Posts Tagged ‘wellpoint’
The Milliman Medical Index has been released for 2010. This is a very good study of healthcare costs and the effects that they have. 2010 marks the 6th year that the study has been performed. The top 100 leading insurers read this report to estimate future health insurance claims costs. You would think that our government officials would all take this study into consideration when they are making laws that effect healthcare.
The topics that are discussed in the Study:
Key Findings
The total medical cost for a typical family of four in 2009 was $16,771. In 2010 the study shows an increase of 7.8% to $18,074. Employers and Employee alike shared the increase in cost this year.
Employers cost at an average of $10,744 surpasses $10,000 for the very first time.
Geographic Differences in Healthcare Costs
The study shows that Miami, New York and Chicago continue to have costs at leasts 10% higher than the national average.
Dissecting HealthCare Costs
In this section the $18,074 is broken down into components of spending.
15% Rx+ 33% Physician +17% outpatient+ 31% inpatient +4% other
Employee’s Share of Healthcare Costs
In 2010 the employer is picking up $10,744 of the $18,074 of total healthcare cost to a family of four.
Economic Effects on Healthcare for People with Insurance
This section is addresses the effects of unemployment and health insurance. The study addresses the effects layoffs have on people who continue to be insured under the employer plan.
Cost Implications of Healthcare Reform on a Family of Four
The study states the cost implications are unclear.
Technical Appedix_Milliman Medical Index
This section discuses how the Index is formed.
2010 Milliman Medical Index
Recently Wellpoint took some really bad press on the treatment of Breast Cancer. Some of that bad press was wrong. Anthem was accused of purposely rescinding policies of women diagnosed with breast cancer. This accusation was really way out of bounds. Wellpoint has paid for the treatment 10 of thousands of women who have suffered from Breast Cancer. So I think its appropriate that Anthem is implementing the key provisions of this new act.
WellPoint, Inc. (NYSE: WLP), the nation’s largest health insurer by medical membership, announced today it will unilaterally implement key provisions of the Breast Cancer Patient Protection Act introduced by U.S. Rep. Rosa DeLauro. These new provisions include more transparent benefit language including clear explanations of benefits to members with breast cancer, and the provisions standardize minimum recovery times in the hospital for women recovering from mastectomy.
The adoption of these provisions builds on WellPoint’s existing leadership in breast cancer treatment. While variability exists within clinical guidelines and state regulations, the vast majority of WellPoint’s members already receive the standard of care indicated in the legislation. However, WellPoint believes that applying this universal minimum standard will both benefit our members, as well as encourage others in the industry to follow and adopt this standard. Beginning July 1, 2010, WellPoint will standardize clinical guidelines for women recovering from mastectomy to offer a voluntary 48-hour minimum in-hospital stay.
“Women recovering from breast cancer surgery will decide, in consultation with their physicians, whether hospitalization for 48 hours is required,” said Sam Nussbaum, Chief Medical Officer, WellPoint. “We are committed to making medical coverage decisions for women with breast cancer that are in accord with the latest scientific evidence and clinical research. It’s important for us and our members that WellPoint continues to lead in this area,” he added.
“We continue to work with the American Cancer Society and academic thought leaders to gain real-world knowledge of breast cancer treatments to shape improvements in care for women with breast cancer,” said Nussbaum. “Our goal is to ensure that our members receive optimal care.”
WellPoint also champions effective member communication and transparency regarding breast cancer diagnosis and treatment options. More than 3,000 nurses and clinical associates work with members daily, to encourage detection of breast cancer at its earliest stages and to ensure that members are receiving the best breast cancer treatments available. Toward that end, WellPoint is taking steps to provide comprehensible, straight-forward explanations of benefits so that members more clearly understand their treatment options.
“WellPoint works to ensure that all of our members are getting best practice care,” said Dijuana Lewis, Chief Executive Officer of WellPoint’s Comprehensive Health Solutions business unit. “We are especially proud of our record in improving care for women with breast cancer in this country and believe these added measures will increase the quality of care that our members receive.”
Anthem plans across the country are working to develop innovative products and programs that help address rising health care costs. Through pay for performance initiatives, consumer directed health plans and transparency initiatives; Anthem is providing access to the information needed to drive down health care costs.
While many people may believe that insurer profits are the driving force behind increasing health insurance premiums, research reveals very different reasons for the high cost of health insurance.
A May 2009 report titled “What’s Really Driving the Increase in Health Care Premiums?” addresses the issue. The report, issued by the WellPoint Institute of Health Care Knowledge, compiles research from sources such as PricewaterhouseCoopers, the Robert Wood Johnson Foundation, the Kaiser Family Foundation, the Bureau of Labor Statistics and the Congressional Budget Office.
According to the report, the “key drivers” of spiraling U.S. health care costs are:
- Advances in medical technology and subsequent increases in utilization;
- Price inflation for medical services that exceeds inflation in other sectors of the economy;
- Cost-shifting from people who are uninsured and those receiving Medicare and Medicaid to the private sector;
- High cost of regulatory compliance; and
- Patient lifestyles, such as smoking, physical inactivity and obesity.
Citing PricewaterhouseCoopers research from 2008, the report found that only three cents of every health care premium dollar is spent on health insurer profit.
According to the Institute’s report, newer medical technologies tend to increase costs because they are generally more expensive than the older technologies they replace. While the availability of more advanced, superior technologies can yield better results for some patients, these technologies and diagnostic tests may be used inappropriately in some situations where existing, older technologies are more effective and accurate.
To view a copy of the full report, click here.
