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Blue Shield and Aetna Raising Premiums by Double Digits in California Over State Objections…Business Model Algorithms Dete

Posted Mar 06 2013 10:46pm

I just wrote this other post on how insurance companies are paying for data, consumer spending data on all of us.  You can hear on the video the person from Blue Cross stating it’ being used to help people adapt healthier life styles…so they need information on everything we electronically buy, like a plane ticket, food at the grocery store, gas we put in our car and so on?   I would say they get it, query it with other data from who knows where and bingo we have new analytics services to sell…that’s how this stuff works folks with error in data bases just passed along.  California tried to negotiate and said Blue Cross came down a little on a few items.  Again remember they use complex analytics to come up with their numbers. 

Waiting for the exchanges to get here, well I hope they do but we have lot of IT work to make it happen and plus guess what, they get to negotiate with insurers once again…just like what you read above.  I keep telling everyone that complexities are leading to a lot more time with the IT infrastructures we have today and it runs everything.  That’s we have laws with no balls as laws are passed without adding an IT infrastructure plan.  If there isn’t one, then corporate America runs wild with their numbers, models and formulas for profit as they have shareholders who want their money.  God forbid don’t move either like what happened below, the cherry picking algorithms are still around to calculate risk and that’s what this is all about.  BD 


Despite objections from regulators, health insurers Blue Shield of California and Aetna Inc. are proceeding with double-digit rate increases that state officials said were unreasonable.

Officials at the California Department of Managed Health Care said increases that average more than 11% for about 47,000 individual and small-business policyholders of Blue Shield and Aetna were unreasonable. But state officials don't have the authority to reject changes in premiums, and increasingly health insurers refuse state demands to lower rates.

"I am disappointed that after lengthy negotiations, Blue Shield and Aetna were unwilling to bring their proposed health plan increases down to a reasonable level," said Brent Barnhart, director of the Department of Managed Health Care.

Meanwhile, a ballot initiative scheduled for November 2014 would grant state officials the power to deny unreasonable increases for health coverage. The insurance commissioner has that authority for property and auto policies under Proposition 103.

Jones has called that lack of rate review a "huge loophole" in California law and in the federal Affordable Care Act.

http://www.latimes.com/business/la-fi-health-insure-rates-20130307,0,1301629.story?track=rss&cid=dlvr.it&dlvrit=52116

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