As the economy continues to shake here and there, consumers are either discontinuing insurance due to financial situations or going to a plan offering less coverage, such as the “lean” plan, and Kaiser is also feeling that heat as well. People are choosing what they believe they can afford.  BD 

Changing health-care economics, and a sickening overall U.S. economy, are causing drastic changes in Bay Area health plan enrollment patterns, and possibly paving the way for fresh demands for systemic reform. Even Kaiser Permanente, the mother ship for traditional managed care, is feeling the heat. Between 10 percent and 11 percent of its recent enrollment has been in plans with "leaner designs," including high-deductible and HSA-compatible versions of its traditional HMO products, said Wade Overgaard, Kaiser's senior vice president for sales and account management.

Trend away from HMOs has reformers concerned - San Francisco Business Times:

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