Health Insurance – Open Mind http://open-mind.org/ Tue, 28 Jun 2022 17:34:24 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://open-mind.org/wp-content/uploads/2021/06/icon-6-150x150.png Health Insurance – Open Mind http://open-mind.org/ 32 32 Target will cover employees’ travel to other states for abortions https://open-mind.org/target-will-cover-employees-travel-to-other-states-for-abortions/ Tue, 28 Jun 2022 17:34:24 +0000 https://open-mind.org/target-will-cover-employees-travel-to-other-states-for-abortions/ A person enters a Target store in Washington, DC on May 18, 2022. Stefanie Reynolds | AFP | Getty Images According to a company memo obtained by CNBC, Target covers employees’ travel expenses if they live in a state where abortion is banned. The new policy will go into effect in July, according to the […]]]>

A person enters a Target store in Washington, DC on May 18, 2022.

Stefanie Reynolds | AFP | Getty Images

According to a company memo obtained by CNBC, Target covers employees’ travel expenses if they live in a state where abortion is banned.

The new policy will go into effect in July, according to the email sent to employees Monday by Melissa Kremer, Target’s chief human resources officer.

“For years, our healthcare benefits have included some financial support for travel when team members needed select healthcare procedures that were not available where they lived,” Kremer said in the memo. “A few months ago, we began to re-evaluate our services to understand what it would look like if we expanded travel reimbursement to include all required and covered treatments but not available in the community of team members. Balanced, these efforts became more relevant as we learned of the Supreme Court ruling on abortion as it would affect access to health care in some states.

With the inversion of Roe v. Wade divided the country into states where abortion is legal and states where it is illegal. The court decision has prompted a spate of announcements from companies that have committed to covering employee travel expenses as part of their health insurance plans. This list spans all industries and includes JPMorgan Chase, Dick’s Sporting Goods and Rivian.

Some companies, like Amazon, announced travel insurance for employees who need reproductive health care in other states before the Supreme Court’s decision. The tech giant said it will pay up to $4,000 annually in travel expenses for abortions and other non-life-threatening medical treatments.

Target did not immediately respond to a request as to whether the travel policy would include a dollar limit. It didn’t say how it plans to protect the privacy of employees applying for travel expenses.

In the memo, the retailer said its reimbursement policy for healthcare travel will include travel for mental health, cardiac care and other services not available near employees’ homes, in addition to reproductive care.

Kremer said Target updated its policy to “ensure our team has equal access to quality, affordable care through our health services.”

In the memo, Target did not comment on the Supreme Court’s decision. Kremer commended Target employees for how they “acknowledge and respect a wide range of beliefs and opinions held by other team members and guests — even when those beliefs differ from their own.”

Other companies have remained silent after the Supreme Court decision. Walmart, the largest private employer in the US, declined to say if or how it will allow employees access to abortions in states where they are illegal. Its headquarters are in Arkansas, a state that already has a law triggering a ban on the books.

However, Walmart covers travel expenses for some medical care — including certain heart surgeries, cancer treatments, and organ transplants — that employees receive at hospitals in other states or cities far from home.

The Supreme Court’s decision has sparked outrage from some employees, who have urged their companies to go further. According to Business, hundreds of Amazon employees have signed an internal petition calling on the company to condemn the Supreme Court’s decision to halt operations in states with abortion bans and allow workers to relocate to other states if they have one live where the procedure is restricted, according to Business Insider.

CNBC’s John Rosevear contributed to this article.

This story evolves. Please check again for updates.

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Bitcoin can fund quality, equitable healthcare for all https://open-mind.org/bitcoin-can-fund-quality-equitable-healthcare-for-all/ Sun, 26 Jun 2022 02:00:00 +0000 https://open-mind.org/bitcoin-can-fund-quality-equitable-healthcare-for-all/ The current global health system is broken As of June 13, 2022, over 6.2 million people have died from COVID-19-related deaths. This is despite the fact that in 2019, US$8.9 trillion or 9.8% of global GDP was spent on healthcare worldwide. In general, half of the world does not have access to basic health services. […]]]>

The current global health system is broken

As of June 13, 2022, over 6.2 million people have died from COVID-19-related deaths. This is despite the fact that in 2019, US$8.9 trillion or 9.8% of global GDP was spent on healthcare worldwide.

In general, half of the world does not have access to basic health services. In addition, the current healthcare system leaves out the most vulnerable groups, leading to health disparities and inequities.

Health is a basic human right. This is how it should be for everyone.

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Four people charged with multimillion-dollar healthcare fraud for defrauding Amtrak | USAO-NJ https://open-mind.org/four-people-charged-with-multimillion-dollar-healthcare-fraud-for-defrauding-amtrak-usao-nj/ Fri, 24 Jun 2022 00:42:57 +0000 https://open-mind.org/four-people-charged-with-multimillion-dollar-healthcare-fraud-for-defrauding-amtrak-usao-nj/ NEWARK, NJ — Three men and one woman were arrested today for participating in a healthcare fraud scheme to defraud Amtrak by bribing Amtrak employees to allow people to make fraudulent applications to the Amtrak health insurance plan , announced US Attorney Philip R. Sellinger. Muhammad Mirza, 50, of Cedar Grove, New Jersey; Devon Burt, […]]]>

NEWARK, NJ — Three men and one woman were arrested today for participating in a healthcare fraud scheme to defraud Amtrak by bribing Amtrak employees to allow people to make fraudulent applications to the Amtrak health insurance plan , announced US Attorney Philip R. Sellinger.

Muhammad Mirza, 50, of Cedar Grove, New Jersey; Devon Burt, 49, of Blue Bell, Pennsylvania; and Hallum Gelzer, 43, of East Orange, New Jersey, were charged in federal court in Newark with conspiracy to commit healthcare fraud. Punson Figueroa, aka “Susie Figueroa”, 55, of Long Island City, New York, was charged with 15 counts of healthcare fraud in the same complaint. The defendants appeared before US Judge James B. Clark III via videoconference today and were released on $200,000 unsecured bail.

According to the documents and testimonies filed in court in this case:

From 2019 to the present, Mirza, Figueroa, Gelzer, Burt and other Amtrak employees — primarily from New Jersey and New York — recruited for participation in the program by offering cash payments in exchange for the employees’ approval to allow Mirza to recruit Figueroa and others to use their patient and insurance information to submit fraudulent claims. Mirza, Figueroa and others benefited from this program by receiving payments from the Amtrak healthcare plan for services that were never performed or that were medically unnecessary. Gelzer, Burt, and others benefited from this program by receiving cash payments from vendors in exchange for allowing those vendors to use their personal and insurance information to submit fraudulent claims, and in exchange for allowing others to participate recruited into the program.

On June 17, 2021, an undercover law enforcement officer posing as an Amtrak employee met with Figueroa at Figueroa’s New York office. Figueroa instructed the undercover agent to sign his name about 30 times for services received and instructed the undercover agent not to date the signatures. Figueroa explained to the informant that the informant has good insurance and that Amtrak has very good benefits. Figueroa submitted, or had submitted, false allegations to Amtrak’s healthcare plan that the undercover cop had visited healthcare providers at least seven times in May 2021 and allegedly used acupuncture and physical therapy services.

The undercover agent only visited Figueroa’s office once more, on July 29, 2021. At that meeting, which was recorded on audio and video, Figueroa presented the undercover agent with an envelope containing $1,000. Figueroa continued to use the undercover cop’s personal and insurance information to make fraudulent applications to the Amtrak health plan, totaling 73 applications. As a result of these fraudulent claims, the Amtrak health plan paid $31,840.

In total, the Amtrak Healthcare Plan has paid at least approximately $9 million as a result of claims related to providers associated with the healthcare fraud scheme.

The charges of conspiracy and healthcare fraud each carry a potential maximum sentence of 10 years in prison and a fine of $250,000 or twice the gross profit or loss from the offense, whichever is greater.

U.S. Attorney Sellinger attributed special agents from the Amtrak Office of Inspector General, headed by Special Agent-in-Charge Michael J. Waters; Special Agents of the Drug Enforcement Administration under the direction of Special Agent in Charge Frank A. Tarentino III; FBI special agents under the direction of Deputy Acting Director Michael J. Driscoll; the US Food and Drug Administration Office of Criminal Investigations, headed by Acting Special Agent in Charge Bradley Greenberg; US Postal Inspection Service postal inspectors headed by Postal Inspector in Charge Damon Wood, Philadelphia Division; and the Amtrak Police Department, led by Police Commissioner Samuel Dotson, with the investigation leading to the indictments.

The government is represented by Assistant US Attorney Katherine Romano of the Health Care Fraud Unit in Newark and Daniel V. Shapiro, Deputy Chief of Crime.

The allegations and allegations contained in the Complaint are allegations only and the accused are presumed innocent until proven guilty.

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Non-profit payers are pushing for health equity https://open-mind.org/non-profit-payers-are-pushing-for-health-equity/ Tue, 21 Jun 2022 20:50:46 +0000 https://open-mind.org/non-profit-payers-are-pushing-for-health-equity/ Stakeholders want to improve access and support efforts to address the social determinants of health. The Association of Community Affiliated Health Plans is calling on the federal government to do more to support efforts to address social determinants of health for the nation’s poor and underserved. The push is part of a new initiative by […]]]>

Stakeholders want to improve access and support efforts to address the social determinants of health.

The Association of Community Affiliated Health Plans is calling on the federal government to do more to support efforts to address social determinants of health for the nation’s poor and underserved.

The push is part of a new initiative by ACAHP and its 74 non-profit membership plans across the country to provide stakeholders and policymakers with a framework to reduce health disparities and improve health outcomes.

Way to improve health equity uses a three-pronged approach to increase equity among plan beneficiaries who are low-income, disproportionately from communities of color, and may be living with disabilities.

Margaret A. Murray, CEO of ACAHP, says the initiative will rely on robust data collection to help improve equity interventions, track public policies that improve equity, and listen and inform from the experiences of other plans to learn.

“Increasing health equity requires a concerted commitment from policymakers and health plans,” Murray said in a press release.

“With an intentional focus on measuring and reporting data and increased support for policies that improve healthcare, Safety Net Health Plans will continue to lead the way in meaningful, innovative advances in health equity,” she says. “Policymakers can support this important effort by supporting policies that enable plans to address social determinants of health as an essential element of health care.”

ACAHP wants federal policymakers to fund more services that address SDOH, including nutrition, transportation and housing programs, and promote access to health care by creating ongoing eligibility for individuals covered by Medicaid and the Children’s Health Insurance program, and extend Medicaid coverage to 12 months after childbirth.

ACAHP also drives a learning collaboration to help safety net health plans promote equity among their members. The two-year program partners with the Center for Health Care Strategies to address health inequalities and assist nonprofit health plans in developing and reviewing strategic equity plans.

“There are no silver bullets for solving the pervasive, systemic inequalities that plague America’s healthcare system, but there are concrete actions that can move the needle,” said Christopher D. Palmieri, president and CEO of Massachusetts-based Commonwealth Care Alliance and Chairman of the Board of Directors of ACAHP. “Health equity can move from an aspiration to a reality, but policymakers need to engage with health plans and others in new and conscious ways path fuels that process.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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INFB health plan program off to a good start – AgriNews https://open-mind.org/infb-health-plan-program-off-to-a-good-start-agrinews/ Sun, 19 Jun 2022 21:10:00 +0000 https://open-mind.org/infb-health-plan-program-off-to-a-good-start-agrinews/ INDIANAPOLIS — A survey found that nearly 100% of current Indiana Farm Bureau health plan owners would recommend the health plan to friends or family. The survey was conducted to learn more about the experiences of Hoosiers participating in INFB health plans. “We always welcome feedback from our plan owners,” said Patrick Williams, manager of […]]]>

INDIANAPOLIS — A survey found that nearly 100% of current Indiana Farm Bureau health plan owners would recommend the health plan to friends or family.

The survey was conducted to learn more about the experiences of Hoosiers participating in INFB health plans.

“We always welcome feedback from our plan owners,” said Patrick Williams, manager of INFB Health Plans. “Hearing from them directly gives us fundamental insights into what’s most important to members new to INFB Health Plans and how we can best serve our current customers.

“Over half of the new members surveyed said they joined INFB to be eligible for INFB health plans, which just goes to show that affordable, reliable health care is important to the farming community.”

The survey found that over 70% of current members are very satisfied with their choice of healthcare providers in their plan.

Regarding new members, 85% said they felt well guided and communicated with throughout the application process.

From January 1, 2021 to April 30, 2022, enrollment in the INFB health plans totaled 2,610 enrolled plans, covering nearly 6,000 people.

The current breakdown of coverage for these plan owners includes:

• 2,089 traditional health plans that include both individual and family plans.

• 384 tooth and vision plans.

• 137 Medicare supplement plans.

Hamilton and Marion boroughs have the most active plans, with more than 100 plans issued in each borough.

To learn more about INFB Health Plans and apply for coverage, visit www.INFBhealthplans.com.

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Women’s Health Insurance Guide 2022 https://open-mind.org/womens-health-insurance-guide-2022/ Fri, 17 Jun 2022 22:10:19 +0000 https://open-mind.org/womens-health-insurance-guide-2022/ health insurance for women For women in the United States, access to affordable coverage in the personal health insurance market has improved significantly over the past decade, in large part due to coverage improvements and consumer protections provided by the Affordable Care Act. Before the introduction of the ACA – mostly from 2014 onwards – […]]]>

health insurance for women

For women in the United States, access to affordable coverage in the personal health insurance market has improved significantly over the past decade, in large part due to coverage improvements and consumer protections provided by the Affordable Care Act.

Before the introduction of the ACA – mostly from 2014 onwards – women faced many obstacles when mating:

  • To date, more than half of the individual tariffs for a 40-year-old non-smoker demanded higher premiums than for a 40-year-old smoker – with exactly the same coverage.
  • More than 90% of individual health plans did not provide routine maternity benefits.
  • In all but five states, pregnancy was a pre-existing medical condition that prevented a woman from purchasing individual health insurance.
  • Many individual health insurance companies did not offer contraceptive protection.
  • Coverage of women’s welfare varied greatly from state to state.

Suggested Literature:

We hope you use this guide to better understand how coverage has improved — and what to expect when choosing a health insurance plan for women’s health care coverage.

Provision for women according to the Court of Auditors

Prior to the implementation of the Affordable Care Act, the amount of preventive care provided to women varied widely from state to state. But from August 2012, all health insurance companies (with the exception of existing health insurance companies) had to cover certain women-specific categories of pension benefits:

  • Well attended mrs
  • gestational diabetes screening
  • HPV test
  • Domestic violence screening and counseling
  • HIV testing and counseling for sexually transmitted infections
  • breastfeeding accessories
  • Advice on contraception and family planning

(Note that additional advance directives went into effect in 2014, including provisions for children and all adults, and additional provisions specific to women.)

Coverage of women’s health services

Maternity care coverage

Prior to 2014, only 12% of individual health insurance plans included maternity benefits. But the Affordable Care Act changed the game. Maternity care is one of the essential health benefits that must be included in all individual and small group insurance policies.

This means that an expectant parent can now receive coverage in any state during open enrollment or during a special enrollment period triggered by a qualifying event. And women no longer pay higher premiums than men, even though every new major medical plan includes maternity insurance.

Coverage of infertility treatments

Infertility treatment is not a core benefit of the Affordable Care Act – and coverage for infertility treatment is not required by the ACA or any other federal law. However, some federal states have regulations that go beyond the minimum requirements set by the federal government with their own laws, ordinances and mandates.

These state rules apply only to state-regulated plans, which include health plans that individuals and businesses purchase from an insurance company. But self-insured employer-sponsored health plans are not subject to state insurance rules.

Literature recommendations:

Abortion Reporting

Abortion insurance is neither required nor prohibited under the ACA. But federal funds can’t be used to pay for abortions unless the situation involves rape, incest, or danger to the life of the mother. Coverage for other abortions varies significantly from one health plan to another.

Contraception coverage

The Affordable Care Act increased access to highly effective long-term birth control without a cost barrier. Under the ACA, healthcare guidelines effective on or after August 1, 2012 must cover at least one version of each FDA-approved female contraceptive method, without cost sharing. These include sterilizations, IUDs, and implants, which before the ACA often had significant upfront costs.

Literature recommendations:

Latest news

Access to health services for women has been greatly expanded under the ACA. This was not only due to the cover orders of the Court of Auditors (e.g. provision and maternity leave), but also because the Court of Auditors has led to many more women being health insured. The expansion of Medicaid, the employer mandate, and access to subsidized coverage in the health insurance exchange/marketplace have all played a role.

But women’s health and care continue to be contentious issues, and the rules evolve over time.

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10 Fresh Herbs With Surprising Health Benefits https://open-mind.org/10-fresh-herbs-with-surprising-health-benefits/ Wed, 15 Jun 2022 21:47:04 +0000 https://open-mind.org/10-fresh-herbs-with-surprising-health-benefits/ Getty Images While some herbs simply enhance the flavor of the food you cook, others can go above and beyond to benefit your health. “The term ‘herb’ has a fuzzy definition,” says Michael Castleman, author of The new medicinal herbs. “What we call medicinal herbs contain chemical compounds that have drug-like effects.” Use caution when […]]]>


While some herbs simply enhance the flavor of the food you cook, others can go above and beyond to benefit your health. “The term ‘herb’ has a fuzzy definition,” says Michael Castleman, author of The new medicinal herbs. “What we call medicinal herbs contain chemical compounds that have drug-like effects.” Use caution when taking these herbs as supplements in pill form, as some are associated with side effects and drug interactions, and always check with your doctor before taking Here we explain how you can use some of these fresh and dried herbs.

1. Basil

If you thought basil was just for making pesto or topping on pizza, think again. Basil is the family name of more than 100 different species. Two of the most well-known varieties are sweet basil and holy basil. Researchers studying basil found that it may help control blood pressure and that its scent relieves stress and reduces anxiety. Clinical studies focusing on holy basil found that participants experienced reduced stress, anxiety, sexual problems, and depression. However, both studies were conducted in a lab, so the benefits may not translate to home use.

Tip: As with other fresh herbs, add basil late; it loses its flavor if overcooked.

2. Dill

Dill is known for its feathery foliage and seeds, and both are used for pickling and cooking. The seeds flavor pickles, flavor borscht, and complement fish. However, dill has much more to offer. Penn State University researchers recruited 71 men and women with risk factors for heart disease and provided daily meals flavored with about a teaspoon of herbs and spices, including dill. After 12 weeks, the participants had both lower systolic (top number) and diastolic (bottom number) blood pressure.

Tip: If you want to get rid of bad breath, chew a handful of dill seeds

3. Garlic

Though widely used as both an herb and a spice, garlic — a member of the lily family — is botanically a vegetable. Its pale yellow flesh has been celebrated for its ability to ward off colds. (Though research hasn’t taken grandmother’s advice.) Some research has found that garlic helps lower blood pressure and prevent hardening of the arteries.

Tip: To activate its health-promoting compounds, chop or crush garlic five to 10 minutes before cooking it or adding it to other ingredients.

4. Ginger

Some call ginger an herb, others a spice, but no matter what you call it, it has a slew of impressive health benefits. Research has found that ginger can relieve knee osteoarthritis pain, suppress nausea associated with motion sickness and seasickness, improve muscle recovery after exercise, and lower high cholesterol. Ginger can even help at the dentist. Patients who have had an impacted molar removed have found that ginger powder is as effective as ibuprofen at controlling pain after surgery.

Tip: The juice that is left over from grating ginger has a lot of flavor. Save the juice and include it in your recipe, it’s recommended chefs illustrated.

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This is how you save on health insurance without having to worry about waiting times https://open-mind.org/this-is-how-you-save-on-health-insurance-without-having-to-worry-about-waiting-times/ Tue, 14 Jun 2022 06:21:44 +0000 https://open-mind.org/this-is-how-you-save-on-health-insurance-without-having-to-worry-about-waiting-times/ So you think you’re paying too much for private health insurance? You’re not alone. However, many people are unable to find a cheaper health insurance deal because they believe that changing insurers involves long waiting times. That is not necessarily the case. It is possible to save on health insurance and avoid new waiting times. […]]]>

So you think you’re paying too much for private health insurance?

You’re not alone. However, many people are unable to find a cheaper health insurance deal because they believe that changing insurers involves long waiting times.

That is not necessarily the case. It is possible to save on health insurance and avoid new waiting times.

The rising costs of health insurance in Australia are a heavy burden on household budgets. That’s why it’s important to compare health plans to make sure you’re not paying too much for your health insurance.

But many people are too afraid to switch providers because they think their new insurer will have to wait long. Fortunately, that’s not necessarily true.

If you switch to equivalent coverage, your new insurer is required by law to account for any hospital waiting time you’ve already completed under your old policy.

Many health insurance companies also do without extras or significantly reduce waiting times as part of regular campaigns.

The rising costs of health insurance in Australia are a heavy burden on household budgets. Photo: Getty

What is equivalent coverage?

Equivalent coverage means that your new health insurance plan offers the same coverage as your old plan.

For example, if you have already completed the waiting period for Silver hospitalization coverage with your existing provider, your new insurer cannot impose a new waiting period for the corresponding Silver hospitalization coverage.

However, waiting periods for extended coverage may apply. For example, if your old policy didn’t cover pregnancy or cataract surgery, your new insurer may set a waiting period if you want to cover them under your new policy.

What about pre-existing conditions?

Many health insurers allow waiting periods of up to 12 months for medical treatment for pre-existing conditions when you are first admitted or extended to hospital coverage, although coverage for psychiatric, rehabilitative, or palliative care can often be obtained after a two-month waiting period.

In most cases, extras don’t take into account any pre-existing conditions – they’re usually covered by your hospital insurance.

You can easily ensure that your new provider does not re-apply for waiting periods for equivalent health insurance – you just need a clearance from your old insurer to confirm that you have already completed these waiting periods.

If you switch to health insurance comparison, our team will take care of this paperwork for you.

]]> Profit-oriented insurers make access to health care more difficult https://open-mind.org/profit-oriented-insurers-make-access-to-health-care-more-difficult/ Sun, 12 Jun 2022 04:00:00 +0000 https://open-mind.org/profit-oriented-insurers-make-access-to-health-care-more-difficult/ According to a recent Harvard CAPS-Harris poll, 52 percent of registered voters said they approve of President Joe Biden’s handling of COVID-19. I also agree. This is excellent news for the President. What this survey doesn’t reflect, however, is how the COVID-19 pandemic has exposed some of the ugliest problems in America’s healthcare system. Even […]]]>

According to a recent Harvard CAPS-Harris poll, 52 percent of registered voters said they approve of President Joe Biden’s handling of COVID-19. I also agree. This is excellent news for the President. What this survey doesn’t reflect, however, is how the COVID-19 pandemic has exposed some of the ugliest problems in America’s healthcare system.

Even if dr. Anthony Fauci says our country is “out of the pandemic phase,” issues highlighted by coronavirus remain front and center. Most notably, medical offices, healthcare systems and hospitals — especially in our most vulnerable communities — that were already struggling to stay afloat are now on the brink of closure.

In order for healthcare facilities to keep their doors open and provide quality patient care, they need adequate staffing, adequate funding, and reliable resources. But even before the pandemic, the nursing shortage in hospitals was a nationwide crisis. According to a 2018 Healthcare Financial Management Association study, about 78% of hospitals said they were facing a worsening shortage of healthcare professionals, forcing them to fill the gaps with traveling nurses and other temp workers that are growing exponentially cost more than routine staff. Increased demand has provided recruiting agencies with an opportunity to raise prices disproportionately, with travel nurse costs nearly tripling and hospitals spending almost 40% of their working budget on travel nurses alone by 2022. It is therefore not surprising that many of these recruitment agencies are currently under investigation for predatory practices.

As a former member of Congress and a former hospital administrator, I believe that one solution to protecting Americans’ access to healthcare would be to ensure healthcare systems are adequately funded and predatory behavior by recruitment agencies, insurance companies, pharmaceutical companies, etc. is investigated and stopped .

Insurance companies got richer during the pandemic through their desire to create value for their shareholders. Unfortunately, hospitals and patients have been fighting on unprecedented levels. Over the past 10 years, the average increase in the cost of coverage has been about 5.3%, but in 2021 the price of health insurance rose 10.4% — almost twice the rate of headline healthcare inflation. Where does all the money go if it doesn’t help patients? I applaud the success of the CEOs of the top seven insurers in the United States, who made $283 million in 2021, and in the first quarter of 2022 alone, the top five insurers made $262.8 billion. However, success should be offset by measuring outcomes and improving inequalities for the patients you serve.

In other words, Big Insurance has created value for corporate governance while creating unintended consequences for the allocation of funds and resources that would otherwise have been available to patients and healthcare systems across the country.

But for some reason, the media, patients, and even healthcare workers have wrongly blamed healthcare systems and hospitals for rising costs and understaffing. This is what happened just now in Indiana, where insurance advocacy groups were trying to blame Indiana hospitals for rising costs of care, while Indiana insurance plans have profited nearly twice the national average for the past few years, earning $300 each year in pure profit for each member . while the national average is $170 per member per year.

During the same period, 2018-2020, Indiana insurance companies received $140 million per year in drug rebates, which accounted for 91% of their profits. According to the Federal Trade Commission, these gains are “post-release rebates” that offer little relief to patients.

It goes without saying that hospitals, healthcare systems, healthcare workers and patients are fed up with these issues that plague our healthcare industry. If nothing is done about practices that focus on making a profit to patients, more hospitals will close, staff levels will continue to decline, and patients will lose access to care, especially in our most vulnerable communities.

As insurance companies count their billions of dollars, hospitals serving urban and rural areas are closing, leaving large gaps in care. A 2021 study found that nearly 47% of counties in the US are considered hospital bed deserts.

We must stand up for this and ensure that our corporate leaders not only have insight into healthy financial statements, but also into healthy living.

Former Ed Towns Assemblyman represented New York for 15 terms. He was director of the Metropolitan Hospital for a decade and then assistant administrator of Beth Israel Hospital. He served in the army and as an educator at Fordham University.

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A positive omnichannel experience is key to customer satisfaction for health insurers https://open-mind.org/a-positive-omnichannel-experience-is-key-to-customer-satisfaction-for-health-insurers/ Thu, 09 Jun 2022 19:56:19 +0000 https://open-mind.org/a-positive-omnichannel-experience-is-key-to-customer-satisfaction-for-health-insurers/ Improving customer experience strategies is a top priority to keep up in the modern market. It goes without saying that most health insurance The digital experiences of plans are not where they should be. In fact, health insurers’ traditional approach to customer experience lags significantly behind other industries that have prioritized digital channels in recent […]]]>

Improving customer experience strategies is a top priority to keep up in the modern market.

It goes without saying that most health insurance The digital experiences of plans are not where they should be. In fact, health insurers’ traditional approach to customer experience lags significantly behind other industries that have prioritized digital channels in recent years. From retail and entertainment to financial services and hospitality, these companies recognize customers’ rising digital literacy and expectations and continue to develop digital experiences that engage their consumers across all channels.

Combine this market-wide push for omnichannel experiences with the healthcare industry’s recent adoption of more clinics, home care, and digital health offerings, and insurers suddenly have a bevy of knowledgeable, digitally-savvy customers demanding more. Put simply, today’s consumers expect personalized, seamless omnichannel services – and insurers, for the most part, are unprepared to meet those demands.

While insurance providers may be striving to keep up with other digitally-enabled industries, they should not respond with an all-out attempt to adopt digital solutions across all value chains, communication channels and member touchpoints. Honestly, that could get very expensive and not reach the desired mark fast enough. To improve customer experience strategies, insurers must ditch their old playbooks and carefully introduce tactics and capabilities that enhance their customers’ omnichannel experience.

Follow this five-phase approach to kickstart this effort:

1. Research your customers, stakeholders, systems and processes to ensure the right context of business and consumer issues. Research can reduce the risk of misalignment with the problem at hand. At this point, it’s important to expand your existing knowledge and evaluate customer personas to solve existing issues or problems. For example, members of dense network plans have different needs than patients on wide area networks. Likewise, members with different health conditions have very different needs. Together, this information is used to inform your digital and physical CX strategies.

2. Define the customer behaviors that will drive business outcomes. Customer journey maps can help insurers better understand how their customers are interacting with their brand across all touchpoints and identify moments of frustration in their customer journeys. For example, a travel mapping exercise for a consumer with limited access to child care would identify this pain point as a barrier to attending doctor appointments.

3. IDevelop creative solutions that address the key moments in customer journey maps. With so many patients having different needs and expectations, health insurers must constantly rethink how they understand their consumers’ differences and offer a range of solutions based on those needs. Wireframes, prototypes and other tools and techniques should be developed to clarify potential opportunities and to consider all channels – from experiences at home or in the clinic to digital apps and chatbots; in addition to traditional calling and portal experiences.

4. Conduct user testing of customer experience tools to align business and customer outcomes. Although each consumer persona group will have different priorities and abilities to use the information presented, these tests allow insurers to see which solutions really work for each audience segment. Throughout the user testing phase, it is important to align metrics and ROI based on consumers’ individual circumstances to assess impact and future investments.

5. Refine implementable solutions while balancing business viability, customer desirability, and technical feasibility. Embedding UX within agile delivery teams ensures that the customer’s experience is consistent with the previously generated design artifacts. Here it is important to commit to an agile delivery model, where new features and journeys are supported on a monthly basis. Then they are iterated to improve, improve and tailor them to each unique person. Use UX best practices to manage the discovery and evolution journey—and ensure you have the right technology stack and application architecture in place to support continuous evolution for your plan members.

To build a strong relationship with the modern customer, insurers need to rethink their CX strategies and prioritize the omnichannel experience journey. Of course, that’s easier said than done. By conducting thorough stakeholder research, assessing the current state of the customer journey, defining tiered solution releases, and reviewing these results, insurers can shape and ultimately improve their approach to holistic customer experiences.

Kevin Benner is the national leader in healthcare solutions at Sogeti, a Capgemini company.

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