The California individual and family plan market place will be changing quite a bit in 2017. Next to confirming if your favorite doctors are covered by the new health plans, many consumers want to make sure their chosen hospital is in-network as well. From information provided by Covered California and the health plans, I have put together a table of California hospitals by region and the health plans they accept.
With the announcement that Blue Shield of California may be dropping Sutter Health physicians and hospitals from their list of network providers in Northern California, Blue Shield members are wondering if their health plans are any good. For all the good of health care reform under the Affordable Care Act consumers are learning that doctors […]
While Covered California was preparing a large press announcement with the California Medical Association (CMA) about extolling the number of physicians that are participating in Covered California individual and family health plans, Health Net was releasing their list of providers in their new narrow network Exclusive Provider Organizations (EPO) and Health Service Plans (HSP). A search […]
There was tremendous confusion over which doctors were in-network for the new individual and family plans offered through Covered California in early 2014. While the major health insurance plans offering PPO and EPO plans maintained the provider networks were the same regardless of whether they were purchased on or off the exchange, doubts persisted fueled […]
In an effort to shed a little light on the range of outpatient surgery costs a health care consumer might have for a particular procedure, Anthem Blue Cross in association with WebMD created a cost comparison website. As a patient, you have more incentive to carefully consider the lower priced options if you have a high deductible plan.
Covered California has already awarded $43 million for public outreach and education. Seven of the recipients that received grant money are organizations that are already involved with the health care industry. Yet we need more money spent just to talk to doctors, nurses and physical therapists?
Part of Covered California’s mission is to improve health care quality and lower costs. In an attempt to meet these goals they announced a partnership with the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely initiative. The Choosing Wisely initiative seeks to encourage better dialog between patients and physicians to reduce duplicative tests based on evidence when charting the most effective course of treatment.
The Centers for Medicare and Medicaid released the cost they pay for the top 100 hospital treatments for beneficiaries of Medicare across the country and the data presentation is virtually worthless to the average human being. The Charge master data set was successful in highlighting the complex and dysfunctional system we have in the U.S. for tracking and paying for health care.
The larger point of Anthem’s discussion is that rising health care costs have several roots. There is no one culprit that is driving costs.
The obstacle in matching your health insurance to a doctor is that health insurance companies contract with physician groups and hospitals. These contracts include negotiated prices for a variety of procedures, tests and office visits.