Shop at the new health exchange, coveredca.com
In San Diego County, six insurance companies will offer plans in the exchange: Sharp Health Plan, Kaiser Permanente, Anthem Blue Cross, Blue Shield, Molina Healthcare and Health Net.
State health exchange opens Tuesday
By Paul Sisson
SDUT
Sept. 30, 2013
Outreach worker Ghaith Al Obaidi of the Borrego Community Health Foundation, chats about the new Covered California health insurance exchange with two unidentified men at the El Cajon Farmer's Market Thursday. The exchange has spent millions on outreach to spread the word about he new exchange at community events, health clinics and other locations across the state.
Despite the political battles being fought over the new federal health care law in Washington, Covered California, the state’s new insurance exchange, is set to open as scheduled on Tuesday.
Californians will be able to sign up for health insurance either on the new marketplace’s website or over the phone. Consumers also can apply for income-based tax credits designed to keep premium costs affordable for families.
Peter Lee, Covered California’s executive director, said Thursday that he is confident the new marketplace will be fully functional in two days, as promised.
“We’re good to go on Oct. 1,” Lee said.
Covered California is a key component of the Affordable Care Act, the sweeping federal health reform law approved in 2010. At the core of health reform, often called Obamacare, is the tenet that most Americans have health insurance by Jan. 1, 2014, or pay a small penalty. Enrollment in exchange plans must occur by Dec. 15 for coverage to start at the first of the year.
While the budget brinkmanship in Washington, D.C., continues, states and the federal government are moving forward with implementation of health exchanges required by the Affordable Care Act.
California is one of 17 states, and the District of Columbia, to create its own exchange while seven more are operating in partnership with the federal government. The federal government will also run exchanges in the remaining 27 states where leadership has generally opposed health reform.
A place to shop
Covered California takes an Internet commerce approach to selling health insurance. Uninsured residents can go online, specify their locations, and see the plans offered in their area.
Much of what consumers will see is already visible on the website. Those who visit today can enter their family size, household income and ZIP code and receive a list of plans displayed side-by-side, with the premium they would pay and whether they would qualify for a tax credit from the federal government.
Lee said that, on Tuesday, a new button will appear on the website allowing visitors to enroll for policies effective Jan. 1. A consolidated physician directory will also be posted Tuesday, which will allow applicants to search for doctors across plans, Lee said.
“We think it’s a big deal to have a consolidated directory,” he said.
For people without computers, the exchange has created two call centers staffed by 442 operators who can guide applicants through the process.
In San Diego County, six insurance companies will offer plans in the exchange: Sharp Health Plan, Kaiser Permanente, Anthem Blue Cross, Blue Shield, Molina Healthcare and Health Net.
On the exchange, each carrier is required to clearly list the premiums and copays it charges, as well as the out-of-pocket maximums, for each policy sold.
Health reform also requires all exchange plans to cover the same 10 categories of “essential health benefits,” which range from emergency services to prescription drugs.
Because the health reform law is so strict about which benefits must be included, consumers will largely be deciding on premiums, coverage levels and doctor networks when making a decision about which plan to purchase.
Showing posts with label California. Show all posts
Showing posts with label California. Show all posts
Tuesday, October 8, 2013
Friday, September 14, 2012
Doctor, Hospital Deals Probed, but not Kaiser Permanente, which does the exact same thing
Isn't this exactly what Kaiser Permanente has done? Does Kaiser have the political clout to escape examination?
Doctor, Hospital Deals Probed
September 13, 2012
By ANNA WILDE MATHEWS
The Sacramento Bee/Associated Press
California's attorney general has launched a broad investigation into whether growing consolidation among hospitals and doctor groups is pushing up the price of medical care, reflecting increasing scrutiny by antitrust regulators of medical-provider deals.
The office of the attorney general, Kamala D. Harris, has sent subpoenas, known as civil investigative demands, to several big hospital operators in the state, including San Francisco-based Dignity Health and San Diego's Scripps Health and Sharp HealthCare. Northern California's 24-hospital Sutter Health system has also received one, as has Santa Barbara-based Cottage Health System, according to people with knowledge of the matter. Subpoenas have also gone to major California health insurers, those people said.
The probe, which has been under way for several months, is examining hospital systems' reimbursement from the insurers, according to people with knowledge of the matter. The regulator appears to be focusing on whether the systems' tie-ups with physicians, as well as ownership of hospitals, have given them the market power to boost prices in a way that violates antitrust law, these people said.
Nationally, health-care providers are rapidly merging into bigger health systems, moves that they say will improve efficiency. The number of hospital deals last year, 86, was the biggest since 2000, according to Irving Levin Associates, a research firm that tracks health-care transactions.
Also, nearly a quarter of all specialty physicians who see patients at hospitals are now employed by the hospitals, according to an estimate from the Advisory Board Co. ABCO +0.51% That is more than four times the 5% in 2000. Among primary-care doctors who see patients in hospitals, the employed share has doubled to about 40% in the same time frame.
The American Hospital Association said consolidation doesn't routinely drive up prices; the California Hospital Association referred questions to the national group. Hospitals are merging and employing more doctors in order to streamline and improve care, under pressure from health regulators urging a more integrated approach under the federal health overhaul law, said Melinda Hatton, AHA's general counsel. "The antitrust agencies and national health-care policy don't seem to be really in sync at this point," she said.
Some research suggests that mergers can drive up health-care prices. A 2010 study published in the journal Health Affairs said concentration among health-care providers in California had led to "a definite shift in negotiating strength toward providers, resulting in higher payment rates and premiums."...
Doctor, Hospital Deals Probed
September 13, 2012
By ANNA WILDE MATHEWS
The Sacramento Bee/Associated Press
California's attorney general has launched a broad investigation into whether growing consolidation among hospitals and doctor groups is pushing up the price of medical care, reflecting increasing scrutiny by antitrust regulators of medical-provider deals.
The office of the attorney general, Kamala D. Harris, has sent subpoenas, known as civil investigative demands, to several big hospital operators in the state, including San Francisco-based Dignity Health and San Diego's Scripps Health and Sharp HealthCare. Northern California's 24-hospital Sutter Health system has also received one, as has Santa Barbara-based Cottage Health System, according to people with knowledge of the matter. Subpoenas have also gone to major California health insurers, those people said.
The probe, which has been under way for several months, is examining hospital systems' reimbursement from the insurers, according to people with knowledge of the matter. The regulator appears to be focusing on whether the systems' tie-ups with physicians, as well as ownership of hospitals, have given them the market power to boost prices in a way that violates antitrust law, these people said.
Nationally, health-care providers are rapidly merging into bigger health systems, moves that they say will improve efficiency. The number of hospital deals last year, 86, was the biggest since 2000, according to Irving Levin Associates, a research firm that tracks health-care transactions.
Also, nearly a quarter of all specialty physicians who see patients at hospitals are now employed by the hospitals, according to an estimate from the Advisory Board Co. ABCO +0.51% That is more than four times the 5% in 2000. Among primary-care doctors who see patients in hospitals, the employed share has doubled to about 40% in the same time frame.
The American Hospital Association said consolidation doesn't routinely drive up prices; the California Hospital Association referred questions to the national group. Hospitals are merging and employing more doctors in order to streamline and improve care, under pressure from health regulators urging a more integrated approach under the federal health overhaul law, said Melinda Hatton, AHA's general counsel. "The antitrust agencies and national health-care policy don't seem to be really in sync at this point," she said.
Some research suggests that mergers can drive up health-care prices. A 2010 study published in the journal Health Affairs said concentration among health-care providers in California had led to "a definite shift in negotiating strength toward providers, resulting in higher payment rates and premiums."...
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