Posts Tagged ‘health insurance companies’

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Group Health Takes A Hit: Humana Latest To Announce Job Cuts

Wednesday, February 17th, 2010

Little more than a month after Philly-based Aetna announced it would lay off an additional 1,250 workers after it issued a similar pink slip notice to 900 employees last November, Humana announced today it would be cutting 2,500 people from its payrolls after losing 11 percent of its enrollments in group health plans. The layoffs amount to about 5 percent of its workforce.

In making the announcement, Aetna president and CEO Michael McCallister said, “This regrettable but necessary reduction in our work force is a direct result of Humana’s need to align the size of our company with that of our membership.”

Humana said most of the cuts would come from attrition, outsourcing some of its business functions and not filling open positions, but told investors it expects to ramp up operations in Medicare and its mail-order pharmacy unit; both of which posted stronger financial results. For the quarter ending December, 2009, Humana posted a 44 percent profit, mostly attributed to growth in its Medicare business.

The move comes at a pivotal time for group health insurance companies, as leading economists and Wall Street analysts report that the U.S. economy is starting to show signs of job growth while Congress is scrapping its health care reform initiatives and starting over. Industry observers expect the U.S. government to introduce changes to the health insurance industry that would, in effect, make it more affordable for individuals to purchase individual and family health insurance policies directly from carriers and brokers. If passed, the change is likely to put an even larger financial dent in the group health insurance market.

Insurers that issue work-based health insurance plans have struggled over the past year to increase revenues, as the economic recession continues to wipe away jobs from the private sector. In addition to the job cuts at Humana and Aetna, other health insurance companies that specialize in group plans; such as CIGNA and Wellpoint, have eliminated more than 1,000 jobs in the past year. President Obama recently announced new banking and grant programs aimed at small business owners in hopes of staging a revival in the national job market.

Anthem Blue Cross of California, among other health insurance plans administered by Wellpoint, announced today it would cancel its previously announced investor conference that had been scheduled next Tuesday so it could prepare for a Congressional hearing prompted after the company said it would hike insurance premiums by 38 percent in May.

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Health Insurance Web Searches Spike, Says ComShare

Tuesday, February 16th, 2010

If there ever was a proof-positive sign the economy and its lingering layoffs are driving people to find their own health insurance plans, this is a big one.

ComScore, the people who measure all-things-online (working behind the iron curtains at Google, Yahoo! and other search engines) just released a study of online health insurance activity in 2009. The study found that nearly 24 million Americans visited a health insurance company Web site during the fourth quarter of 2009, representing 10 percent of the total U.S. online population.

Aetna led the pack of health insurance companies that attracted the most traffic with nearly 5 million visitors during October, November and December of 2009, followed by Blue Cross Blue Shield sites with 4.1 million visitors (17.4 percent penetration). Kaiser Permanente clocked in with 3.1 million; UnitedHealthcare snatched 2.2 million visitors; CIGNA got 2.6 million and Wellpoint sites attracted a combined count of 2.2 million homepage hits.

All things considered, the Web is growing as the primary source of information people turn to first about everything. Internet searching has grown to 175 million per hour, according to comScore stats. In December 2009 alone, there were 131 billion Internet searches conducted around the globe. Health insurance companies comprise a small piece of the whole Internet search world, but significant nonetheless.

“Consumers are increasingly turning to the Internet as one of their first destinations to research health insurance, whether it is gathering information to evaluate options or seeking answers to questions concerning their current provider,” said comScore director Susan Engleson in a press release accompanying the stats. “Having a strong online presence serves as both a gateway to consumers as well as an important branding opportunity for health insurance organizations.”

A Stanford University study following some 66,000 Americans and their use of the Internet for individual health insurance found very similar results. An excerpt of “Consumers’ Use of the Internet for Health Insurance” reveals greater opportunities for health insurance companies to attract more traffic to their Web sites:

“Analysis of Internet applications for consumer health has focused on the extent to which people use the Internet for information about health and healthcare. The role of the Internet in the relationship between consumers and health plans has received considerably less attention. Nevertheless, the potential impact of Internet applications in this area is large. Health insurance is a complex and information-intensive product, requiring extensive coordination among consumers, patients, insurers, and providers. In theory, consumers, purchasers, and health plans could benefit substantially from technological innovation that either improved the ability of consumers to obtain information about the types of health insurance available to them or reduced the cost or increased the quality of health insurance products.”

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Outcomes Driven Medicine: UnitedHealthcare Speeds Ahead

Wednesday, February 10th, 2010
The buzz in health care for hospitals and health insurance companies these days is outcomes- and evidence-based medicine. If the deepest cost-cutting proposals of health care reform on the table in D.C. come  to pass, doctors, hospitals and essentially any company that delivers direct medical care services could eventually be held to a set of standards set by companies who compile results of controlled research studies about patient protocols and disease management practices that deliver the best possible physical outcome.

Under this system, if a doctor doesn’t follow the protocols, medical health insurance companies don’t pay the bill.

UnitedHealthcare became the first major health carrier to announce its intent to dollect data from doctors and share it amongst all their contracted providers. Beginning today, United’s Oncology Care Analysis is aggregating data from more than 2,600 oncologists and 8,600 patients diagnosed with breast, colon or lung cancer. After the data is analyzed against an alliance of 21 participating U.S. cancer centers, known as the National Comprehensive Cancer Network (NCNN), it’s distributed to United’s network providers as a soft mandate at this point in time, to follow the recommendations when treating patients with similar medical demographics.

United is billing the reports as a way to help improve the quality of cancer care by showing how well a particular patient is complying with their medications or sharing inromation about procedures performed by other specialists. At this point, the medical sata sharing initiative will be limited to United’s cancer patient group — which accounts for $2.5 billion of United’s annual spending.

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Anthem Blue Cross Hikes Rates By A Third In California

Tuesday, February 9th, 2010
One of California’s biggest health insurance carriers, Anthem Blue Cross, will increase  its individual health insurance premiums by nearly 40 percent starting next month.

The announcement came within hours of the Obama Administration’s call for Congressional Republicans and members of his own party to meet at the White House for a televised summit on moving forward with health care reform. President Obama appeared to use the announcement as political proof that health care reform is “essential,” while his Secretary of Health and Human Services denounced the insurance carrier in a statement later in the say.

“As we continue the health insurance reform debate in Washington, this announcement reminds us that too many Americans can be left with unaffordable insurance each time the rates of rules change in the private market,” said Sebelius. “It’s clear that we need health insurance reform that will give American families the secure, affordable coverage they need.”

Meanwhile back in Anthem’s home state, California Insurance Commissioner Steve Poizner publicly scathed the company and urged individuals looking for affordable health insurance plans to compare rates with other carriers. Poizner said he was “Alarmed” by the larger-than-expected rate increase and said his department would examine Anthem’s actions in the coming days.

Health insurance is regulated in the individual states where they are sold. In Calfornia, state law requires that health insurance companies spend at least 70 percent of every dollar earned from their premiums on medical care. Poizner said he has hired an outside actuary to review Anthem’s increase “to ensure they are complying with this state law. If we find that their rates are excessive, I will use the full power of my office to being these rates down.”

Complicating Anthem’s justification for the increase, its parent company, Wellpoint Inc. announced it had earned $2.7 billion during the previous business quarter. Neither Anthem nor Wellpoint made a public statement to the news media about its rate plan at the time this story was published.

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Insurance Without Borders: Will Buying Health Plans Across State Lines Help?

Monday, February 8th, 2010

With health care legislation on perpetual pause in Congress, Republicans are proposing some new ideas for getting the deal done. From hybrid health insurance exchanges to mandates requiring everyone to be covered, the debate has shifted to what is likely to close the debate and get a bill on the President’s desk: allowing Americans to buy health coverage across state lines.

Currently, people can buy health policies only from health insurance companies licensed by the states in which they live. This is why you find, for instance, Blue Cross and Blue Shield plans that are essentially privatized entities incorporated and sold exclusively in the states in which they are sold. Auto and home insurers have used this same approach for years.

Remember when Allstate and its Good Neighbor competitor dropped coverage on houses in hurricane-prone Florida and other coastal states? Insurance companies can cut bait in states where they have a subsidiary company underwriting their policies. Allstate wasn’t writing your policy, Mr. Homeowner. It was Allstate Floridian – a separate, but equally capitalized company that was set up to take cover when floods rolled in.
The Republican idea of buying health insurance across state lines has been altered a bit, but it is incorporated into the Democrats’ House and Senate bills, and expected to be the centrepiece of any health care legislation that wins final passage.

Congressional Republicans have proposed the concept in the past and Sen. John McCain, R-Ariz., embraced it as part of his 2008 presidential campaign. Advocates — including some insurers and small business groups — say it would give the more than 17 million Americans who buy individual coverage a greater choice of plans and the possibility of lower prices.

But critics, including the National Association of Insurance Commissioners say the provision would erode state government consumer protections, leave policyholders with inadequate coverage and could actually lead to higher premiums for some people. On the flip-side, allowing people to buy health insurance from any company regardless of where they call home would encourage competition for your business. That usually leads to lower prices and, in effect, more affordable health insurance for all.

Regardless of what Congress decides to do about health care reform, there are options readily available. Insurance companies report an increase in short term health insurance which in essence, provide guaranteed coverage for major medical expenses for a pre-determined amount of time. With the rise in unemployment and prospects of new job growth ever-stagnant, we can expect to see short term medical plans grow in popularity and affordability.

No matter how you slice it, insurance by its very nature is risk. Risk breeds fear. Fear breads inaction.
Critics say that selling insurance across state lines might not save much money, and point to a 2005 CBO report that says: “if only those benefit mandates imposed by the states with the lowest-cost mandates were in effect in all states, the price of individual health insurance would be reduced by about 5 percent, on average.”
But when you consider the cost of a major medical insurance plan for a chronically ill individual can approach an average of $400 per month, that 5 percent “on average” is money in the bank.

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Pharmacy Profits Up In Down Economy

Monday, February 8th, 2010

Investor backlash over its aggressive acquisition and merger strategy in recent months, CVS Caremark Corp (CVS.N) said recent problems at its pharmacy benefits management unit have been corrected and it posted a slightly better-than-expected rise in quarterly profit, driving the company’s shares up as much as 8.8 percent. CVS also said 2010 earnings could top analysts’ views.

Just three months ago, CVS shocked investors when it said the pharmacy benefits business (formerly Caremark) which administers prescription drug benefits for employers and health insurance companies and operates a large mail-order pharmacy, lost out on about $4.8 billion of business heading into 2010, leading to the departure of the unit’s president. Investors appeared to be unconcerned that total sales missed analysts’ projections, as sales at its retail drugstores that have been open at least a year far outpaced recent results at larger rival chain Walgreen Co (WAG.N).

CVS Chief Financial Officer Dave Denton told Reuters during the earnings conference call that consumers were still “very cautious” with regard to their spending, which could affect CVS stock value in future quarters.

Retail pharmacies are taking a hit on in-store, non-drug items as the current economic recession continues to drag. Non-drug items like groceries, photo finishing and the like account for more than one half of a typical pharmacy’s profit. Last week, Walgreen posted its second consecutive monthly drop in same-store sales, with January falling 1.1 percent, while smaller Rite Aid Corp’s (RAD.N) same-store sales have fallen for eight months in a row.

CVS had no new comments about the U.S. Federal Trade Commission’s investigation into some of its business practices, which followed its acquisition of Caremark.

CVS and Walgreens have recently launched retail medical clinics in many of their locations to participate in insurance company networks that pay benefits on individual and group health insurance plans when walk-in, immediate care clinics are used for routine medical care. The clinics were very popular during the recent U.S. H1N1 Flu outbreak when vaccines were made available at CVS, Walgreens and other retail drug chains.

A study issued last week by labor consortium Change to Win, which pushed for the FTC to examine the CVS and Caremark merger, said CVS charges the U.S. government more for some generic drugs than participants in its retail generic discount program pay. Denton, who called the report “a lot of rhetoric,” said the government is pleased with CVS’s pricing and service. Other major mail order pharmacy programs have since revised their pricing structures, offering similar discounts on refills regardless of whether a generic is substituted for a name brand prescriptions.
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California Insurance Chief Recovers $112 Million

Friday, February 5th, 2010

California’s state budget woes just got a bit of a boost from its State Department of Insurance.

Steve Poizner, the California State Commissioner of Insurance announced Friday that his office has successfully recovered nearly $113 million in 2009 from consumer claims of fraud and misconduct amongst the state’s insurance companies and independent agents successfully prosecuted for their crimes. Poizner claims this is the most money ever recovered by the office under any previous insurance commissioner. The state recovered about $62 million from health insurance companies, consumer fraud investigations and insurance brokerages in 2008.

Made up of two separate divisions, California’s Department of Insurance’s Consumer Services and Market Conduct branches recovered about a fourth of the money reportedly put back into the state’s coffers after closing wildfire-related insurance auditing cases that lingered from 2007 and 2008. The Market Conduct Division, which regulates health insurance companies alongside property and automobile insurers, recouped $23 million.

Poizner is in the midst of a heated race between former eBay executive Meg Whitman to replace current Governor Arnold Schwarzenegger for the Republican nomination. Chuck DeVore, a relative unknown state assemblyman from Orange County is also running for the office. The heated race has led to claims that Poizner himself may have benefitted from his elected office. Among other accusations from his opponents, last month, the San Jose Mercury News and Associated Press reported that a relative of Poizner is accused of submitting inflated claims for auto insurance repairs and pocketing the difference.

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So Much For Socialized Medicine – Canadian PM Heads To U.S. For Surgery

Thursday, February 4th, 2010

In a move destined to become fodder for late night talk shows, not to mention both Houses of Congress, Newfoundland Canadian Premier Danny Williams will undergo heart surgery later this week in the United States, according to the Canadian News Network and the National Post newspaper there.

Deputy premier Kathy Dunderdale confirmed the treatment at a news conference Tuesday, but would not reveal the location of the operation or how it would be paid for.

“He has gone to a renowned expert in the procedure that he needs to have done,” said Dunderdale, who will become acting premier while Mr. Williams is away for three to 12 weeks.In consultation with his own doctors, he’s decided to go that route.”

Mr. Williams’ decision to leave Canada for the surgery has raised eyebrows over his apparent shunning of Canada’s socialized health care system, a model for which the Obama Administration has been pushing for at the resistance of Congress and national polls indicating the majority of U.S. citizens do not support reforming the health care industry, nor further regulation of health insurance companies.

“It was never an option offered to him to have this procedure done in this province,” said Dunderdale, refusing to answer whether the procedure could be done elsewhere in Canada.

Mr. Williams, 59, has said nothing of his health in the media. “The premier has made a commitment that once he’s through this procedure and he’s well enough, he’s going to talk about the whole process and share as much detail with you as he’s comfortable to do at that time,” she said.

“Canada: The Land of Health Care So Awesome That Its Politicians Undergo Surgery in the United States,” one American Pundit wrote sarcastically in reaction to the National Post story.

“Canada keeps its costs down, in part, by neglecting the expensive business of advanced specialty care knowing that the U.S. is next door to help,” wrote a commenter in a USpoliticsonline forum.

Dunderdale wouldn’t say where in the U.S. Mr. Williams is seeking treatment.

A popular Progressive Conservative premier, Mr. Williams has also seen his share of controversy. During the 2008 federal election, Mr. Williams vehemently opposed the Conservative government, launching his “Anything But Conservative” — which has been credited with keeping the Tories from winning any seats in the province. He’s also drawn criticism for his support of seal hunting.

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Health Insurance Scams: Foreclosure “Help” Part II?

Tuesday, February 2nd, 2010

It’s a sad reality, but when a national crisis takes hold, so too do shady figures willing to create a business opportunity.

Last year, when home foreclosures and unemployment created the perfect storm for American Dream melt-down for many Americans, business licenses were also hitting record highs. Many of them were issued to “foreclosure specialists,” attorneys and legal defense funds with questionable integrity looking to cash in on desperate homeowners with seemingly nowhere to turn but the first billboard or web banner ad promising to save their homes. And cash in they did.

Usually the scam went something like this: Homeowner behind on payments calls toll-free number. Seemingly caring professional promises to help, sometimes giving false guarantees that they won’t be forced out of their homes. Homeowner sends certified check to foreclosure firm at temporary post office box as a “retainer,” held until foreclosure firm begins negotiations with mortgage company. Check received by firm. Phone number disconnected. Web site removed. Homeowner savings gone, Sheriff arrives at front door.

Until states like New York (known for their tough records consumer protection laws and of successful prosecutions for breaking them) started a very public crack-down on these foreclosure schemes late last year, coupled with the federal government’s scramble to crack down on mortgage companies sitting on mountains of paperwork, foreclosure “help” was the biggest business out there for the scheming entrepreneur. Of course, there are still many of them out there fully staffed with hungry self-starters in windowless call centers. But they’re not growing as much.

Attribute it to the recovering housing market or the fact that more mortgage companies are willing to make a deal, but foreclosure defense scams are dropping from the public radar in favor of the next big crisis: The perceived lack of affordable health insurance.

Chances are, the same guys who promised to save your home from being taken over by the bank may be calling you or netting you on the Internet with promises of guaranteed health insurance benefits from some companies that sure sound legit. Consider some of the companies who bankrolled insurance premiums from hundreds of people who were either denied coverage from major health insurance companies or couldn’t afford the plans: In Missouri, “Americans for Affordable Healthcare, Inc.,” “Key Benefits Administrators, Inc.,” and “Serve America Assurance, Ltd.” were among several other outfits who sold great sounding policies with affordable group health insurance rates. But they weren’t worth the paper they were written on — if there was any paper at all.

The Missouri Department of Insurance filed a motion to haul 12 of the individuals behind some 14 fake health insurance companies to face charges they defrauded Missouri residents out of $2,000 each for a “membership” in their insurance plan. One consumer, according to the St. Louis Post Dispatch, wound up with a $60,000 medical bill after he realized his policy was little more than a poker chip on a scammer’s table.

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Blue Cross Blue Shield Breaks Immediate Care Barrier

Friday, January 29th, 2010

Blue is now taken at Take Care.
Blue Cross and Blue Shield of Florida announced this week that effective right away, its four million subscribers can receive benefits under their health insurance plan for medical services provided at Take Care Health Health Systems immediate care centers located inside Walgreens drug stores throughout the state of Florida. With more than 80 percent of all insured Floridians now covered under BCBS health insurance plans, Walgreens is looking to boost visitors to its Take Care locations in hopes of creating a one-stop-shop for medical care.

Walgreens is rapidly playing catch-up in the trend toward walk-in medical care as its top competitor, CVS is rapidly boosting its retail healthcare presence in the Florida market. CVS’ MinuteClinic walk-in health care chains first started popping up inside its own pharmacies in 2002. The clinics boast over 4 million visits and accept health insurance coverage from most of the major health insurance companies in the nation. Last month, MinuteClinic announced it would begin accepting Humana insurance plans.

Insurance companies and medical care providers are encouraging patients to seek out medical care at so-called immediate care centers as a method of reducing overall healthcare delivery costs. When compared to a typical visit to a private physician or an emergency room, retail walk-in clinics are usually cheaper to use as they are typically staffed by nurses and nurse practitioners and confine their treatment to minor illnesses and injuries.

Health insurance companies are taking a cue from the retail pharmacy industry by becoming more of a retail brand themselves. Blue Cross Blue Shield of Florida is building a chain of its own “Blue” locations throughout the state. Initially, the insurance giant plans to provide consumer advice and consultations about its insurance plans. Nurses will also be available at the stores to provide simple physical exams and other routine medical care provided for under family health insurance. Look for BCBS to open new stores in Ft. Lauderdale, Miami, Jacksonville, Tampa and Orlando soon.

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