News in brief - Sept. 11, 2000

Insurers seek change of court venue - Many are switching doctors - CIGNA launches plan for small firms - Coverage rates vary - Plans raise rates despite gains - Report sees treatment variation - Court levels retirement benefits - Aetna overcharges patients - Utah inmates must pay for doctors - Groups reach deals with Blue Cross

Sept. 11, 2000.

Insurers seek change of court venue

Aetna U.S. Healthcare and Prudential Healthcare are seeking to change the venue from Miami to Philadelphia of class action racketeering lawsuits against them.

Federal courts in Philadelphia are thought to be more receptive to managed care interests. A federal appeals court there recently dismissed a racketeering lawsuit against Aetna.

Many are switching doctors

More than one in eight Americans changed their doctors or other providers last year, according to a report by the Center for Studying Health System Change.

Reasons cited were physician retirement or unavailability (24%), quality of care (23%), convenience (12%), physician no longer available through health plan (9%), a switch in health insurance (9%), and the need for a specific physician (5%).

CIGNA launches plan for small firms

Cigna HealthCare is launching its first health plan specifically targeting small employers this month in the Phoenix area.

The company said Cigna CareNetwork of Arizona initially will serve firms with 50 or fewer employees, a sector that has had coverage dropped due to premium hikes.

Coverage rates vary

The rate of residents without health insurance varies from 7% in Akron, Ohio, and Harrisburg, Pa., to 37% in El Paso, Texas, according to a survey of 85 metropolitan areas by the Center for Health Policy Research at the University of California at Los Angeles. Researchers attributed the variations to numbers of immigrants and of employers providing coverage.

Plans raise rates despite gains

In the first six months of this year, nationwide HMOs regained a firm financial footing, with only Aetna U.S. Healthcare posting earnings lower than expected, but analysts say premiums still should rise up to 12% next year.

Cigna HealthCare, the nation's third largest health insurer, raised its premiums even while reporting an 11% second-quarter profit in 2000. PacifiCare Health Systems just posted a higher-than-expected second-quarter profit after raising premiums 8%.

Report sees treatment variation

Pennsylvania HMOs' hospital admission rates for asthma, heart attack, heart failure and hysterectomy vary widely, the Pennsylvania Health Care Cost Containment Council reports. For example, asthma admissions vary from 4.1 to 9.4 per 10,000 adult subscribers, the report said.

Court levels retirement benefits

Employers must provide the same level of coverage to younger retirees as those eligible for Medicare, according to a decision by the 3rd U.S. Circuit Court of Appeals.

The court said policies favoring younger retirees who aren't eligible for Medicare violate the Age Discrimination in Employment Act.

Aetna overcharges patients

A computer error at Aetna U.S. Healthcare's National Advantage Plan caused about a dozen companies to overpay for discounted medical services. Aetna said it had charged patients a percentage of the full price for services instead of a portion of the discounted rate. The company was fixing the problem.

Utah inmates must pay for doctors

Starting next month, prisoners at the Salt Lake County Jail will be charged a co-payment to see doctors. The new co-payment program is needed to cut down on prisoners' abuse of the current system, a spokesman for the jail said.

Groups reach deals with Blue Cross

A pair of hospital groups have reached agreements with Blue Cross of California, averting a crisis for the health plan's patients at more than 50 medical facilities. Scripps Health and the nonprofit Catholic Healthcare West reached the multiyear agreements after tense negotiations with Blue Cross.

Scripps Health, with five hospitals, reached its agreement as a late August deadline approached in negotiations that had been ongoing since May. Scripps originally moved to end its contract with Blue Cross last fall.

The contract between Catholic Healthcare West and Blue Cross had been set to expire in August as well. The hospital chain, which operates 43 facilities and seven medical groups, also was seeking more money to cover the cost of patient care.

Catholic Healthcare West filed a $50 million lawsuit in June against Blue Cross, owned by WellPoint Health Networks of Thousand Oaks, Calif., over payment issues and two weeks ago took out full-page ads across the state criticizing the health plan. The agreement will not affect the lawsuit, the hospital group said.

All parties declined to disclose financial terms of the agreements.