UnitedHealth, a health industry goliath, has its hand in doctors’ offices, surgery centers, technology services and prescription drugs. It is the industry model, and CVS and Aetna, says one expert, are ‘wannabes.’
The president’s move to end payments that reduce out-of-pocket costs for low-income consumers had already been anticipated in California and some other states — and could hit a legal snag.
After regulators questioned Anthem’s forecast for medical costs, the company agreed to reduce rate hikes on its individual and small-business health plans next year, saving customers an estimated $114 million.
Covered California authorized a 12.4 percent average surcharge on silver-tier plans, the second-least expensive option sold on the exchange. It brings the total average premium increase on those plans to nearly 25 percent next year.
Agency says a removable cap will lower the risk of antibiotic resistant infections but some experts see it as a modest step in curbing the sort of deadly outbreaks that occurred a few years ago.
The company’s drug spending prediction, far above other insurers in the individual market, has experts scratching their heads. Anthem cites market volatility.
But such single-payer proposals have slim prospects, as even some Democratic leaders express reservations.
Fed up with high hospital costs and limited competition, Santa Barbara County sends willing employees out of town for better bargains. Local governments are slowly joining private employers in aggressively seeking out the best care for the lowest price.
It’s the second fine this year for California’s largest health plan, the only one to be penalized by Medi-Cal officials since at least 2000. The HMO says it will hand the information over by next month.
Little-known rules require all health insurance companies to help pay claims when any one of them fails. Penn Treaty failed big — and insurers around the country are likely to pass on those costs to policyholders. California consumers may be hit hardest.