Insurance

News on the state's largest health insurers; the effects of health care reform on coverage; rising premium costs.

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Blue Cross To Expand Results-Based Doctor Payments System

The state’s largest health insurer, Blue Cross Blue Shield of Massachusetts, is moving to expand its system of paying doctors for the quality of their service. It replaces the traditional system of paying doctors for the number of services provided.

To talk about what’s driving this, Andrew Dreyfus, the company’s CEO, joins Morning Edition.

To hear the full interview, click on the audio player above.

Gov. Baker Forces Resignation Of 4 Health Connector Board Members

Gov. Charlie Baker sought and received the resignations of four member of the state’s Health Connector board, including MIT economist Jonathan Gruber, who came under fire for saying it was “the stupidity of the American voter” that led to the passage of President Obama’s 2010 heath care law.

The move helps Baker consolidate his authority over the agency responsible for helping Massachusetts residents find affordable health care plans.

Gruber became a political lightening rod following his comments and was chastised by opponents of the law. He was called to testify before Congress in December, when he told lawmakers he was “inexcusably arrogant” when he made the statement.

Besides Gruber, Baker also asked for the resignations of board members George Gonser, John Bertko and Rick Jakious — all appointees of former Gov. Deval Patrick. Continue reading

Partners HealthCare Drops Bid To Acquire South Shore Hospital

Partners HealthCare is withdrawing its bid to acquire South Shore Hospital, state Attorney General Maura Healey’s office announced Tuesday.

The move comes less than a month after a judge rejected a deal Partners had struck with former Attorney General Martha Coakley’s office that would have allowed Partners to acquire South Shore and two other local hospitals in exchange for some limits on price and staff increases.

In a statement Healey’s office said the state would continue to evaluate Partners’ bid to acquire Hallmark Health Corp.’s Lawrence Memorial and Melrose-Wakefield hospitals “if and when Partners and Hallmark complete pending federal regulatory obligations.”

“We appreciate the thoughtful process that Partners engaged in while making this important decision, and believe it is the right choice for Partners and the Commonwealth,” Healey, who opposed the deal Partners had reached with Coakley, said in the statement. “We are thankful for the valuable input that was provided by the health care community throughout this process to help reach this result.”

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Health Connector Extends Sign-Up Deadline By A Week

The Massachusetts Health Connector is extending the deadline to complete an application and pick a health plan until Feb. 23.

The deadline had been Feb. 15, but officials pushed it back a week because heavy snowstorms have made it hard for some people to sign up for insurance.

Officials say the extreme weather also led to a number of days this month when the call center was short-staffed, leading to long wait times.

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Groups Resist Baker Push On MassHealth

Updated at 4:30 p.m.

BOSTON — Groups representing people dependent on state health insurance programs are resisting Gov. Charlie Baker’s push for authority to make major changes in the MassHealth program.

Advocacy groups on Monday were delivering letters to Baker administration officials and legislative leaders expressing opposition to powers sought by Baker in his emergency legislation (H 49) to balance the state budget. Baker has requested authority to restructure MassHealth benefits “to the extent permitted by federal law.” Continue reading

Earlier:

New Partners CEO Says He Will Explore Expanding Outside Of Mass.

The incoming CEO at Partners HealthCare says the network will continue to expand, but not necessarily in Massachusetts.

Dr. David Torchiana said a judge’s rejection of Partners’ plan to acquire three more hospitals in the state was clear.

“We’re obviously chastened by the verdict,” Torchiana said. “There wasn’t any ambiguity to the message that we got back.”

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Judge Rejects Partners Deal To Acquire 3 Hospitals

Updated 6:30 a.m.

BOSTON — The state health care market is reverberating with the aftershocks of a major court decision Thursday which rejected a deal that would have let Partners HealthCare, the state’s largest hospital network, acquire at least three more hospitals.

Suffolk Superior Court Judge Janet Sanders gave two reasons for rejecting the deal former Attorney General Martha Coakley’s top staff spent months thrashing out with Partners. First, she says, it is not in the public interest.

Allowing the network to expand “would cement Partners’ already strong position in the health care market and give it the ability, because of this market muscle, to exact higher prices,” Sanders said.

For proof, she cited the work of the state’s Health Policy Commission. It concluded, in separate studies, that adding both South Shore Hospital and two Hallmark Health hospitals to the Partners system would increase health care spending by $39 million to $49 million a year in Massachusetts.

“If we’re going to have the cost of health care grow at a more normal rate, we need to have enough competition in the marketplace so that no part of the system can dictate prices,” said Stuart Altman, chair of the Health Policy Commission. “If you get too big, as Partners has become, it sort of destroys the concept of a competitive marketplace.”

Sanders’ second reason for blocking the deal: it would just be too difficult to enforce. Her opinion offered a few examples.

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Trouble With State Health Connector’s Call Centers Frustrates Insurance Seekers

Update at 9:17 p.m.: Gov. Charlie Baker has extended the deadline for signing up for coverage:

Original post:

Frustration with the state’s Health Connector is mounting.

Today (Friday) is the deadline for coverage that begins Feb. 1, but an untold number of residents say they’ve hit roadblocks while trying to enroll and pay for a plan. The problem at this stage is not so much the new website — it’s the call centers. Continue reading

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Gov. Baker Names 2 Top State Health Care Officials

Gov. Charlie Baker has tapped two top health care officials.

Baker announced Thursday that Louis Gutierrez will serve as executive director of the Massachusetts Health Connector, which oversees the state’s health insurance marketplace and website.

Baker also appointed Daniel Tsai as assistant secretary for MassHealth, the state’s Medicaid program.

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