Comments for Healthcare Town Hall

Comment on Final rule on affordability of family health coverage and health insurance premium tax credit by ObamaCare’s Unfair Treatment of Middle Class Families | John Goodman's Health Policy Blog | NCPA.org

Mon, 13 May 2013 13:13:09 +0000

[...] Employee Benefit Research Group reports that under the IRS final rule, the affordable coverage requirements in the ObamaCare law apply only [...]

Comment on Five common gaps for exchange readiness by Robert Smith

Robert Smith — Mon, 29 Apr 2013 13:28:06 +0000

I agree with all of these and especially #4. States have not updated their network adequacy standards and in some cases don’t have any standards at all. Having detailed Network Adequacy standards helps prevent adverse selection among the QHP’s. Many states have simple standards of measuring PCP’s as a group and All Specialists as a group. A common mistake is not defining the proper specialists for the target population as mentioned above. Some carriers may simply choose to leave out Chronic Condition specialties while being able to claim they have met the “specialist” standards. That drives those chronic conditions to other carriers that have a good mix of specialists. It starts with the states to define good adequacy requirements. 920-739-4577

Comment on Does the proximity of IT firms influence the cost of EMR? by Abid Shahzad

Abid Shahzad — Tue, 09 Apr 2013 12:50:36 +0000

Agreed that remote areas have problems for electronic health records. But these issues can be reduced using cloud/web based ehr software, as these don't require special hardware like servers, backup machines, firewalls, electricity backups. Practices having Internet connection, even not fast one, can access them. And their data is stored in the cloud, so there are less security, crash, failure issues as compared to application based software.

Comment on Understanding healthcare costs: The employer-sponsored insurance system by SarafinaBloom

SarafinaBloom — Fri, 05 Apr 2013 00:18:58 +0000

@Bill Gustafson As a rule everyone dies of something, and most often medical providers are involved. I agree that it is cheaper to treat healthy people and with the implication that unhealthy living costs all of us. However pooling costs, combined with prevention, combined with reducing overhead and administrative costs by providers and insurers is the proven method for keeping premiums low. A well-designed single payer system can accomplish this, as has been demonstrated in other countries.

Comment on Accountable care organizations: The new provider model? by James Bradley

James Bradley — Wed, 03 Apr 2013 15:40:53 +0000

Can you say “Herding Cats”? We have experienced many version of the same model over the last 20 years under the names PPO’s, PHO’s, CISNs, IPA’s and other variations. Some have been successful only to say that a few remain in operation but never had the long term effect of changing our healthcare delivery paradigm.

The true test of “Viability” is the financial integrity of each organization as to say “Deep Pocket funding”. Daniel hit the nail on the head. ACO’s taking on the “Life Time” of care for the population will clearly lead ACO’s to a quick end without some other form of funding. We can do the traditional “Risk Sharing” with reinsurance but even those are slowing dying off with claim cost increases of late.

Gov’t subsidies would be a great “carrot” with a clearer definition on sharing in savings.

So time to dig deep and see if this will be another model that will succeed or “die on the vine”.

Comment on Perspectives on medical malpractice self-insurance financial reporting by Javier Sanabria

Javier Sanabria — Wed, 03 Apr 2013 15:17:04 +0000

Thank you for bringing the dead link to our attention. We have replaced it. You can also find the article at the following link:

http://insight.milliman.com/article.php?cntid=8208

Comment on Perspectives on medical malpractice self-insurance financial reporting by ronnie dennis

ronnie dennis — Mon, 01 Apr 2013 17:33:05 +0000

I would like to read the following article: Perspectives on medical malpractice self-insurance financial reporting.How do I gain access?

Ronnie Dennis

Comment on Medical underwriting and risk adjustment practices: United Arab Emirates by Medical underwriting and risk adjustment practices: United Arab | Health Insurance for Expatriates

Sat, 23 Mar 2013 16:57:11 +0000

[...] Reading: Medical underwriting and risk adjustment practices: United Arab This entry was posted in Health Insurance International News by Health Insurance for Expatriate. [...]

Comment on Medical underwriting and risk adjustment practices: United Arab Emirates by Healthcare Town Hall » Medical underwriting and risk adjustment … | Health Insurance for Expatriates

Mon, 18 Mar 2013 23:23:48 +0000

[...] from: Healthcare Town Hall » Medical underwriting and risk adjustment … This entry was posted in Health Insurance International News by Health Insurance for Expatriate. [...]

Comment on Will ACOs increase medical malpractice claims? by Denny Roberge

Denny Roberge — Mon, 18 Mar 2013 17:46:24 +0000

My opinion is that Medical Malpractice is a concern today and will always remain a concern and it is more an issue of tort reform than anything else.

Theoretically, ACOs should create larger more integrated risk pools and that alone may decrease the expense. As ACOs develop and formulate clinically proven protocols, the cost of care should decrease and as long as protocols are followed and sound medical decision around them prevails, the industry should see less successful malpractice claims.