The insurer's dilemma

This is a very difficult period for insurance companies in Massachusetts. Regardless, not profit, being you see much control over the reserve margins and profitability. Much of this is unfair, but I think this is just a sign of the times. Hospitals face a similar problem to. Doctors are certainly next line.

But Massachusetts insurers have an additional problem.As we have discussed were mainly participants in creating a very large differences in which payment is based prices between hospitals, rate differentials on provider Marktmacht.Sie are now under pressure to limit increases in the hospitals, but those who have extended will have received those are not necessarily the higher prices.

However, insurers are those who are renewing say you expect no rate increase far below the inflation rate should increase at all or at best medical costs. These hospitals by definition are those without market power.If the insurers to changes keep low rate, is the disparity between the have's and the have not's wachsen.Dies increases the market power of their competitors, so that doctors in their networks to poach and win more market power. This increases the percentage of patients are suppliers of high-rate, the total health care costs aggravating.

So far I haven't seen any effort by insurance companies, this Gordian Knoten.Ein company promotes capitation or global payments in response to the problem.But capitation based on embedded refund patterns doesn't solve the problem of rate Differentiale.In of fact perpetuates the problem.

Transparency with regard to the prices could create a moral imperative that would help guide that would move things in the right direction, a shift in the negotiations.I either individually or collectively, ask any progress on the part of payors to publish prices to existing State.

Transparency with regard to the quality and safety could contribute to a marketplace for insurance products, that see based on results rather than Marktmacht.Ich not step on the part of the insurance carrier, either individually or collectively, asking the State, useful data on this front-publish or use your own commercial agency to such publication as part of their contracts with providers require.

Properly constructed and implemented administrative rate setting could also help, disparities in the course of time to beheben.Ich see no step on the part of the insurance carrier, either individually or collectively, to the State engage in rate setting to questions.

So while I'm unfair attacks on insurers who are part of the political environment of sympathy for that, I'm to links Fragen.Was it is to you in favor of are uncontroverted resolve, worsened a problem that even the very situation relating to the insurance industry?

July 23, 2010

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