Entries by David Anderson

Convergence

Via @McKinsey: Low-price exchange plans ↑ premiums, high-price ↓. What you’d expect in a newly competitive market. pic.twitter.com/ThHgjFJsPf — Larry Levitt (@larry_levitt) September 24, 2014 The important thing to remember is that 2014 was a beta test year for Obamacare.  Some insurers went into the market with loss leader membership build strategies, others went in […]

Narrow networks aren’t new

A Modern Healthcare article has an extensive piece on initial Exchange consumer reaction to narrow networks.  Besides wanting better web directories, people are relatively happy with them. However there is a throw-away line at the end concerning the proliferatin of narrow networks on the commercial/employer sponsored insurance side of the business that I think is […]

Insurance companies as countervailing forces

The Incidental Economist’s Nicholas Bagley has a good set of comments on the New York Times great article on drive-by doctoring for massive out of network charges. First he looks at the current legal dynamics of contracts of adhesion for individuals and providers.  There is probably a theoretical course of corrective action for massive billing objections, […]

Tools to detect bullshit

At work, we received a response to a request for proposals that was incredible and fantastic.  I don’t mean that the proposal would save money, reduce confusion, reduce false denials and holds on services or even give a senior executive a suite full of nubile young women whose virtue had already been negoatiated.  I truly mean […]

Simple solution to Medicaid wait times

The Washington Post’s Wonk Blog reported on how people on Medicaid expansion felt about the program earlier this week: Medicaid enrollees are generally happy to have coverage, though many are encountering roadblocks to receiving the care they want, according to new research that provides one of the earliest insights into people’s experiences under the expanded […]

Early roll-outs for 2015 open enrollment

Just a couple of technical notes that are making me more confident about the roll-out of the Exchanges for the 2015 Open Enrollment period. Maryland is going to a window-shopping model:  The second year of Maryland’s health insurance marketplace for individuals and families begins on Nov. 9 when consumers will have access to a newly […]

Referee thoughts

Just a couple of thoughts as my coffee brews this morning. Why does Major League Baseball expect that all of their umpires will be at least competent at all four primary umpire positions?  First base is a very different skill set than calling the plate, and second base has a different set of expectations and […]