A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Health Care Market

Where Is Medicaid (National) Going?

Two articles over the past two weeks give a revealing portrait of important and evolving changes in today's Medicaid program, the essential health insurance safety new for about 55 million of America's neediest. The new Nov-Dec issue of Health Affairs has a lead article by James Robinson, "Insurers Adapt to an Eroding Workplace Market." Bottom line -- growth in employee enrollment in private health insurance plans is flat as a pancake and, in fact, slightly declining. But the national insurers are doing quite well, thank you, by growing the enrollment in public programs, chiefly Medicare... Read more »

Are the Gloves Coming Off?

I should be quiet about this, but it demands comment. One of my favorite political scientists, E.E. Schattschneider, taught that it's the disadvantaged (aka: losers) in corporate conflict who always cry foul and plea for help. The winners always talk about letting the market work and keeping government out (think Netscape vs. Microsoft, physicians vs. managed care). Came to mind this morning when I read Steve Bailey's influential Boston Globe column, "Partners vs. Everyone." The argument against Partners gets taken one step further in today's blog by Paul Levy. Read more »

No Market Merger Special Commission Meeting this Week

We just got notice that the Special Commission studying the market merger will not be meeting this week. The next meeting is scheduled for next Tuesday, November 21st at 1:00 pm. Read more »

Connector Board Policy Subcommittee to Meet this Saturday

The policy subcommittee of the Connector Board will meet Saturday (Nov. 18) from 10am to 1pm to determine how it will advise the larger Board on the various decisions it must make in regards to minimum creditable coverage and the non-subsidized plans that will be offered through the Connector. This open meeting promises to be interesting. Stay tuned for the location. Read more »

Working Backwards toward Minimum Creditable Coverage

A must-see powerpoint was curiously missing from the materials distributed at the Connector Board meeting on Thursday and is not posted on the Connector website. Buried on slide 10 is the Connector staff’s formula for defining minimum creditable coverage – pick a premium and work backwards (and, by the way, the $200 premium was not a mandate by the administration or legislature). Isn’t the purpose of mandating a minimum creditable level to ensure that Massachusetts residents have adequate health care coverage? And, if so shouldn’t the minimum creditable coverage standard be based on what... Read more »

11-9 Market Merger Commission Meeting Cancelled

Dear Special Commission Members: We got this at 3:15 this afternoon... I apologize for the late notice, but herby notify you that the meeting of the Special Commission on the Merger of the Nongroup and Small Group Markets that was scheduled for Thursday, November 9, 2006, is cancelled. I am working on scheduling the next meeting and will notify you of the date and time. Nancy Schwartz Director, Bureau of Managed Care Division of Insurance Read more »

Dueling Letters on “Low-Cost” Insurance

The debate about skinny health care plans hit the Op/Ed page of the Globe this week. Round 1 was launched a letter from former HCFA staffer and all around health insurance expert Rebecca Derby. Round 2 came in a letter from Health Markets CEO William Gedwed. Read more »

Market Merger Commission meeting 11-2-06

A larger than usual crowd turned out for today’s meeting of the Small/Nongroup market merger commission, and got not much of a show. The Commission discussed baseline assumptions and rating factors, then went into executive session to discuss confidential information from insurance carriers. The Uninsured Next week the Commission plans to discuss assumptions about the demographics of the uninsured population. The assumptions will be based on data from the Division of Health Care Finance and Policy (DHCFP) and the Urban Institute. The Commission will make assumptions about which uninsured... Read more »

"Shift Left" -- Andy Grove Takes on Health Care

Andy Grove is one of the smartest business minds in America. His 1996 book, Only the Paranoid Survive, is a business classic I have found deeply helpful. He introduced the concept of "strategic inflection points" (which I've heard Romney use several times) when the choice becomes: change the fundamental model and prosper or don't and die. Grove is now getting interested in health care, as today's Wall Street Journal column indicates. His ideas or often riveting, and whether he's right or wrong, he's definitely worth hearing.John McDonough PORTALS By LEE GOMESAndy Grove Enters New Post-... Read more »

Market Merger Commission to Meet on Thursday

The Commission on the Small/Nongroup market merger will meet this Thursday, 10 to 11:30am at the Division of Insurance at One South Station. Check out the Agenda below. Doesn't look as enlightening as earlier meetings, though still worth attending to hear what they say about research assumptions. These meetings are a great opportunity to learn the complexity of what may happen to the private insurance market post merger, post mandate, post creation of Connector products.Agenda: 1. Data retrieval update 2. Initial data analysis (summary tables) 3. Assumption review for baseline forecast Read more »


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