Tenet and Aetna Ink Multi-Year Deal

Tenet Healthcare Corp. has reached a four-year agreement with Aetna to keep members in-network at all of Tenet’s hospitals, emergency, outpatient centers, and employed physicians. The deal follows similar agreements with Humana and Cigna over the past year, after negotiations with Cigna dragged on for 11 months. The agreement with Aetna, which is now owned by CVS Health and covers 39 million members, has an option to extend for a fifth year. Ron Rittenmeyer, Executive Chairman and CEO of Tenet, said via release, “We value our relationship with Aetna and look forward to continuing to provide their members with high-quality,… Full Story

Expert Opinion: Medicare For All vs. Price Transparency

The cost of healthcare dominates today’s political discussion; the public consistently ranks it as the  number one issue they want government to address. So far, the discussion has centered on two polar opposite two avenues of approach: greater government control thorough various flavors of “Medicare for all;” and unleashing the forces of market competition through greater healthcare price and quality transparency. One of these two approaches ultimately is likely to prevail at the expense of the other.  Which one will is presently in doubt, but the resolution may not be long in coming. Medicare for All is a central theme… Full Story

Texas Needs to Prepare for 2021 – Now

I recently read an interesting article by the Kaiser Family Foundation analyzing uninsured adults in states not expanding Medicaid coverage as part of the Affordable Care Act (ACA). The ACA expanded Medicaid coverage to nearly all adults with incomes up to 138 percent of the Federal Poverty Level (FPL). In examining the Kaiser fact sheet, some interesting points stood out: In the U.S., only 14 states have not expanded Medicaid; If all states expanded Medicaid, 4.4 million uninsured non-elderly adults would be eligible for coverage (1.4 million live in Texas) Of the Texans eligible under Medicaid expansion, 67 percent are… Full Story

Blue Cross Blue Shield President Dan McCoy’s Photography Passion

Hacking through the jungle on a remote Indonesian island, Dr. Dan McCoy found himself in the middle of a curious mix of indigenous and modern culture. The villagers lived without electricity and running water, but often wore t-shirts with brands and images they may have known nothing about. He was a long way from the buttoned-up offices where he serves as President of Blue Cross Blue Shield of Texas, but that is exactly where he wanted to be. McCoy’s passion for street photography is one that he developed after years of work in the dark room, transitioning from a self-described… Full Story

Making Data Analytics Sexy in North Texas Healthcare

The ability to accumulate data in the healthcare industry is enabling personalized medicine to improve treatment and reduce cost, but the massive amounts of data healthcare industries produce present new challenges. A study from Dallas’ NTT Data Services and Oxford economics sheds some light on dealing with data in healthcare. Only a quarter of healthcare organizations have standardized their data well enough to allow it to be shared across the business. The sheer volume of data being generated can be daunting and only five percent of healthcare data is ingested and utilized, says Karen Way, health plan analytics and consulting practice… Full Story

Bringing the Free Market to Dallas Healthcare

At the Free Market Medical Association conference earlier this spring, Johns Hopkins surgeon Dr. Martin Makary showed the crowd a chart about how prices for different items has changed since 1998. Housing, childcare, and wages were up significantly, while cars and clothing had remained mostly static. Toys, televisions, and cell phone service were much lower than 20 years ago. But the items with the largest jumps, around 200 percent more expensive than 20 years ago, are hospital services and college tuition. Makary, best-selling author of The Price We Pay about how employers and families can lower healthcare costs, went on to… Full Story

Join Us for D CEO’s Value-Based Care Healthcare Breakfast Panel

In many of today’s medical practices, patients and their insurers pay for the procedures and time spent treating their illness, regardless of the outcome. Whether or not the patient needed that blood test, brain scan, or knee scope, they are paying for it directly or indirectly. While it would be bad business to intentionally stack up unnecessary charges, even the most well-meaning providers are incentivized to provide more medical treatment than is actually necessary because of the fee-for-service model of healthcare. But with skyrocketing health costs adding pressure to the employers and taxpayers who pay for healthcare, new systems have… Full Story

“Providers Will Run Amok” – Dallas Does Too Many Surgeries

Half of all adults are impacted by musculoskeletal conditions, greater than the number of people impacted by chronic heart and lung conditions, according to the Centers for Disease Control. But because of mismanaged care, many of these injuries are costing patients, their employers, and taxpayers much more than they should. At a recent meeting of the Dallas-Fort Worth Business Group on Health, Dr. Scott Conard of Converging Health moderated a discussion about how to bring down MSK costs between Catalyst Health CEO Dr. Chris Crow, Vice President of Clinical Strategy at Airrosti Dr. Chris Cato, and Administration Services Manager for the… Full Story

Health Insurers To Pay Record Rebates After Individual Market Stabilizes

A new report from the Kaiser Family Foundation shows that insurers are more profitable than ever, and are expected to pay around $800 million in rebates to individual market consumers, a record since the passing of the Affordable Care Act. The insurers did not meet the ACA medical loss ration threshold, which requires 80 percent spending of premium revenues on healthcare claims or quality improvement activities. Though the early years of the ACA were often volatile and insurers reacted with increased premiums, by 2017 the individual market had stabilized, and premiums were expected to level out as well. But with… Full Story

How Much are Patients Paying to Deliver Babies in Dallas?

In the Dallas area, new moms will find a nearly $5000 range in price range to deliver their baby. As healthcare costs continue to rise, price transparency has become a key strategy for those trying to bring high prices and the stress they put on the system under control. Hospitals are now asked to post their prices online, but most are difficult to interpret and somewhat meaningless unless one knows how their insurance deductible and coinsurance will impact the final cost. The Robert Wood Johnson Foundation funded the Healthy Marketplace Index, where they analyzed negotiated rates between providers and insurance… Full Story