October 1st, 2011 by PreparedPatient in News, Opinion
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Cigna launched a $25 million “GO YOU” national branding campaign last week signaling that they are gearing up for tons of new customers as health reform rolls towards 2014. That new business will come from the millions of Americans now uninsured who will start getting government subsidies as an encouragement to buy health insurance coverage. If those uninsured folks don’t get coverage, they will have tax penalties to pay.
No insurer wants to be left behind in this expanding marketplace, so Cigna, by being first out of the gate, hopes to build brand awareness that will ring bells in 2014 when consumers must buy insurance. It’s a smart strategy. One industry consultant says “most insurers have not built enough brand equity with consumers.”
Cigna’s ad campaign positions health insurance as Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 9th, 2011 by PreparedPatient in Health Policy, Opinion
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It’s official now. The government has proposed that descriptions of health insurance policies will resemble those nutritional labels on canned and packaged foods—the ones you look at to find out how much sodium there is in Birds Eye peas versus the A&P brand. Instead of getting the scoop on salt or sugar, shoppers will learn what they have to pay out-of-pocket for various medical services. They’ll also get some general information, like what services are not covered, and how much they’ll have to pay for maternity and diabetes care and breast cancer treatment, all organized in a standard format designed for easy comparison shopping. Insurers will have to translate common insurance jargon into plain English.
The health reform law requires these “Coverage Fact Label” disclosures, and tasked the National Association of Insurance Commissioners (NAIC) with creating them. The NAIC released some samples a few weeks ago. Theoretically, consumers armed with this information will choose wisely, and as free-market advocates say, their choices will regulate prices that insurers will charge. If consumers choose the low-cost plans, Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
February 18th, 2009 by Dr. Val Jones in Health Policy
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At the recent Medicare Policy Summit, Tim Hermes, the Senior Director of Government Affairs for Sepracor, offered an overview of Medicare’s current cost control strategy. These six strategies are part of Medicare’s policies, but are not necessarily applied evenly or consistently.
1. Functional Equivalency: if 2 drugs are deemed to be functionally equivalent, then their average sales price may be linked so they are reimbursed at the same rate.
2. Inherent Reasonableness: CMS has the right to decrease payments for treatments, that are deemed not to be inherently reasonable, by increments of 15% at a time.
3. Widely Available Manufacturing Price (WAMP): when the average sales price of a drug is higher than the WAMP, CMS has the right to reduce the drug’s price to the WAMP.
4. Coverage Restrictions: CMS can choose to restrict coverage for any drug, especially for off-label uses.
5. Judicial Bar: Only Medicare beneficiaries can sue CMS. Manufacturers may not.
6. Congress: there are several committees that have jurisdiction over Medicare, including the Senate Finance Committee, the House Ways and Means Committe, and the House Energy and Commerce committee. Congress can enact legislation to decrease the average sales price of drugs, and can influence Medicare cost control mechanisms.
