cmonfils | March 19, 2012
Source: Agency for Healthcare Research and Quality (AHRQ), 3/5/2012, www.ahrq.gov
A new study, entitled “An Experiment Shows That a Well-Designed Report on Costs and Quality Can Help Consumers Choose High-Value Health Care,” has been funded by HHS’ Agency for Healthcare Research and Quality (AHRQ) and appears in the March issue of Health Affairs. (more…)
cmonfils | March 12, 2012
Three cheers for Susan Feigin Harris of Baker & Hostetler LLP, for her report on “Health plan flexes its muscle: providers face out-of-network challenges” … You’ll definitely want to read this article, posted on the Association of Corporate Counsel’s website, http://www.lexology.com/19415/author/Susan_Feigin_Harris/.
This article addresses such hot topics as out-of-network discounts provided by physicians and other facilities, patient financial obligations, and the hallmarks of managed care – volume and steerage in the creation of tightly managed delivery networks – and freedom of choice and medical professional decision-making. The article uses as its springboard a lawsuit filed by Aetna, regarding the provision of out-of-network care and the various parameters associated with the delivery of such care, but covers a lot of ground. A great read worth your time.
cmonfils | May 27, 2011
May 26, 2011 By Liz Kowalczyk, Globe Staff
A new report from Governor Deval Patrick’s administration documenting what hospitals are paid for common procedures reveals some eye-opening differences in price. Also noteworthy is that even routine procedures, like removal of the appendix and gallbladder, are concentrated in the highest-priced hospitals, pushing up health care costs even more. (more…)
cmonfils | May 1, 2011
www.cnn.com By Amanda Gengler April 25, 2011
(MONEY Magazine) — Rising medical costs hobbled General Motors and Chrysler, and they’re swallowing up state budgets. The country’s long-term financial prognosis is grave largely because of health care entitlements.
And if you haven’t gotten a raise lately, you can partly blame the spike in your employer’s insurance premiums, up 9% since last year, according to Aon Hewitt. Even if you did get a raise, you probably didn’t keep much of the cash: The same survey found that out-of-pocket health costs rose more than 12%. (more…)
cmonfils | April 25, 2011
All of you have undoubtedly dealt with a situation where there are only a few hospitals in a region, and they abuse that fact liberally. This dispute, which was recently settled in Texas, is titled United States of America and State of Texas v. United Regional Health Care System, 2011 WL 846762 (N.D.Tex.). You will recognize the story, as it has certainly happened to you, too! (more…)
cmonfils | April 22, 2011
2011 WL 846762 (N.D.Tex.) (Trial Pleading) United States District Court, N.D. Texas. Wichita Falls Division UNITED STATES OF AMERICA and State of Texas, Plaintiffs, v. UNITED REGIONAL HEALTH CARE SYSTEM, Defendant.No. 7:11CV00030.
February 25, 2011.
Complaint
For Plaintiff United States of America, Christine A. Varney, Assistant Attorney General for Antitrust. Joseph F. Wayland, Deputy Assistant Attorney General. Patricia A. Brink, Director of Civil Enforcement. Joshua H. Soven, Chief, Litigation I Section. Peter J. Mucchetti, Assistant Chief, Litigation T Section. Scott I. Fitzgerald (WA Bar #39716), Andrea V. Arias, Amy R. Fitzpatrick, Adam Gitlin, Steven B. Kramer, Richard Liebeskind, Richard D. Mosier, Mark Tobey, Kevin Yeh, Attorneys for the United States, United States Department of Justice, Antitrust Division, Litigation I Section, 450 Fifth Street, N.W., Suite 4100, Washington, DC 20530, Telephone: (202) 353-3863, Facsimile: (202) 307-5802. For Plaintiff State of Texas, Greg Abbott, Attorney General of Texas. Daniel T. Hodge, First Assistant Attorney General. Bill Cobb, Deputy Attorney General for Civil Litigation. John T. Prud’homme, Jr., Chief, Antitrust Division, Office of the Attorney General, 300 W. 15th St. 7th floor, Austin, TX 78701, Telephone: (512) 936-1697, Facsimile: (512) 320-0975.The United States of America, acting under the direction of the Attorney General of the United States, and the State of Texas, by and through the Texas Attorney General, bring this civil antitrust action to enjoin defendant United Regional Health Care System (“United Regional”) from entering into, maintaining, or enforcing contracts with commercial health insurers that effectively prevent those insurers from contracting with United Regional’s competitors, in violation of Section 2 of the Sherman Act, 15 U.S.C. § 2, and to remedy the effects of its unlawful conduct. Plaintiffs allege as follows: (more…)
cmonfils | April 21, 2011
Hospitals with significant market dominance in their local areas may want to review their contracts with insurers in light of recent statements—and now action—on the part of antitrust enforcers with President Barack Obama’s administration.
“Let me be clear,” Assistant Attorney General Christine Varney warned five months ago when announcing an antitrust lawsuit against a Michigan health insurer. “We will challenge similar anti-competitive behavior anywhere else in the United States.” (more…)
cmonfils | April 11, 2011
Below are several bills that have been filed in the 2011 Legislative Session that are of interest to TABA members, with a brief description of each bill. This includes TABA’s bill on pricing disclosure, HB 2430.
TABA has a short video to promote HB 2430. To view the video go to:
http://pricedisclosure.blogspot.com
Ater viewing the video, you can click to support the bill. Please forward the link to your co-workers and clients. We would like to show as much support for the bill as possible before it comes up for vote. (more…)
cmonfils | April 5, 2011
Please see the following that has been passed on by Robyn Jacobson, President, Texas Association of Benefits Administrators.
For those of you interested in how the market is becoming innovative in health pricing, please take a moment to look at the link below. This is a twist on price disclosure tha t is structured like “priceline” where patients post medical procedures they need and then physicians can bid on them. Also, www.castlighthealth.com is another web company that is tracking provider pricing for the consumer and just received $81m in venture cap ital investments.
