|Florida Health Insurance Blog #18|
Do you have questions regarding your Alachua Florida health insurance policy? If you already have coverage you should be able to call your local provider for answers to all your questions. On the other hand, if you don't yet have a policy you may have questions that need answered. In this case you need to know what questions you have on your mind, as well as who you can turn to for answers.
The questions you have will be based on your situation. As noted above, if you already have coverage you may have questions on billing, in-network doctors, co-pays, etc. If you don't have coverage you may need to find answers on the cost of buying a policy, available options, and other like details. No matter what you need to find answers to any questions that are bugging you.
When you don't get your questions answered nothing good can come from this. Instead, you are taking the risk of losing money and not having the right coverage. Do you think that this is a good position to be in? Definitely not.
If you have any questions pertaining to your Florida health insurance policy or one that you want to buy be sure to get them answered at once. The more answers you have the more comfortable you will be when buying Florida health insurance coverage. And as you know being comfortable with your policy is very important.
NEWS THAT AFFECTS YOUR HEALTH INSURANCE RATES::
DAVIES, one of the largest public affairs agencies in the country, today released the results of its third annual National Payor Survey of hospital executives. The survey measured hospital executives' perceptions of the nation's largest health insurance companies. It was coupled with the first National Payor Survey of employers, a new survey that targeted individuals responsible for selecting health plan coverage for employers of all sizes.
The only survey of its kind in the country, the National Payor Survey of health plan reputation targeted hospital leaders who negotiate contracts with major health insurance companies - hospital CEOs, CFOs and directors of managed care. Total responses represented more than 18% of the hospitals in the country, which is an increase of 78% from the 2007 survey.
Although health plans are rated poorly in a variety of other surveys - including JD Powers and Harris Poll - the DAVIES survey revealed two outliers in the health insurance community. For the first time, hospitals identified a preferred business partner in Aetna. And for the third straight year, UnitedHealthcare stood out dramatically as a bad actor in its ratings.
Aetna as Preferred Partner
For the first time, the survey revealed a preferred partner for hospitals and physicians. Aetna received a 64% favorable rating (compared to a 34% unfavorable rating), which was 9% better than CIGNA, the second-best rated plan and a full 48% better than the worst rated plan, UnitedHealthcare. The survey reveals a strong preference from hospitals based on trust, honesty, business practices and good faith negotiations.
"Aetna is clearly the preferred health insurance partner for hospitals and health systems across the United States," said Brandon Edwards, President/COO of DAVIES. "When you combine this survey data with recent publicly traded health plan earnings announcements, it's clear that provider trust and satisfaction are leading indicators of organic membership growth. This bodes well for Aetna, and perhaps CIGNA, as they look at 2009 commercial enrollment retention, as well as 2010 commercial enrollment growth."
UnitedHealthcare as a Negative Outlier
The survey revealed that 82% of respondents indicated an unfavorable opinion of UnitedHealthcare, which is actually an 8% improvement for them over last year. This contrasts with an average unfavorable rating of 34% among all other insurance companies in the survey.
"Employers and health plan members take note - hospitals and physicians deal with health plans every day, and they know who can be trusted to treat people fairly and deal in good faith," said Edwards. "They have reasonably good reimbursement rates for hospitals and physicians, but the survey reveals that hospitals simply don't trust UnitedHealthcare to follow-through on its promises. Given UnitedHealthcare's recent admission of problems with their PacifiCare subsidiary and other customer service issues, it's not surprising to see significant commercial enrollment losses from Bank of America to American Airlines to 7-Eleven and other large employers."
One striking finding is that UnitedHealthcare was not the largest payor in terms of revenue for the average hospital, and its reimbursement rates were not significantly lower than other major health plans. UnitedHealthcare is paying as much or more than other insurance companies for healthcare services but they are viewed as the worst performer by a large margin. The survey makes clear that dissatisfaction is driven by distrust, dishonesty, flawed business process, inadequate claims processing, claims denials and other business process problems.
The survey gathered data on hospital leaders' opinions on the largest health insurers or insurer groups in the nation: Aetna, CIGNA, Coventry, Wellpoint/Anthem, Humana (new to the survey this year), UnitedHealthcare and independent nonprofit Blue Cross and Blue Shield plans. Participants were asked to rate these companies on more than a dozen categories, from image and reputation to detailed contract negotiation and claims processing issues. In addition, participants were able to distinguish between their ratings of Anthem, Anthem-owned plans like Blue Cross Blue Shield of Georgia, and independent Blue Cross plans. The survey results are anonymous to protect hospitals from retaliation by health plans who may not have appreciated the criticism.
According to Steve Forbes, Republican, and owner of Forbes Magazine: National health care expenditures in the U.S. are large and rising. Health care costs currently comprise over 16% of U.S. gross domestic product and are forecast to reach more than 20% of GDP by 2018, according to the Centers for Medicare and Medicaid Services (CMS).
Expressed in terms of GDP, this is much higher than in countries with systems that deliver better overall health care outcomes--such as France. Health care spending is also projected to grow 2.1 percentage points faster than GDP from 2008 to 2018. Similarly, federal spending on Medicare will roughly double by 2018.
In order to afford President Barack Obama's ambitious plans to expand health care coverage--and pay for the broader reform proposals contained in his Feb. 26 budget outline--these costs must come down. To this end, reform advocates inside and outside the White House view tackling 'over-consumption' of health services as essential.
Supply-sensitive care. Research has shown that areas of high spending have more hospital beds, more physicians and more specialists per capita; and patients in high spending regions have more doctor visits and hospitalizations. The discretionary care that is provided more often in places with greater per capita medical care supply is termed 'supply-sensitive care'--because it is induced by elevated supply.
Crucially, supply-sensitive care is seemingly wasted--more services per patient do not generally lead to better access to care, higher quality of care or better health outcomes and can even lead to worse access, poorer outcomes and lower patient satisfaction.
Reform. Decreasing or eliminating supply-sensitive care could greatly reduce health spending without rationing beneficial care--an important lesson for policymakers, since U.S. voters see rationing as one of the worst elements of health care systems outside the U.S. There are several initiatives that could offer a way forward:
--Accountability. At present, no individual party--physician, hospital, etc--is directly accountable for the overall quality and costs of care, or for inefficiency in local capacity. Accountable care systems (ACSs) are entities responsible for integrating care for patients across providers (physicians, nurses, etc.) and settings (hospitals and nursing homes) over time. ACSs help to coordinate care and improve quality by designating a party that is accountable for outcomes.
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