Remember Bill Clinton’s 1992 campaign mantra, “It’s the economy, stupid!” A study released today by the Robert Wood Johnson Foundation indicates those four words are the best answer to the question, “Why are so many employers dropping health insurance?” Or, to put it another way, economic …
QNHII Regs Due Thursday—After Only Five Years
January 28, 2015 Leave a Comment
When the Affordable Care Act (ACA) was signed into law back in 2010, it directed the Centers for Medicare & Medicaid Services (CMS) to establish the Consumer Operated & Oriented Program (CO-OP). The point of the CO-OP is to foster creation of membership-governed QNHIIs. What’s a QNHII? you’re …
Hospitals and Health Insurers Prodded on Same-Sex and Transgender Issues
December 12, 2014 Leave a Comment
In separate actions yesterday, CMS and the New York State insurance regulatory authority took steps to (a) assure equal treatment of same-sex spouses by hospitals and (b) insurance coverage of medically necessary transgender treatment by health insurers. The CMS action took the form of a proposed rule making it …
Illinois Blues Won’t Let Hospitals Jointly Negotiate Unless They’re Married
October 8, 2014 Leave a Comment
Remember when Hollywood wouldn’t show an unmarried couple in bed together? Blue Cross-Blue Shield of Illinois is taking that approach to contract negotiations. If hospitals want to negotiate jointly with the insurer, they have to be merged. Clinical integration isn’t sufficient. It may be an …
CHI Takes the Plunge into the Insurance Business
July 30, 2014 Leave a Comment
For several years now hospital systems have been tip-toeing around the business of health insurance. They’ve been signing up for Medicare Advantage plans, taking on more and more risk, managing care and raiding health insurance companies for executive talent. Now a major national health system is diving …
FEDS WIDEN HEALTH COVERAGE FOR OBESITY
April 4, 2014 Leave a Comment
Advocacy groups for the obese are applauding a recent directive by the federal Office of Personnel Management (OPM) on obesity treatment coverage. In a March 20 directive to health plans covering federal employees, OPM’s Director of Healthcare & Insurance ordered the plans to stop excluding coverage of …