Report That Finds Sharp Increase In Commercial Health Care Prices Highlights Geographical

first_img One health plan from a well-known insurer promises lower premiums but warns that consumers may need to file their own claims and negotiate over charges from hospitals and doctors. Another does away with annual deductibles but requires policyholders to pay extra if they need certain surgeries and procedures. Both are among the latest efforts in a seemingly endless quest by employers, consumers and insurers for the holy grail: less expensive coverage. (Appleby, 3/13) Report That Finds Sharp Increase In Commercial Health Care Prices Highlights Geographical Differences In Costs “That fact that you could be paying 2.5 times more for the same healthcare services in San Jose than in Baltimore suggests there is a lot of variation in prices across the country,” said Bill Johnson, lead author of the report. Meanwhile, Humana launches a bundled-payment model for some Medicare Advantage members. Cambia Health Solutions, operator of the Regence BlueCross health insurance operation in Oregon and three other states, is affiliating with a slightly larger health plan in North Carolina. Cambia and Blue Cross and Blue Shield of North Carolina will combine their boards of directors and certain management and administration functions but will remain separate not-for-profits. No money changed hands. The new entity will be called Cambia Health Solutions. (Manning, 3/12) Modern Healthcare: Spinal Fusion Bundled-Payment Model Launched By Humana Humana launched a new bundled-payment model for Medicare Advantage members who undergo spinal fusion surgery, the insurer announced Tuesday. The model, which includes four independent physician practices participants, is the third bundled-payment model for the Louisville, Ky.-based insurer. Physicians enrolled in the model will receive bonuses based on their costs and quality performance on the two most common types of spinal fusion surgery: lumbar and cervical. (Castellucci, 3/12) In other health industry and insurer news — Dr. Patrick Conway will become CEO of Portland, Ore.-based company Cambia Health Solutions in addition to maintaining his current role as CEO of Blue Cross and Blue Shield of North Carolina, the companies announced Tuesday. The move is part of a so-called strategic affiliation between the two not-for-profit companies, in which they will share management, administrative, operational and other corporate services under a long-term services management agreement under the Cambia name. (Livingston, 3/12) Commercial healthcare prices in metro areas are rising while usage is falling, according to a new analysis. Prices increased 13% as utilization dropped 17% from 2012 to 2016, a new iteration of the Health Care Cost Institute’s analysis of more than 1.8 billion commercial claims revealed. Metro areas with higher prices tended to have lower use, and vice versa, HCCI researchers found. (Kacik, 3/12) Modern Healthcare: Blues North Carolina CEO To Lead Cambia Health In Affiliation Kaiser Health News: New Health Plans Expose The Insured To More Risk This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. The Associated Press: Blue Cross Insurers In N. Carolina, Oregon To Mix Leadership Two Blue Cross Blue Shield insurers on both U.S. coasts will invest jointly in high-cost management technology and share insights into improving health care in a long-term agreement that will leave the companies as separate entities. Blue Cross Blue Shield of North Carolina and Portland, Oregon-based Cambia Health Solutions said Tuesday that they will share top executives but will keep separate their assets and insurance policies. Cambia’s new board will be mixed. (3/12) The parent company of Illinois’ largest health insurer, Blue Cross and Blue Shield of Illinois, made a profit of $4.1 billion last year – more than three times as much as it did the year before, according to recent financial statements. Much of that increase was driven by $1.7 billion the company got back from the federal government last year because of changes made under the new tax law. Blue Cross’ parent company, Health Care Service Corporation, operates health insurance plans in five states, including Illinois, and is based in Chicago. (Schencker, 3/12) Chicago Tribune: Blue Cross And Blue Shield Of Illinois Parent Company Tripled Its Profit To $4.1 Billion Last Year Modern Healthcare: Commercial Healthcare Prices Outpace Inflation Threefold The Oregonian: Oregon Health Insurance Giant Cambia Finds Partner 2,800 Miles Away last_img

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