But but but the death spiral!
The article reports data from only 10 states. Not included in those ten is California - the most populous.
If you want to get more depressed about the future of healthcare, get ready for outcome-based, bundled payments made to what are going to be called something like “group medical homes” or ACO’s (ie a large practice of multidisciplinary providers, many of whom wil be owned by hospitals) https://www.acponline.org/running_practice/delivery_and_payment_models/
Frankly, the history of most of this thread was some predicting the worst before enough details came in. Do we really need to return to that?
Rate increase requests are only the requests. My Insurer asked for greater than 10%, same as they did the last few years. The regulators will review. If they operate as before, it will be cut back.
Too soon to know, folks.
If you are referring to my post, LF, I had shared this info in another thread about the future direction of healthcare, and noticed that some of the posts a few back had talked about reimbursement, so shared it here as well. Hadn’t noticed that those posts were from several months ago, but someone had just bumped the thread! That said, I happened to have dinner with someone last night who sells individual insurance plans, and we were discussing personal plans, subsidized coverage, etc. Seemed poignant, but no matter.
Jym, where I live, its too soon to fear the medical home concept. That’s only my situation, my area, sure.
No, I meant a large, distracting chunk of the thread history is unfortunate general alarmism, supported by random anecdote, fear mongering- as opposed to neutral info sharing.
A rational approach can be helpful.
My friend last night was commenting that few hospitals in our area are accepting HMO insurance exchange plans. I was surprised. Well, sorta surprised. The networks, and systems that accept the plans, are limited.
As for the medical home plans, having attended several presentations, being in the healthcare field, it is not something to assume will be in the distant future. Many providers, practices and hospitals are posturing for this.
@jym626 - how is the medical home concept different from, say, Kaiser?
Exactly, LF.
As for the preliminary prediction of 4.4% increase – with all the usual caveats about carriers, location, etc. – that is astonishingly low, if you’ve been in the individual market for decades as I have. Before ACA, I considered 15% to be a good year.
And it’s not just health insurance costs which are being tamed. Health care costs (which despite confusion mongering, is not the same thing) are growing at record lows.
Sorry, but ACA is working. 
ETA – For those who are unhappy with the eventual finalized rate increase, guess what? You can change plans or even carriers, without penalty, without underwriting – thanks to ACA.
The doctors in the kaiser system are salaried. And all work for one employer. That may or may not be true under the medical home model. And if fees are bundled the home primary doctor may be reticent refer for an expensive procedure.
http://www.latimes.com/business/la-fi-obamacare-patient-privacy-box-20150622-story.html
I am curious to see what the new rate schedule is in California.
That would be the extreme fear.
What would be extreme fear? That a Dr. would be reticent to refer out for a $2500 -$3000 procedure if it was going to come out of his pocket because he would have to share the bundled reimbursement with the other Dr to whom he referred and might have to justify how it helped with treatment outcome? It isnt fear. This was an example given at a conference presented by a person who sits on organizational leadership committees and the policy and planning healthcare boards, was for 15 years a representative on the AMA’s CPT panel, then elected to a voting position on the CPT panel, as well as serving on the Center for Medicare and Medicaid’s Medicare Coverage Advisory Committee. When he talks, I usually listen.
Jym626, what does the Dr or person you mentioned want to see happen to contain costs?
I don’t think I could answer that for him, or very eloquently. He was reporting the directions in healthcare, not his personal opinion.
Ok… That’s a good answer.
That’ll be $50. Oh, and your insurance doe not cover that consultation service
Lol!
Not how it’s intended to work, which is why I’m calling it extreme. Throughout this thread, some of us have held to one caveat: consider the source, that person’s or entity’s interests.
Of course they have to consider how outcomes can or will be affected. The existence of an expensive procedure does not always make it the right course, the compassionate choice, or yield the outcome. To reduce it to fee-sharing confuses me. One thing some of us came to understand, over the course of this very long thread, is that any HMO-like structure today is NOT the past ridiculousness.
And medical practices are currently profit-sharing.
Unfortunately many things dont work the way they are intended to. He has his ear to the conversation from the powers that be, and presents at the annual conferences.
Many, many medical practices here are being bought up by the hospitals.