Last week, we saw that accountability in health care reform is not just about Providers becoming accountable to low cost and high quality; Payers are also accountable. We've seen fraudulent providers get caught and penalized; now we're seeing unreasonable insurers stopped in their tracks. Secretary Sebelius called on two insurance companies to drop unreasonable rate hikes in nine states.
"Thanks to the Affordable Care Act consumers are no longer in the dark about their health insurance premiums," said Secretary Sebelius. "Now, insurance companies are required to justify rate increases of 10 percent or higher. It’s time for these companies to immediately rescind these unreasonable rate hikes, issue refunds to consumers or publicly explain their refusal to do so."
In these nine states, the insurers have requested rate increases as high as 24 percent. These increases were reviewed by independent experts to determine whether they are reasonable. In this case, HHS determined that the rate increases were unreasonable, because the insurer would be spending a low percentage of premium dollars on actual medical care and quality improvements, and because the justifications were based on unreasonable assumptions.
In light of the March 19 HHS press release and this week's Supreme Court hearings on "health care reform", it's worth re-emphasizing that the Affordable Care Act and many other examples commonly cited in the media as health care reform are more accurately called "health insurance reform". Health care reform and key concepts like accountability, transparency, portability and interoperability are not up for discussion. Like EHRs and the new technology of health care, these basic tenets are here to stay. Expect to see them everywhere, including in your own back yard. And prepare your business for them accordingly.
Alistair Jackson, M.Ed.
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