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Fiscal cliff deal threatens Indiana co-op health plan

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Last week’s fiscal cliff bargain in Congress dealt a potentially fatal blow to a new health insurance plan that was set to launch this year.

The deal in Congress killed funding for new co-op health insurance plans created by the 2010 Patient Protection and Affordable Care Act. The co-ops, called Consumer Operated and Oriented Plans in the act, were supposed to provide not-for-profit alternatives to existing health insurers across the country.

In Indiana, an organization called Remedy Indiana had asked the federal government for $62 million in loans to launch its health insurance plan. The organization, led by Indianapolis physician Ned Lamkin, has letters of support from all of the state’s major hospital systems—such as Indiana University Health in Indianapolis and Deaconess Health System in Evansville—to participate.

Some employers and benefits brokers also were involved in Remedy Indiana’s plans.

Lamkin said he expected a funding decision from the Obama administration in the first quarter, which would have allowed Remedy Indiana to start offering its plan to employers by the end of 2013. Remedy Indiana already had managers lined up to run the organization.

“It was a shocker for everyone,” said Lamkin, CEO of Remedy Indiana. “It is very discouraging to get so far along and then have the rug pulled out from underneath us.”

Remedy Indiana’s goal is to shift the task of managing patients’ health away from health insurers and back to hospitals and physicians—saving significant money by eliminating waste.

In the short-term, Remedy Indiana planned to save money by getting rid of the need for large profits, fat executive salaries and insurance programs that, in Lamkin’s words, are more focused on making profits than on benefiting patients.

In the long-term, Remedy Indiana planned to convene physicians from all its participating health systems, by specialty, to analyze cost, quality and research data to find better ways of treating patients for less money.

“In collaboration with the health systems, we thought it was too good a chance to make a difference,” Lamkin said.

Lamkin, who also is president of the Indiana Employers Quality Health Alliance, isn’t giving up. He noted that the National Alliance of State Health Co-ops is working on Capitol Hill to get Congress to reconsider the halt of co-op funding—which received no debate before its inclusion in the fiscal cliff deal that passed the Senate 89-8 on Jan. 1.

Lamkin said he's also considering other funding options. For example, he will ask Indiana’s hospital systems to consider funding Remedy Indiana on their own. Many hospitals, such as IU Health, St. Vincent Health, Community Health Network and the Suburban Health Organization, already are considering offering or expanding provider-led health plans.

“They basically could assume responsibility for what they do. Right now, they have health plans battering them over the head,” Lamkin said.

 

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  1. These higher rates Co. e about only because physicians are now hospital employees. otherwise physicians couldn't charge these rates and share the windfall with the hospital. Community/rural hospitals probably not buying physicians practices and thus weren't getting the windfall anyway.

  2. The incentive for poor people to get themselves off public assistance and "no longer be poor" is even with help...they're STILL POOR! Being poor, even with some assistance, isn't all that pleasant. (I speak from experience) It's a stubborn myth that poor people, who are on public assistance, are sitting in the lap of luxury. You should try living on just those "freebies" that you mentioned and see how meager they actually are. By the way, I didn't mean you had to buy/own a puppy...just pet one. :)

  3. As near as I can tell the minority has ZERO constitutional obligation to offer a quorum to the majority. A requirement for quorum was inserted into the constitution so that tyrannical majorities could not simply shove through odious and objectionable legislation (which is exactly what they did.) By allowing a tyrannical majority to charge fines against the minority for exercising their constitutional prerogative to deny quorum the court as made a mockery of constitutional governance in the state of Indiana.

  4. The voters elected the Reps to make a vote not walk out on the vote. They had to the right to exercise their opinion and vote "no" to the bill. Let me ask you this if you walked out of your job for 5 straight weeks would you get paid? Would you even have a job to go back to? If any elected official walks out on the people they should be arrested for stealing tax dollars from the public. They were elected to do a job and not leave when the job gets stuff.

  5. I have been to several of their locations in Pennsylvania and always go in for 1 item and leave with a basket full of things. I'm very happy they decided on Indiana, now if only they would put the other store in eastside.

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