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Health Costs

State seeking more choice in 2015 health plan

State officials said Tuesday that they plan to increase the number of insurers and health plan options for state employees and teachers next year.

The State Health Benefit Plan (SHBP) has been a target of fierce criticism since Jan. 1. That’s when changes to its benefit design, plus the use of just one insurer, sparked widespread complaints about a lack of choice of insurance plans and higher health care costs.

Sarah Lesley and her daughters joined a Capitol rally in February against the change in the state health plan.

Sarah Lesley and her daughters joined a Capitol rally in February over the state health plan.

Now, though, the Department of Community Health is asking for proposals for a second statewide insurer to offer a high-deductible health plan, a Medicare Advantage plan for retirees, and a statewide HMO.

The current single insurer for SHBP, Blue Cross and Blue Shield of Georgia, would retain its health reimbursement arrangement plans and Medicare Advantage plans, plus add a statewide HMO option for the 2015 plan year. A third insurer would offer a fully insured in-network-only option for metro Atlanta, under the Community Health plan.

“SHBP is looking to enhance member choice in the 2015 plan year,” said DCH Commissioner Clyde Reese in a statement

The State Health Benefit Plan covers 650,000 state employees, teachers, other school personnel, retirees and dependents. With those numbers, the plan’s members can be a political force in an election year such as this one. When many of them began to complain about this year’s plan, and some began to organize, the state moved swiftly to amend it. full story

FTC seeks more time on Phoebe decision

The Federal Trade Commission on Monday requested 60 days beyond a previous deadline to decide whether to sign off on its 2013 antitrust settlement with an Albany hospital system.

Monday was the FTC’s deadline to finalize the agreement with Phoebe Putney Health System. But in a filing in U.S. District Court, the agency asked the court for more time.

In the filing, the FTC asked the court to give it until June 13 — or until 30 days after a state agency determines whether a potential divestiture of the Albany hospital that Phoebe Putney acquired in 2011 would require regulatory approval — whichever date is earlier.

The state agency’s decision could be pivotal to whether the FTC goes through with the settlement or resumes its legal battle in the high-profile antitrust case. full story

FTC may revive Phoebe fight, seeks state guidance

Georgia’s high-profile hospital antitrust saga may not be over after all.

The Federal Trade Commission is asking a state agency whether a potential divestiture of the Albany hospital that Phoebe Putney acquired in 2011 would require certificate-of-need regulatory approval.

Phoebe Putney Memorial Hospital

Phoebe Putney Memorial Hospital

Last August, the FTC and Phoebe Putney Health System announced they were settling the agency’s long-running antitrust suit over the hospital acquisition, and that the deal would allow Phoebe to keep control of the former Palmyra Medical Center.

But that deal has not yet been finalized. And the FTC, in a letter Monday to the Georgia Department of Community Health, indicated that the legal opinion by state officials may make a difference in whether it goes through with the settlement.

The letter noted that the FTC gave preliminary agreement to the settlement based on its understanding that the state’s certificate-of-need (CON) laws — which limit the number of health care facilities in the state — would prevent a breakup of the merged hospitals.

But now the possibility of undoing the merger appears to be more than hypothetical. A potential buyer for the former Palmyra has come forward, the FTC letter said. full story

Kaiser wins regional satisfaction award

For the fifth straight year, Kaiser Permanente ranked No. 1 in customer satisfaction among health plans in a three-state region that includes Georgia, according to a 2014 study by J.D. Power and Associates released Monday.

Kaiser Permanente's facility in Kennesaw

Kaiser Permanente’s facility in Kennesaw

Ranking second and third in the South Atlantic region were UnitedHealthcare of Georgia and Blue Cross Blue Shield of North Carolina.

The region consists of Georgia, North Carolina and South Carolina. Kaiser does not operate in either of the Carolinas but has more than 250,000 members in Georgia.

The  study by J.D. Power – famous for its automobile reviews – surveyed 34,000 health plan members of 136 health plans across 18 U.S. regions. The survey targets six factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service. full story

Critics of state health plan take message to Capitol

Jennifer Ludlum, a Gwinnett County educator, wore a sign around her neck Tuesday with a number on it: $3,455.09.

That amount, she said, represents her out-of-pocket medical costs so far in 2014, for a visit to her neurologist, an MRI –- she has multiple sclerosis –- and surgery for her daughter.

“That’s more than I make in a month,’’ said Ludlum, who pointed out that she has the Gold option, with the highest premiums, as a member of the state health plan for state employees and educators.

Sarah Lesley and her daughters joined the Capitol rally.

Sarah Lesley and her daughters joined the Capitol rally.

Ludlum was among the roughly 100 people who rallied on the steps of the state Capitol on Tuesday to protest the changes implemented this year to the State Health Benefit Plan. Those changes have sparked a groundswell of criticism from thousands of Georgians about a lack of choice of insurance plans and higher health care costs.

The rally was organized by a Facebook group of teachers, state employees and retirees that has grown to 14,000 members. Ashley Cline, founder of the group, called Teachers Rally to Advocate for Georgia Insurance Choices (TRAGIC), told the crowd that state officials chose budget savings over the welfare of state employees with the health plan changes. full story

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