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The first large insurer has indicated that they will not play in the Ocare cesspool next year. Humana has indicated they will not be a part of the scheme for 2018. This may change with the new Trump rules that he has announced. Humana is not a large player in the Ocare circles. However, Molina Healthcare is a major player in the Medicaid arena. They are also threatening to pull out of Ocare as they posted huge losses of $110 million in 2016. The Aetna CEO actually said that Ocare was in a death spiral saying more insurers will quit the product in 2018. The CMIO of the AMA Dr. Michael Hodgkins stated that EMRs are still not doing right by the physicians. They are still causing too much time on non-clinical garbage which is not meaningful to the physicians and is causing burnout. Illinois Medicaid is in trouble in the central part of the state. The state has a rule that 50% of the Medicaid patients must be in managed care plans. In central Illinois there are no managed care plans after the Hospitals refused to deal with Molina. The other managed care plan had previous ly dropped out. This area of the state has few competitors and are into fee for service. The patients will not be seen as fee for service. The DC public laboratory has erred in the testing of Zita for hundreds including pregnant women. They have shipped the specimens to the CDC and other labs for re-testing. At least two that were read as negative are really positive for the virus. The lab said it was a math error. Top Kaiser reported its 2016 earnings. They had an operating revenue of over $64 Billion and a huge net income increase of $3.1 Billion from $1.9 Billion the year prior. Membership increased 4.2% or almost 450,000 people. CHS is selling 25 hospitals to try to recoup some of the $1.7 Billion net loss in 2016. They also have a debt of about $15 Billion. The poor performing hospitals are the ones they purchased several years ago from another poor organization HMA. The CEO of Swedish Health in Seattle, Anthony Armada, resigned after he was accused of offering illegal incentives to the neurosurgeons to increase volume an perform unnecessary surgery. Swedish has shown significant problems in state results of complications. A physician is taking the helm. Top DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the
information presented. |
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