Major Insurance Conglomerate To Raise Rates By Double Digits

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*Major Insurance Conglomerate To Raise Rates By Double Digits http://atlas.md/blog/2014/03/major-insurance-conglomerate-to-raise-rates-by-double-digits/* // *Atlas.md | EMR Software for Concierge Medicine http://atlas.md/blog/2014/03/major-insurance-conglomerate-to-raise-rates-by-double-digits/*

 

WellPoint surprised industry experts when it announced it will likely seek "double-digit plus" rate hikeshttp://www.fiercehealthpayer.com/story/wellpoint-predicts-double-digit-rate-increases/2014-03-27?utm_source=rss&utm_medium=rss. Insurers still have two months before they must submit their 2015 rates, so WellPoint's prediction could impact other insurers' rate-setting plans, Bloomberg reported.

Premium rates for 2015 will increase, although the rise in premiums will vary, depending on the region, state and insurer. The increases stem from the Obama administration's many delays and changes to the healthcare reform law, FierceHealthPayer previously reported.

"On a year-over-year basis on our exchanges, and it will vary by carrier, but all of them will probably be in double-digit plus," Ken Goulet, executive vice president for WellPoint's commercial and specialty business, said at the company's recent investor meeting.

Initially one of the loudest critics of the Affordable Care Act, WellPoint now stands to benefit significantly from the law-it's the largest participant of all exchanges and already boosted membership by increasing its Medicaid participation.

What's more, WellPoint CEO Joseph Swedish told analysts during an earnings call in January that its enrollment numbers have been "very consistent with our expectations," adding that the company does "feel good about what we've seen thus far in the exchanges."

That's why the second-largest insurer's announcement startled some analysts. "The double-digit increase surprised me," Stephen Zaharuk, an analyst at Moody's Investors Service, told Bloomberg. "If everything's working according to plan, then the increases should be where the medical trend is, which should not be double-digit."

Agreed! But what about the fact that Direct Care is effectively providing coverage for 80% of what patients need, and giving them steeply discounted labs/prescriptions/MRIs/CT-Scans...

Oh and we're saving patients 30%-60% on their monthly insurance premiums because they can switch to a wrap-around plan and only use insurance in case of a rare emergency....

But other analysts believe WellPoint's prediction reveals that the insurer is trying to play it safe. "They don't know what the risk pool looks like yet, and until they get some experience, they're going to be more cautious," Ana Gupte, an analyst at Leerink Swann & Co., told the news outlet.

Obamacare is really starting to read like grade A bureaucratic meddling. Get more people to enroll in insurance by promising that it will be cheap. And then increase the rates. Oh, and face a fine if you renege on your insurance coverage.

It's not like this hasn't been pointed out before. Look at what ICD-10 and EMR subsidies have done for major corporations -- some companies have seen insane revenue growthhttp://atlas.md/blog/2014/03/for-years-the-rand-corporation-claimed-emrs-would-save-us-100-billion-per-year-until-their-own-research-proved-otherwise/-- from $1 billion a year in sales all the way to $3 billon per year -- all because of government regulation.

Thanks, but no thanks. We're going to fight to bring actual care that's actually affordable -- with as little insurance as possible..

CMS to release payment data

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The Center for Medicare Services (CMS) announces release of Medicare payment data

So....CMS....will you also be releasing the various costs of providing these services?  Here are some examples (since you are only inclined to provide one side of the equation as well as being hell-bent on painting doctors as fradulent and over-paid):

1.  The trend of small business expenses.  You know, crazy, non-essential things such as heating oil, electricity, staff, supplies, etc.  For reference, my heating bill is about $1200 every 3 weeks.
 2.  The increasing cost of malpractice insurance.
3.  The significant increase in the DEA registration fee so I can prescribe medication (http://www.amednews.com/article/20120409/business/304099974/6/)
4.  The graph showing that, over the past 20 years, payment from Medicare has not kept up with the cost of providing care....in fact, it has been a "loss"! (see page 13 - http://www.ama-assn.org/resources/doc/mss/cola_medicare_pres.pdf)
5.  The number of hours physicians have had to devote to administrative burdens such as fighting with insurance companies so that patients can receive the care their doctor, you know....they one who went to medical school to learn how to care for patients, is recommending?
6.  would you like me to continue or is this a good place to start?

The doctor will see you now, but only for 5 minutes

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"40 patients a day"

That's the new goal set forth for the doctors and mid-level providers employed by a local "big box" healthcare system.  "Keep your patient encounters to a maximum of 5 minutes"

5 minutes?  Really?

5 minutes to introduce themselves (because you are unlikely to see the same "provider" each time), listen to your story of what brought you to the office, exam you, formulate a diagnosis, make treatment recommendations and answer any questions you may have in addition to discussing any treatment options.

Crazy....absolutely crazy!

What if:

  1. you have diabetes, high blood pressure, heart disease or high cholesterol and need help getting your condition under control?
  2. you have more than 1 question or want to know all your treatment options?
  3. you have a mole that might represent skin cancer?
  4. you have an urgent issue that needs to be addressed?

I suspect the answer (because the doctor or mid-level provider only has 5 minutes) is:

  1. "schedule another appointment"
  2. "go search the web....here are some websites to look at"
  3. "I'll refer you to another doctor for that"
  4. "this is too much for me to address in an office visit, so I'm going to send you to the Emergency Department"

5 minute "rule"?  Yeah, we don't like that so much and we suspect patients won't either.