19. February 2008 by Jon Moss.

Humana has a nifty little tool allowing for the access and analysis of small employer group plan utilization.  Would it be helpful for you as a small business to be able to know how often your employees:

• visit the doctor
• purchase prescription drugs
• meet deductibles & out-of-pocket maximums

 That type of information is extremely important to employee benefit specialists.  It allow us to determine which benefits are more important to the employees, and which ones are less used.  When implementing an HSA or HRA knowing this type of data is crucial to the success of the plan.

 Humana has recently updated BUD to allow brokers, and the small businesses they advise, access to actionable, group-specific benefit information previously available only to large companies, allowing employers to model the impact of different benefit designs, track health plan usage, and ultimately better budget for employee health care – a large and growing bottom-line expense for many small firms.

“BUD empowers brokers to deliver an unparalleled level of guidance to small companies as they make critical decisions about their health coverage,” said Jerry Ganoni, president, Humana Small Business. “Many companies unknowingly provide richer benefits than their employees use or want. With knowledge gleaned from BUD, small businesses are better able to choose the most appropriate health benefits solution for their workforce.”

Designed with the help of Humana’s actively-appointed brokers and agents, BUD features two primary tools to help employers choose and use their health plan with confidence: the Health Utilization Tool and the Contribution Strategy Tool, both of which protect the privacy of employee health information by removing identifying data.

The Health Utilization Tool offers employers information about employee usage of key services, including doctor office visits, prescription drug purchases, inpatient admissions, outpatient surgery and emergency room visits. Brokers can show small employers how the usage of these services by their own employees compares with that of similar accounts in the same geographic area and industry. Brokers can help employers track deductibles and out-of-pocket expenses to see how many employees have satisfied zero percent, 50 percent or more, and 100 percent of their in- and out-of-network limits.

Posted in technology, insurance companys, consumer-driven, group, medical | No Comments »

19. February 2008 by Jon Moss.

AvMed Health Plans announced recently it is adding several new small group plans, some of which are 50 percent less than their existing plans.

The lower-priced plans offer low co-payments for routine visits to primary care physicians and specialists and low co-pays for prescription drugs. The company is also adding new pairing choices to allow small group employers more flexibility.

Gainesville-based AvMed Health Plans provides health care coverage to both small and large employer groups in Florida and has offices in Orlando, Miami, Fort Lauderdale, Tampa, Gainesville and Jacksonville. The company also provides Medicare in Miami-Dade and Broward counties.

Posted in insurance companys, group, medical | No Comments »

19. February 2008 by Jon Moss.

A bill introduced in the Georgia General Assembly aims to put the skids on double-digit increases in health insurance premiums in the state.

But opponents fear new regulations could spook some insurance carriers from entering the Georgia market.

If House Bill 923 becomes law, health insurance companies will not be allowed to issue new health insurance products or impose renewal increases on health products until rates have been approved by state regulators. Carriers would have to financially justify rate hike requests. Thirteen states have similar requirements for health insurance carriers.

Critics of the bill say it would artificially lower rates, keep new insurers out of Georgia and drive smaller, less capitalized players out of business. Proponents say the legislation, which has an identical version in the Senate, would hold health insurers accountable for the rates they charge, something that insurers in other markets — such as auto and homeowners — are already subject to. Escalating health insurance premiums have contributed to the uninsured rolls, currently at about 1.7 million in Georgia.

Posted in health insurance reform, medical | No Comments »

19. February 2008 by Jon Moss.

Healthline Networks, an upstart San Francisco-based health-care search engine and web portal company, says it’s gaining ground on industry leaders in the health search arena.

This week Healthline enhanced its offerings by adding “drug search capabilities” that let consumers research pharmaceuticals, identify drug interaction issues, and study options such as medicinal herbs and supplements. It’s also adding new content from Yardley, Pa.-based StayWell, which will provide articles, tools and quizzes for the site.

The 9-year-old company, which rebranded and retooled in 2006, has raised $35 million in capital since late 2005, including $21 million last summer, and in recent months has roughly doubled its monthly portal visitors to 15 million. Revenue doubled last year, and is expected to double again this year, says Chairman and CEO West Shell III, although he declines to provide specifics. A spokeswoman admits the company’s made more progress in signing partnerships and attracting web visitors than generating revenue so far; much of its business comes from providing the technology behind other health search engines and portals.

“We’ve got lots of money in the bank and we’re launching a major search platform for Aetna,” Shell adds, on top of the drug-search step he calls “a very significant platform enhancement.”

Posted in consumer-driven, medical | No Comments »

19. February 2008 by Jon Moss.

Florida’s HMOs had a healthy combined profit of $540 million for the first nine months of 2007.

That’s a whopping 33.3 percent increase when compared with a $405 million profit for the same period in 2005, according to data just released by the Florida Office of Insurance Regulation. Third-quarter 2006 numbers were unavailable.

The state’s 37 HMOs brought in a combined $12.4 billion in premiums, or a 4.5 percent profit margin, for the first nine months of 2007, compared with $8 billion in premiums, or a 5 percent profit margin, for the same period of 2005.

The slightly lower profit margin is due to costs continuing to grow faster than premiums, says Doug Sherlock, president of Sherlock Co., a North Wales, Pa., firm that provides financial analysis for health plans and investors.

Posted in insurance companys, medical | No Comments »

19. February 2008 by Jon Moss.

Over five years, Tennessee hospitals would feel $2.5 billion worth of President George Bush’s $196 billion proposed cuts to Medicare and Medicaid should his budget pass without change.

According to numbers from the Tennessee Hospital Association, the impact would be first felt in 2009 to the tune of $215.3 million. Health and Human Services Secretary Michael Leavitt said last week that Medicare will go broke in 11 years if nothing is done.

“We don’t believe the cuts will be accepted very well in Congress so we’re not doing a full court press right now,” says David McClure, THA’s vice president of finance. “We’re not asking our members to contact their legislators until this thing moves a little further down the road.”

McClure says if the cuts aren’t approved, he’s still afraid they can be used as a blueprint for future budgets to help balance Medicare’s budget or use the cuts to pay for other government functions like the war or to stimulate the economy.

Posted in Medicare, health insurance reform, medical | No Comments »