Entries Tagged as ‘Insurance’

September 25, 2009

Sermo makes the connection: Health Reform leads to Cash-based Practices

Connection (kə-nĕk’shən) n.

The act of connecting.
The state of being connected
An association or relationship

Sermo finally makes the connection between all the health insurance reform conversations and the inevitable consequence of pushing a large percentage of providers toward a cash based practice. I have highlighted the rise of direct practice multiple times, and believe enough in [...]

August 20, 2009

Utah leads out with new virtual health insurance exchange

Exchange (ĭks-chānj’) n.

To give in return for something received; trade
To give and receive reciprocally; interchange
A place where things are exchanged, especially a center where securities or commodities are bought and sold

There have been several interesting health finance innovations that have been announced recently which have relevance to health reform in general and the [...]

February 18, 2009

Cuomo Bully Pulpit: All Payers Database to be a reality

Bully pulpit (bʊl’ē pʊl’pĭt) n.

Public Office of sufficiently high rank that provides the holder with an opportunity to speak out and be listened to on any matter.
An effective mechanism to bring issues to the fore that were not initially in debate, due to the office’s stature and publicity.

I never knew that Andrew Cuomo had such [...]

February 10, 2009

The Price of Opacity: Lessons Learned from UNC

Opacity (ō-păs’ĭ-tē)

The quality or state of being opaque.
Something obscure, impenetrable
Dullness of mind

I have been intrigued by the recent settlement by United with NY regarding underpayments to physicians based on faulty estimates of what constitutes a fair market rate (Ususal aNd Customer or “UNC”) for physician health services. As predicted, it has set off [...]

February 10, 2009

“An Unnecessary Effort”: Wuesthoff Health Pays for EOB’s

Unnecessary (ŭn-nĕs’ĭ-sĕr‘ē) adj.

Not necessary; needless.
Serving no useful purpose or function

You have got to love it, huh? Did you see the most recent series of lawsuits just announced by the AMA. They must just be loving the opportunity to pile on their arch nemesis insurance companies at a time when their very future is in question.  [...]

January 13, 2009

Mary Jerome: The Rosa Parks of Transparency

Scheme (skēm) n.

A systematic plan of action
A secret or devious plan
An orderly combination of related parts

“Usual and customary” just became “Transparency and consistency”
The United Health Group, in what will become a sweeping decision (interesting interview with author here) within the Health Insurance industry, was just levied a $50M wrist slap by New York [...]

January 9, 2009

Transparency Trek: The Million EOB March

Trek (Trĕk) n.

A journey or leg of a journey, especially when slow or difficult.

A journey by ox wagon, especially a migration

I have been thinking alot about EOB’s. How did these anomolies of reason, this perversions of clarity, and obfuscators of objectivity come into existence? To what intent are they provided to the “beneficiary”.  Every [...]

August 27, 2008

Healthcare Dysincentives: Who is left holding the bag?

Holding the Bag (hōl’dĭng thə băg) N.

Abandon someone, force someone to bear the responsibility or blame.
This idiom grew out of the earlier give one the bag (to hold), which dates from about 1600 and alludes to being left with an empty bag while others have taken the valuable contents.

I grow weary of the socialists in [...]

April 29, 2008

True Insurance: Removing the Moral Hazard

True (trū) adj.
1. Consistent with fact or reality; not false or erroneous
2. Real; genuine, rightful; legitimate, fundamental, or essential
3. Accurately shaped or fitted and conforms to rule, standard or pattern
I recently came across an article so good that I thought it should be republished in its entirety. The article was written by Frank Timmons and [...]

February 29, 2008

First Party Financing – Lets Get Real About Health Care

Financing (fə-năns’) v.

To provide or raise the funds or capital for: financed a new car.
To supply funds to: financing a daughter through law school.
To furnish credit to.

The crisis that is American health care continues to get bad news. However, in a lame duck year, everyone realizes that not much is going to [...]