INdiana Systemic Thinking

February 13, 2008

Health Blog Roundup: Step-dads, Chelsea Clinton, Statins Make Women Stupid, etc…

Here are some of the posts I found interesting this morning from the list of national health blogs I keep track of:

From the Wall Street Journal Health Blog:

Do statins “make women stupid“?

Blue Cross of California wants doctors to help them cancel patient policies.

Dr. Grohol’s World of Psychology:

Making sense of suicide and drugs.

On the Radar:

Chelsea Clinton hates her health insurance.

Hidden Agenda in CDHPs

From MSNBC:

It’s tough being a step-dad!

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February 9, 2008

Indiana Doc Leads Healthcare for All Fight

The Indianapolis Star has this artcle about Dr. Rob Stone.  You may not agree with everything he says, but at least he’s out there trying to do something about the insurance problem.

Stone, an emergency room physician at Bloomington Hospital, has emerged as one of Indiana’s most outspoken advocates for making insurance accessible to all. He is co-founder and director of Hoosiers for a Commonsense Health Plan, which contends that the current system is too profit-driven, too inefficient, and leaves too many people without affordable access to health care.

One of Stone’s favorite targets is Indiana’s largest health-care insurance provider, Indianapolis-based WellPoint, a $61 billion health insurance giant that provides coverage to 35 million people in America.

“WellPoint epitomizes our system,” he said. “They’re it.”

Stone’s PowerPoint presentation lays out his case. A Medicare-type program for all is better than the current system, he says. Medicare is currently for the elderly.

One slide — with information attributed to the International Journal of Health Services in 2005 — shows Medicare overhead spending was 3.1 percent of its budget, compared with 26.5 percent for investor-owned Blue Cross and Blue Shield plans.

Another slide — with information from the Employer Health Benefits Annual Survey and Bureau of Labor Statistics — showed that from 2000 to 2006 health insurance premiums rose 87 percent while workers’ earnings rose 18 percent.

For its part, WellPoint sees having a competitive, free-market system as key to improving the quality of care and controlling costs.

“We believe a single-payer health-care system would hinder progress in these areas by eliminating competition and restricting patient choice and could require patients to endure long wait times for care while possibly reducing the quality of health care,” WellPoint spokesman Jim Kappel said in an e-mail.

In its recent earnings report, WellPoint touted that it lowered its administrative expenses to 14.5 percent of premium revenue in 2007 from 15.7 percent in 2006 even as it added 708,000 members.

The company also pointed to flaws in other nations’ health-care systems.

“In Canada, which has a single-payer system, the average wait between a general practitioner referral and a specialty consultation at times has been longer than 17 weeks.”

Stone stands by his position. He recalls a patient who refused to seek treatment for chest pains that turned out to be a heart attack. He finally sought treatment for a second attack, only because the first attack left him disabled — but now eligible for government coverage.

“Medicare works pretty well, and it’s been around for a long time, so why not pattern something after Medicare?”

January 24, 2008

What Healthcare Crisis? Wellpoint Cashes In

According to 4th quarter results just released, Anthem’s parent company, Wellpoint, continues to rake in huge amounts of cash.  From the Indianapolis Star:

The Indianapolis-based company, which operates Blue Cross and Blue Shield plans, reported net income rose to $859.1 million, or $1.51 per share, from $801.1 million, or $1.28 per share, in the 2006 quarter. Results included investment gains of about a penny per share in each period.Revenue climbed 7 percent to $15.56 billion from $14.58 billion a year ago, helped by a 7 percent rise in premiums.

“We are pleased that WellPoint achieved its earnings per share expectations during 2007 and continued its strong organic membership growth. We view this as an excellent indication that customers continue to find great value in the products and services we are providing to the marketplace,” said Angela F. Braly, president and chief executive officer of WellPoint.

January 21, 2008

Anthem CEO Interviewed: Wants MORE Business

From the Indianapolis Star this morning comes an interview with the new CEO of Anthem.  Really nothing new (about Anthem) in the article and the reporter asked a lot of softball questions.  What was new, at least to the Blogmeister, is Anthem’s new buddy-buddy relationship with M-Plan who has apparently decided they cannot compete with Anthem and is giving them a large portion of their business. 

Say what you want about the government running a single payor health system, but it appears Anthem is well on their way to providing a private single payor health system, at least in Indiana.  As you read the quote from the story below, keep in mind WellPoint, Anthem’s parent company, according to CNN, made almost 57 billion dollars in 2006 (2007 isn’t available yet).

Anthem Blue Cross and Blue Shield of Indiana is big and it’s getting bigger.

The healthinsurer, part of Indianapolis-based industry giant WellPoint, provides health benefits for roughly 2.5 million Hoosiers. Anthem controls about 60 percent of the commercial health insurance market statewide, according to an analysis by the American Medical Association.

Robert Hillman took the helm of that insurance behemoth when he was named president of Anthem Blue Cross and Blue Shield in Indiana last October.

These are busy times at Anthem. The insurer has been working — under an endorsement agreement with M-Plan, a 125,000-member Indianapolis health maintenance organization that is shutting down — to gain new members. Anthem also is helping to run Indiana’s Healthy Indiana Plan, which provides coverage for low-income Hoosiers.

But Anthem also is involved in high-profile disputes with two physician practices over reimbursement rates and frequently is criticized for selling coverage that many say is simply unaffordable.

Hillman talked with The Star last week after his first few months leading Anthem in Indiana. This is an edited transcript of that conversation:

Question: What are your biggest priorities?

Answer: The primary goal is to make sure we fulfill our mission, which is to improve the lives of the people we serve and the health of our community. We’re looking at making sure that we continue to deliver products that provide value to our customers and that we’re participating in programs that are really improving the health and wellness not only of our members but also the community at large.

Q: Given Anthem’s large market share, where do you see the biggest potential for growth?
A: We still think the consumer- directed market is a big market opportunity for us. The other, obviously, is the uninsured market, particularly in the two- to 50- employee market, where you have really an alarming number of employers who are electing not to participate in the private health- care market and are dropping their health-care coverage.

It’s an opportunity to develop products that bring those folks back into the private payer market.

Q: How much business did Anthem capture from M-Plan shutting down its HMO business? Has the transition been smooth?

A: Well over 50 percent (accounting for 75,000 to 80,000 new Anthem members) of that business transitioned over from M-Plan.

The transition went really smoothly because the partnership with M-Plan, once they decided to exit the business, the cooperation on their part in working not only with our sales team but also our operations team, you couldn’t have asked for a better number.

Q: Indiana has roughly 750,000 people who are uninsured. As the state’s largest commercial health insurer, does Anthem share in the blame for the large number of people who find health coverage unaffordable and unattainable?

A: I don’t think there’s any single payer that’s to blame. We’re all operating in the system that we’re operating in, which is the private payer system, which is an employer-based system. No employer is required to offer health insurance, nor is any (insurer) required to offer health insurance.

What I do think we have an obligation to do, and it’s a challenge, is to try to develop products that are affordable and that provide value to employers and their employees so they want to participate in the private-payer system.

We have an obligation to cooperate whenever we can and however we can with government, like we have cooperated with Gov. Daniels and his Healthy Indiana program.

January 10, 2008

New Pres. and CEO for Unit @ Wellpoint

From the Indy Star:

WellPoint today announced that Brian A. Sassi has been appointed president and chief executive officer of the company’s consumer business unit, which includes Medicaid customers.

Sassi, formerly president of Blue Cross of California, replaces Joan Herman, who announced her plans last year to retire in 2008.

Sassi will assume full duties of the job Feb. 1.

“Brian Sassi has a 25-year career in the health insurance industry and an impressive record of accomplishments in our company,” said Angela F. Braly, president and chief executive officer of Indianapolis-based WellPoint, in a statement.Since joining Blue Cross of California in 1989, Sassi has held a number of leadership roles, including vice president of operations and strategic initiatives.
Prior to joining Blue Cross, Sassi held a number of industry management positions.

December 12, 2007

Wellpoint to Grow Business

Sometimes, ya pick your battles and just let stuff go.  In the interest of full disclosure, the Blogmeister is an Anthem Provider.  Anthem owns Wellpoint, or Wellpoint owns Anthem.  I can’t keep it straight.  Just read between the lines carefully on this one.

From the Indianapolis Star:

“WellPoint, already the nation’s largest commercial health insurer in terms of membership, is aiming to get even bigger.

Chief Executive Angela Braly, speaking today during the company’s annual investor conference, said continued growth is key to her company’s strategy of using its national reach to improve service and to help control the rising cost of health care.

“We’re very focused on disciplined growth,” said Braly, who added that WellPoint has added about 700,000 members in 2007.

Indianapolis-based WellPoint provides health benefits to about 34.8 million across the nation, including Blue Cross and Blue Shield plans in 14 states.

Braly said WellPoint is using its large size to increase efficiencies through efforts such as disease-management programs designed to make sure people with chronic conditions, such as diabetes, get recommended care.

“With such broad and deep networks, we believe we can really have an impact on the cost and quality of health care,” said Braly, in her presentation to open the investor conference in Westlake Village, Calif., where WellPoint has invested in a luxury hotel and spa.

Braly also said the company will be active in the ongoing political debate over health care. Those efforts, she said, include working with the federal and local government to help provide benefits to more people, as well as using information gleaned from its massive membership base to highlight health care needs for the nation and individual states where it does business.

Braly also reaffirmed WellPoint’s expectation to grow its earnings per share by 15 percent for the coming year.”

The complete story is here.

Here is a little more from today’s Indy Star:

“WellPoint said it is working with government agencies, developing new ways to control costs, and it will be active in the ongoing political debate over health care. In Indiana, the company will administer the new Healthy Indiana Plan, a state initiative to provide coverage for low-income Hoosiers.”

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