MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'aetna'. Sat, 03 Sep 2011 02:02:21 +0100 http://www.medworm.com/index.php?rid=4997647&cid=t_118583_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F5UZx6zS7roM%2F Ever since the American Recovery and Reinvestment Act became law in February 2009, giving birth to the phrase “meaningful use,” I’ve wondered when private insurers would follow the federal government’s lead and start offering financial carrots and sticks for using and not using EHRs. After all, one of the purposes of the Medicare and Medicaid incentive program was to address the fact that payers tend to reap the greatest financial gains from hospitals and physicians adopting EHRs, even though most if not all of the cost of acquiring the technology falls on the provider. Federal officials have made it clear all along that “meaningful use” is just that, the meaningful use of the technology. The government was not simply going to write checks so providers c... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4997647 Thu, 30 Jun 2011 18:02:52 +0100 4997647 http://www.medworm.com/index.php?rid=4606052&cid=t_118583_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FFiK0SOKwv4Q%2F Where, oh where, did your health care budget go? A larger chunk apparently went to pay for brand-name* prescription meds which, on average, rose 6.9 percent last year. The increase nudged past the 6.8 percent average advance registered in 2008, which was the largest annual jump since Barclays Capital began tracking price hikes, The Wall Street Journal reports. Some of the biggest: the Benicar blood pressure pill sold by Daiichi Sankyo rose 29.3 percent; the Gleevec cancer treatment marketed by Novartis jumped 20.9 percent; Johnson & Johnson’s Concerta pill for ADD moved up 19.7 percent; Pfizer’s Lipitor cholesterol blockbuster popped 12.4 percent, and the Plavix bloodthinner sold by Bristol-Myers Squibb and Sanofi-Aventis rose 13.2 percent. Obviously, drugmakers are &#8220... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4606052 Thu, 17 Mar 2011 12:15:48 +0100 4606052 http://www.medworm.com/index.php?rid=4433159&cid=t_118583_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2F2011-predictions-mu-goes-tactical-aco-strategic In the Healthcare IT (HIT) market, 2010 was the year of meaningful use (MU). Healthcare organizations (HCOs) of all sizes developed plans, began making IT modifications and began adopting the technology they needed to meet Stage One MU requirements and subsequently receive incentive payments, some of which began being disbursed in late 2010. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4433159 Thu, 03 Feb 2011 18:53:35 +0100 4433159 http://www.medworm.com/index.php?rid=4424219&cid=t_118583_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FUEK_Vp45QKM%2F By Michael F. CannonAccording to the Denver Business Journal: A spokeswoman for Aetna confirmed Monday that the insurer will no longer sell new individual-market health insurance policies in Colorado and will terminate current policies held by state residents no later than July 31, 2012. Aetna had already announced that it will no longer sell child-only coverage or small-group coverage in the state.   Colorado is one of 34 states where insurers fled the market for child-only coverage as a result of ObamaCare.  Colorado took steps to try to stabilize its child-only market, and is considering requiring insurers to sell child-only coverage as a condition of selling coverage directly to adults. Aetna isn’t commenting on whether ObamaCare played a role in its decision.   Aetna customer... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4424219 Tue, 01 Feb 2011 13:43:59 +0100 4424219 http://www.medworm.com/index.php?rid=4399826&cid=t_118583_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FTU6O6Hd_s60%2F Another day, another letter to the FDA commish from a group of bipartisan US senators over the biologics debate. The latest missive comes from health committee chair Tom Harkin, John McCain, Chuck Schumer and Sherrod Brown, who are “extremely concerned about possible misinterpretations” of the biosimilars statute “that could further delay the availability of generic biologic drugs.” They are referring to a provision in the healthcare reform law that says generics can enter the market after a brand-name biologic has had exclusivity for 12 years. But earlier this month, a different group of senators - Orrin Hatch, Kay Hagan, Michael Enzi and John Kerry - wrote FDA commish Margaret Hamburg to urge a different interpretation that would favor brand-name drugmakers and biotechs. At issue... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4399826 Tue, 25 Jan 2011 16:57:23 +0100 4399826 http://www.medworm.com/index.php?rid=4382949&cid=t_118583_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FbWRWTVXZO5M%2F Another nasty lobbying battle has broken out over biosimilars. And the latest involves a group of generic drugmakers, insurers and pharmacy benefit managers, which are pushing back against a recent effort by brand-name drugmakers to weaken a part of healthcare reform that is supposed to create competition for expensive biologics. The provision says generics can enter the market after a brand-name biologic has had exclusivity for 12 years. But earlier this month, a bipartisan group of four US Senators - including Orrin Hatch, Kay Hagan, Michael Enzi and John Kerry - wrote FDA commish Margaret Hamburg to urge a different interpretation that would favor brand-name drugmakers and biotechs. Their letter was circulated on and beyond Capitol Hill by, among others, the BIO trade group. At issue is... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4382949 Fri, 21 Jan 2011 14:25:26 +0100 4382949 http://www.medworm.com/index.php?rid=4331237&cid=t_118583_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FibJkV92R2cc%2F In a move that will hearten breast-cancer patients, several large insurers will continue to cover the Avastin medication, even though the FDA is taking steps to remove that indication for the Roche drug. The agency is doing so after analyzing clinical studies that found Avastin does not prolong overall survival or provide a sufficient benefit in slowing disease progression to outweigh serious side effects (back story). Among the insurers are UnitedHealth and WellPoint, which have cited a recommendation by the National Comprehensive Cancer Network, a non-profit group of oncologists whose guidance is closely followed. However, eight of the 33 members on its breast cancer panel have various ties to Roche and its Genentech unit as advisory board members, speakers, consultants, expert witnesses... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4331237 Tue, 11 Jan 2011 13:26:25 +0100 4331237 http://www.medworm.com/index.php?rid=4225183&cid=t_118583_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F12%2Fhealth-insurers-sanctioned-fined.html It has not been a good few weeks for big US health insurance companies.  First was a report (e.g., per the Wall Street Journal) that three companies had been suspended from selling Medicare Advantage plans:The U.S. government's Medicare program has ordered three health insurers--Universal American Corp. (UAM), Health Net Inc. (HNT) and Arcadian Health--to stop marketing to and enrolling new members in their Medicare Advantage health and prescription-drug plans, saying the companies violated regulations. In particular,Universal American was told to stop marketing to and enrolling people in its Medicare Advantage plans effective Dec. 5. The action doesn't affect current members or the enrolling of beneficiaries in the company's stand-alone Medicare prescription-drug plans.Health Net had... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4225183 Fri, 03 Dec 2010 17:03:00 +0100 4225183 http://www.medworm.com/index.php?rid=4159209&cid=t_118583_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FcA9IZ3ouTMQ%2F By Michael F. CannonReuters has helpfully published another article demonstrating that ObamaCare‘s biggest cheerleaders are the insurance and drug industries.  That’s because, barring repeal and despite the Obama administration’s fatuous rhetoric about standing up to the special interests, ObamaCare will shower those industries with massive subsidies.  Excerpts follow. Health Overhaul Should Press Ahead: Industry By Susan Heavey Thu Nov 11, 2010 1:39pm EST NEW YORK (Reuters) – Repeal reform? No thanks, say health insurers, drugmakers and others looking for a clearer picture of the U.S. healthcare market after the bruising passage of the controversial overhaul law… The new healthcare law created “a stable, predictable environment, however painful it ha... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4159209 Thu, 11 Nov 2010 21:45:07 +0100 4159209 http://www.medworm.com/index.php?rid=4074062&cid=t_118583_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fun-insurance-reform%2F2010.10.15 Who doesn’t need insurance reform? Why, the insurers like Aetna, Cigna, and BCS Insurance, that’s who! From Emergency Physicians Monthly: By threatening to raise health care premiums by 200 percent or threatening to drop coverage altogether, the companies got the Department of Health and Human Services to cave. Now the companies have our government’s blessing to continue offering “insurance” to their employees that is capped at a few thousand dollars per year instead of the $750,000 required in the health care law. Perhaps GruntDoc said it best: “I am not an Obamacare fan, and would like it repealed, with smaller, more focused Bipartisan fixes, but if the government is going to pass something then roll over this easily to special interests… it’s already worse th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4074062 Fri, 15 Oct 2010 19:00:00 +0100 4074062 http://www.medworm.com/index.php?rid=4018156&cid=t_118583_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F7D33y_6u4ec%2F By Michael F. CannonMany employers, such as McDonald’s, provide health benefits that are less comprehensive than most.  They may have an annual claims limit of $10,000 or less.  But if you’re young, healthy, and need to pinch your pennies, that may suit you just fine.  According to Jerry Newman, a SUNY-Buffalo professor who wrote a book about working at McDonald’s, “For those who didn’t have health insurance through their spouse, it was a life saver.” These are the health plans (and the workers) that are seeing the highest premium increases under ObamaCare.  The Wall Street Journal reports: Trade groups representing restaurants and retailers say low-wage employers might halt their coverage if the government doesn’t loosen a requirement for &#8... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4018156 Thu, 30 Sep 2010 19:14:04 +0100 4018156 http://www.medworm.com/index.php?rid=3957897&cid=t_118583_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FDKojA3KM-8w%2F By Michael F. CannonThis week saw more bad news for ObamaCare.  So the Obama administration slipped on the brass knuckles. Last week brought news that health insurance premiums grew by a smaller increment in 2010 than in any of the past 10 years.  On Tuesday, The Wall Street Journal reported that ObamaCare appears to be turning that around: Health insurers say they plan to raise premiums for some Americans as a direct result of the health overhaul in coming weeks, complicating Democrats’ efforts to trumpet their signature achievement before the midterm elections. Aetna Inc., some BlueCross BlueShield plans and other smaller carriers have asked for premium increases of between 1% and 9% to pay for extra benefits required under the law, according to filings with state regulators. Th... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3957897 Fri, 10 Sep 2010 20:32:44 +0100 3957897 http://www.medworm.com/index.php?rid=3889156&cid=t_118583_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fgoogles-window-healthcare-it-market One of the major goals of the federal government's push for nationwide electronic medical record adoption is to create an information network where "health data can flow freely, privately, and securely to the places where they are needed." So far, this is proving to be a challenge for the nation's hospitals and doctors. (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=3889156 Fri, 20 Aug 2010 15:57:23 +0100 3889156 http://www.medworm.com/index.php?rid=3880944&cid=t_118583_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F1OYcnjqulm8%2F The HITECH Law Blog had a post recently titled “Commercial Payors Implementing EHR Meaningful Use Criteria in P4P Programs.” Here’s a short excerpt: On August 5, 2010, four major commercial health insurance payors participated in the Health Industry Forum in Washington, D.C., to discuss private industry collaboration with the United States Health & Human Services Department (HHS) to support providers in the adoption of certified electronic health records (EHRs). Leading the Forum’s panel discussion was David Blumenthal, M.D., Chief of the Office of National Coordinator of HIT. All four payors will include the Meaningful Use criteria in their pay for performance (P4P) programs. The 4 insurance groups identified are Aetna, Inc and its subsidiary, ActiveHealth Managen... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3880944 Tue, 17 Aug 2010 16:29:56 +0100 3880944 http://www.medworm.com/index.php?rid=3798534&cid=t_118583_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2Fn4-kpQw9l88%2F Obama isn't anti-business, Aetna CEO Williams said, but the administration may lack an understanding of what it takes to run a business. In the interview, Williams also talked about the company's recent deal with CVS Caremark and reiterated that the deal was the best option for the company and its shareholders (rather than a full-out sale of Aetna’s business.) Williams made the comments to WSJ in "The Big Interview" video that can be seen in full on WSJ.com Friday morning. (Source: WSJ.com: Health Blog) WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=3798534 Thu, 29 Jul 2010 00:20:59 +0100 3798534 http://www.medworm.com/index.php?rid=3718697&cid=t_118583_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FlMT1GNwF2yc%2F Last night, the latest chapter in the Provenge saga was unexpectedly written - the news that the Centers for Medicare & Medicaid Services was reviewing coverage for the Provenge prostate cancer vaccine sent Dendreon shares plunging as much as 23 percent in after-hours trading. Coupled with manufacturing constraints that are causing rationing, investors were caught off guard. That’s because a National Coverage Determination usually isn’t issued for cancer treatments. In fact, an NCD is uncommon for new drugs, in general. What likely prompted this move were requests from local Medicare providers, or what RW Baird analyst Chris Raymond calls “local fiscal intermediaries.” Why? Remember that Provenge is unusual in that it works by stimulating a patient’s own ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3718697 Thu, 01 Jul 2010 12:36:12 +0100 3718697 http://www.medworm.com/index.php?rid=3710519&cid=t_118583_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F06%2Fwellpoint-dont-know-much-about-computer.html Big US based health care insurance companies have not been covering themselves in glory in the last week.Aetna's Math ErrorsFirst, there was the case of Aetna's mathematical prowess, e.g., as reported by the Los Angeles Times:A second insurance company in California has killed plans for double-digit rate hikes for individual policyholders because of errors in its filing that would have inflated premiums, state regulators said Thursday.Connecticut-based Aetna Inc. had sought an average 19% increase in rates for its 65,000 individual customers, but pulled back after multiple math errors in its paperwork were found by its own staff and by an independent consultant working for the state.Aetna's decision follows a similar move by Anthem Blue Cross, which canceled a rate increase of as much as 3... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3710519 Tue, 29 Jun 2010 21:49:00 +0100 3710519 http://www.medworm.com/index.php?rid=3023077&cid=t_118583_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F11%2Faetna-government-contract-discredited.html Last week, the Sacramento Business Journal reported on irregularities in how health insurance/ managed care giant Aetna obtained a contract with the US military health plan Tricare:Aetna Inc. hired a former high-level Tricare employee with access to proprietary information about Health Net Inc.’s performance that could have given Aetna a competitive edge in its bid for a lucrative military health care contract, the U.S. Government Accountability Office has concluded.The GAO details six flaws in the procurement process in new documents posted online Tuesday and recommends that Aetna should be excluded from the competition, leaving Health Net 'as the only viable awardee.'The agency recommends Tricare officials perform a thorough review of what sensitive information the former Tricare emplo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3023077 Mon, 23 Nov 2009 21:43:00 +0100 3023077 http://www.medworm.com/index.php?rid=2160333&cid=t_118583_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F02%2Faetna-settles.html As reported by the Hartford Courant:Aetna will reimburse more than $5.1 million on 73,000 health claims for college students it underpaid between 1998 and April 1, 2008, under a nationwide agreement announced Monday by New York Attorney General Andrew M. Cuomo.The claims involved out-of-network care in which Aetna Student Health — formerly called Chickering Student Health — paid physicians what it considered reasonable and customary. Doctors whose charges were higher could bill students for the balance.Aetna will reimburse students if they paid such a balance. If a student wasn't balance-billed, Aetna will reimburse the doctor. The company says its under-payments averaged $25 each nationwide.The inadequate claim payments stem from outdated information that Aetna and other insurers used... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2160333 Wed, 04 Feb 2009 22:07:00 +0100 2160333 http://www.medworm.com/index.php?rid=2079027&cid=t_118583_122_f&fid=36582&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSharpBrains%2F%7E3%2F495728856%2F This article provides is a very good market overview. The reporter and I also discussed in depth the need for better consumer education and professional development, so people can make informed decisions, and for cognitive assessments to serve as independent baseline, help identify priorities and measure results. Please note that our market estimates do include revenues of computerized cognitive assessments, today mostly used in clinical trials, and wthin the military and sports teams. 2) Navigating the brain fitness landscape: do's and don'ts (McKnight's Long Term Care News) Comment: "Choosing the right cognitive fitness product or program for senior living residents is harder than it sounds. But understanding residents' needs, identifying your objectives and considering the total c... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=2079027 Fri, 26 Dec 2008 18:03:07 +0100 2079027 http://www.medworm.com/index.php?rid=1947960&cid=t_118583_122_f&fid=36582&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSharpBrains%2F%7E3%2F447995271%2F My apologies for not writing in a few days...the Global Agenda Summit in Dubai has required all my attention - I will summarize the great experience when I land back in San Francisco tomorrow night. The concepts of night and day do become challenging when working for a few days in a place with a 12-hour time difference with one's home base. Sleep is indeed very important to maintain top cognitive shape...which leads me to a fascinating news announcement: Health insurance firms offering online cognitive therapy for insomnia (Los Angeles Times) - "helping consumers get a good night's sleep has become a priority for most of the top-tier U.S. health insurance companies, including WellPoint, Aetna, Cigna, Kaiser Permanente and several Blue Cross plans. Their new programs don't involve slee... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=1947960 Mon, 10 Nov 2008 03:52:44 +0100 1947960 http://www.medworm.com/index.php?rid=1551902&cid=t_118583_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F321339367%2F Hired someone new and exciting? Promoted a rising star? Finally solved that hard-to-fill spot? Share the news with us and we’ll share with it others. That’s right. Send us your announcements and we’ll find a home for them. Don’t be shy. Everyone wants to know who is coming and going, especially with all the layoffs. Despite the downsizing, there is movement. Here are some of the latest changes. Recognize anyone? Wyeth named ceo Bernard Poussot as chairman; Hospira named Sumant Ramachandra as senior vp; Pharmaceutical Profiles hired Jo Collier as vp of medical research; Aetna hired Steve Kelmar as head of government relations; Uluru named Ronald Ahrens to its board; Alpharma named Ron Warner exec vp and chief scientific officer; Alpharma named Scott Shively senior vp, commercial ope... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1551902 Fri, 27 Jun 2008 11:38:23 +0100 1551902 http://www.medworm.com/index.php?rid=1537804&cid=t_118583_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2008%2F06%2Ffiercehealthit.html Just a quick note: I'm the guest host, as it were, of FierceHealthIT this week. I wasn't sure until it was too late if I was supposed to write a commentary, so I didn't, but four of the top five story summaries this week carry my byline:"Study: Physician adoption of EHRs continues to lag""MI, WI advance health information exchange""PHRs make inroads with health plans""WellPoint says e-prescribing could be a Trojan horse for HIE"The one I didn't write, "Top P4P hospitals to score $7m in bonuses from CMS," ran in the daily FierceHealthcare last Thursday. (Source: Neil Versel's Healthcare IT Blog) Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1537804 Mon, 23 Jun 2008 18:10:00 +0100 1537804 http://www.medworm.com/index.php?rid=1420667&cid=t_118583_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F283888268%2F The battle to lower prescription drug costs is causing still more friction between doctors and insurers. Take the case of Lloyd Negoescu, who took Lopressor to stabilize his blood pressure, until his Medicare Part D plan changed, and his new insurer, RxAmerica, stopped paying for the brand-name med. His doctor wrote letters to appeal, to no avail. “They wanted me to try generics first. My blood pressure went up astronomically on the new drugs,” the 57-year-old disabled man tells The Star-Ledger of New Jersey. Negoescu is an example of what’s known as step therapy - requiring patients to try and fail with lower-cost meds before insurers will pay for more expensive, brand-name, drugs. To insurers, the practice directs patients away from costly meds and toward equally effe... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1420667 Mon, 05 May 2008 12:02:18 +0100 1420667 http://www.medworm.com/index.php?rid=1322414&cid=t_118583_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F256844786%2F When using a search engine, should results be customized based on your personal health information (PHI)?  Should your search engine of choice take into account your previous history of medical searches, or even provide results tailored from data about your personal medical history? Two companies — Aetna and Microsoft — have come up with 180 degree different answers. In this post, I will: Describe how Aetna’s and Microsoft’s approaches differ Speculate on why their approaches make strategic sense for the respective companies Explore how technology and expectations about using PHI for search are likely to change over time Aetna’s SmartSource and Microsoft HealthVault  Aetna has adopted a more aggressive strategy of using your PHI to improve search results. Microsoft Healt... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1322414 Mon, 24 Mar 2008 05:09:29 +0100 1322414 http://www.medworm.com/index.php?rid=1300456&cid=t_118583_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F250829885%2F Aetna recently made another big announcement relating to their PHR.  While the concept of what they’re doing is very appealing, it strikes me that health plans in general face an uphill battle in getting consumers to adopt and use personal health records (PHRs). I’ll describe 4 factors behind my thinking: Lack of Trust Lack of Access to Clinical Data Lack of Permission Lack of Convenience in Consumer Workflow (more…) Share This Related posts (and # of comments) A First Comparison of Google Health and MS HealthVault (5) Four Misconceptions About HealthVault and the Emerging Personal Health Information Ecosystem (PHI-Ecosystem) (7) Connecting the Dots…Google Health Promises to Create AND Dominate Next Generation PHRs (44) Birth Announcement: th... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1300456 Thu, 13 Mar 2008 16:53:02 +0100 1300456 http://www.medworm.com/index.php?rid=1225336&cid=t_118583_145_f&fid=35710&url=http%3A%2F%2Fstoryofhealing.com%2F2008%2F02%2F12%2Fmedia-in-medicine-what-of-the-insurance-companies-other-issues%2F The Lost Angeles Times recently reported more of these online consults. Doctor visits in the United States have surged 20% in the last five years to more than 1.2 billion visits annually, according to the Centers for Disease Control and Prevention. Even as the population ages, the number of doctors is falling across the country, and experts predict that office wait times will increase in the coming years. — “People can wait a long time to get in to see their primary-care doctor and longer for a specialist. . . . To have immediate access is huge,” said Dr. Melissa Welch, Aetna’s Northern California medical director. Insurance companies apparently opened up and expanded coverage to these web-based services, according to the same article. …Aetna Inc., the natio... the story of healing blogs http://www.medworm.com/rss/comments.php?id=1225336 Tue, 12 Feb 2008 21:14:57 +0100 1225336 http://www.medworm.com/index.php?rid=1143521&cid=t_118583_158_f&fid=36024&url=http%3A%2F%2Fblog.healthtalk.com%2Fcaregiver%2Fjeff%2Fa-caregiver-rants-about-insurance-company-communication%2F I’m an easy-going sort usually, so why do I find it so hard to keep my temper when I’m talking to customer service reps at insurance companies? Case in point: A week or so ago, out of the blue, Pops got a letter from Aetna welcoming him to the Aetna Medicare Rx Plan – except nobody had ever enrolled him in the Aetna Medicare Rx Plan. The letter was full of irrelevancies and was unhelpful in explaining why he was getting it. I told him I would call Aetna and find out what was going on. I did remember that last year the EPIC New York State Prescription Plan, in which Pops had been enrolled for years, required him to sign up for a Part D prescription plan and provided a list of alternative plans. At that time, I called and talked to the EPIC rep and picked a plan called RX1 administered... Caregiver Notes blogs http://www.medworm.com/rss/comments.php?id=1143521 Fri, 11 Jan 2008 00:32:22 +0100 1143521 http://www.medworm.com/index.php?rid=964756&cid=t_118583_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F172109131%2F The big insurer is taking a cue from Medicare and tightening reimbursement on Amgen’s Aranesp and Epogen, as well as Johnson & Johnson’s Procrit meds, according to The Los Angeles Times. The move comes just three months after Medicare greatly lowered the maximum dose for which it would provide reimbursement for the drugs. The restrictions follow studies that raised concerns the meds may be harmful to some patients and controversy over higher dosages administered by some docs. And other insurers are expected to follow suit. “Aetna is likely to be the first of many insurers to change their guidelines,” Bear, Stearns biotech analyst Mark Schoenebaum tells the paper. Aetna’s new policy is less restrictive than Medicare’s but severe nonetheless, the Ti... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=964756 Fri, 19 Oct 2007 14:56:40 +0100 964756 http://www.medworm.com/index.php?rid=728416&cid=t_118583_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2007%2F07%2Fblogscan-when-fighting-wooden-headed.html On the Running a Hospital blog, Paul Levy describes how Virginia Mason Medical Center in Seattle tried to increase the quality and efficiency of its services for specific medical conditions, with prompting from health insurer Aetna Inc. We had posted about these efforts, which seemed to be one antidote to the sort of wooden-headed health reimbursement policies leading to higher costs and lower quality that we have decried. The problem with Aetna's and Virginia Mason's well-intentioned efforts were that they have hurt the Medical Center's bottom line, which is mainly a factor of the traditional, wooden-headed reimbursement policies of other commercial insurers, and of Medicare and Medicaid. It seems no good deed goes unpunished.... (Source: Health Care Renewal) Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=728416 Wed, 11 Jul 2007 19:29:00 +0100 728416 http://www.medworm.com/index.php?rid=693270&cid=t_118583_132_f&fid=35011&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fmndoci%2F%7E3%2F127585203%2F At DIA, someone from Aetna talked about CareEngine, a proprietary system for personalized health records (PHRs). I am sure just the thought of an insurance company having a system with access to genetic records and recommending action is enough to worry the hell out of many people, but for a second, lets try and avoid that aspect. Essentially what CareEngine does is take all your medical information, including genetic information and provide you a list of gaps in your healthcare, e.g. tests you should be taking because you show a pre-disposition to some condition, etc. How should such a system be implemented? Now that our second is over, I am not sure I am comfortable with a third party payer having access to all these medical records and recommending treatments. A system independent of he... business|bytes|genes|molecules blogs http://www.medworm.com/rss/comments.php?id=693270 Sun, 24 Jun 2007 21:28:48 +0100 693270 http://www.medworm.com/index.php?rid=611604&cid=t_118583_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2007%2F05%2Fmore-on-disparities-between.html We recently posted a summary of an article in the Annals of Internal Medicine by Bodenheimer and colleagues(1) which helped explain the increasing gap between how US primary care, generalist, and "cognitive" doctors are reimbursed by Medicare, and how proceduralists are reimbursed. Hard on the heels of that comes an analysis of the 10 year trends in Medicare spending,(2) with an accompanying editorial in the New England Journal of Medicine.(3) The first article provides new data about how the Resource Based Relative Value Scale (RBRVS) system has functioned (dysfunctioned?) to create this disparity, mainly because of how reimbursements are updated, and now new procedures are valued.The editorial does a nice job summarizing the main points. As author Joseph Newhouse noted, "The resource-bas... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=611604 Wed, 09 May 2007 20:13:00 +0100 611604