From the Headlines: AMA Issues Report Card on Insurers - and Costs are Going Up

Perhaps spurred by the recent trend of insurance companies rating physicians on a variety of performance measures, the docs are getting even. The American Medical Association released their first report card on insurers. They reviewed Medicare and seven national commercial health insurers, focusing primarily on the accuracy and timeliness of payments. They based their findings on a random sampling of 3 million claims.

Medicare came out on top - with 98% of the services billed being paid. UnitedHealthcare had the lowest rating, with only 62% being paid at the contracted rate.

The article claims that 14% of a physician's total revenue is spent trying to get paid. You can read the full story here.

In another report, a "study by PriceWaterhouseCoopers predicts that medical costs will increase 9.9 percent in 2008 and an additional 9.6 percent in 2009." More than 500 employers and health plans were surveyed for this report.

Dr. David Chin, leader of the Health Research Institute at PriceWaterhouseCoopers said, "Health care providers, insurers and employers will have to monitor medical costs carefully if we are to avoid a resurgence of the double-digit annual increases seen in the past." You can read this story here.

Passing off the increases to employers and/or the insured will not be a sustainable solution, in my humble opinion. With the current state of the economy - record high gas prices and the cost of groceries climbing - hard-working Americans and business owners (particularly small businesses) will not be able to shoulder the burden.

From The Headlines: NY Medicaid To Stop Paying For 'Never Events'

Last September I blogged about Medicare's decision to suspend payments for hospital-caused second surgeries (see my 9/4/07 post) that will start this October. At that time I predicted that within a year private insurance companies would follow suit.


Today, the New York state Medicaid program has announced that it will no longer cover avoidable hospital errors that result in procedures or surgeries. You can read the article in its entirety here.

There are four months left until the new Medicare policy goes into affect. Still plenty of time for other states and private insurers to hop on board.