This is what it is, states can apply for grants to submit what type of business intelligence or mathematic functionality they plan to use to provide better figures based on configured algorithms to keep on top of economic conditions relative to health insurance premium adjustments. The entire press release contains a lot of mumbo on what the grants are for, but this is it in 
a nutshell- algorithms . Nothing gets done today without “those algos”.
It includes Medical Loss Ratio governing and you can’t do that without some algorithms and hopefully honest information gathered from the health insurance companies to compare to hit the 80%. Just last week all the insurance regulators did not meet their deadlines on a federal basis, again I assume they are still working on their algorithms that they live and die by to score and asses all of us to project our cost of sickness. Perhaps at the state level we can generate some better functioning algorithms? I’m sure they will all get around to it once they have figured out what numbers insurers figure out what they need for the shareholders so we can see what’s left over.
HHS deadline for Medical Loss Ratio Plan Is Missed by Insurance Regulators – Not Done With the Algorithms Yet?
Last month only 27 states had responded on their plans for regulating the medical loss ratios, so perhaps additional grants will help push the rest of this along.
It sure would be nice not to have this 800# gorilla around and this is big project that will require states to update infrastructures and more. If you don’t get those algorithms developed, states are certainly going to have a hard time battling the insurance industry that has the technology of “machine guns” while the rest of us are kind of running around with “swords and daggers”. In essence this is a big battle of the algorithms of cost.
We have all found out what happens when the weapons are not equal and algorithms are used to under pay both doctors and patients. We have one case settled with claim forms we can send in and there’s a ton more of those in court or filed. I’m not exactly sure what is going on here, but HHS seems to like the algorithms and software from one of the exact same companies too? Anyone have a clue here? BD
"Reach for the Top" Program Combines Prototype from Ingenix (A Wholly Owned Subsidiary of United Healthcare) for Public/Private Community Health Data on HHS.Gov Site
New grant program providing $250 million to states over next five years will strengthen oversight of insurance premiums and rate hikes
HHS Secretary Kathleen Sebelius today announced the availability of $51 million in Health Insurance Premium Review Grants through the Affordable Care Act. These funds are the first round of grants available to states through a new $250 million grant program to create and strengthen insurance rate review processes.
“This is an important step in putting consumers back in control of their health care,” said Secretary Sebelius. “These new grants will help states protect consumers and small employers by holding insurers accountable for unreasonable insurance rate increases that have made coverage unaffordable for many American families. By strengthening oversight of insurance premiums, these grants will help put affordable coverage back within the reach for Americans
who have been hit hard by skyrocketing costs.”
All states and the District of Columbia are eligible for this first round of rate review grants. To receive a grant, a state must submit a plan for how it will use grant funds to develop or enhance its process of reviewing and approving, disapproving, or modifying health insurance premium requests. States with successful applications will receive a $1 million grant during the first round.
The Health Insurance Premium Review Grants that will be available during FY 2010 are only the first in a five-year grant program. HHS will take applications for a second round of state grants beginning in Fiscal Year 2011, after new regulations regarding rate review take effect. Second-round grants will allow states to further strengthen their rate review, and begin to provide the Secretary of HHS with the rate data required under the law.
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