Would You Believe A Premium Hike Of 30 Percent?


Barring a sudden economic downturn or a major international crisis, managed care reform legislation is likely to dominate Congress in the precious few weeks between summer recess and Election Day.

The American Association of Health Plans has joined the fray, warning of extreme economic consequences if four major aspects of reform legislation become law. AAHP released a Barents Group/KPMG Peat Marwick study that analyzed not specific bills, but provisions — some or all of which are part of each of the major reform proposals in Washington. The report suggests that if you think this year's relatively small premium increases were cause for concern, you haven't seen anything yet.

The study found premiums would rise between:

  • 2.7 and 8.6 percent if health plans are exposed to greater malpractice liability
  • 2.2 and 6.9 percent if utilization review is deemed to be a medical decision
  • 4.1 and 6.1 percent if plans are prohibited from determining medical necessity
  • 6.6 and 8.6 percent if plans are required to allow any willing provider — "willingness" means the provider agrees to go along with the rules of the health plan — to give care

When all of these factors are taken together into a worst-case scenario, the result could be a premium hike of more than 30 percent. Barents derived its estimates from Congressional Budget Office projections.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

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