Mr. President, Aren’t You Just Kicking the Can Down the Road?
Pieces of the health care portion of the Obama budget are leaking out ... for Medicare Part B now.Cutting Medicare HMO payments by $175 billion over ten years.Reducing Medicare hospital ... reduction is the cut to Medicare HMO payments. This one is hardly a risky political move as everyone [more...]
Date: 2009-02-26 02:55:00
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Obama Health Care Budget
Well, details of the Obama “down payment on health care reform are filtering out. They include ... —as is done for Medicare Part B now. • Cutting Medicare HMO payments by $175 billion over ten ... . Some of it may be indirect, as HMOs tighten financial screws on doctors to compensate for Medicare HMO losses [more...]
Date: 2009-02-26 14:17:00
GAO Report: Medicare Advantage Exposes Seniors To Serious Financial Risks
When lawmakers approved the Medicare Modernization Act, they offered an extra subsidy to Medicare Advantage plans (MA) ... obtaining services, a practice that may have violated laws governing PFFS plans. Medicare FFS plans, HMO ... . The deal was this: Medicare would pay about 13 to 17 percent more for beneficiaries enrolled [more...]
Date: 2008-12-16 14:28:55
Is Etanercept the Cure for Alzheimer's
Alzheimer's is the sixth leading cause of death recently surpassing diabetes ... a year. It's not an approved Alzheimer's treatment so it is not covered by Medicare or Medicare HMOs [more...]
Date: 2009-02-04 18:51:40
Lack of Physician Payment Flexibility
Physicians are different from other professionals by virtue of the ground rules for contemporary medicine ... . Their fees are dictated to them by Medicare, Medicaid, HMOs, PPOs, and other third party payers. The money ... for in the United States. An orthopedic surgeon might be reimbursed $500 by Medicare for setting a simple [more...]
Date: 2008-12-07 14:24:00
Patrick.net launches sister site for nursing home information
The housing bubble blog Patrick.net recently launched a Web site oriented towards those families in need of information on nursing homes ... -approved health care plan called SCAN: SCAN Health Plan® is a "Medicare Advantage" HMO, serving ... and I had a hard time trying to quickly figure out the system, between Medicare, Medicaid, admissions policies [more...]
Date: 2009-02-06 05:59:00
Travel Insurance Needs
Visiting different places around the world is a lot of fun. However, there is always the issue of safety and security. The answer to this dilemma is travel insurance. It’s not the same thing when you are self insured. Most likely, Medicare, HMO’s and PPO’s will not cover you abroad. You’ll never know how much [more...]
Date: 2009-02-17 06:29:01
Medicare Advantage Payments to Insurers--Baucus Zeroing In!
Senate Finance Chair Max Baucus (D-MT) released his health plan white paper last week.Buried in it was this regarding how private Medicare payments to HMOs should be changed:“Congress must act to level the playing field between traditional Medicare and Medicare Advantage payments [more...]
Date: 2008-11-17 14:00:00
Time for a change
Last week i found out that i had a brain tumor, and since then i have been waiting for my insurance company to either accept or deny charges for ... in this system. He does not except HMO PPO Medicare or medicaid, but instead deals in a cash only [more...]
Date: 2008-12-16 02:30:20
Obama's Budget Picture Forms
Call it the White House austerity plan. President Obama's budget outline for 2010, to be released tomorrow, ... payments to insurance companies that offer HMOs and PPOs through Medicare. According to ABC News's Jake Tapper, Obama will also endorse Medicare premium increases for seniors making more than [more...]
Date: 2009-02-26 01:14:17
Introducing Douglas B. Sherlock MBA CFA
About Our Newest Thought-LeaderBy Ann Miller; RN, MHADouglas B ... and its HMO product for Medicare beneficiaries. Sherlock was formerly Vice President of Salomon Brothers ... . He was the Greenwich Survey First Place HMO Analyst and a runner-up in the Institutional Investor polls [more...]
Date: 2009-03-05 00:17:24
Equality Before the Doctor?
NPR reported yesterday that Justice Ginsburg's chances of surviving pancreatic cancer are much better than most of those who suffer from it because ... if under pressure from an HMO, if they were only receiving medicare payments, if they were performing [more...]
Date: 2009-02-17 04:05:00
Government: Making Health Care Unprofitable Since....
From my Tweets (Timothy Burke, to be exact):Here is what Ceci Connolly is reporting at the Washington Post: ... to what Medicare HMOs get but it would seem the docs and hospitals would be in for some pretty big cuts as well [more...]
Date: 2009-02-25 22:16:24
Repackaging Bad Ideas in Health Care
I fail to see why Ezra Klein is so excited about a proposal by Bobby Jindal to move Medicaid recipients in Louisiana into managed care plans ... systems. There is a tremendous difference between Medicare for All and Medicaid ... care. This HMO model was tried (and to some degree still exists) for employer-paid health care [more...]
Date: 2008-11-15 09:06:34
Profits soar at Universal American in 4Q
February18 Profits more than doubled at Universal American Corp ... s Medicare Advantage HMO health plans, posted an 18.6 percent growth in membership last year to 54,300 people ... in its Medicare health insurance plans and expansion in new markets.Net income totaled $63.9 million [more...]
Date: 2009-02-18 20:04:57
Government Mega Budget, Big GDP Revision, Gold Advice, Water Crisis, and More!
by Addison Wiggin & Ian Mathias Latest government budget shocks the Street… Health care, ... spending plus Obama’s declared desire to renegotiate Medicare agreements bumped the HMO (an index [more...]
Date: 2009-02-27 19:45:54
"Obama Budget Would Creat $634 Billion Health Care Fund"
Here is what Ceci Connolly is reporting at the Washington Post:President intends to release a budget tomorrow that creates a 10-year, $634 billion " ... to what Medicare HMOs get but it would seem the docs and hospitals would be in for some pretty big cuts [more...]
Date: 2009-02-25 21:19:00
All together now, Dems: McCain bad for seniors
While Barack Obama was warning a crowd in Virginia that Republican John McCain would slash funding or Medicare, ... payments to HMOs. Our friends at Politifact will be sorting it all out shortly... [more...]
Date: 2008-10-17 20:39:42
The HMO Death Watch 2 - How Shall We Regard Medicare Advantage?
DrRich has never really understood the government’s rationale for funding Medicare Advantage ... -seeking entities knocking about within the American economy, even within the healthcare sector ... to prove that they can deliver quality healthcare with greater efficiency and better outcomes than [more...]
Date: 2008-12-12 15:38:55
Fixing Health Care
The cost of health insurance continues to climb unabated ... trillion, or nearly 15 percent of GDP, on health expenditures. Medicare, the government’s single ... monthly premium charged by an HMO or a payroll tax collected by Uncle Sam, someone has to pay [more...]
Date: 2009-02-27 02:08:27
Tough Week on Wall Street
Watch - Video Format HereThis was a week driven by government expectations and investor disappointment ... to support. The HMOs was the catalyst one the Obama healthcare plan cutting Medicare and other benefit payments to providers under the proposed plan. The Dow Jones HMO index fell nearly 20% on the week [more...]
Date: 2009-02-27 21:42:50
WSJ Health Blog, HMO Stocks Take A Dive
Posted by Sarah Rubenstein Company Medicare Advantage Share of Revenue Aetna 18% Cigna 3% Coventry 31% Humana 51% UnitedHealth 23% WellPoint 6% HMO stocks took a beating today as investors digest the Obama budget proposal’s push to cut federal payments to insurers that run private Medicare Advantage plans [more...]
Date: 2009-02-26 23:46:00
OOPSIE (AKA thanks a lot Barry)
While we were sleeping (presumably), our brilliant leaders cooked up a way to nationalize Citipuke without actually "nationalizing" it, ... what Sallie Mae shareholders think about that idea: And on a personal note, HMO's are getting crushed this month, ostensibly on the idea that Medicare reimbursements are going down [more...]
Date: 2009-02-27 14:04:00
Hope Springs Eternal
Watch - Video Format HereIn this morning’s Chart-of-the-Day I stated there was still hope no matter how small ... below the November low. Basic materials were up 4.8% finding support at the 120 mark. HMO’s gained back 4% of the 10% losses from yesterday on the Medicare news. This is a sector to watch [more...]
Date: 2009-02-24 22:39:37
Will somebody in the Obama Administration please pay their taxes? (I’m looking at you Daschle and Killefer)
President Barack Obama has now lost two nominees to unpaid taxes (and nearly lost a third in Tim Geithner) ... a lot of drug company, HMO and medical establishment lobbyists with his book, Critical, that calls ... for such a Medicare expansion in an LA Times oped. Daschle’s also talked tough about the waste among [more...]
Date: 2009-02-03 20:58:55
Coventry's management shakeup
Yesterday's announcement that Coventry had replaced CEO Dale Wolf with former CEO Allen Wise came after an internal review of the company's ... at its commercial and Medicare health plans, unexpectedly low business volume and higher overhead spending ... in the small group HMO business. He has extensive experience in this space, including a stint running [more...]
Date: 2009-01-27 12:00:13
QUALITY: Valuing Primary Care
Stop the world. Primary care doctors want to get off ... to the PPO and HMO models. He says he was both surprised and frustrated when he began spending more time ... on Medicare and Medicaid. According to the foundation's report, over a third of those surveyed [more...]
Date: 2008-11-18 23:01:00
Why are your health care costs so high?
Well, here’s a hint:Georgia’s top health agency plans to charge health insurers millions of dollars in extra fees to help pay for the state’s ... for HMO insurance. It remains unclear why the agency is singling out the HMOs; officials said that it is their interpretation of the federal law. The plan would not affect PPOs, Medicare or self-insured [more...]
Date: 2008-10-06 07:40:39
Daschle and Obama Create the National Coordinator of Health Information Technology to Curtail Costs by Depriving Americans of Needed Care
Excuse me, my Dem dears, but why isn't our camera-loving, speechy Obama crowing about this as one of his triumphs? Read on and find out ... , this is all in black and white. The government will function like a corrupt HMO, using bureaucrats to make rules ... , and thus relieve medical professionals from the need to use their experience and brains. Medicar [more...]
Date: 2009-02-21 20:29:00
Conservative Stimulation
Irwin Stelzer has a smart and unexpected piece in the Weekly Standard, praising the general outlines of the Obama stimulus package ... correctly locates the most important area for reform in the fee-for-service Medicare system (although Obama hasn't said he's headed there yet). Obviously, if the rest of us make do with hmo's [more...]
Date: 2009-01-26 19:58:29
A letter to Coventry employees
Among the loyal readers of ManagedCareMatters are more than a few with Coventry email addresses ... story. The secondary market strategy for the small group HMO business made, and makes, sense. The distribution strategy worked reasonably well, as did pricing discipline. Some of the work on Medicare [more...]
Date: 2009-01-29 12:16:19
2009 Medicare Supplement vs Medicare Advantage update
A little over a year ago I wrote a blog entitled Medicare Supplement vs Medicare Advantage ... to the plans and feedback from our customers. This is a fairly long subject, but I’ll try and keep a :HMO: logical flow. The previous HMO will have a hover but the other will not. Here is a :photo: popup [more...]
Date: 2009-02-23 18:48:34
How to drive a doctor out of primary care
A family physician chronicles his journey from an HMO to urgent care to practicing outside of the insurance system ... doctors is a significant driver of physicians leaving generalist practice. Medicare and Medicaid [more...]
Date: 2009-02-24 13:51:03
IPA: Health Care Summit: Single Payer Excluded?
Health Care Summit: Single Payer Excluded? Institute for Public Accuracy 3 March 2009 STEFFIE WOOLHANDLER/DAVID HIMMELSTEIN “Many people ... in the Senate at this point, is one of the biggest recipients of HMO dollars in this country. He got $200,000 ... Obama’s White House made crystal clear this week: a Canadian-style, Medicare-for-all, single [more...]
Date: 2009-03-03 22:02:22
Answers About United Way and Nonprofits, Part 3
Taking Questions Gordon J. CampbellThe president and chief executive of United Way of New York City is answering selected readers’ questions ... accepting questions for this feature. I volunteer for a nonprofit that assists Medicare beneficiaries ... and financials. Having such a road map will guide your organization in determining what types of grants [more...]
Date: 2009-01-30 19:30:07
Health Care Delivered as It Should Be
Hardly anyone has a good word to say about this country’s fragmented system for delivering and paying for long-term care, with one exception: ... , for an annual fee generally paid by Medicare and Medicaid. The care can be delivered at home, a PACE center ... embraced by Congress, which eventually authorized all PACE programs as Medicare providers.The [more...]
Date: 2009-01-08 13:20:28
Obama Care
From Ceci Connolly at the WaPo : By first identifying a large pot of money to underwrite health-care reform — before laying out a proposal ... the finished product to lawmakers, who quickly rejected it… Medicare and Medicaid, the government ... where the private Medicare plans will bid market to market to compete with the traditional Medicare [more...]
Date: 2009-02-26 16:40:27
Health Insurers Offer to Accept All Applicants, on Condition
By now it’s pretty clear that the Obama administration will make health coverage a priority item. The question is, what form will it take? ... way. Or would it be an HMO-type of service where the government decides who are the participating ... for the coverage? Do the elderly pay more for coverage? Again, how is this different from Medicare [more...]
Date: 2008-11-20 19:08:09
Hidden in the Porkapalooza
11 February 2009, 9:31 am There’s been a lot said about the pork stuffed in the stimulus sausage by Democrats, but one thing few mentioned ( ... to get treatment without insurance). And if you think HMO’s and PPO’s have reduced your choices, you ain’ ... that come with age instead of treating them. That means the elderly will bear the brunt. Medicare [more...]
Date: 2009-02-11 14:31:36
Great Day and More Washington Antics
Good morning everyone. Weather is lovely with a bit of rain on the way. Work is good and today we have a big company meeting. Two hours long, but worth it. I will be connecting from home, via Skype. Works great and I can attend the meeting in my ‘jammies :-) Before we get started, here's a little goodie, just for fun [more...]
Date: 2009-02-26 10:32:00
MCCAIN WINS DEBATE- Does it Matter?
It wasn't close. To all but the strongest supporter of Senator Government, John McCain won last night's battle at my . The question now is, "was it enough to win the war?" John McCain Struck, Struck hard but every time a knockout punch was served to him, he went for being a gentleman instead of a politician fighting for the future of the country [more...]
Date: 2008-10-16 11:55:40
Let’s Talk Healthcare… Again
There is a hue and cry in this nation for a national (socialized) healthcare program. I don’t blame people for making noise on this topic… let’s face it: we’re long overdue for some kind of change, hopefully for the better. It is a good thing that the S-CHIP program passed recently, providing healthcare to children with almost no exceptions [more...]
Date: 2009-02-16 23:16:53
Seniors - Don't Get Sick If Stimulus Bill Passes!
I thought I had seen it all with the bank bailouts and the automobile bailout but THIS is just beyond the pale ... elderly citizens which will cut down on Medicare and Social Security spending. I am not kidding ... the actual bill. But here's a little taste to whet your appetite... Remember when HMO's were all the rage [more...]
Date: 2009-02-10 00:41:00
Do I need travel insurance?
In the United States health insurance, unlike many other countries, you can find dozens of Blue Cross Blue Shield plans ... years have Medicare. All of these different types of plans have many various benefits, costs ... care overseas you may be covered but probably will have to call your insurance company or HMO [more...]
Date: 2009-02-27 00:46:19
Accountable Care Organizations
Accountable Care Organizations Last week, the journal Health Affairs published an important article calling for the creation of “Accountable Care Organizations” in the Medicare program. Reform of how health care is actually delivered ... worry that HMO-style organizations have strong incentives to withhold needed care. And so, the authors [more...]
Date: 2009-02-02 23:01:00
Medicare Advantage HMO Stocks Down Big This Week
Matthew Holt, publisher of the Health Care Blog, and I have been in a state of incredulity over Wall Street’s head in the sand view of the Medicare ... s victory last November that HMO stocks heavily invested in the Medicare Advantage business had not paid ... disproportionately invested in Medicare Advantage, like Humana and Universal American, were down [more...]
Date: 2009-02-27 19:15:00
The Nature of the Opposition
Matt Singer is keeping me honest : Health Care for America Now’s blog responded to what I wrote earlier this morning about the meaningful difference between Max Baucus’s healthcare plan and the Massachusetts plan, but there’s something ... of Obama’s plan that’s most opposed by business and their aligned conservative groups. For 99 [more...]
Date: 2009-03-05 20:25:46
Green Party offers six steps for economic recovery
Posted at Green Party Watch: The Green Party offered up today six solutions to save the U.S. Economy. 1. Enact a massive Green Public Works program 2. Bail out towns, cities and states over private corporations 3. Jump start our mass transit system 4. Enact a single-payer universal health care system 5 [more...]
Date: 2008-12-10 18:09:43
The Stimulation Method (or, The Economics of Everything)
As I said in the previous post, beyond some specific questions about how the "stimulus plan" may not help women in the workforce, I actually have alrger questions about the whole package, more generally. I have to admit I've been skeptical since November, when in the rush of Obama's victory, we were told that the first order of business" [more...]
Date: 2009-01-11 18:01:11
The Most Annoying Part of Every Republican Speech
A lot is being written about McCain's speech this morning: that it was boring, that it wasn't delivered particularly well, that it was light on substance, that it was disjointed and schizophrenic, that it wasn't as negative as some were expecting, etc. I agree with all of those assessments [more...]
Date: 2008-09-05 08:08:08
