Health Insurance Blog

In an interview with Scott Serota, President of the Blue Cross Blue Shield Association (BCBSA), discussed the recently adopted 4-point health care proposal that was adopted by the BCBSA board of directors.

Serota said that one of the goals that the BCBSA is seeking to achieve is to ensure that health care costs do not rise any faster than the costs of other goods and services.  He went on to say that in order to do achieve that goal, the delivery system must be improved, and unneccesary procedures eliminated (as much as 30% of procedures rendered today).  In addition, Serota expressed the importance in getting people who are eligible for government programs enrolled, and developing new health plans to supplement high-deductible health plans for the “young invincables”.

Serota also discussed a rule under under the McCain health care proposal in which Medicare no longer would reimburse hospitals for 10 preventable conditions and the effect that it would have on employer-sponsored health care.

Open enrollment for the North Carolina Health Insurance Risk Pool , began as of October 20th following the recent acceptance by the North Carolina DOI of their rates and health benefit plans.

The North Carolina Health Insurance Risk Pool (NCHIRP) is now doing business as Inclusive Health and can be found online at www.inclusivehealth.org, or by calling 1-866-665-2117.

NCHIRP was created in August 2007.  It provides affordable North Carolina health insurance coverage for residents of the state who don’t have access to an employer-sponsored health plan and, because of their health conditions, face high health insurance premiums or cannot obtain individual health insurance at all, because they won’t be accepted by health insurance carriers.

Plans like Inclusive Health are a great step forward in providing health insurance options to millions of Americans across the country with few if any opportunities to receive adequate health insurance coverage.

Anthem Blue Cross Blue Shield of Indiana (a subsidiary of Wellpoint) announced an incentive program for physicians in their network which could increase their reimbursements by 10% if they follow recommended care guidelines.

Bonuses that physicians would be eligible for would be based their relative ranking when comparing the health status of their patients to others in the region.

The effectiveness that this program will have on improving care for Indiana residents is yet to be determined.

More information about Indiana health insurance, and a listing of top carriers who provide individual health insurance plans to Indiana residents.

Wellpoint in conjunction with X Prize Foundation, has announced a $10 Million competition to produce a system of health care proposals that would improve health care quality and reduce costs.  Wellpoint will payout the prize to the winner of the competition.

The competition could take several years as proposals would be tested in various state markets and the proposals must prove to be effective in order to qualify for the $10 Million prize.

This is a great step in getting all stakeholders involved in solving the health insurance challenges facing our country, ranging from the huge numbers of uninsured in this country, to the escalating health care costs, to rising health insurance rates that must be borne by individuals and families.

Medical tourism is a practice that has become more common over the past year, and some health insurance companies are now starting to get on-board with the practice and actually paying bonuses to members who agree to get procedures done in this way.

In short, Medical tourism is the practice of traveling overseas to have medical procedures or surgeries done in order to save money.  Over 50 countries have now identified medical tourism as a national industry.

Some health plans are beginning to cover procedures such as heart surgeries, hip/knee replacement and other pricey procedures due to the money that they can save.  For example, open heart surgery in the U.S might cost $100,000, but at an accredited hospital in India, the same procedure might cost only $8,500.

As you can see, the economic advantages of medical tourism are clear, but is it safe?

A recent UCLA study compared 33 patients who had kidney transplant surgery overseas vs. 66 who had the same procedure done here in the United States, at the UCLA hospital.  The study found that 30% of patients who had the procedure done overseas had kidney rejection vs. 12% for those treated at UCLA.  In addition, the rate at which patients needed to be hospitalized due to infection was 3 times higher with the overseas patients.

You can see why medical tourism would be a controversial process for health insurance companies to get involved with.  Nevertheless, Blue Cross Blue Shield of South Carolina (BCBSSC) has created a subsidiary for medical tourism that maintains an international network of doctors and hospitals covering Thailand, Costa Rica, Ireland, Turkey and other destinations.  In addition, Anthem Blue Cross & Blue Shield, will roll out a medical-travel benefit with one of the employer groups they cover in January of 2009.

CIGNA last week launched a facebook page that includes online courses, games, tools, calculators and podcasts designed to help people make better health care decisions.  In addition, CIGNA is offering rewards for every three questions that are correctly answered by visitors.   The reward is in the form of donations of clean water to children in India.  Since the program launched last week, more than 25,000 days worth of clean water has been donated.

The page also contains interactive charts that helps people understand the health care reform proposals from presidential candidates, and how they might affect families and individuals.

Similar online educational tools have been launched by other health insurance companies such as Aetna, but as far as we know, this is the first to utilize Facebook in this manner.

An Organization called Health Insurance For All Americans (HIFAAM) is rallying to press elected officials to pass legislation that would provide affordable health insurance coverage to all Americans and legal residents without excluding individuals with pre-exisiting conditions.

The founder of HIFAAM, Ameeta Rupani, says that her organization represents a non-partisan approach, with no funding from either political party and is not calling for socialized of nationalized health insurance.

HIFAAM plans to hold peaceful rallies across the country, until elected officials find a solution to the nations health care crisis.

HIFAAM is offering to organize fund-raisers for Presidential candidates, Senators, and Members-of-Congress who endorse their mission.

Those interested in reaching this organization can do so via

email: leaders@healthinsuranceforallamericans.com or

phone: 973 200 8218 x4.

UnitedHealth Group announced that Ovations, their health and well-being company for seniors, is launching a new portfolio of Medicare Health Plans for 2009.

Ovations’ Medicare portfolio includes Medicare Advantage plans, Medicare Part D prescription drug plans, Medicare Supplement insurance programs, and innovative special needs plans.

to find more information about the new medicare plans being offered by UnitedHealth Group, visit www.uhcmedicaresolutions.com

CEO of Kaiser Permanente, George Halverson recently weighed in on health care reform and what he thought would happen in the short term.

In summary, Mr. Halverson stated that he believes there is a very high likelihood that some level of health care reform will emerge from out of Washington as early as next year.  However, the possibility depends on which presidential candidate gets elected. If Republican candidate John McCain is elected he won’t have his own party in charge of Congress, so reform is less likely.  While It is a priority for the McCain campaign to get something passed as it relates to health care reform, it is a much higher priority for Dem. candidate Barack Obama.   Halverson believes there would be  a high likelihood that Obama would get something done relatively early in his administration if elected.

According to a report released by the U.S. Census Bureau, in the United States in aggregate roughly 17% of the population (under age 65) goes without health insurance coverage.

Texas had the highest % of their state residents  go uninsured than any other state as 26.3% of Texas residents (under age 65) went without health insurance coverage.  New Mexico and Florida claimed the next highest levels of uninsured with 24.2% and 24.0% respectively.

The states with the lowest uninsured % include Minnesota 9.5%, Hawaii 9.7%, Wisconsin 10.3%, and Iowa 10.4%.

The U.S. Census report also broke down uninsured numbers across racial lines.  The broad findings as they relate to race found that Hispanics are far more likely to go without health insurance than either whites or African-Americans.  More specifically, in Texas for instance, over 40% of Hispanics went without health insurance, while the African-American uninsured % was 24% and 16% for whites.

On a positive note, nationally the Hispanic uninsured % declined from 34% (15.3 Million) to 32% (14.8 Million) from 2006 to 2007.  In addition, the number of uninsured children decreased from 8.7 Million to 8.1 Million.

The tremendous disparity in uninsured levels by state to state can be partly explained by health insurance mandates that exist on the state level that drive health insurance premiums.   States that have more expensive mandated benefits, for example, might require health insurance companies to charge significantly higher health insurance premiums in that state pricing out many more individuals and families form purchasing individual health plans.  This is precisely what McCain’s health reform plan is seeking to eliminate by creating a national health insurance marketplace and allowing customers to purchase health insurance plans from other states if they offer a health plan that is a better fit for their health care needs and budget.