Medicare to Hospitals: The Patient is Always Right

Starting in fiscal year 2014, Medicare will start rewarding hospitals with high quality care and penalizing hospitals with low quality care.  The rewards and penalties will be financial in nature. High-quality hospitals will receive a bonus and low-quality hospitals will receive a financial penalty.  There is a lot of existing documentation on this hospital value-based…

The End of Health Reform Starts in Ohio?

One of the key tenets of health reform is that insurers cannot charge different premiums to individuals based on their pre-existing conditions.  Under this type of system, the optimal strategy for many individuals is to not buy any health insurance until one gets sick.  Since insurers cannot charge these sicker people higher premiums based on…

Industry Consolidation

Last year, I mentioned how ACO requirements will lead to more industry consolidation.  A recent article by the Economist is finding that my prediction is becoming a reality. “Cigna, an insurer based in Connecticut, said it would pay $3.8 billion for HealthSpring, which offers services and insurance to the elderly. It is the latest deal…

Health Exchanges

The California Healthcare Foundation (CHCF) notes that States face a number of challenges when determining how to design their Health Exchanges mandated by health reform.  Today, I briefly highlight some of the requirements State Exchanges must fulfill.

Predicting a Religious Revival in 2014

The Healthcare Economist predicts a religious revival in 2014.  Let me be more specific, in January 2014.  How do I know this?  Am I a religious man?  Has God spoken to me? Let’s just say I have a certain insight.  In 2014, the individual mandate goes into effect.  All individuals must buy health insurance or…