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Health Costs

Mega-merger would bolster Blue Cross here

Anthem’s agreement to buy Cigna for $48 billion, if consummated, would cement the dominant position of Georgia’s leading health insurer.

The insurer deal, announced Friday, follows the merger agreement announced earlier this month between two other insurance heavyweights, Aetna and Humana. And both fit into the picture of fast-paced consolidation across the health care industry, partly driven by changes from the Affordable Care Act.

clipboardIf both consolidations are approved by regulators and shareholders, the national effect would be huge, with the number of large, for-profit health insurers shrinking from five to three.

Indianapolis-based Anthem is the parent company of Blue Cross and Blue Shield of Georgia, which is the big player in the Peach State, with about 3 million members here.

Cigna officials here could not be reached for comment, but one industry estimate put that insurer’s health plan and Medicare membership in Georgia at roughly 600,000. full story

WellStar in talks to buy Tenet’s hospitals in state

(Updated at 2:15 p.m.)

WellStar Health System, fresh from abandoning a proposed deal with Emory Healthcare, has now landed a new potential partner.

The Marietta-based WellStar is beginning negotiations with Tenet Healthcare to buy Tenet’s five hospitals in Georgia — all in greater metro Atlanta.

North Fulton Hospital

North Fulton Hospital

The two organizations issued a statement Thursday confirming the start of “exclusive, non-binding discussions’’ about a potential sale of Tenet’s Atlanta-area hospitals and other facilities to WellStar.

“This is to ensure that these hospitals and facilities are best positioned to meet the needs of their communities and continue delivering high-quality health care for many years to come,’’ said the statement.

WellStar and Tenet declined further comment about the potential deal.

The wave of consolidation in the health care business was also evident elsewhere Thursday, with reports on a looming deal by Anthem to acquire fellow insurer Cigna. full story

Poll finds big gaps in rural health care

Most rural Georgia residents in a new survey say they have experienced problems with the affordability of health insurance and the cost of health care.

Healthcare CostWhen asked the biggest problem facing local health care, 68 percent named cost, with quality of care and access to care trailing far behind, according to the survey of 491 people. It was conducted by Opinion Savvy and commissioned by Healthcare Georgia Foundation.

The poll may be the first to focus entirely on rural health care issues in Georgia. It comes in the wake of four rural hospital closings in the state since the beginning of 2013.

Those hospitals closed due to financial problems, and the economic and medical effects of their loss have drawn the attention of Georgia’s political leadership.

Across America, rural residents generally lag far behind people in other areas when it comes to health and quality of medical care.  full story

Georgia trails other states in home health ratings

Just 12 percent of Georgia home health agencies received a superior 4-star or 5-star rating in a new Medicare quality ranking system for that industry.

home-health-stars-570The only states worse than Georgia in percentage of top-rated home health agencies were Alaska, with 0 percent, Washington state, with 3 percent,  Wyoming, with 4 percent, and Oregon, with 9 percent.

Most Georgia home health agencies (63 percent) received a 3-star or 3.5-star rating, while 25 percent got 2.5 stars or lower, according to a Kaiser Health News analysis.

The rankings for home health agencies, released last week, are the latest quality-based star ratings of medical providers from Medicare.

Such measures help provide more transparency for consumers to assess the care delivered by an organization. full story

Big insurance deal raises questions, fears

The biggest health insurance deal ever was announced earlier this month.

And though it is yet to be reviewed by regulators, the proposed transaction has already prompted concerns about its potential impact in Georgia and elsewhere.

Aetna’s $33 billion acquisition of Humana will get close regulatory scrutiny by state and federal officials over its effect on competition and prices.

Mark Bertolini

Mark Bertolini

Central questions about the deal include:

Will it lead to higher health insurance premiums? Will it contribute to the trend toward limited consumer choice of medical providers?

A deal would substantially affect Georgia, if only because of the numbers of insurance consumers affected. The merger would double Aetna’s enrollment in the state to roughly 1.4 million.

State insurance regulators and the U.S. Department of Justice will review the transaction from a competition standpoint.

The Medical Association of Georgia, meanwhile, said Thursday that it has “grave concerns” about the merger and “is evaluating every option to protect physicians and patients in the state.”   full story

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