The money, known as reinsurance payments, helped MDwise, Anthem, Humana, Assurant and the Physicians Health Plan of Northern Indiana keep a lid on their losses even as lots of new patients with expensive or untreated medical conditions migrated into the private insurance market.
Wellness company On Target Health LLC, which one year ago launched a program to help overweight workers lose fat but not muscle, is seeing strong results from its first two clients.
Cigna said Anthem’s a risky bet due to fallout from its massive data breach, lawsuits that accuse it of conspiring to inflate prices, and lack of a growth strategy. But Wall Street thinks this deal is going to happen, unless Cigna can find another buyer.
But hospitals’ list prices in Indiana are more than three times what the federal Medicare program pays.
If Anthem merged with Cigna Corp. it would create a behemoth with even greater negotiating power, which could benefit employers but hurt doctors and hospitals.
The Obama administration could write a new regulation. Congress could pass a short law. States could run a low-cost exchange. But the politics might require all parties to let the tax credits die while they try to pin the blame on the other side.
The new version of the Healthy Indiana Plan, backed by Obamacare funding, has enrolled 229,000 new participants in four months without breaking stride.
It took $394,000 to rank in the top 1 percent of U.S. earners in 2013. And more than 100 of the Indiana contingent in that exclusive club were physicians employed by one of the four major hospital systems that operate in the Indianapolis area.
The individual hospital campuses around Indianapolis saw their collective revenue rise 8 percent and their collective operating profits rise 22 percent from from 2011 to 2013. That’s solid, just not stellar, growth.
In Indiana, Anthem has struck accountable care organization deals with 14 health care provider groups and signed up nearly 2,900 primary care providers to its medical home program. And it’s pushing for more in the future.
For employer health plans, diabetics generate $10,000 more per year in medical bills than non-diabetics. That means the rise in the prevalence of diabetes over the past 25 years is costing Hoosiers an extra $2.6 billion annually.
That’s less than one-tenth of 1 percent of what Hoosiers and their health plans spend on hospital care each year. But it’s a step in the right direction.
A Health Department audit found nurse staffing routinely short on two patient units at IU Health’s Methodist hospital, where nurses are trying to organize a union.
To satisfy patients with high-deductible health plans, Northwest Radiology has introduced flat-rate pricing for its imaging scans. It’s a centuries-old concept among postal services, but for health care, it’s revolutionary.
A growing number of hospitals locally and nationally hiring scribes to help doctors fill out electronic medical records, which were billed as a time-saver over paper charts.
By subtly threatening the loss of patients via a new “reference lab network,” the Indianapolis-based health insurer has persuaded 63 Indiana hospitals to slash their prices for blood and tissue testing by as much as 80 percent—beyond the discounts Anthem had already negotiated with them.
Hospitals and doctors still aren’t seeing a wave of new patients because rising deductibles in patients' health plans are continuing to delay medical procedures, even though their job prospects are better than they’ve been in years.
Nurses in Indiana are underpaid, relative to their peers nationally. They are not overworked from a sheer number of hours, but the demands of hospitals nurses have spiked recently, reducing nurses’ margin for caring for patients with a human touch. For a business that competes on service and, increasingly, on price, those are big problems.
IU Health had one of its most profitable years ever in 2014, as it cut staff, boosted its physician office visits and improved bill collections. But it is still hoarding cash to be ready for future cuts in reimbursement as well as future building projects.
Think we’re almost done with changes from Obamacare? Think again. Things won’t settle down any sooner than 2017, and they could actually get even wilder after that.
