Medica First Health Plan to Create Mobile App for Comparing Health Care Costs.

Innovation Alert!

Medica, a health insurance company headquartered in Minneapolis, became the first health plan to launch a mobile application to help consumers compare cost information for a variety of medical procedures. The app, based on the Web site MainStreetMedica.com, is available at the iPhone App Store.

In a press release, the carrier said it is making the mobile app available as the demand for consumer health information is exploding. According to an analysis published by Manhattan Research in February 2009, more than 10 million U.S. adults use mobile devices for health information. That’s not surprising as consumers are paying a greater share of their health care. Meanwhile, the trend toward better informed, empowered consumers helps promote market-based reforms and greater competition.

“MainStreetMedica.com is a proven resource for consumers who want to know how much a medical service or treatment will cost before they have a procedure,” said Rob Longendyke, Medica senior vice president of marketing and corporate communications.

“Until recently, consumers had little or no access to comparative information about physicians and hospitals. Without transparency like actual cost information, market forces can’t work. Given a level playing field, consumers will do to health care what they have done throughout the rest of the economy – make choices based on their values. Empowering consumers with the tools they need to make value-based decisions will stimulate health care to be more efficient, effective, affordable and accessible.”

Both the Main Street Medica mobile app and the Web site are available to all consumers, not just Medica members. iPhone users can also download the mobile app at: Medica.com.

Accenture Launches Innovation Center for Health.

Accenture, the big global management consulting, technology services and outsourcing company based in Chicago and London, has announced the launch of the Accenture Innovation Center for Health.

The company says that through the center they will address critical dimensions of improving the performance of healthcare systems, including the impact of healthcare reform in multiple countries, health information exchanges, electronic medical records, using data to drive clinical transformation and integrated health management, and other payer and provider issues and solutions, including ICD-10 compliance.

Accenture said in a press release that the center will identify and develop innovative ideas and solutions to help clients achieve high performance in the healthcare industry by producing comprehensive, fact-based research reports, organizing client workshops, and facilitating industry forums.

Medical College to Provide Specialty Services to Underserved Area via Innovative Telehealth Network.

Innovation Alert!

AmeriChoice by UnitedHealthcare, a Medicaid managed care organization that provides medical and behavioral health care services to TennCare members in East, Middle, and West Tennessee has expanded access to specialty health care services using a telehealth network.

Through an arrangement with Meharry Medical College, AmeriChoice members throughout Tennessee, who are seeking adult specialty services such as a dermatologist or a neurologist, will be able to visit a local community health center and use telehealth technology to consult with specialists composed of physicians who also serve on the faculty at Meharry Medical College.

According to a release issued by AmeriChoice, recent telehealth infrastructure expansion is propelling the advancement of telemedicine technology allowing patients to access medical or behavioral health specialists at local community health centers instead of traveling to the city.

AmeriChoice, a unit of UnitedHealth Group (NYSE: UNH), serves more than 2.7 million people in Medicaid, Medicare and Children’s Health Insurance Programs in more than 20 states and the District of Columbia.

House Healthcare Bill Would Impact HSAs.

Nancy Pelosi

The massive healthcare reform bill unveiled today by top House Democrats contains a couple of provisions that will impact those with Health Savings Accounts (HSAs).

Section 531 of the bill limits nontaxable reimbursements from Health Savings Accounts (HSAs) for drugs and medicines. After December 31, 2010, except for insulin, a prescription will be required in order for the purchase of drugs and medicines to be reimbursable. This change would also apply Flexible Spending Accounts (FSAs) and Health Reimbursement Arrangements (HRAs).

A second change that will impact HSAs is in Section 533.  This provision will increase the penalty for nonqualified distributions from Health Savings Accounts from 10 percent to 20 percent.  It will likewise apply to taxable years after December 31, 2010.

CNN reported that the House Democratic leadership is working to post the text of the final bill online early next week and has agreed to give members 72 hours to read it before a vote. Under that timetable, the House would begin debating the bill at the end of next week.

Highmark, One of America’s Healthiest Companies.

Congratulations to Highmark, largest health insurer in Pennsylvania, for being named as one of “America’s Healthiest Companies.”

The company received the 2009 Well Workplace Award for its commitment to protecting and enhancing the health and well-being of its employees. Highmark provides its 11,000 Pennsylvania-based employees a comprehensive wellness program.

Highmark earned a gold designation as a company that has successfully built comprehensive worksite wellness initiatives and is demonstrating and documenting concrete outcomes. Highmark is just one of 59 companies to receive the Well Workplace Award this year.

A Highmark study published in the Journal of Occupational and Environmental Medicine in 2008 showed that employers can save $1.65 in health care expenses for every dollar spent on a comprehensive wellness program. Through a four-year period, Highmark saved $1.3 million on health care costs through its wellness program

State Lawmakers Push for Health Care Opt-out.

The Kansas City Star has picked up on a story that could begin the shape the healthcare reform process. Apparently, three Republican lawmakers in Kansas want to give the state an opt-out should Congress pass health reforms that mandate individual health insurance. The amendment would say no law can require individuals or employers to buy health insurance.

The Star goes on to say that their proposal, which would alter the Kansas Constitution, is similar to efforts under way in more than half the states. It’s a pointed attempt to get President Barack Obama and Congress to back off efforts to retool the nation’s health care system.

These state initiated efforts may be more of an attempt to influence policy in Washington than they are legitimate effort s to block legislation that may get passed by Congress.

To be added to the state constitution in Kansas, the legislation must be passed by a two-thirds majority of the Kansas House and Senate and then be approved by voters next year.

Still, it will be interesting to see if any of these state level push-backs build any traction.

Christmas Comes Early for Some Senate Healthcare Reform Objectors.

Harry Reid

Christmas is coming early to some of the Senators who say that the have objections to the the Senate healthcare bill.

The Los Angeles Times reported this morning that Majority Leader Harry Reid (D-Nev.) has intensified negotiations with a handful of Democrats whose support is crucial to passing the legislation.

You see, Reid needs 60 votes to prevent the Republicans from using parliamentary tricks that would keep the bill from coming to the floor — and eventually from being brought to a final vote.

That means that Reid will need the votes of all 58 Democrats and the two independents who caucus with the Democrats, or some Republican defectors, in order to keep the bill alive.

So, according to Times, there is some old fashioned horse trading taking place to ensure that the votes line up when they are needed.

Let’s see what is on the wish lists of some of these key votes. First, the Times reports, that Indiana Sen. Evan Bayh, says he is worried about the bill’s fiscal impact. But Reid has made him more amenable to it by promising to modify a proposed 10-year, $40-billion excise tax on manufacturers of medical devices, a major Indiana industry.

Next, Sen. Ben Nelson (D-Neb.), a former state insurance commissioner, is adamantly opposed to a provision that would impose new antitrust requirements on the health insurance industry, which is also one of his big campaign contributors. So, according to the Times, the Democratic leadership is exploring ways to address Nelson’s concerns.

Then there is Sen. Mary L. Landrieu (D-La.) who says she is “very skeptical” of the public option, yet wants a “principled compromise” that would drive down insurance costs.

The Times noted that, for her, Democratic leaders may find another point of leverage far removed from the healthcare bill: Landrieu’s conservative state has been clamoring for more government aid for Hurricane Katrina damage.

So, if you are a Democratic Senator wanting to grease the skids of some favored project, now would be the time to let Harry Reid know that you have an objection to the healthcare bill. All this must be keeping Harry Reid very busy these days.

Op-outs, Co ops, and Triggers. Oh, my!

The conservative think tank, The Heritage Foundation, in today’s Morning Bell reacted to Senate Majority Leader Harry Reid’s (D-NV) announcement that the health care legislation he is drafting will include a government-run health insurance plan by saying that it doesn’t matter what vehicle he chose. Op-outs, co ops, and triggers all lead to the same place – everyone in a government-run health plan.

Take the op-out. The piece notes that Reid has not provided a lot of details about how the plan would work. But, what we do know is that the plan would take effect in 2013 and states would have until 2014 to pass legislation declining participation in the program.

Here is what has the Heritage Foundation so worried.

“In 17 states Democrats control both houses of the legislature and the state house. In another 24, Democrats control at least one legislative chamber or the governor’s mansion. That, they say, leaves a total of only 9 states where Republicans run the entire show — Texas, Utah, South Carolina, South Dakota, North Dakota, Missouri, Idaho, Florida, and Georgia. That, according to the Heritage Foundation, means Americans in 41 states are all but guaranteed to have no choice but to endure the government run health plan.”

Turning to the idea of the co-ops that Sens. Chuck Schumer (D-NY) and Kent Conrad (D-ND) have both been pushing, the Heritage Foundation reminds us of the collapse of the mortgage market in warning us that this is a model guaranteed to fail.

“Simply calling some form of a government-sponsored enterprise (GSE) a “cooperative,” for instance, would be only another type of public plan in disguise. … One need look no further than Fannie Mae and Freddie Mac to see how GSEs can distort the market and leave taxpayers with huge liabilities. Decades of market distortions generated by their implicit government backing, compounded by the effects of repeated political meddling by Congress, put those GSEs at the very epicenter of the mortgage market collapse that triggered the current financial crisis and recession.”

Lastly, there is what the Heritage Foundation calls the “Trigger Trap”, an approach favored by Senator Olympia Snowe, (R-ME). A trigger is a legislative tool that would put in place automatic benchmarks that if not met, would immediately unleash the government-run system into the market. For example, if 95% of Americans as defined by the bill don’t have adequate health coverage by a certain date, the public option would be “triggered.”

The Heritage Foundation:

“What a trigger does is hold off the tough decision until future, uncertain circumstances. The public option would essentially become law today, but not go into effect until an undetermined time when economic conditions could be even worse. Had Congress enacted a trigger to save Clintoncare, the trigger would have forced states to implement HMOs at exactly the time everyone was moving away from that overly rigid version of managed care.”

Is it any wonder that the public option has become the most contentious aspect of the healthcare reform debate? It is shaping up to be the overarching factor that will determine how healthcare is financed and delivered going forward. Regardless of your point of view, this is where the action will be going forward.

FACT CHECK: AP Finds Health Insurer Profits Not So Fat.

Check out this quiz that appeared on Yahoo News this past Sunday.

Quick quiz: What do these enterprises have in common? Farm and construction machinery, Tupperware, the railroads, Hershey sweets, Yum food brands and Yahoo? Answer: They’re all more profitable than the health insurance industry.

The article written by an Associated Press reporter went on to point out that in the health care debate, Democrats and their allies have gone after insurance companies as rapacious profiteers making “immoral” and “obscene” returns while “the bodies pile up.”

The Associated Press notes that ledgers tell a different story. Here are the numbers:

Health insurers posted a 2.2 percent profit margin last year, placing them 35th on the Fortune 500 list of top industries. As is typical, other health sectors did much better — drugs and medical products and services were both in the top 10.

The railroads brought in a 12.6 percent profit margin. Leading the list: network and other communications equipment, at 20.4 percent.

HealthSpring, the best performer in the health insurance industry, posted 5.4 percent. That’s a less profitable margin than was achieved by the makers of Tupperware, Clorox bleach and Molson and Coors beers.

The star among the health insurance companies did, however, nose out Jack in the Box restaurants, which only achieved a 4 percent margin.

UnitedHealth Group, reporting third quarter results last week, saw fortunes improve. It managed a 5 percent profit margin on an 8 percent growth in revenue.

By the way, Bloomberg is reporting this morning that insurers’ stocks fell 2.5 percent yesterday. The reason? Senate Democratic Leader Harry Reid said he will ask the U.S. Senate to vote for a government-run health-insurance program that would allow states to opt out.

That should teach those rapacious profiteers a lesson.

Dr. John Kitzhaber: Still Making Sense in Healthcare Reform Debate.

Dr. John Kitzhaber

Kaiser Health News, today, featured an interview with Dr. John Kitzhaber. You may recall that Dr. Kitzhaber is the former Democratic governor of Oregon who shook up that state’s Medicaid program a few years back with a plan that some thought was rationing. He is also the person I wrote about back in June under the headline: Kitzhaber Delivers Wake Up Call to AHIP.

In that June 4, blog post, I referred to Kitzhaber as being the third wheel on a panel at AHIP Institute that featured Jeb Bush, the former Governor of the State of Florida and Howard Dean, MD, Chairman, Democratic National Committee,

Rather than dwelling of the finer details of how to fix the current system to provide coverage to more people, as Bush and Dean did in their remarks, Kitzharber told the representatives of America’s Health Insurance Plans gathered in San Diego that they were missing the point and needed to change their business model.

“Healthcare is a means to an end,” he said. “The end is health.”

Kitzhaber noted that most of the factors that contribute to poor health in this country have nothing to do with access to health insurance coverage. They are lifestyle choices, environmental issues and so fourth.

A system that promotes health

“If we really want to address health,” he told the AHIP audience, “we need to work on developing a system that promotes health and not one that is geared towards spending massive amounts of money on people after they have reached a health crisis that could have been prevented with the proper emphasis in prevention and wellness.”

According to Kaiser Health News (KHN), Kitzhaber, 62, who is again running for governor in 2010, is still promoting unorthodox strategies to address U.S. health care problems.

This issue will bankrupt the country

“The problem with the debate going on in the nation’s capital today is that it has nothing to do with creating a system that provides for the health of Americans,” he said recently at a presentation at Elmhurst College in suburban Chicago. “It’s about paying for the system we already have.” Not only is that system a clunker, he told KHN that he also believes it is a cash-guzzler that will bankrupt the country.

Kitzhaber told KHN, “To fix the health care system, people are going to have to be willing to put their personal interest behind the general public interest. This issue, if we don’t get our arms around it, is going to bankrupt the nation.”

“In 16 months, the leading edge of the baby boomer generation is going to come on Medicare. That is going to drive the national debt through the ceiling. We are in a trajectory, if nothing happens, to default on our national debt. The implications are staggering.”

Kitzhaber’s comments made sense in June and the make even better sense in October, now that we have seen the approaches Congress is taking to “fix” healthcare.

Read entire KHN story.

Photo: www.johnkitzhaber.com