Insuring Resources Commentary:
This is how Wisconsin can lead the way to show how efficient health care can be delivered. Health care reform must include incentives to providers to share their costs and quality outcomes to drive competition to more cost effective and quality care.
The WHIO Health Analytics Exchange announced today the launch of a database to assess health care quality, costs.
For more information visit WHIP at http://www.wisconsinhealthinfo.org/
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from the Milwaukee Journal Sentinel
Nov. 16, 2009 3:10 p.m. |
A 4-year-old collaborative effort to collect data from Wisconsin's insurers, hospitals, major employers and others has launched a database that can be used to analyze health systems' performance.
The WHIO Health Analytics Exchange contains information from millions of insurance claims and is being used by large medical groups, state government, business groups and other members of the Wisconsin Health Information Organization, said Julie Bartels, the organization's executive director.
The database shows, for example, that treatment for congestive heart failure in the Fox Valley and Madison costs significantly less than the statewide average, meaning those areas are much more efficient at caring for that disease, Bartels said.
Treatment for congestive heart failure costs slightly more in the Milwaukee area than the statewide average, the data show.
"The breadth of information in our repository is astounding," said Bartels, who will discuss Wisconsin's experience building the database Tuesday at an American Health Insurance Plans conference in Chicago.
"To us, the real opportunity is to look across all the claims aggregated here and get a picture of where we have cost-effective health care being delivered in Wisconsin, and where we have an opportunity to improve the cost-effectiveness of health care," said Karen Timberlake, secretary of the state Department of Health Services and a WHIO board member.
It's difficult to see trends when comparing a few heart attack treatments. But when you can look at thousands of procedures around the state, "it's really powerful," Timberlake said. "You start to see there are real differences in the way medicine is practiced."
That kind of information will help medical providers improve their care, said John Toussaint, president and chief executive of the ThedaCare Center for Healthcare Value in Appleton. If a provider discovers it is expensive or less efficient in a certain area, it "can either say, 'I'm going to put resources into this, or maybe not do it anymore,' " Toussaint said.
Ten founding members contributed $3 million to WHIO to develop the database, and six more fee-paying members have joined. The state contributed $1.55 million.
WHIO has given a three-year, $4.5 million contract to Ingenix, a health care information and research company, to manage the data warehouse and analyze the information. Ingenix is part of UnitedHealth Group Inc.
"We all know there is waste going on in health care, and it contributes to higher health care premiums," Timberlake said. "This is one way we in Wisconsin can work to hold down the cost."
Showing posts with label competition. Show all posts
Showing posts with label competition. Show all posts
Monday, November 16, 2009
Wednesday, October 7, 2009
Health Care Reform is like Watching Sausage Being Made
There's a popular saying in public policy circles and it goes something like this- Watching public policy being made or decided is like watching sausage being made. Its an ugly process filled with all kinds of questionable ingredients but in the end its hoped that it comes out tasting pretty good.
Well, health care reform sure has mirrored the process of making sausage. Let's hope what we get in the end is more Brat than wurst.
Here's a link to a New York Times story--
http://www.nytimes.com/2009/10/07/health/policy/07health.html?_r=2&emc=tnt&tntemail0=y
The article provides details on five individual senators and their widely different viewpoints/concerns on the Baucus Senate Bill that is getting the most attention and debate right now in the Senate Finance Committee. Four of these Senators are Democrats and Olympia Snowe is a Republican from Maine.
Legislation this huge and complex will definitely cause individual legislators, not to mention the American public, to have a wide variety of opinions on the legislation as a whole. Each individual Senator may also view the bill as having ten things they like and want and an equal number they cannot live with or vote for.
Below are excerpts from the article providing those Sentaors' individual concerns related to the bill.
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Sen. Rockefeller D- W.V. - he's upset that a health care bill poised for approval by the Finance Committee would turn nearly a half-trillion dollars over to insurance companies, whose profits he says are “out of sight.” He went on to say that, "It’s an imperfect bill, with a lot of pluses and minuses.”
Sen. Snowe R- Maine -- She worries that the bill would require people to buy insurance they cannot afford. Ms. Snowe’s views reflect the concerns of many centrist Democrats. She worries that some middle-income families will find insurance unaffordable, even with federal subsidies. And she wants to give the private insurance market an opportunity to work, under new federal rules, before setting up a government plan in states where affordable coverage proves unavailable.
Sen. Lincoln D- AR-- She fears that the bill would be too costly for the government.
Sen. Wyden D- OR -- He warns that the bill would lock many workers into health plans selected by their employers, without allowing them to shop for better, cheaper plans, an alternative that could help drive down costs for everyone. Wyden noted that the committee’s bill would not offer additional options to the overwhelming majority of Americans who already have insurance. His concern is shared by some Democrats and also by many Republicans, who say the bill does not do enough to let the marketplace spur competition.
Sen. Ben Nelson D- Nebraska, says he believes the "laboratories of democracy typically work,” -- it might make sense for states to act as a testing ground for a public option. Rockefeller said this approach was unacceptable to him. State health plans would not be strong enough to compete effectively with big private insurance companies, he said.
Well, health care reform sure has mirrored the process of making sausage. Let's hope what we get in the end is more Brat than wurst.
Here's a link to a New York Times story--
http://www.nytimes.com/2009/10/07/health/policy/07health.html?_r=2&emc=tnt&tntemail0=y
The article provides details on five individual senators and their widely different viewpoints/concerns on the Baucus Senate Bill that is getting the most attention and debate right now in the Senate Finance Committee. Four of these Senators are Democrats and Olympia Snowe is a Republican from Maine.
Legislation this huge and complex will definitely cause individual legislators, not to mention the American public, to have a wide variety of opinions on the legislation as a whole. Each individual Senator may also view the bill as having ten things they like and want and an equal number they cannot live with or vote for.
Below are excerpts from the article providing those Sentaors' individual concerns related to the bill.
---------- -------------- --------------
Sen. Rockefeller D- W.V. - he's upset that a health care bill poised for approval by the Finance Committee would turn nearly a half-trillion dollars over to insurance companies, whose profits he says are “out of sight.” He went on to say that, "It’s an imperfect bill, with a lot of pluses and minuses.”
Sen. Snowe R- Maine -- She worries that the bill would require people to buy insurance they cannot afford. Ms. Snowe’s views reflect the concerns of many centrist Democrats. She worries that some middle-income families will find insurance unaffordable, even with federal subsidies. And she wants to give the private insurance market an opportunity to work, under new federal rules, before setting up a government plan in states where affordable coverage proves unavailable.
Sen. Lincoln D- AR-- She fears that the bill would be too costly for the government.
Sen. Wyden D- OR -- He warns that the bill would lock many workers into health plans selected by their employers, without allowing them to shop for better, cheaper plans, an alternative that could help drive down costs for everyone. Wyden noted that the committee’s bill would not offer additional options to the overwhelming majority of Americans who already have insurance. His concern is shared by some Democrats and also by many Republicans, who say the bill does not do enough to let the marketplace spur competition.
Sen. Ben Nelson D- Nebraska, says he believes the "laboratories of democracy typically work,” -- it might make sense for states to act as a testing ground for a public option. Rockefeller said this approach was unacceptable to him. State health plans would not be strong enough to compete effectively with big private insurance companies, he said.
Monday, August 17, 2009
Important News about Insurance Agents and the Public Plan Option
Agents Win Key Health Reform Provision
As reported by National Underwriter, insurance agents have won a critical change in the House Energy and Commerce Committee version of healthcare reform legislation.
Through language negotiated by conservative Democrats as the House prepared to leave July 31, agents won explicit authority to sell within the health insurance exchanges that would be created under the legislation.
The provision in the bill reported out by the E&C Committee would also give agents the authority to sell the so-called public plan in the event that such entities are created under the final version of the legislation, according to officials of the Independent Insurance Agents and Brokers of America.
The key amendment to the E&C bill was added at the request of Rep. Charlie Melancon, D-La., Rep. Baron Hill, D-Ind., and Mike Ross, D-Ark., according to IIABA officials.
Other provisions sought by agents included in the E&C bill would double the small-business exemption from the employer mandate to $500,000 in payroll, from the former $250,000, and would add language explicitly allowing the creation of cooperatives, although the public plan is still in the bill.
They also cautioned that House Democratic leadership has given “no assurances” that the final bill that goes to the House floor in September would contain the provisions. That is because the E&C bill must be reconciled with versions of the legislation reported out by the House Ways and Means Committee and the Education and Labor Committee.
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As I said in an earlier blog the public plan option would be unfair competition to private health plans IF agent commissions and other items like advertising costs were not included in the public plan option's costs. Now it seems possible that the public plan option may provide a fair competitor to private plans. It all depends on what happens in the conference committees which reconcile differences in the various bills that are passed by the House and Senate committees.
Stay tuned and participate in the debate on your health care future...
As reported by National Underwriter, insurance agents have won a critical change in the House Energy and Commerce Committee version of healthcare reform legislation.
Through language negotiated by conservative Democrats as the House prepared to leave July 31, agents won explicit authority to sell within the health insurance exchanges that would be created under the legislation.
The provision in the bill reported out by the E&C Committee would also give agents the authority to sell the so-called public plan in the event that such entities are created under the final version of the legislation, according to officials of the Independent Insurance Agents and Brokers of America.
The key amendment to the E&C bill was added at the request of Rep. Charlie Melancon, D-La., Rep. Baron Hill, D-Ind., and Mike Ross, D-Ark., according to IIABA officials.
Other provisions sought by agents included in the E&C bill would double the small-business exemption from the employer mandate to $500,000 in payroll, from the former $250,000, and would add language explicitly allowing the creation of cooperatives, although the public plan is still in the bill.
They also cautioned that House Democratic leadership has given “no assurances” that the final bill that goes to the House floor in September would contain the provisions. That is because the E&C bill must be reconciled with versions of the legislation reported out by the House Ways and Means Committee and the Education and Labor Committee.
------
As I said in an earlier blog the public plan option would be unfair competition to private health plans IF agent commissions and other items like advertising costs were not included in the public plan option's costs. Now it seems possible that the public plan option may provide a fair competitor to private plans. It all depends on what happens in the conference committees which reconcile differences in the various bills that are passed by the House and Senate committees.
Stay tuned and participate in the debate on your health care future...
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