Doesn’t surprise me a bit
Today’s Washington Post has a story about how the health insurance companies deciced on how much they would pay policy-holders for visits to out-of-network physicians based in a “customary” charge that was calculated by the insurance industry.
They routinely shortchanged policy-holders by nearly 30 percent, costing consumers billions.
The practice was detailed today in a US Senate Finance Committee report. According to the Post:
” As it turns out, insurers typically used numbers from Ingenix Inc., which was a wholly owned subsidiary of the big insurer UnitedHealth Group. As such, Ingenix had an incentive to produce benchmarks that low-balled usual and customary rates and shifted costs from insurers to their customers, the report said.
“Making matters worse, Ingenix got all of its data from the same insurers that bought its benchmark information, the report said. Insurers that contributed data to Ingenix often “scrubbed” their data to remove high charges, and Ingenix further manipulated the numbers, removing valid high charges from its calculations, the report said. ”
New York Attorney General Andrew Cuomo described it last year as “a scheme by health insurers to defraud consumers by manipulating reimbursement rates.” A dozen insurers have reached settlements with Cuomo agreeing to change their practices.
But, really, we can trust them with our health care system.
Read the entire story here:
Have a beer in May
Stop into Altamont Brewing, 1042 Haywood Road, West Asheville, any time in May and ask for their "charity" beer of the day. Buy one and Life o' Mike gets $1. In fact, we get a buck for each one sold. So go in every day and have one to support Life o' Mike.
Thanks, Altamont!
Patient Pals & Family Friends
Life o' Mike has a peer support program for people with one or more serious or chronic medical issues or disabilities.
We aim to reduce isolation and fear among people who have conditions, including psychiatric illness, HIV/AIDS, diabetes, mild dementia or other cognitive disorder or disability, thereby reducing depression and complications as people learn to improve self-management of their medical conditions.
Patient Pals help alleviate feelings of isolation and frustration. They can help people develop a list of questions to ask the doctor and then accompany the person to the doctor to make sure all the questions are answered, taking notes to be sure the person understands the doctor’s answers.
Our trained volunteers also accompany their “Pals” to art exhibits, movies and walks outdoors, meet for coffee, call to check in and more.
Our Pals have experienced weight loss, improvement in diabetes, HIV, psoriasis, depression and more, just because they have someone who cares about them. Some relationships develop into longer-term friendships; other Pals move on to more independent lives.
Family Friends are there to help caregivers and other family members grow into their new role.
We need volunteers, who are asked to donate a minimum of one hour a week. Training is free and includes information on active listening, ways to help and when to know more help is needed.
And of course, we need funding.
To learn more, call Leslie Boyd at 828-243-6712 or e-mail lifeomike@gmail.com.
Start From Seed
Life o' Mike has a new program- Start from Seed (SFS).
SFS is a volunteer doula program aimed at providing non-medical, comprehensive support to low income, high-risk women and families of Buncombe County focusing on three areas:
1. We help new doulas with certification and training in return for their participation as a volunteer doula for SFS
2. We mentor volunteer doulas with their first few clients
3. Our volunteer doulas provide birth and postpartum doula services to low income, high risk moms, providing support and tools to empower them as a new parent.
A birth doula is a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; a postpartum doula provides emotional and practical support during the postpartum period.
Start from Seed clients are referred to us from the Buncombe County Department of Health’s Nurse-Family Partnership Program, Western North Carolina Community Health Services, and Mission Hospital. The Program is intended and designed for growing clients’ inner strength and helping them gain empowerment to help them cope with the emotional, physical and mental challenges of childbirth, labor, and motherhood.
Our new moms and their infants have many needs. If you would like to help them get off to a good start, please visit our Start from Seed web site: Start from Seed, or call Program Director Chelsea Kouns at 804-814-9946.
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