GAO wants assessment of crowd-out under SCHIP
The General Accountability Office says the Centers for Medicare & Medicaid Services needs to upgrade its information on whether crowd-out should be a concern in states due to the State Children’s Health Insurance Program. Some states have raised concerns that individuals might substitute SCHIP for private health insurance - known as crowd-out. The GAO recommends that CMS ensure that states collect and report consistent information on whether SCHIP applicants have affordable private insurance available to them.
Seniors aren’t choosing best Medicare drug plans
A study from the Kaiser Family Foundation finds that most seniors enrolled in Medicare’s prescription drug benefit plan did not choose one of the lowest-cost drug plans offered in their area. The study used actual pharmacy claims experiences and premium and cost-sharing information about Medicare prescription drug plans to determine whether seniors chose the lowest-cost plan for them. The study found that only 6 percent of seniors chose the lowest-cost plan offered in their area in 2006.
Industry expert says P4P movement needs leadership
The healthcare industry broadly agrees that payment reform is key to healthcare reform, says Robert Galvin, MD, director of Global Healthcare for GE Corp, but the big questions are whether pay-for-performance, or P4P, will result in better value and who will lead the movement. Galvin warns that without coordination and input from the private sector, the healthcare industry runs the risk of growing chaos if payment rates are wildly different, which may lead to termination of pay-for-performance efforts.
BCBS of Michigan reports negative earnings for 2008
Blue Cross Blue Shield of Michigan reported a net loss of $144.9 million in 2008, which company officials blamed primarily on significant losses on individual policies. Daniel Loepp, BCBSM’s president and CEO, said Michigan’s “broken individual health insurance regulatory system” has seriously impaired the health insurer’s financial performance. He said individual policies offered by the company incurred a loss of $133.2 million last year. “The economy has challenged every business in Michigan,” said Loepp.