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Ark Insurance Solutions is a licensed and certified representative of Medicare Advantage organizations and stand-alone prescription drug plans. Each organization has a Medicare contract. Enrollment depends on contract renewal.
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Important News From Aetna
/by Rebecca YatesOn October 10, 2018 we learned that the Department of Justice (DOJ) will allow CVS Health’s acquisition of Aetna to proceed.
Under the DOJ consent decree, closing of the CVS Health-Aetna transaction may proceed prior to the effective date of Aetna’s previously announced divestiture of its entire standalone Medicare Part D business to a subsidiary of WellCare Health Plans, Inc.
You do not need to do anything new or different as a result of this announcement. Aetna and CVS Health will continue to operate as separate companies until the CVS Health transaction is complete.
While the DOJ decision is an important step toward finalizing the CVS Health transaction, closing remains subject to certain state regulatory approvals and satisfaction of other closing conditions. We continue to expect the CVS Health transaction to close this year.
We value our relationship, and will keep you informed every step of the way in accordance with the terms of our current agreements.
Source: This message is for informational purposes only, is not medical advice and is not intended to be a substitute for proper medical care provided by a physician. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to aetna.com.
Amazon Partners with Blue Cross, Medical Supplies Now Available for Purchase
/by Rebecca YatesGreat news for Amazon shoppers and Regence Blue Cross members.
Retail medical supplies and equipment can now be purchased through an Amazon Local Associates shopping page. Blue Cross members can shop, buy and file a claim through the Regence website at:
https://www.regence.com/web/regence_producer/
“Once members have accessed this page:
1) Members will be prompted to sign an authorization agreement opting them into the program
2) They will be given a unique, one-time 10% off discount code that they can apply in the discount coupon field on the Amazon checkout page for applicable equipment and supplies
3) The member is then redirected to the Amazon Local Associates shopping page where they can shop for and purchase medical equipment and supplies
o Please remember to apply your unique discount code upon checkout to receive the 10% discount.
o This program will be in place until the end of September, with the potential to extend further based on member engagement.”
Source: https://www.regence.com/web/regence_producer/
Recent Study Looks At Health Care Pricing
/by Rebecca YatesAccording to a recently published healthcare economics paper, different insurers pay varied prices for the same services and procedures at the same hospital, indicating that bargaining leverage really does impact healthcare prices.
Authors took actual data from claims for three national insurers. Studies showed that dominate hospitals can dictate how much they are going to get paid for specific services and procedures. For hospitals that hold an monopoly in their area, that number was 12.5% higher than those who had nearby competitors. For more concentrated markets, providers can shift more risk to insurers, which affects the ability to keep prices at a set standard.
“The two main types of contracts use prospectively set prices that pay a fixed dollar amount based on the DRG classification code, or a model that sets payments as a percentage of hospital charges.
Hospitals are likely to prefer the latter because they get paid for every service they provide, and thus bear less risk. This drives prices up and also places less pressure on the hospital to reduce costs.”
In simply terms, it’s about negotiation. The hospital may charge $50,000 for a hip replacement, but the negotiated price may be more like $22,000, Medicare reimbursements would be even less.
“Researchers also found that prices increased by more than 6% when merging hospitals were less than 5 miles apart. They didn’t find significant price impact when the hospitals were separated by at least 25 miles.”
Sources: The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured Zack Cooper (Yale University) Stuart V. Craig (University of Pennsylvania) Martin Gaynor (Carnegie Mellon University and NBER) John Van Reenen (Massachusetts Institute of Technology, CEP, and NBER)
Modernhealthcare.com
Health Care Cost Institute