28. February 2008 by Jon Moss.

Google on Thursday laid out plans for one of its most anticipated new services, a digital health records system meant to give users more control over their personal healthcare.The plans would put Google’s database of health records at the heart of a broader health information system that draws in health insurers, doctors and others, potentially giving the internet company a central role as the health industry moves towards greater use of information technology.

The initiative also opens a new front in Google’s spreading confrontation with Microsoft. The software company launched its own personal health records system, known as HealthVault, late last year.

Eric Schmidt, chief executive, outlined the Google Health plans at a conference in Florida on Thursday. The system will be based on personal health records that patients authorise their health insurers, doctors and others to move into Google’s database.

Other companies will then be able to write software applications that make use of these data, for instance creating services that help patients manage their medications or warn parents when their children need inoculations.

“There are a lot of applications you can’t envisage today,” Mr Schmidt told the Financial Times, adding that the overall aim was to improve the health of users by improving the quality of care.

That “platform” strategy could one day make the Google database the foundation of a more automated health information service. “We hope to get partnerships with all the health companies, so that if you have a prescription we just suck it straight in,” Mr Schmidt said.

Personal health record systems are not new, but the idea has been slow to catch on since there have been few incentives for doctors to automate health records or for patients to try to draw all their personal information together in one database.

The biggest incentives for people to use the new system include the ability to take control of their own records when they change health insurers or doctors, Mr Schmidt said. Also, patients who obtain drugs from more than one pharmacy will benefit if their records are consolidated in one place, he added.

For now, Google has no plans to sell advertising around the health service, Mr Schmidt said. Instead, it hopes to raise awareness of the Google brand and encourage greater use of its search engine.

-FT

Posted in technology, consumer-driven | No Comments »

27. February 2008 by Jon Moss.

The Department of Justice (DOJ) has filed an antitrust lawsuit in U.S. District Court in Washington in an effort to impede UnitedHealth Group Inc.’s proposed $2.6 billion acquisition of Sierra Health Services Inc.

According to the Department, UnitedHealth must sell portions of its business first to ensure competition.

Although UnitedHealth has agreed to those conditions, the DOJ’s antitrust lawsuit cited concerns that the merger would reduce competition in the Medicare health insurance market in Nevada, according to reports.

The Department’s proposal, which must be approved by the court, asks that UnitedHealth sell portions of its Medicare Advantage business in the Las Vegas-area for the merger to proceed, according to reports.

Otherwise, officials with the Department argue, the new company would control 94 percent of the Medicare Advantage market in that area.

Posted in insurance companys | No Comments »

27. February 2008 by Jon Moss.

In an effort to increase the funding and efficiency of health care for Native Americans, the Senate voted 83-10 to approve legislation intended to provide the group with greater access to health care services — including screening and mental health programs.

Native Americans typically experience higher death rates due to alcoholism, drug use, diabetes, cardiovascular disease and suicide rates, according to reports.

In addition to expanding tribal access to Medicare and Medicaid, the bill — which would authorize approximately $35 billion for Indian health care programs over the next 10 years — would also enhance programs at the Indian Health Service, help construct and revamp health clinics on reservations, and attempt to recruit more Native Americans into the health care industry, according to reports.

Posted in political, health insurance reform | No Comments »

27. February 2008 by Jon Moss.

A new study, released today by the National Association for Insurance Commissioners (NAIC), indicates that although 84 percent of baby boomers say access to health insurance is important when choosing a retirement date, 64 percent do not have a comprehensive understanding of their Medicare eligibility.

Only 36 percent of the 377 boomers surveyed — all born between 1946 and 1964 — say they knew that Medicare eligibility begins at age 65, 21 percent thought Medicare coverage began at age 62, and 9 percent said age 67.

Additionally, 6 percent think the eligibility age for Medicare is 59 ½ and 28 percent say they are unsure of the age, according to findings.

According to the NAIC, only 43 percent of respondents say Medicare eligibility is an important factor in determining when they will retire, but 48 percent expect to use Medicare to cover their health care needs in retirement.

Researchers conclude that many baby boomers are unclear about access and eligibility to Medicare and could be missing out on benefits that have already qualified for.

Posted in Medicare | No Comments »

27. February 2008 by Jon Moss.

Aetna announced today that it has launched a secure, provider Web site with NaviMedix, a leading innovator in automating health care provider communications.

Through NaviNet, NaviMedix’ s multi-sponsor health care communication platform, health care providers have easy, one-stop access to most major payers and select regional carriers, improved security options and improved electronic administrative transaction capabilities, according to reports.

Aetna’s secure provider Web site via NaviNet offers many easy-to-use features to both participating and nonparticipating physicians, hospitals and other health care professionals, the company says.

Free, real-time transactions are available with Aetna as well as other payers including major health plans and the Medicare program and enhanced administrative options provide one-stop service, as only one user name and password is needed to interact with Aetna or other health plans.

Meanwhile, health care providers can check eligibility and benefits in real time, submit or inquire about claims, review claim payment policies, view and print explanation of payments online within 24 hours of claims processing, obtain electronic remittance advices, access Aetna’ s education site and conduct many other activities, according to Aetna.

Posted in health insurance reform, insurance companys | No Comments »

27. February 2008 by Jon Moss.

Last Sunday the Wichita Eagle published a story on how a local Kansas hospital has discounted  slashed their price on a common type of heart surgery.  They did it to be more competitive in the marketplace.  Apparently they felt strongly about gaining more share of the market.  They’re even advertising in Canada and the UK (for people who don’t want to wait for their government-provided medical plans to schedule procedures, and are willing to pay)  Here’s the story in it’s entirety:

Galichia Heart Hospital says it will begin charging a flat fee of $10,000 for one of the most common types of open heart surgery — undercutting hospital charges by at least $25,000.

The discounted fee is the latest plan by the physician-owned hospital to attract more patients. The hospital also promises a 15-minute wait time and a $50 co-pay in its emergency room.

Galichia officials say the discounted rate applies to standard coronary artery bypass graft surgery, but only for cases where there is little chance for complications. Patients with risky health issues such as diabetes or who have had the surgery before are not eligible.

Hospital officials are frank about their motives: They want a bigger piece of the patient base in Wichita and beyond.

“We’re very serious about presenting cost-effective products and options for our community and for the region and nationally,” Galichia hospital chief executive Steve Harris said.

“I think it will turn some heads. This isn’t just a good rate. It’s a world-class rate.”

Getting patients

About five of every 1,000 people need open-heart surgery every year, so a community this size produces roughly 2,000 procedures annually, Harris said.

Surgeons at Galichia Heart Hospital perform about 200 open-heart surgeries a year. Harris said he would like to see that increase by 100 this year.

The idea behind the rate cut is threefold, he said. The hospital wants to attract cash-paying uninsured workers, get the attention of insurance providers and cost-conscious employers in Wichita, and tap into medical tourism — the trend of patients going out of the country to purchase affordable surgery.

“We’re making money at this rate,” Harris said. “We’re challenging our colleagues to really square off against rising health care costs.”

Physician-owned hospitals in Wichita have historically struggled for market share in a city where the two major hospital systems — Via Christi Regional Medical Center and Wesley Medical Center — contract exclusively with insurance providers.

Galichia officials are hoping their new rate causes the area’s largest insurers — Blue Cross and Blue Shield of Kansas and Via Christi-owned Preferred Health Systems — to consider steering some of their client base to Galichia.

“This is a much better rate than anybody else is giving Blue Cross or Preferred Health,” Harris said. “We’re not an in-network provider. We’re sort of challenging (them) to rethink their contracting strategies.”

Blue Cross, at least, is intrigued, although the state’s largest insurer said it would abide by its contractual obligations.

“Blue Cross… members are free to receive services from any hospital they choose with the understanding that their benefits will be applied differently when they use non-contracting facilities,” spokeswoman Mary Beth Chambers said.

“We direct members to the hospitals where we have contracts because of the discounts we receive from those contracting providers. If one hospital is charging less than others in the area then that is good for the community and could help lower overall health care costs for everyone.”

Making waves

Galichia’s new rate could threaten larger community hospitals, although executives at each declined to comment.

Administrators at Kansas Heart Hospital, of which Via Christi is a minority owner, said the Galichia plan is “very interesting” but unlikely to make a dent in their business, which is based largely on physician referrals.

“I’m not sure what impact it could have,” said Lynn Jeane, chief operating officer. “And I’m not sure how many people needing heart surgery are going to be out shopping for the lowest price.”

Supporters say physician-owned hospitals are extremely efficient, making such cost-cutting strategies possible.

“It’s a gutsy move, but I understand what they’re trying to get done,” said Jim Sergeant, past president of the Kansas Surgical Hospital Association and chief executive of Salina Surgical Hospital. “If you take a hard look at costs, you can do premier services at a very good price.”

Galichia hospital also is running ads this weekend in Canada and the United Kingdom, targeting countries where government health plans have created long waits for elective surgeries. Such environments have fostered medical tourism to such places as India, where patients can get procedures done inexpensively.

“The price… is absolutely stunning,” said Rick Baker, a Canadian who founded Timely Medical Alternatives and North American Surgery. His companies connect clients with specialty hospitals that agree to perform certain surgeries at low, contracted rates.

“The solution to America’s health care problems is (for) people to find a way to negotiate very good prices,” he said.

Posted in health insurance reform, consumer-driven, medical | No Comments »

26. February 2008 by Jon Moss.

Post-primary polling shows small business owners and their employees are a significant voting segment equal to, and larger than, well-established voting blocs like veterans and union members.The National Federation of Independent Business, the nation’s leading small business advocacy association, conducted one national survey and six state-specific surveys Tuesday, polling Democrats in California, Missouri and Arizona, and Republicans in California, Missouri and Georgia. Not only did the results illustrate this voting bloc’s significant presence, it showed health care to be one of the most important issues to small businesses.

Polling data from the four states show the impressive strength and bandwidth of small business owners and their employees:

• In California, small business owners and employees made up 28 percent of the Democrats who voted on Super Tuesday, versus union members who were 24 percent.
• In Missouri, small business owners and employees comprised 32 percent of the Republicans who voted, versus 21 percent¹ who were veterans. On the Democratic side in Missouri, small business owners and employees were 28 percent, versus 16 percent who were union members.
• In Georgia, small business owners and employees were 38 percent of the Republicans who voted, versus 19 percent² who were veterans.
• In Arizona, small business owners and employees made up 31 percent of the Democrats who voted, versus 13 percent who were union members.

“More than ever before, small business men and women made up a significant voting bloc on Super Tuesday. It is clear they are a voting segment that should receive the same attention from candidates as other groups, including veterans and union members,” said Todd Stottlemyer, NFIB president and CEO. 

Despite their significant presence, the issues that matter to small business owners and their employees have been overlooked by the presidential candidates. In fact, the national survey found that 81 percent of owners and 52 percent of employees do not feel the candidates are adequately addressing issues that are important to them, especially health care. Presidential candidates are not effectively considering and reaching this significant voting segment, a group that grows each year as corporate downsizing impacts large employers.  

The rising cost of health care is a major concern for small business owners and their employees who continue to be squeezed by premium increases and state mandates. Nationally, 51 percent of small business owners and 47 percent of their employees say they have had difficulty keeping up with the cost of health care. And both groups feel that the presidential candidates are not saying enough about health care on the campaign trail.     
 
“The research shows that health-care reform is a top concern for America’s job creators, and they are desperately seeking help from the next president,” continued Stottlemyer. “Small business owners and employees are bearing the overwhelming burden of a broken health-care system that needs real reform. Candidates from both parties need to address this crisis head on. Because when you fix health care for small business, you fix it for America.”

-NFIB survey results

Posted in political, health insurance reform, group | No Comments »

26. February 2008 by Jon Moss.

Humana Inc. is realigning its subsidiary that comprises ancillary insurance benefits such as dental coverage and life insurance and renaming the division Humana Specialty Benefits.

The former HumanaDental Insurance Co., based in Green Bay, Wis., has served as a sort of “holding place” for products that fall outside of the company’s traditional medical offerings, said Jeffrey B. Bringardner, president of Humana’s Kentucky market.

With recent acquisitions of CompBenefits Corp. and KMG America Corp., both of which closed during the fourth quarter of 2007, Humana’s ancillary-product offerings have expanded significantly.

Membership in the specialty benefits division has more than tripled following the two recent acquisitions, to 6.8 million from 1.9 million

Posted in insurance companys | No Comments »

26. February 2008 by Jon Moss.

A slew of bills proposed in the current session of the Kentucky General Assembly would require health insurers to expand services they must cover.  The proposed mandates have sparked opposition from Kentucky doctors and health insurance providers.  The proposed legislation includes bills that would require health benefit plans to cover services such as colorectal cancer screenings and mammograms. Other proposals address terms of the relationships between health care providers and health insurance companies.

Melodie Shrader, executive director of the Kentucky Association of Health Plans, said many of the proposals are “unnecessary regulation.” The association represents six insurance providers, including Humana, Anthem. and Aetna.

If the past is any indication, whenever government mandates benefits rates usually go up.

Posted in health insurance reform, medical | No Comments »

26. February 2008 by Jon Moss.

Colorado Gov. Bill Ritter’s recently unveiled health package isn’t wildly expensive, doesn’t try to change too much and won’t require a people’s vote to raise taxes.   Still, questions remain: Will it do much? And, where will the state find the money to pay for the limited initiatives it does propose?  Ritter said the package, a collaborative effort with state legislators, provides the “first steps” toward improving access and expanding availability of health care in the state while making it more affordable for businesses and individuals. 

Called “Building Blocks for Health Care Reform,” the package almost doubles the number of Colorado children covered under government health plans, creates a new center to study health care costs and makes comparison information about insurers available to consumers and encourages efficiencies — such as standardized insurance cards — in Colorado’s health system.

Read the press release

Posted in children | No Comments »