Understanding Health Care

Excerpt: "This district court opinion holds interest for health care providers and benefit fiduciaries alike. As against a motion to dismiss, the district court holds that the plaintiffs have stated a cause of action against the health care provider for balance billing, i.e., billing the balance 'owed' after their health plan paid the PPO discounted rate." (Attorney Roy F Harmon III in the Health Plan Law blog)

13 pages. Excerpt: "Health care providers and members of Congress have raised concerns that consolidation in the private health insurance industry may be resulting in less competitive markets and contributing to rising health insurance rates paid by consumers and employers. However, measuring the extent of changes in market competition over time or the effects of changes is challenging. . . . Despite [the] challenges, researchers have used the data available to study competition in health insurance markets, typically using one of two measures of competition: (1) HMO market concentration or (2) the number of HMOs in a market." (U.S. Government Accountability Office)

3 pages. Excerpt: "On July 29, 2009, New York Governor David Paterson (D) signed into law three health reform bills -- one extending the period for state health coverage continuation rights from 18 to 36 months, one requiring insurers to offer continued coverage for unmarried adults through age 29 under their parent's individual or group health insurance policies, and one instituting a series of managed care reforms." (Buck Consultants)

Excerpt: "Consumer Driven Health Plans (CDHPs) in the U.S. have surpassed HMO plans in covered employees, according to preliminary results released by United Benefit Advisors (UBA) from its 2009 UBA Health Plan Survey, a plan benchmarking poll with 17,655 plans from 12,316 employers reporting. According to a press release, CDHPs grew at a rate of 33.9% this past year and now cover more employees (15.4%) than HMO plans (13.6%)." (PLANSPONSOR.com; free registration required)

After years of denying the long-term effects of concussions sustained by football players, the National Football League has reported on a study it commissioned that found that Alzheimer’s disease or similar memory-related diseases appeared to have been diagnosed in the League’s former players vastly more often then in the national population.
 
According to a New York Times story published on September 29, 2009, "These numbers could become the Leagues’ first public affirmation of any connection between Alzheimer’s disease and football-related concussions.”  Dr. Julian Bailes, Chairman of the Department of Neurosurgery at West Virginian University School of Medicine and former team physician for the Pittsburgh Steelers, whose research found similar links four years ago, was quoted as saying,  “This is a game-changer - the whole debate, the ball’s now in the NFL’s court.  They always say, ‘We’re going to do our own studies’ and now they have.” 
 
According to the study, the researchers conducted a phone survey of 1,063 retired players who were asked a series of questions which were derived from the standard National Health Interview Survey, so that rates could be compared with those previously collected from the general population.  The researchers found that 6.1 percent of players age 50 and above reported that they had received a dementia-related diagnosis, five times higher than the cited national average of 1.2 percent.  Players ages 30 - 49 showed a rate of 1.9 percent or nineteen times that of the national average of .1 percent.

You can read the full article online here.