The Health Care Blog

HOUSE HEALTH CARE REFORM: IGNORING THE ELEPHANT?

By ROGER COLLIER After some frantic last minute political gyrations and a lot of pressure from the President, House Democrats have announced details of their draft health care reform bill. Much as expected, the 852-page bill emerging from three House...
July 15, 2009 in Health Plans, Policy/Politics, Reform, Roger Collier | Permalink | Comments (5)

Eliza gets a nice write up in BusinessWeek

BY MATTHEW HOLT Indeed, it’s so nice that methinks Lucas & Alex were quite seductive! Speaking as a friend and one who’s been indoctrinated into the cult of Alexandra Drane, its interesting to see the mainstream press picking up the...
July 13, 2009 in Health 2.0, Health Plans, Technology | Permalink | Comments (0)

Op-Ed: Forward thinking health plans? Look for the guys with the white hats

By RICHARD NOFFSINGER The public noise about health care reform has painted the parties involved in broad brush strokes that tell consumers which in the fray are the good guys and bad guys. News reports have for so long vilified...
July 13, 2009 in Data Analytics, Electronic Medical Records, Health Plans, Op-Ed | Permalink | Comments (10)

Behind the Curtain: Wendell Potter on the Industry's Management of Care and Reform

By BRIAN KLEPPER Stop what you're doing and take out a half-hour to watch this week's superb Bill Moyers' 3-part show, especially the extended interview with Wendell Potter, former CIGNA VP Corporate Communications, for a frank, insider's discussion of how...
July 10, 2009 in Brian Klepper, Health Plans, Policy/Politics, Reform | Permalink | Comments (9)

Rantology: Cannon on Freedom or Power?

By Matthew Holt Ah-ha. Michael Cannon has now replied to me and it basically comes down in his mind to me being a crypto-fascist Stalinist wanting to break the will of the American people mediated through its representatives, the health...
June 30, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (25)

A little more on insurers, and reform means more of the same

By Matthew Holt In the comments on my piece on Michael Cannon (which Michael has not commented on sadly, as I was hoping for a nice fight! Michael has replied here and I'll reply back on Monday), everyone’s favorite insurance...
June 27, 2009 in Health Plans, Matthew Holt, Policy/Politics | Permalink | Comments (31)

Op-Ed: A Social Democrat Weighs in on a Government Health Plan

By DAVID HANSEN I was born into a Berkeley family of Social Democrats—my father studied Swedish economic policies—then I trained in social-democratic Economics in Scandinavia, before cutting my career teeth in a Norwegian Labor Party think tank. I thereby personify...
June 24, 2009 in Health Plans, Op-Ed | Permalink | Comments (21)

More bad press for Insurers. Will anyone care?

By Matthew Holt Jon Cohn notes that Wendell Potter, a former PR executive with Cigna and Humana. will be appearing before a Senate Commerce Committee today. Note the word “former”. Trudy Lieberman has an interview with Potter where he repeats...
June 24, 2009 in Health Plans, Policy/Politics | Permalink | Comments (20)

Your AHIP Quiz Question of the Day

By Matthew Holt This is something that's been puzzling me for a few weeks. We all know that insurers are very good at making sure that they insure healthier risks than average. In the individual market they do this openly,...
June 21, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (20)

The Dumbest Thing I Have Ever Seen An Insurance Company Do

By ROBERT LASZEWSKI And, I’ve been in the business for 37 years. First, let me stipulate we really need a system of universal care where everyone gets to have insurance. But we don’t yet so certain rules are unavoidable until...
June 20, 2009 in Health Plans, Robert Laszewski | Permalink | Comments (28)

Beyond the Beltway – How Most of America Sees Health Reform

By BILL KRAMER What are people saying about health reform beyond the beltway and outside the health wonk debates? I’ve been meeting with Rotary Clubs and local Chambers of Commerce during the last several months, and they’re talking about different...
June 17, 2009 in Health Plans, Obama administration, Policy/Politics, Reform | Permalink | Comments (10)

The Health Industry's Achilles Heel

By BRIAN KLEPPER and DAVID C. KIBBE "You never want a serious crisis to go to waste." - Rahm Emanuel, White House Chief of Staff Timing matters. The health industry has demonstrated steadfast resistance to reforms, but its recently diminished...
June 10, 2009 in Brian Klepper, David Kibbe, Health Plans, Obama administration, Policy, Policy/Politics, Quality, reform, The Industry, Transparency | Permalink | Comments (15) | TrackBack

Data-Driven Health Care: An Interview with Jerry Reeves, MD

An under-the-radar debate is occurring in health care between those who say data shows that practice variations across the land are “unwarranted” and those who maintain that such variation is inevitable given socioeconomic population differences and cost of practice differences...
June 8, 2009 in Dartmouth Atlas, Economics, evidenced-based medicine, Health Plans, Obama administration, Patient Safety, Physicians, Policy/Politics, primary care, Quality, The Industry, Transparency | Permalink | Comments (17)

The National HIT Organizations - How it All Works

By John Halamka Several blog readers have asked me to take a fresh look at all the organizations related to ARRA and explain how it all works. Here's my understanding: Office of the National Coordinator The Obama administration's ONC is...
June 8, 2009 in Health Plans, The Industry | Permalink | Comments (2)

Michael Porter--seduced, converted, or bludgeoned into accepting reality?

By Matthew Holt What a difference a few years makes. Michael Porter is the Harvard Business School prof who charged into health care a few years back. He (with Elizabeth Teisberg) wrote a book called Redefining Health Care which suggested...
June 4, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (34)

American Well gets busy with guidelines, Optum

By Matthew Holt Our friends over at American Well have two announcements today. First, they’re releasing what they call Online Care Insight, which is essentially the integration of care guidelines into their online care system. We saw a glimpse into...
June 3, 2009 in Health 2.0, Health Plans, Technology | Permalink | Comments (3)

Cal Blue Shield wins recision case, but it's very, very strange

By Matthew Holt So Blue Shield of California wins the first case it’s fighting over the recission issue. But it’s in very strange circumstances. The plaintiffs (a couple trying to get coverage for a doctor they like that wasn't in...
May 29, 2009 in Health Plans | Permalink | Comments (7)

I'm not sure that's how Uwe meant it!

By Matthew Holt The AP has a puff piece on the greatness of Karen Ignagni. Well greatness if greatness is defined as doing anything it takes to screw the nation on behalf of her organization’s members, all the while telling...
May 25, 2009 in Health Plans, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (6)

Octomum gives Kaiser a bellyache

By Matthew Holt First KP somehow gets landed with the Octomum, whom they most surely didn't provided with the IVF in the first place. My assumption is that the multiple birth cost them into the middling 6 figures. Now because...
May 16, 2009 in Health Plans, Hospitals | Permalink | Comments (3)

Vaccine refusal, or Jenny McCarthy, better with fewer clothes on

By Matthew Holt Kaiser Permanente has released a study from its EMR database looking at use of vaccines in its Colorado region. KP in Colorado has data on about 480,000 members dating back to the mid-1990s from when they started...
May 13, 2009 in Electronic Medical Records, Health 2.0, Health Plans | Permalink | Comments (3)

The Public Plan--Mutual Assured Destruction?

By ROBERT LASZEWSKI I typically don’t talk about my travels on this blog but something happened this week that bears reporting. Whether the federal government should or should not offer a public health plan alternative to compete with private insurers...
April 20, 2009 in Health Plans, Obama administration, Policy, Policy/Politics, Robert Laszewski | Permalink | Comments (7) | TrackBack

The Biggest Health Care Controversy on the Hill

By ROBERT LASZEWSKI Since when was a two-tiered health insurance system a Democratic policy goal? Among Democrats in the Congress and at the White House there is a great deal of interest in creating a government-run health plan in the...
April 16, 2009 in Health Plans, Robert Laszewski | Permalink | Comments (29)

Herzlinger--Enthoven was right all along

By Matthew Holt In a blog piece called Why Republicans Should Back Universal Health Care Regina Herzlinger says something that I more or less agree with. Switzerland's system isn't a bad option. Neither for that matter is Holland's. Now of...
April 13, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (3)

Kaiser Permanente CEO George Halvorson on reform and life after IT

By Matthew Holt George Halvorson is the CEO of Kaiser Permanente, and the driving force behind both the HealthConnect EMR implementation and a national player in the health reform debate. I got to talk to him at HIMSS where he’d...
April 8, 2009 in Electronic Medical Records, Health Plans, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (4)

So what's the real usual, customary and reasonable price of care?

By Matthew Holt The Ingenix mess apparently won’t go away. Sen. Jay Rockefeller is now going after the health plans for using Ingenix’ database. Ingenix and some of its customer health plans have already settled with several states, but apparently...
March 31, 2009 in Health Plans, Policy, Policy/Politics | Permalink | Comments (38)

Will CIGNA Remake The Health Plan Marketplace?

By BRIAN KLEPPER America’s health plans are floundering. If their job has been to provide the nation’s mainstream families with access to affordable care (let’s leave quality out of it for the moment), they have failed miserably, though they were...
March 30, 2009 in Brian Klepper, Health 2.0, Health Plans, Marketplace, primary care, reform, The Industry | Permalink | Comments (15)

Karen Ignagni lie of the day, part 68

By Matthew Holt The big insurers now seem to be doing anything they can to prevent a Medicare-equivalent public plan being launched to beat them up. Yes AHIP has apparently decided to throw the schlockmeisters off the boat, and more...
March 25, 2009 in Health Plans, Matthew Holt, THCB | Permalink | Comments (46)

Tom Epstein, Blue Shield of California, on the hot seat

By Matthew Holt A couple of weeks ago the PR company for Blue Shield of California contacted me asking if I wanted their take on health reform. I somehow suspect that the PR flack concerned wasn't as familiar with the...
March 19, 2009 in Health Plans, Matthew Holt, Policy, Policy/Politics | Permalink | Comments (5)

A Sticky Solution to a Sticky Problem

By ALISTAIR ROCK “Don’t pull the knot tight,” the philosopher Ludwig Wittgenstein once warned, “before being sure you have got hold of the right end.” Those who hope to sort out the tangle of health care spending would do well...
March 16, 2009 in Health 2.0, Health Plans, Marketplace, Technology, The Industry, Web/Tech | Permalink | Comments (23)

Is the Healthcare Economy Rightsizing?

By Brian Klepper and David C. Kibbe More than at any time in recent memory, powerful forces are buffeting the health care sector. We are in the midst of profound upheaval, driven by market and policy responses to the industry's...
March 12, 2009 in Brian Klepper, Current Affairs, David Kibbe, Economics, Health Plans, Marketplace, Medical Devices, Policy, Policy/Politics, The Industry | Permalink | Comments (33)

My forecast: a sad conclusion to the health care bubble...

Brian Klepper and David Kibbe have written a terrific piece on how and why health care is in a handbasket and wondering where it’s going. But as we ex-futurists know, there’s lots of luck required to make a good forecast....
March 12, 2009 in Health Plans, Matthew Holt, Pharma, Policy, Policy/Politics | Permalink | Comments (12)

A Broker's Lament: We Brought This On Ourselves

By JOHN SINIBALDI A huge segment of the American population is simply far too strapped to ever afford the premiums and costs associated with health insurance/health care as it is structured today. It isn't the employees of government (local, county,...
March 7, 2009 in Economics, Health Plans, Marketplace, Obama administration, Policy/Politics, reform, Small Business, The Industry | Permalink | Comments (60)

I really don't understand Wall Street, part 98

By Matthew Holt On the campaign trail Obama said that he would if elected cut the overpayments to Medicare Advantage plans by about $15bn a year. Once elected he confirmed that he would. Stupid me thought that this would mean...
February 27, 2009 in Health Plans | Permalink | Comments (7)

Divided we might get somewhere, but not yet

By MATTHEW HOLT The NY Times describes the Republican-less lobbyist meetings with Democrats that are allegedly getting towards a consensus on an individual mandate as the way to universal health care. Funnily enough some of those same groups (e.g. The...
February 20, 2009 in Election 08, Health Plans, Mandates, Matthew Holt, Obama administration, Policy, Policy/Politics | Permalink | Comments (7)

Connecting the dots--Uninsured people are poor!

By MATTHEW HOLT A bunch of random articles all hit at once on Wednesday morning. And they win the John Madden award for stating the bleedingly obvious. This is kind of a companion piece to my rant about Friday's NY...
February 20, 2009 in Health Plans, Matthew Holt, Obama administration, Policy, Policy/Politics | Permalink | Comments (10)

Frances Dare, Cisco's optimist, and KP's Garfield Center

By Matthew Holt From time to time we check in with my pal Frances Dare who is Cisco’s optimist about the impact that IT will have on health care (FD I’ve worked for Cisco in the past). Here’s an interview...
February 13, 2009 in Health Plans, Technology | Permalink | Comments (0)

The AMA Wins a Round Against Accountability and Patient Information

By Brian Klepper On January 30th, a 3-judge DC appeals court overturned a lower court decision that would have forced public release of Medicare physician data. Writing for the majority in a split 2-1 judgment, Circuit Judge Karen LeCraft Henderson...
February 6, 2009 in Brian Klepper, Consumers, Current Affairs, Health Plans, Policy, Policy/Politics, Quality, reform, Technology, The Industry, Transparency | Permalink | Comments (12)

Five "Shovel-Ready" Health Care Reforms

By Brian Klepper & David C. Kibbe Microsoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We...
January 21, 2009 in Brian Klepper, David Kibbe, evidenced-based medicine, Health Plans, Marketplace, Obama administration, Physicians, Policy, Policy/Politics, primary care, Quality, reform, Technology, The Industry, Transparency, Web/Tech | Permalink | Comments (18)

As Medical Tourism Grows, Hold On We're In For a Wild Ride

By Bob Wachter Until now, medical tourism has been a curiosity, iconic “Wow, Look How Flat the World Is Becoming,” fodder for stories on 60 Minutes. But as health insurers and employers get into the act, get ready for some...
January 17, 2009 in Bob Wachter, Health Plans, International, Physicians, The Industry | Permalink | Comments (24)

Unpacking the Ingenix Settlement

By ROBERT LASZEWSKI Earlier this week, New York Attorney General Andrew Cuomo announced a "victory" in his battle with the insurance industry over how out-of-network physician claims are paid. Cuomo had argued that the industry's use of its out-of-network "customary...
January 14, 2009 in Health Plans | Permalink | Comments (11)

"The Innovator's Prescription": Christensen's Book Offers Insightful Dx, Unrealistic Rx

By Vince Kuraitis and David C. Kibbe Being big fans of Clay Christensen and his theory of disruptive innovation (DI), we have been awaiting his just-released book The Innovator’s Prescription: A Disruptive Solution for Healthcare . The book is co-authored...
January 8, 2009 in Economics, Electronic Medical Records, Health Plans, Policy, Policy/Politics, reform, Technology, The Industry | Permalink | Comments (8)

Shocker--Karen Ignagni almost tells the truth

The NY Times' Robert Pear has an article on the politics of the Obama Administration introducing a public plan as part of FEHBP. As you might expect a boat load of Republicans who were told in grade school that private...
January 8, 2009 in Economics, Health Plans, Hospitals, Medicare Advantage, Obama administration, Policy, Policy/Politics | Permalink | Comments (20)

Poizner: talks tough, wimps out WITH UPDATE

By Matthew Holt Previously in the long running retroactive insurance cancellation story I’d accused Steve Poizner (yes, the only Republican I’ve ever voted for and) California state insurance commissioner of being a bit soft. Now he really needs calling out....
January 7, 2009 in Health Plans, Matthew Holt, Policy/Politics | Permalink | Comments (16)

Now United HealthGroup settles with investors, your Friday teaser

By Matthew Holt Can someone tell me how much money Bill McGuire has got left?
December 19, 2008 in Health Plans, Matthew Holt | Permalink | Comments (4)

Jack says cover the uninsured & spend less!

By Matthew Holt It’s no secret what the Dartmouth group’s solution for the health care system has been — reduce practice variation, get surgery and physician resource use rates similar to the Mayo Clinics' of the world, and take the...
December 18, 2008 in evidenced-based medicine, Health Plans, Physicians, Policy, Policy/Politics | Permalink | Comments (5)

Now, Sleepless in San Francisco

By Matthew Holt Having returned from Seattle, the persistent itching from the sand-fly bites of Roatan has awakened me at 5 a.m. So I’m commenting on three pieces of news, which I've commented on before here and at Spot-On. First,...
December 5, 2008 in Health 2.0, Health Plans, Hillary Clinton, Marketplace, Matthew Holt, medicare, Medicare Advantage, Policy, Policy/Politics | Permalink | Comments (1)

Sleepless in Seattle

By Matthew Holt In a 36 hour span I left the mountains of Copa Ruinas in Western Honduras, had dinner in South Beach, Miami and after stopping off to see that Health 2.0 central in SF hadn’t collapsed, ended up...
December 4, 2008 in Conferences, Economics, Health Plans, Matthew Holt, Medicare Advantage | Permalink | Comments (8)

Small Business Coverage: A Report from the Trenches

By Brian Klepper John Sinibaldi, a well-respected health insurance agent in St. Petersburg, Fla., has become prominent in Florida's broker community because he counsels and services a large book of small business clients and studiously tracks the macro trends that...
November 25, 2008 in Brian Klepper, Economics, Health Plans, The Industry | Permalink | Comments (4)

Health care costs are crippling small businesses

By John Sinibaldi I've got news for the folks doing the International Foundation of Employee Benefit Plans' survey: Smaller businesses, especially those defined as true small businesses with two to 50 full-time employees, are strapped beyond belief when it comes...
November 25, 2008 in Health Plans, Marketplace, The Industry | Permalink | Comments (4)

The inconvenient truth

By Sarah Arnquist The Los Angeles Times ran a great series last week called "Shedding Risk" in which it detailed through compelling human stories the erosion of the health insurance market. It's definitely worth finding the time to read. Matthew...
October 29, 2008 in Health Plans, Marketplace, Policy, reform | Permalink | Comments (12)