"Plans steer patients to lower-cost hospitals; Blue Cross latest to add fees for expensive care
February 10, 2011|Liz Kowalczyk, Globe Staff
Hundreds of small businesses have signed up in the past month for a new Blue Cross Blue Shield health insurance plan that charges employees hefty fees for seeking care at more expensive hospitals, in an effort to steer them to lower cost care.
The popularity of the plan — Blue Cross Blue Shield of Massachusetts says it is the fastest launch ever of a new product — is the latest sign that the once radical idea has been embraced as a way to control soaring health care costs, even as pricier hospitals warn of a possible backlash and cuts in services.
Related: The Culture of Blue Cross
And I'm bothered by the reference to my health as a "product."
Other Massachusetts insurers also report brisk business in plans that offer lower premiums in exchange for limits on use of high-cost care. The plans either charge consumers extra for receiving care from popular but expensive hospitals or doctors, or bar them altogether from seeking treatment at those institutions and practices....
If it LOOKS LIKE A DUCK, and QUACKS like a DUCK, and WALKS LIKE a DUCK, then it is RATIONING!
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Yes, that HIGH-QUALITY, HIGH-COST care is ONLY FOR SPECIAL PEOPLE!
Related: More opt for low-cost coverage
That's cuz we's don'ts gots no moneys.
At least it's booming business for Blue Cross. That is the only health that matter$.
Thankfully, we have a governor looking out for your health:
"Patrick proposes health fee overhaul; Seeks power to examine insurer contracts as part of shift to budgeted care" February 17, 2011|Liz Kowalczyk, Globe Staff
The legislation underlines the administration’s plan to shift most Massachusetts employees, Medicaid recipients, and other residents with state-subsidized health insurance — about 1.7 million people, or 1 in 4 residents — to a new cost-conscious health care payment system, in which doctors and hospitals are put on a budget for each patient’s care....
The legislation would also establish standards for groups of hospitals and doctors called accountable care organizations, which are expected to become common as providers band together to treat patients and coordinate their care for a budgeted fee, splitting the payment....
See: The Massachusetts Model: Trailblazing Blueprint
Obama's HMOs
Does the name change fool you?
The plan — the culmination of two years of debate among health providers, insurers, consumer advocates, legislators, and the administration — appears to stop short of dismantling the traditional payment system used for the majority of privately insured patients.
So it is going to be a TWO-TIERED SYSTEM, 'eh?
That system, called fee for service, pays doctors and hospitals a negotiated fee for each procedure and visit, and it is widely viewed as lacking coordination and as driving up costs by encouraging unnecessary tests and procedures. The more treatment doctors and hospitals give, the more money they collect....
Yeah, IGNORE the MILLIONS being paid out to CEOs, etc.
The governor’s legislation stops short of requiring providers to band into accountable care organizations or of requiring insurers to pay providers based on a budgeted amount....
The administration had talked about wanting to move toward global payments, in which insurers provide a set amount that covers all of a patient’s care, no matter how much or how little treatment is given.
So don't get sick, Bay Stater!
Maybe you ought not read these:
The Massachusetts Model: Office Visit
The Massachusetts Model: Doctors' Diet
When are the wars and Wall Street going to go on a diet?
But administration officials said yesterday that other types of alternative payment systems may also improve care and drive down costs.
“The biggest downside to requiring global payments is that this is an experiment that hasn’t been done before,’’ one official said....
Not officially, anyway; they just deny services and payments that have the same effect.
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Related: Patrick presses for legislation to curb health care costs
Massachusetts senate leader vows to act on health payments plan
Children’s zeroes in on its costs
Tagged by the attorney general and insurers as one of the state’s most expensive hospitals, Children’s Hospital Boston is moving aggressively to cut health care costs while seeking to sustain its elite reputation for pediatric care.
City, town health plans most costly, report says
Health insurance plans to cover city and town employees cost 37 percent more than similar plans for workers at private companies, mostly because municipal employees pay minimal copayments or deductibles when they get care, according to a new statewide survey.
Related: The Massachusetts Model: Municipal Health Mess
Towns to Pay Health Tax For Public Servants
A Healthy Insult For the American People
Those are the kinds of things that make me sick.
