Entries by David Anderson

IUDs and future costs

Interuterine devices (IUDs) are now one of the two recommended forms of birth control for teenagers.  This is good news on multiple fronts as IUDs are extremely reliable, relatively inexpensive, and the woman controls her reproductive choices.  She does not need to worry about how long that condom had been in that wallet, whether or not he will […]

Pricing and the next best alternative

The Incidental Economist passes along a pair of interesting studies as to how Medicare pricing and provider reimbursement influences private payer provider reimbursement.  The short story is that over a long time period, private pricing imperfectly tracks Medicare pricing.  The longer story will be after the quotes:  Jeffrey Clemens, Joshua Gottlieb, and Adam Shapiro make […]

More on PreferredONE

Last week, I posted that PreferredOne, the largest insurer by membership on the Minnesota Exchange, was leaving the individual market.  They were losing money on the policy and I looked at some basic information and came to the following conclusions: It is not shocking though. I think a few things are happening. PreferredOne either was… […]

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 […]