Happy Hump Day to you all! Remember don’t take yourself too seriously. Enjoy.
Happy Hump Day to you all! Remember don’t take yourself too seriously. Enjoy.
Beginning August 1 2013 Mutual of Omaha will no longer sell Medigap/Medicare Supplement insurance plans in the State of Texas under the Mutual Of Omaha Brand. Instead all Medigap/Medicare Supplement plans will be offered by Mutual Of Omaha affiliate “Omaha Insurance Company”.
Anyone with a Mutual Of Omaha Medigap/Medicare Supplement plan will still be able to keep in and Mutual Of Omaha will continue servicing and paying your claims. Beginning August 1,2013 agents and brokers will no longer be able to offer for sale the Mutual Of Omaha branded plans.
If you have any questions or know of anyone who has a Mutual Of Omaha Medigap/Medicare Supplement policy with questions just call me at 1.855.664.2771 and I’ll be glad to help by answering any questions you may have.
By Kathryn Mayer | June 28, 2013
The Obama administration issued final rules Friday for the birth control mandate under the Patient Protection and Affordable Care Act, an area of the massive health overhaul that generated some of the greatest opposition.
The mandate — effective Aug. 1, 2012 — requires most employers to cover a range of birth-control methods in their health plans without charging a co-pay or a deductible.
Religious groups have strongly opposed the rule, and dozens of lawsuits against the federal government followed. Meanwhile, the administration — as well as women’s rights advocates — continued to praise the contraception mandate, saying it gives women control over their health care.
Health and Human Services Secretary Kathleen Sebelius said Friday the final rules “strike the appropriate balance” between respecting those religious considerations and increasing access to important preventive services for women.
Related story: White House Backs Down on Birth Control
“The health care law guarantees millions of women access to recommended preventive services at no cost,” Sebelius said in a statement.
“Today’s announcement reinforces our commitment to respect the concerns of houses of worship and other nonprofit religious organizations that object to contraceptive coverage, while helping to ensure that women get the care they need, regardless of where they work.”
The final rules finalize the proposed simpler definition of “religious employer” for purposes of the exemption from the contraceptive coverage requirement in response to concerns raised by some religious organizations.
These employers, primarily churches, may exclude contraceptive coverage from their health plans for their employees and their dependents.
Women at nonprofit, religious-based organizations — such as at certain hospitals and universities — will have the ability to receive contraception through separate health policies at no cost.
The approach taken in the final rules is similar but simpler than that taken in the proposed rules, and addresses many stakeholder concerns, HHS said.
Announced early last year, the original mandate required most employers, including religious-affiliated organizations, to cover a range of birth control methods.
That triggered a fast and intense pushback from Catholics and other religious groups that oppose birth control, and called the mandate an attack on their religious freedom.
In February, the administration proposed a work-around for religious nonprofits that object to providing health insurance that covers birth control, attempting to create a barrier between religious groups and contraception coverage, through insurers or a third party.
But groups such as the U.S. Conference of Catholic Bishops continued to oppose the regulations.
Proponents of the mandate argue that the requirement is a “win” for women, and will help reduce unplanned pregnancies and abortions.
“The magic combination of responsible public and private policies and responsible behavior on the part of men and women can make all the difference in helping reduce unplanned pregnancy and improving the education and employment prospects of women and their families,” Sarah Brown, CEO of The National Campaign to Prevent Teen and Unplanned Pregnancy, said last year.
The Catholic Church has yet to respond to the final rules.
On the Third Hand: Birth control
Birth Control Mandate Hits Groups That Backed PPACA
15 PPACA provisions that will take effect in 2014
By Alson Martin | June 3, 2013
The effective date of the Patient Protection and Affordable Care Act (PPACA) is March 23, 2010, although various provisions have their own effective dates from January 1, 2010, (the small business income tax credit) through 2018. The start of 2013 saw the launch of a number of key provisions, among them Medicare tax increases, limits on Health FSA deferrals and the requirement that W-2 reporting note employer and employee payments for certain health care items in 2012.
But 2014 is the year when most core pieces of PPACA will be put into effect, notably the mandates that employers with 50+ employees provide health insurance and that individuals obtain minimum essential health coverage for themselves and their dependents, whether or not they have access to coverage through their employer.
Equally momentous, beginning Jan. 1, 2014, states are required to have opened a state-run health insurance exchange, or to have partnered with the federal government to open an exchange. In theory, within these exchanges, insurance companies will compete for business on a transparent, level playing field, which should reduce costs and give individuals and small businesses the purchasing power enjoyed by big businesses. However, health reform does many things to increase costs by covering those who are now uninsurable and by increasing mandated benefits. Many predict these factors will far outweigh any efficiencies created by the exchanges and that health insurance prices will increase. If exchanges succeed, they will create the first viable alternative to the group markets for the younger than age sixty-five population.
In short, there’s a lot to track over these next six months. Read on for 15 provisions that will become effective on Jan. 1, 2014.
1. Health Insurance Nondiscrimination Requirements
Code Section 105(h) currently taxes the benefits received by highly compensated employees (HCEs) under discriminatory self-funded health plans. PPACA has extended these nondiscrimination rules to insured plans. It is unclear whether this change imposes tax penalties or is a substantive requirement. Employers with discriminatory insured arrangements, however, will need to consider changing them. Grandfathered plans are exempt from this rule.
This new requirement was originally intended to be effective for plan years beginning on or after September 23, 2010. The effective date was postponed in 2010 until IRS publishes a notice, which has not yet been issued. The provision may not be effective in 2014 but it likely will be.
2. State Health Insurance Exchanges
Each state must establish a health insurance exchange (or HHS will do so) for use by the uninsured and small employers with 100 or fewer employees (although states may set the cap at 50 employees). The exchanges will offer fully insured insurance contracts that provide essential health benefits at different levels of coverage (bronze, silver, gold, and platinum). Employees of small employers who offer health insurance coverage through an exchange may pay their employee premiums for such coverage on a pre-tax basis through the employer’s cafeteria plan.
3. State Health Insurance Exchange Tax Subsidies
Individuals who do not have affordable minimum essential coverage from their employer will be eligible for tax credit subsidies for their health insurance purchase on a state exchange if their income is below 400 percent of federal poverty level.
4. Employer Mandate (Pay or Play) Tax Penalties
Employers with fifty or more full-time equivalent (FTE) employees will be required to offer their full-time employees (FTEs) minimum essential health coverage or pay a fine of up to $2,000 per year for each FTE in excess of thirty FTEs if any employee receives a premium tax credit on a state health insurance exchange. If an employer provides minimum essential health coverage to its FTEs, but fails to pay at least 60 percent of its actuarial value or the coverage is considered unaffordable (costs more than 9.5 percent of household income), then the employer must pay a penalty of up to $3,000 per year for each FTE who receives the premium credit on an exchange, but not more than would be owed for the $2,000 per year penalty. An FTE is defined as an employee who is employed for thirty or more hours per week, calculated on a forty-hour work week. This provision also applies to grandfathered plans.
5. Individual Mandate Tax Penalty
Individuals are required to obtain minimum essential health coverage for themselves and their dependents or pay a monthly penalty tax for each month without coverage. The monthly penalty tax is one-twelfth of the greater of the dollar penalty or gross income penalty amounts. The dollar penalty is an amount per individual of:
$95 for 2014 (capped at $285 per family),
$325 for 2015 (capped at $975 per family), and
$695 for 2016 (capped at $2085 per family).
These dollar penalties will be indexed for inflation starting in 2017.
The gross income penalty is a percentage of household income in excess of a specified filing threshold of:
1 percent for 2014,
2 percent for 2015, and
2.5 percent for 2016 and later years.
In no event will the maximum penalty amount exceed the national average premium for bronze-level exchange plans for families of the same size.
Minimum essential coverage includes Medicare, Medicaid, CHIP, TRICARE, individual insurance, grandfathered plans, and eligible employer-sponsored plans. Workers compensation and limited-scope dental or vision benefits are not considered minimum essential health coverage.
6. Automatic Enrollment
Employers with more than 200 employees who maintain one or more health plans must automatically enroll new full-time employees in a health plan. The employer must give affected employees notice of this automatic enrollment procedure and an opportunity to opt out. State wage withholding laws are preempted to the extent that they prevent an employer from instituting this automatic enrollment program. The final effective date was [will be?] established by DOL regulations.
7. Pre-Existing Condition Exclusion Practices Eliminated
Pre-existing condition exclusions no longer will be allowed in group health plans or individual insurance policies, not even the limited exclusions previously allowed under HIPAA. This also applies to grandfathered plans.
8. Ninety-Day Maximum Waiting Period
Group health plans and health insurance issuers may not impose waiting periods of more than ninety days before coverage becomes effective. This also applies to grandfathered plans.
9. Cost-Sharing Limits
Group health plans, including grandfathered plans, may not impose cost-sharing amounts (i.e., copays or deductibles) that are more than the maximum allowed for high-deductible health plans (currently these limits are $5,000 for an individual and $10,000 for a family coverage). After 2014, these amounts will be adjusted for health insurance premium inflation.
10. Annual or Lifetime Limits
Group health plans, including grandfathered plans, may no longer include more than restricted annual or any lifetime dollar limits on essential health benefits for participants. Limits may exist in and after 2014 for non-essential benefits.
11. Wellness Program Health Plan Discount
The maximum premium discount an employer can offer under its health plan for participation in a wellness program is 30 percent. This is an increase from the prior 20 percent maximum premium discount. Regulatory agencies can increase this maximum discount to 50 percent in the future.
12. Coverage for Those in Clinical Trials
Insurers and health plans, unless grandfathered, may not discriminate against an individual for participating in a clinical trial. If a plan covers a qualified individual, it may not deny or impose additional conditions for participation in a clinical trial.
13. Employer Minimum Essential Coverage Reporting
All employers providing minimum essential coverage must file information with the IRS and plan participants.
14. Large Employer Health Information Reporting
Large employers and employers with at least fifty full-time equivalent employees must submit annual health insurance coverage returns to the FTEs and the IRS. The returns must certify whether the employer offers healthcare insurance to its employees and, if so, describe the details regarding plan participation, applicable waiting periods, coverage availability, the lowest cost premium option under the plan in each enrollment category, and other information.
15. Medicaid Expansion
The U.S. Supreme Court in effect ruled that the requirement for states to offer Medicaid benefits to all persons with incomes at or below 133 percent of the federal poverty level is optional with each state. States that participate in the expansion will receive full reimbursement of their additional Medicaid costs from the federal government until 2017. At that time, reimbursement will gradually decline to 90 percent of extra costs in 2020 and thereafter.
| Written by IHU staff writter
Filed under Basics,Healthcare Reform
Affordable Care Act Health Insurance plans , tiers and Standards
Bronze, Silver, Gold, and Platinum Health Insurance plans. These are names that will soon become very common to every individual purchasing a health care plan. Insurance is something that is often very difficult and challenging for individuals to understand; additionally due to the complexity of the subject individuals often have a very hard time comparing insurance plans. This article focuses on the Affordable Care Act Health insurance plans tiers and standards.
As part of the Affordable Care Act, starting in January 2014 all health plan providers will be required to meet new federal requirement with regards to the standardization of health insurance plans. The law hopes that standardization of health insurance plans will provide consumers the ability to make better decisions when it comes to comparing difference between health insurance plan options and also help guard against insurance company efforts to cherry pick the healthiest people.
What does standardize health insurance plans means and why will it help consumers?
As part of the Affordable Care Act, all health insurers will be mandated to offer plans to consumers that fit within four tiers of coverage: Bronze, Silver, Gold, and Platinum. Any insurer selling plans within one of the health insurance market places must offer at minimum a silver and gold plan as part of their product offerings.
Each plan being offered must offer the minimum essential health benefits. Hence ensuring the scope of benefits provided by the plans are the same. However, as the plan tiers change so will the cost sharing requirement. The amount an individual consumer or family will pay out of pocket will change from tier to tier. For example, a Bronze Health Insurance plan will have an individual pay more out of pocket expense for the same scope of benefits compared to a Silver health insurance plan.
Note: No health insurance plan will be allowed to charge a deductibles, co-payments, or co-insurance – greater than the limits for high-deductible plans. Additionally health plans for small businesses are barred from charging deductibles greater than $2,000 per year for individual coverage or $4,000 per year for family coverage. Through the Affordable Care Act health plans can not charge a deductible or any cost-sharing for certain. preventive health services.
Each Health plan tier will provide four different level of coverage. The level of coverage will be based on the actuarial value. The actuarial value according to healthcare.gov is
“…the percentage of total average costs for covered benefits that a plan will cover.” For example, if a plan has an actuarial value of 70%, on average, you would be responsible for 30% of the costs of all covered benefits. However, you could be responsible for a higher or lower percentage of the total costs of covered services for the year, depending on your actual health care needs and the terms of your insurance policy. This is very different than your monthly premium you pay for your plan; a monthly premium and individual pay.
While the actuarial value for each health insurance plan that falls within one of the tiers will be the same, the premiums (The monthly fee a person pays a health insurance company to maintain their health insurance coverage) will vary for plans within the same tier level. Variation in price will change from one insurer to another, based on multiple factors such as overall use of services, the prices of health care services negotiated by the insurer, and how the plan controls its services.
Affordable Care Act Health Insurance plans: Bronze In the chart illustrated above a bronze health insurance plan would cover 60 percent of all health care costs for an individual. Enrollees of that plan would be responsible for paying 40 percent of the costs.
Affordable Care Act Health Insurance plans: Silver In the chart illustrated above a silver health insurance plan would cover 70 percent of all health care costs for an individual. Enrollees of that plan would be responsible for paying 30 percent of the costs.
Affordable Care Act Health Insurance plans: Gold In the chart illustrated above a Gold health insurance plan would cover 80 percent of all health care costs for an individual. Enrollees of that plan would be responsible for paying 20 percent of the costs.
Affordable Care Act Health Insurance plans: Platinum: In the chart illustrated above Platinum health insurance plan would cover 90 percent of all health care costs for an individual. Enrollees of that plan would be responsible for paying 10 percent of the costs.
While this chart represent an average view of the tiered plans an individuals with high-cost health conditions could possibly end up paying more than the average person, based on their health conditions.
Please feel free to contact 123insurME.com with your questions.
Or call us Toll Free 1.855.664.2771. We will be able to assist you, your family or small business enroll in a health care plan that’s right for you. October 1, 2013 starts “Open Enrollment”,
You then can chose a health insurance plan, and on January 1 2014 your plan will be effective and you would start using your health insurance. Be sure to book mark our blog so you can keep up with all of the changes to come.
This Article was written by: Jeffery Young & Chris Kirkham and appeared today in the Huffington Post. It’s a long article but you need to read it completely.
When a patient arrives at Bayonne Hospital Center in New Jersey requiring treatment for the respiratory ailment known as COPD, or chronic obstructive pulmonary disease, she faces an official price tag of $99,690.
Less than 30 miles away in the Bronx, N.Y., the Lincoln Medical and Mental Health Center charges only $7,044 for the same treatment, according to a massive federal database of national health care costs made public on Wednesday.
Americans have long become accustomed to bewilderment and anxiety when confronting health care bills. The new database underscores why, revealing the perplexing assortment of prices for medical care, with the details of bills seemingly untethered to any graspable principle.
Even within the same metropolitan area, hospitals charge prices that differ by staggering degrees for the same procedures. People without health insurance pay vastly higher costs for care when less expensive options are often available nearby. Virtually everyone who seeks health care winds up paying inflated prices in one form or another as these stark disparities in price sow inefficiencies throughout the market.
While this basic picture has emerged as the consensus reality among health care experts, their evidence has been primarily anecdotal. Hospitals have protected their price lists — documents known as charge masters — as closely guarded secrets.
Their prices are secret no more.
The database released on Wednesday by the federal Centers for Medicare and Medicaid Services lays out for the first time and in voluminous detail how much the vast majority of American hospitals charge for the 100 most common inpatient procedures billed to Medicare. The database — which covers claims filed within fiscal year 2011 — spans 163,065 individual charges recorded at 3,337 hospitals located in 306 metropolitan areas.
The Obama administration shared the data in advance with The Huffington Post, The New York Times and The Washington Post. What emerges through a preliminary analysis is a snapshot of an incoherent system in which prices for critical medical services vary seemingly at random — from state to state, region to region and hospital to hospital.
These price differences impose a uniquely punishing burden on the estimated 49 million Americans who have no health insurance, experts say. They are the only ones who see on their bill the dollar amounts listed on these official price lists. Yet these same prices effectively shape what nearly everyone pays for health care, because they determine how much private health insurance companies must surrender in reimbursement for services. That in turn influences the size of the premiums that insurance companies charge their customers.
Obama administration officials declined to characterize the causes of these gaping disparities in price, leaving unclear whether they reflect some form of malevolence — profiteering by some institutions or price-rigging — or rather more nebulous factors, such as varying estimates about the underlying costs of providing services.
[Click here to search the database.]
Administration officials said they offered up the data with hopes that its release would administer a market corrective, forcing hospitals to take greater heed of competitors while arming ordinary people with information they could use to seek a better deal. The data could also spur health insurance companies to negotiate with hospitals to seek lower prices.
“Our purpose for posting this information is to shine a much stronger light on these practices,” said Jonathan Blum, director of the Center for Medicare. “What drives some hospitals to have significantly higher charges than their geographic peers? I don’t think anyone here has come up with a good economic argument.”
The very fact that prices are now public may bring change, he added. “Hopefully, it will cause hospitals themselves to take a hard look at their charge-master practices and to ask hard questions of themselves as an industry why there is so much variation,” he said.
Within the nation’s largest metropolitan area, the New York City area, a joint replacement runs anywhere between $15,000 and $155,000. At two hospitals in the Los Angeles area, the cost of the same treatment for pneumonia varies by $100,000, according to the database.
Public access to this data on hospital charges pulls back the curtain on one of the most troubling characteristics of the American health care system: Medical providers set their prices in ways that seem arbitrary, with little oversight and practically no market incentive to reduce them, because almost no one actually pays the official rates.
The data lands as unexpected health care bills continue to be a leading cause of financial ruin for American families. Uninsured and low-income people are often subject to aggressive debt collection by hospitals and their agents when their illnesses result in bills they cannot pay.
Even among people of means, skepticism about American health care is common and with reasons based in data: Americans typically pay higher prices for health care than people in other countries, without gaining higher-quality care or superior health.
The new trove of billing data seems certain to amplify calls for a solution to rising medical costs — not only for ordinary people, but for the economy as a whole. Health care spending continues to grow faster than the economy, though the rate of increase has slowed in recent years, prompting hopes that a fix may be materializing.
In 1999, average charges billed to Medicare were equal to 104 percent of the cost to provide medical care, according to a report issued last June by the Medicare Payment Advisory Commission, an expert panel that counsels Congress. By 2010, the ratio had more than doubled to 218 percent.
The Centers for Medicare and Medicaid Services long has had access to hospital charges via the cost reports facilities must submit to the agency, said Blum, the Obama administration official. Before now, few had given a thought to making the data public. His agency’s actions were inspired in part by a sweeping Time magazine article on hospital charges by author Steven Brill published in March, Blum said.
The newly released data covers facilities that were collectively responsible for 90 percent of inpatient claims to Medicare while excluding certain institutions, such as children’s hospitals and cancer centers.
The Huffington Post reviewed the two dozen types of services billed to Medicare at least 100,000 times in fiscal 2011 in 13 metropolitan areas spanning the U.S. The locations varied in population from less than 1 million to the largest three metro areas: New York; Los Angeles; Chicago; Portland, Ore.; Austin, Texas; Jacksonville, Fla.; Richmond, Va.; Birmingham, Ala.; Tucson, Ariz.; Honolulu; Madison, Wis.; Provo, Utah; and Chattanooga, Tenn.
How is it possible that two hospitals in close proximity would set prices as differently as Bayonne Hospital Center in New Jersey and the Lincoln Medical and Mental Health Center in New York? It’s partly a relic of how hospitals used to operate and partly reflects their strategies to maximize revenues in ways that don’t have a direct connection to the cost of the care they provide any individual patient.
“The charge masters are totally irrational,” Robert Laszewski, a former health insurance company executive who consults for health care companies as president of Alexandria, Va.-based Health Policy and Strategy Associates, wrote in an email to The Huffington Post.
Hospitals used to base prices on health care costs and on the need for profit that would, among other things, enable them to make investments in their facilities, Laszewski explained. “They became the baseline from which the hospitals started,” he wrote. But over time, hospitals raised charges in anticipation of negotiating discounts with private health insurance companies while maintaining their revenue streams, he said.
Prices have continued growing over decades to the point where there is no plausible justification for them, according to Laszewski: “Over the years, the charge masters have become more and more disconnected from reality.”
The charges are the prices hospitals establish themselves for the services they provide. Although Medicare and Medicaid don’t base their payment rates on these figures, private health insurance companies typically do, which means they usually pay more for the same health care than the government does. That translates into higher premiums for people with insurance. And uninsured people are expected to pay the full list price or a discount from that number, which tends to mean they pay more than anyone else.
When a hospital doesn’t get paid as much as it wants from one source, it tries to make up the difference in other ways, such as billing so-called self-pay patients — almost always the uninsured — for the full list price of a service, said Robert Huckman, a health care expert at Harvard Business School. Even when hospitals agree to huge discounts for patients who can’t pay the bill, those discounts are taken from inflated prices much higher than those the government or private insurance companies pay, he said.
“The charge master is complete nonsense that really doesn’t matter — unless you are an uninsured person and you’re getting these huge bills driving you toward bankruptcy,” Laszewski wrote. “The biggest irony of the U.S. health care system is that only the uninsured — often people who don’t have a lot of money — are the only ones the hospital expects to pay these incredibly inflated list prices!”
Hospitals also inflate charges to raise money for things that aren’t related to treatments, said former Sen. David Durenberger (R-Minn.), who is senior health policy fellow at the University of St. Thomas in Minneapolis.
“The biggest factor by far, in my experience, is what are you trying to cross-subsidize,” he said. Hospitals will increase charges to finance things like technology upgrades and education and research and to compensate for their operational efficiencies, Durenberger said.
Myriad reasons legitimately explain how a health care service may be priced much differently from area to area, including labor costs and other local economic circumstances. But such factors fail to explain price discrepancies among hospitals in close proximity, Huckman said. “There’s no doubt that the variation in charges is significantly larger than the variation in the underlying costs for these hospitals,” he said.
The new Medicare database is replete with examples of inexplicably high prices and wide variations between hospitals in the same geographic area. The peculiar disorganization of the American health care system is evident by looking at just a few instances.
In the New York metro area, Bayonne Hospital Center — part of a chain called CarePoint Healthcare — charges the highest prices for several types of procedures, including COPD treatment, among the regional hospitals reviewed by HuffPost. Its price for that treatment runs four times the average in the New York area, according to the database. Medicare — the government health care program for older people and people with disabilities — paid an average of $6,826 for these same treatments within the New York area — or less than 7 percent of Bayonne Hospital Center’s charge.
Major joint replacement surgery at the hospital comes in at $155,769, which is almost three times the local average and more than nine times the price at Lincoln Medical and Mental Health Center in the Bronx. Medicare paid an average $18,944 in that area.
Garfield Medical Center in Monterey Park, Calif., outside Los Angeles, charges $241,654 to take care of a patient undergoing renal failure with major complications, which is almost 10 times the price at Beverly Hospital about 5 miles away in Montebello and more than three times the regional average.
And Birmingham’s Brookwood Medical Center has the highest charges in 14 of the 24 Medicare billing categories in area facilities HuffPost reviewed, including a $156,958 price for simple pneumonia and inflammation of the lung. That’s almost 12 times what the same treatment costs at Russell Hospital about an hour away in Alexander City, Ala., and about four times the local average.
Loyola Gottlieb Memorial Hospital in Melrose Park, Ill., outside Chicago, charged the highest prices for 16 of the 24 procedures reviewed by HuffPost. For kidney failure, Loyola Gottlieb charged $97,926, more than twice average cost of 59 hospitals in the Chicago area. The price is more than five times what John H. Stroger Jr. Hospital, 12 miles to the east, charges.
Those numbers reflect data from fiscal year 2011, and an official from Loyola University Health System, which runs the Gottlieb Memorial Hospital, said the hospital has reduced charges by an average 25 percent since then. “Loyola University Health System closely monitors charges and conducts reviews regularly to ensure that the health system is competitive in the Chicago market,” said Chief Financial Officer Jay Sial, in a written statement.
The other hospitals named in this article did not respond to or declined requests for comment.
The public availability of hospital charges is unlikely to bring swift and radical change to pricing or spare uninsured patients from exorbitant bills, said Huckman, the Harvard health care expert. Still, he added, it’s a good start.
“It would be hard for a hospital — unless there’s a justified reason — to be able to preserve a large margin over what its otherwise equal competitors charge,” Huckman said. “If someone knows the amount that even the most advantaged payer reimburses a hospital for a particular service and they can take that in with their own bill, I think that gives a pretty powerful opportunity for that customer to interact with the organization and say, ‘Why is my number so different?'”
Jay Boice, Aaron Bycoffe and Andrei Scheinkman contributed to this report.
The Most Expensive Cities For Health Care