Here we go again with accountability once more in the lime light with the City wanting to know how the rate increases are derived and of course like everything else they are “modeled”.  Kaiser states their formulations are “proprietary” so what else is new with insurers, this goes on all the time. image We don’t know about the pricing “black boxes” aka the models that insurers use.  People want to know where the cost increases budgeted and where their money goes.  Recently in the news Kaiser is looking to sell their Ohio operations stating it’s a money loser, but wait, Kaiser is still non profit, right?  Non profits can make money but they have provisions under which they operate that require re-investing such.  Kaiser was also recently hit with a $4 million dollar fine related to not providing sufficient mental health. 

Kaiser Permanente Working On Deal to Sell Their Ohio Operations to Catholic Health Partners–Not Making Any Money Here

The city has had a long time relationship with Kaiser and changing carriers would mean a disrupt for many of course with having to find new doctors etc.  The committee chairman wants to hear more from Kaiser and wants numbers, aka the data.  Even with the for profit carriers it’s getting difficult to see exactly what they are doing today as SEC rules don’t require listings for what is called a “significant operation” so you don’t find all the insurer subsidiaries listed with public companies either.  Less and less information seems to be the case today with decision makers and it looks like the time has come to where in the age where transparency is spoken all the time, they want some of it.  Really, we all want transparency and information rather than a spiffy marketing piece that tells us we are getting it.  There’s a lot of that out there today as marketing for profits is on steroids like we have never seen, and of course it too is modeled.  BD

San Francisco is threatening to dump Kaiser Permanente to force the health insurance provider to cough up details behind medical expenses and to lower costs after hitting The City with a more than 5 percent rate increase.

That means costs would increase to $322.8 million annually, of which workers would pay $27.2 million and The City $295.6 million.

Labor leaders and members of the Board of Supervisors are weighing legal and political options as they run up against deadlines to vote on Kaiser's 2014 health rates for more than 40,000 city workers

For months, the Health Service System board, which administers health benefits for active and retired city workers, has attempted to bring down Kaiser's rates and demanded information to justify the increase. Kaiser officials have refused to hand over data, saying the information is proprietary.

Health Service System acting Director Lisa Ghotbi advised supervisors to approve the rates and said she has begun working with Kaiser on 2015 rates while "concurrently pursuing cost-competitive alternatives to Kaiser."


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