Don’t you just love it that health are drowning in their own complexities, and yes they built this system as complexities have been very instrumental on making money for all of them.   imageYou wear folks down and they give up, big with health insurers and has been for years way before Affordable Care Act.  In addition Aetna got hit with a lawsuit relative to disclosures with shareholders on political contributions that go back a few years. 

Aetna Gets Hit With Federal Lawsuit Accusing CEO and Board of Directors Of Providing False And Misleading Information To Shareholders–SEC Violation

In view of all of this and in order to provide care, you do have to ask the question has segmentation been over used for the sake of profits?  It’s starting to look that way as we get down to every bottom penny and the whole idea is to take expense and spread it out over a large group but with segment a lot of this, the risk pools shrink.  The models and algorithms are clashing again. 

President Obama’s Decision to Extend Insurance Polices Will Help Consumers While Insurers Bring Out Their Quants to Re-Design Their Business Intelligence Profit Models-And Are We Over Segmented In Practice?

If consumers can renew then it appears that mathematical model should work.  In California we don’t have this worry with individual policies as Aetna has pulled out of that market earlier this year but some got a big surprise on their last premium payments being bumped up and they have moved on to purchase other new subsidiaries over seas. 

The complexities will continue to play out in healthcare until somewhere along the line we back up a little bit and get some models that will work for everyone.  The ACA is working to remove some of the profit models that have plagued citizens for years, like pre-existing conditions but this clashes with insurer risk pools.  We have all become victim of our own IT infrastructures.  BD

Insurance Business Still Clashing With ObamaCare Relating to Policy Cancellations, Quantitative Driven Analytics and Pricing Collisions: “ACA Static Law” Versus “Non Static” Mathematical Insurance Profit Models…

(Reuters) - Aetna Inc's CEO said on Thursday that the time frame is too short for the U.S. health insurer to go through the regulatory processes it needs to reinstate or extend canceled health plans and that it will not be doing so.

CEO Mark Bertolini made the comments at an investor meeting where he gave an update on how the insurer is affected by the U.S. Affordable Care Act.

Last month, President Barack Obama said that insurers could extend these health plans under a temporary transitional policy that allowed canceled plans to be reinstated and extended into 2015 whether they complied with the ACA or not.

Obama made the policy change after hundreds of thousands of individuals received notices that their plans were being canceled. The cancellations became a political issue because Obama had promised Americans that if they liked their plan, they could keep it.

Aetna said, however, that it has offered early renewals on plans, which allow consumers to keep their coverage for up to a year longer and into late 2014.


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