There’s been a lot of “Aetna” in the news the last couple of days and you can see where they are also cutting off doctors in Texas and in other states.  The analytics did a number on the doctors and many times only one sick patient who requires specialist care does that as it throws off their average to where they are lowered to a general doctor instead of a preferred MD in the Aetna rankings. 

Aetna Notifies 130 Texas Doctors That It Will Terminate Their Contracts on July 1 – E & M Codes Primary Levels 4 and 5 Billing Analytics For Peer Comparison Used To Substantiate the Decision - Video


In California we actually have 2 agencies that monitor health insurance increases, the Department of Managed care and the Insurance Commission so if they don’t get an increase on one end of the type of policy, it has occurred on the other end.  Aetna paid $1.7 billion in dividends and I wonder how many of those who received payments are actual Aetna patients?

There is also a move to put this on the ballet to where the insurance commission can in fact deny such increases if not justified.  This is kind of aimage catch 22 situation with doctors and hospitals fearing their compensation will go down further.  Let’s also not forget that insurance companies have many owned subsidiaries today and below is one of them, so we have insurance and care on one side and then a subsidiary knocking on the doors of the doctors and hospitals to also sell them software.  BD

Medicity (Wholly Owned Subsidiary of Aetna) To Provide HIE Services In Hawaii To Integrate Medical Records–Subsidiary Watch


SACRAMENTO — Aetna, the state's third-largest health insurance company, is raising rates for thousands of small-business customers to a level that state insurance regulators call "excessive."
California Insurance Commissioner Dave Jones on Thursday criticized Aetna Life Insurance Co. of Hartford, Conn., for raising health insurance group rates by an average of 8% a year for about 77,000 employees of small companies. The rate increases, which took effect April 1, were as high as 21% in some cases, Jones said.
Jones' questioning of the Aetna rates is the first time a commissioner has publicly declared rates unreasonable or excessive. Jones used the opportunity to also restate his support for a proposed statewide ballot initiative that would give him the same power to approve or reject changes in health insurance rates that he has for automobile, homeowners and other types of property and casualty insurance.,0,618532.story


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