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CPBJ Extra Blog

Perspective is a good thing

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Gaining a better overall understanding of some of the complex entities I cover is a perpetual item on my to-do list.

Therefore, when I saw that Highmark posted a passel of financial statements as part of its request for approval to merge with Blue Cross of Northeastern Pennsylvania, I was thrilled.

See the chart at the bottom of this article for a cursory overview at best, featuring just three data points from each filing listed for the third quarter of 2013. I'm not going to pretend it will give you a comprehensive, nuanced understanding of Highmark the big nonprofit entity with many subsidiaries, because it won't. But if you, like me, mostly think of Highmark as the Pittsburgh-based health insurer that is getting really involved with some healthcare providers out in Western Pennsylvania, it may be illuminating.

Also, you should look at another part of the filing, the Highmark Corporate Organizational Chart.

• • •

For a very long time now, we've been hearing that some businesses will see premiums increase because of Obamacare, and some will see them decrease. Thanks to a new report by the Centers for Medicare & Medicaid Services Office of the Actuary, there is now a more detailed prediction for small employers. And I quote:

"Therefore, we are estimating that 65 percent of the small firms are expected to experience increases in their premium rates while the remaining 35 percent are anticipated to have rate reductions."

Which segment are you in?

The preceding paragraph is interesting as well.

"In 2012, about 18 million people were enrolled in the small group health insurance market through employers with 50 [or] fewer employees. About 8 percent of small firms offered a self-insured health plan, therefore about 17 million people received coverage in the fully-insured small group health market. These 17 million people will be affected by the new premium rating requirements contained in the ACA. Before the premium rating provision of the ACA took effect, firms with employees who had better than average health risks would typically pay lower premiums, and therefore, they were more likely to be the firms that offer health insurance. As a result, most of people with coverage in the small group market have premium rates that are below average. Based on our review of the available research and discussions with several actuarial experts, we have estimated that roughly 65 percent of small employers offering health insurance coverage have premium rates that are below average."

• • •

Speaking of quantifying things, here's a study on Obamacare's annual fee on health insurance by The American Action Forum, which describes itself as "a 21st century center-right policy institute." The study's goal was to estimate the impact of the tax on individuals; whether you agree with its findings or not, the numbers are an interesting place to start the discussion.

• • •

In news that is not earth-shattering but nonetheless good to know, I have this today: Memorial Hospital in York and Highmark Blue Shield have announced the finalization of a new agreement that continues their longstanding relationship.

Effective Feb. 1, the new contract continues to provide Highmark members in-network access to Memorial and various services, whether elective or emergency. Physicians on the hospital's medical staff are also be in the Highmark network.

• • •

I have two thoughts on this news release titled "Donated Dental Services Program ready to serve Pennsylvanians."

1. Hadn't heard of it before, but sounds like a good idea.

2. In the context of the whole state budget, $150,000 sounds like very small potatoes.

• • •

Finally, the next time you want to discuss the issues of Obamacare and redistribution, you might want to take a look at this Urban Institute report titled "Redistribution Under the ACA is Modest in Scope."


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