Some insurance companies reduce commissions to trim losses
February 06, 2016
At DocSpot, our mission is to connect people with the right health care by helping them navigate publicly available information. We believe the first step of that mission is to help connect people with an appropriate medical provider, and we look forward to helping people navigate other aspects of their care as the opportunities arise. We are just at the start of that mission, so we hope you will come back often to see how things are developing.
An underlying philosophy of our work is that right care means different things to different people. We also recognize that doctors are multidimensional people. So, instead of trying to determine which doctors are "better" than others, we offer a variety of filter options that individuals can apply to more quickly discover providers that fit their needs.
February 06, 2016
Kaiser Health News published an interesting article recounting some of the travails that insurance companies have been encountering on insurance exchanges. Apparently, even though gold plans cost consumers more, they have proven unprofitable for a number of health insurance companies. The plans have proven so unprofitable that the pool to help mitigate against high-cost patients has been more than depleted, with HHS only having enough to pay 13% of what it owed for 2014. It's unclear to me why the insurance companies can't simply raise premiums to make those plans more profitable. Instead, some health insurance companies are trying to reduce enrollment in the unprofitable plans by not paying commission to brokers when they sign someone up for a gold plan.
Apparently, a number of people signed up for insurance plans outside of the regular enrollment window and some of them have been exiting their insurance plans after expensive treatments. To discourage this practice, some insurance plans are also eliminating commissions for brokers when they sign someone up outside of the regular enrollment window.
January 31, 2016
The Kaiser Family Foundation published a survey with interesting results. Apparently, people's views of the Affordable Care Act haven't changed that much since 2010 (slightly more negative). Surprisingly, despite all the complaints about the cost of health care, 61% of non-elderly insured Americans think that their health insurance is a good value or an excellent value. Also somewhat surprising (in light of news about narrow networks) is that 84% of non-elderly insured Americans are somewhat satisfied or very satisfied with their selection of doctors. Overall, the price of various aspects of health care seem to be important to be people, but not an overriding concern.
The poll only sampled 1,204, so it's unclear to me how representative the findings are.
January 23, 2016
For a while now, Medicare has been transitioning away from strictly flat-fee payments (fee-for-service). For example, a while back, Medicare introduced the concept of bundled payments for hospital procedures, where hospitals are reimbursed one total amount for an inpatient visit, regardless of the hospital's cost. It has since moved on to rewarding those hospitals that perform well on certain quality metrics and imposing penalties on hospitals with high readmission rates. On the individual physician level, Medicare started to pay doctors extra if they used a certified electronic health record with the HITECH Act. Medicare also started paying for doctors to report certain outcome information via a program known as PQRS.
While the payouts of the physician programs have been a relatively small portion of the overall Medicare payments, last year, Medicare announced that they aspire to link 30% of their payments to getting better results and better value. That percentage is to rise to 50% in 2018. That they recently reiterated those goals suggest that maybe we will see a significant shift in payments, and therefore practices. It'll be interesting to see how much that percentage actually changes throughout 2016.
January 13, 2016
We plan on changing co-location providers this weekend, so this site will be unavailable for a couple of hours (perhaps more).
Hopefully, the move will be complete before Saturday morning.
January 10, 2016
Rising drug costs have frequently been in the news recently, and USA Today published another article in that vein. New drugs are expected to come on the market. While many of the new drugs will be covered by insurance, there is concern that the extremely high price tags will still place them out of reach of many patients (given that patients will still need to pay a portion of the costs). It appears that even treatments that have been around for a while (such as insulin) have risen in price recently.
As patients become more and more exposed the increasing costs of health care, I expect that many will start to learn what is and is not covered by their health plans and may start to make different selections when they choose a plan. Beyond that, however, I would also expect that patients start to question the cost-effectiveness of certain treatments or tests (as well as better understanding their side effects).