Behind the scenes at a health insurer: How the money is made, or why the Medical Loss Ratio matters

Behind the scenes at a health insurer: How the money is made, or why the Medical Loss Ratio matters

A contributor to one of my online communities, Scott Haas, wrote this to the group the other day in the context of what happens behind the scenes in health insurance. His note primarily concerns the Medical Loss Ratio formula and the way it was changed by the Affordable Care Act — and the role of […]

Could we be at the edge of health care’s tipping point? Care And Cost

Could we be at the edge of health care’s tipping point? Care And Cost

“Health care wonks play a game where they wonder whether health care really is changing in ways that are palpably better for everyone,” Brian Klepper writes over at careandcost.com and the Valid Points Newsletter. “Everyone, that is, except for the senior executives of the drug and device firms, electronic health record companies, major health plans […]

Hey, Humana! Can we help you figure out how much an X-ray costs?

Hey, Humana! Can we help you figure out how much an X-ray costs?

Humana, the big health insurer, came visiting the other day to ask ClearHealthCosts how much an X-ray costs. They spent 8 minutes and 46 seconds reading this blog post. You can see on the screenshot here of our analytics program. Interestingly, they came to us via the sketchy informationvine.com search. They came lots of other […]

Hmm. The price: $12.10 without insurance, $38 with.

Summary: A friend writes: In July, a close friend of mine celebrated his 65th birthday. My friend, who I’ll call Howard, spent the weeks leading up to his birthday reviewing his options for Medicare enrollment, carefully picking the plans that made most sense for him: a Part A plan for hospitalizations; a Part B plan […]