Insurance Companies Join the Fight Against Opioid Epidemic

Health insurance companies are now joining the fight against Opioid addiction. Cigna, a health insurance firm that insures about 14 million Americans, is the newest major health insurance provider to fight the staggering opioid addiction numbers and deaths. The company is targeting what experts are saying the number one cause of the addiction, over-prescribing of prescription painkillers like oxycodone, hydrocodone and morphine.

Other insurance companies like Aetna and Blue Cross Blue Shield have also taken similar steps over the past several years to prevent deaths and pull down the numbers of people who get addicted to this drugs. It doesn't just save a lot of people, it also makes good business sense. According to research, it cost public and private insurance companies about $72.5 billion annually to deal with prescription painkiller abuse, treatment and “diversion” (when patients sell the medication instead of taking it).

Big health insurance companies do have access to prescription information for its customers. The have records every-time their customer fill a prescription using their insurance. Cigna’s new measure will be to flag customers who are deemed high-risk — either for getting large amounts of opioid medicines, for getting narcotics from different doctors or for being on the medicines for a long time and they will contact with those customers’ doctors.

The doctor can give their patients other treatment options if addiction is an issue. If the doctor feels the patient still needs to be prescribed long-term narcotics, Cigna can limit where the patient is able to pick the medicine up and which doctors are able to prescribe narcotics to them, so that the doctor is able to closely monitor whether that patient seems to be needing more and more painkillers.

Cigna is targeting to lessen the number of opioid prescriptions written to its customers by 25%, back to the number of prescriptions that were being written in 2006, which the insurer calls “pre-crisis.”

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Aetna will buyout rival health insurer Humana for $37 billion

Health insurance company Aetna Inc is said to have struck a deal to purchase Humana Inc for about $37 billion, or roughly $230 per Humana share, in a cash-and-stock deal.

Humana shareholders will get $125 in cash and 0.8375 Aetna shares for each share held, an about 23% premium to the stock's closing price on Thursday. Following the deal, Aetna's shareholders would own about 74% of the combined company.

Once done the new company will boast more than 33 million members, and bring in estimated revenue of about $115 billion per year. 56% of the revenue will be from government-sponsored programs like Medicare.

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Mother Billed $950,000 for Child Birth in the US

Is giving birth in the US this expensive? Toronto Sun reported about Jennifer Huculak from Saskatchewan, Canada has been billed $950,000 by a hospital in the United States for giving birth to her daughter. This happened last year October 2013, Jennifer was pregnant and having vacation with her husband Darren Kimmel in Hawaii. Then her water broke, she was airlifted from Maui to a nearby hospital in Honolulu, Huculak and was confined in the hospital for 6 weeks before giving birth to a premature baby girl named Reece. She gave birth through an emergency C-section and her child was in neonatal intensive care unit for two months before they were able to leave the hospital.

Saskatchewan Blue Cross, her insurance company said that her coverage had been denied because of a pre-existing condition that the company said that can result to high-risk pregnancy. The doctors who operated her told the insurance company that the pregnancy was healthy but still got denied.

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Chao: Health Insurance Marketplace is Still Incomplete

Henry Chao the deputy chief information officer at the Centers for Medicare and Medicaid Services said that the federal health insurance marketplace is not yet complete. He said that they are still building the “back office systems." 

“we still have to build the financial management aspects of the system, which includes our accounting system and payment system and reconciliation system,” he said. "This part is still being developed and will be tested."

He admitted Tuesday that up to 40 percent of IT systems supporting the exchange still need to be built.

The Obama government completed the online system which allowed consumers to apply for insurance, compare health plans and enroll however, many parts of the system were still being repaired and were not performing as well as they had hoped.

“It’s not that it’s not working,” Chao told lawmakers at an Energy and Commerce Oversight and Investigations subcommittee hearing. “It’s still being developed and tested.”

Financial management tools are not yet done, he said, particularly the process that will deliver payments to insurers.

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Infographics on Why Others Can't Keep Their Old Insurance Plans

Check out the Infographics done by NYTimes, which explains why some people can't keep their insurance plans. It is very detailed and easy to comprehend. President Barrack Obama promised that people can keep their old insurance plan under the Obamacare, however the truth is most need to buy a new plan.

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