The ongoing saga that is the threat of insurance premium hikes in California. Essentially all of the major plans, with the exception of BS of Ca., have agreed to delay implementation of increases that were supposed to have taken place in March — citing concerns echoed by the state’s insurance commissioner. As for Blue Shield,

The company is moving ahead with rate increases for the third time since October. Some of its 194,000 individual policyholders were notified recently that they would receive all three at once. Blue Shield spokesman Tom Epstein replied that an independent actuarial review of its rates requested by the company is on track to be completed before March 1.

Posturing on the part of the insurance companies, or forestalling the inevitable in a state already besieged by significant numbers of unemployed, uninsured, and sky high budgetary deficits? | LINK

RELATED: California Once Again under HHS Scrutiny for Excessive Insurance Premium Increases

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Twin Cities-based insurer United Health isn’t going down the vortex of government-mandated healthcare for all. No sir, not without a fight. In addition to making its case at the organization’s nosebleed levels of hierarchy, the company is going to the trenches, recruiting its number one asset — human capital — to carry much of the grunt work for them.

In a form letter sent out to all of its employees, the company is (strongly) urging them to get on the employer’s bandwagon and send out criticisms against the recent House bill ensuring a solid public option. An obvious reason behind such moves could certainly mean protecting profits. A less evident more naive reason might be out of civic duty — an employer engaging in the public debate by simply allowing its employees to freely communicate with those who make the laws (which ultimately affect its employees’ jobs). Talk about thinking oneself into a circle… | LINK

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MN based payer United Health, which has had its share of fiscal problems in the past few years, may not be in a position now to offer advice on the ethics of stock options and other matters of CEO compensation, but the insurer is weighing in on what it thinks should be the route healthcare organizations should take to cut at the extreme waste in healthcare financing. Citing the familiar refrains of hospitalization prevention, greater physician “efficiency” in care delivery, measured utilization of certain imaging and other advanced diagnostic technologies, and general emphasis of quality over quantity in matters of healthcare spending, the organization appears to be positioning itself as a leading trendsetter in health policy thought. Why is United Health so bullish on this issue? Because their senior VP for clinical advancement says they have used such disciplined ideas in their organization. Well, if that’s the case, Obama and congress probably would like a little more clarification. | LINK

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Minneapolis-based UnitedHealth, which also happens to be the largest healthcare insurer in the state of New York, has settled out of court to pay $50 million to establish a new database that will be used to determine rates for patients who choose physicians outside of the insurance giant’s network. An investigation begun by NY Atty. General Andrew Cuomo concluded a UnitedHealth subsidiary known as Ingenix Inc. was rigged to limit payments to doctors and, therefore, forced consumers to pay more. Cuomo also alleged that there was a conflict of interest because UnitedHealth owns the database.

Typically, patients usually pay 20% of their medical visits to out-of-network physicians. The overall base amount (which also includes the 80% the insurer pays) is determined by a complex method which uses data obtained from that patient database to determine the insurer’s charges to the patient and payments to the provider. Factors such as geographical data and age demographics also play a part. Patients are not supposed to be shortchanged because of this alleged “oversight” by UnitedHealth, says Cuomo. | LINK

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Healthcare consumers should have the right to buy insurance for the right to have healthcare insurance, um, right?

Called UnitedHealth Continuity, the product is not actual medical insurance, but is aimed at people who may have insurance now but are worried they may lose it — and may not be able to get replacement insurance on their own.

They may expect to retire early, for example, before they qualify for Medicare. Or they might be worried about the possibility of losing their jobs and their health coverage.

Puts a new wrinkle on the moral hazard hypothesis. | LINK

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