antibiotics (ATBs) with routine recklessness… Many dentists irrationally prescribe ATBs before teeth cleanings and other procedures.
– Not a syllable in the ~2000 page health care reform law that affects dentists.

Filed Under: Dental

A Good Start With Colorado Senate Bill 115

March 16, 2010 By Louise Norris

[…] Ultimately, I’d like to see us reach a point where medication waste is virtually eliminated. Medication bottles that allow pills to be removed but not re-inserted, or a switch to only using blister packs for pills, could allow even partially used prescriptions to be returned to pharmacies for redistribution. And with the cost of prescriptions becoming more of a barrier between patients and needed treatment, the destruction of perfectly good unused medication seems like a travesty.

Filed Under: Health Care Goodies, Providers

Grand Rounds Vol. 6 No. 8

November 17, 2009 By Louise Norris

How To Cope With Pain brings us a truly amazing video. It’s a reminder to be thankful for all that we have, and for the things in life (like this video) that inspire us. It’s well worth the five minutes it takes to watch it.

Amy Tenderich of Diabetes Mine shares a “would you rather…?” moment from her 9-year old daughter. It’s a poignant reminder, seen through the eyes of a child, that all of the parts of our lives – even the bad parts – combine to make us who we are […]

Filed Under: Health Care Goodies, Health Insurance Reform, Medicare, Policy, Providers

Health Wonk Review

November 12, 2009 By Louise Norris

Welcome to the Health Wonk Review. 2009 has been an exciting year for health care reform, and last Saturday’s passage of HR3962, the Affordable Health Care for America Act, has given us plenty to talk about. For anyone who hasn’t kept up on the details of the House reform bill, I want to start things off with a four-part series from Tim Jost, who holds the Robert L Willett Family Professorship of Law at the Washington and Lee University School of Law. His articles were published at Health Affairs Blog, and amount to an excellent primer, written in plain English, for people who want to understand HR3962, but don’t have time to read all 1990 pages […]

Filed Under: Health Care Goodies, Health Insurance Reform, Medicare, Policy

Drug Industry Wrongs Impacting Health Insurance Benefits

September 10, 2009 By Louise Norris

Pfizer was also illegally marketing Bextra, Lyrica, and Zyvox. They have settled for a record $2.3 billion, but Dr. Zhang points out that the sum is equal to three weeks of sales at Pfizer. Seems a bit paltry when you think about it. It’s like fining the average family a couple thousand dollars. Sure, it would sting a bit, but it wouldn’t really take that long to pay it off and forget about it. […]

Filed Under: Health Care Goodies, Individual/Family Health

Not Just Health Insurance That Needs Reform

August 10, 2009 By Louise Norris

Has anyone else noticed that the the term “health insurance reform” has started to be used in place of the term “health care reform”? Perhaps reform proponents are counting on the poor perception of the health insurance industry held by many Americans. By renaming the reform, perhaps they believe that more people will support it. […]

Filed Under: Health Insurance Reform, Individual/Family Health, Insurance Companies

Colorado House Kills Oral Chemotherapy Bill

May 4, 2009 By Louise Norris

The Colorado House killed a bill today that would have required Colorado health insurance companies to cover oral chemotherapy pills. Diane Primavera (D-Broomfield), sponsored Senate Bill 250 in the House, and had support from patient advocate groups and the pharmaceutical industry. But the House Health and Human Services Committee voted 7 – 4 to kill the bill. […]

Filed Under: Broomfield, Health Care Goodies, Individual/Family Health, Kaiser Permanente

Doctors and Patients and Healthcare Reform

March 11, 2009 By Louise Norris

[…] Our system doesn’t reward doctors who spend time with their patients. Instead it rewards doctors who see the most patients in the least amount of time (writing a prescription for an antibiotic is a good way to move patients along). Expecting change to come from patients isn’t fair. But it’s also not fair to expect change to come from the medical profession as a whole until we make some changes to how doctors are reimbursed for the services they provide.

Filed Under: Health Care Goodies, Health Insurance Reform, Providers

Health Insurance And Clinical Trials

January 21, 2009 By Louise Norris

Diane Primavera, our local Colorado state representative from Broomfield, has proposed a bill that would prevent health insurance companies from canceling policies of insureds who choose to enroll in clinical trials of experimental treatments. We appreciate Primavera’s healthcare reform efforts for Colorado. […]

Filed Under: Health Insurance Reform, Insurance Companies

Abilify vs Havidol

November 2, 2008 By Jay Norris

Louise and I were watching Saturday Night Live last night and the first commercial after one of the skits was for “Abilify”. A lot of times SNL has a parody commercial right after the skits before the real commercials. I was 100% sure this was a parody, obviously a joke name, a list of really… Read more about Abilify vs Havidol

Filed Under: Health Care Goodies

Grand Rounds at Edwin Leap

July 31, 2008 By Louise Norris

Since health insurance is our niche, I tend to focus on health insurance related articles when I highlight entries for the Colorado Health Insurance Insider. But this week some posts that caught my eye had nothing to do with health insurance at all. I just liked them, and thought you might […]

Filed Under: Health Care Goodies

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