New Study Finds Lack of Competition Among Health Insurers

The vast majority of commercial health insurance markets in the United States are dominated by one or two health insurers, according to a newly updated analysis released by the American Medical Association.

The 2010 edition of Competition in Health Insurance: A Comprehensive Study of U.S. Markets found that 99 percent of health insurance markets in the U.S. are "highly concentrated", based on the 1997 U.S. Department of Justice and Federal Trade Commission Horizontal Merger Guidelines. This indicates a significant absence of competition among insurers. In 48 percent of metropolitan statistical areas, at least one insurer had a market share of 50 percent or more. Read more....   

Healthcare Fraud News... 

Employers, college admissions officers, and divorce lawyers use social networking sites like Facebook and MySpace to do background checks. Now health insurers are getting into the act. Such sites have become the latest tools for detecting fraud, which the industry says costs the United States as much as $80 billion a year and accounts for 3%-10% of total healthcare spending.

One 30-year-old patient, for example, took a medical leave from her job for major depression. When a representative of her insurer saw photos of her on Facebook frolicking at a beachand hanging out in a pub, she was deemed depression-free and able to work; her payments abruptly stopped.  Click and scroll to read more...    

Physicians to get Relief from Medicare Lab Paperwork Rule 

The AMA and groups representing clinical laboratories had urged CMS to rescind a new requirement that doctors sign off on lab tests.

Responding to pressure from the American Medical Association and others, the Centers for Medicare & Medicaid Services has indicated that it will rescind a new Medicare rule requiring physicians to provide their signatures on requisitions for laboratory tests. Doctors had warned that the rule would have created paperwork headaches for medical professionals ordering and fulfilling lab test requests, ultimately having an adverse impact on patient care.

The signature policy has been on the books since Jan. 1, but it was never enforced by the Medicare agency. CMS finalized the rule in its 2011 physician fee schedule in November 2010. However, citing concerns about lack of awareness of the change in the health care industry, the agency delayed enforcement of the policy until April 1, 2011. Click and scroll to read more....    

New Partnership

Arizona Foundation for Medical Care has signed a partnership with EMI Health (formerly Educators Mutual) to be their network of choice in Arizona for their TPA services.  

For an easy to manage integrated, self-funded program look no further than VentureNet Healthcare.

VentureNet simplifies the self-funded process by providing one access point for groups, eliminating the need to maintain separate network access in different states.  

Beginning with new client implementation through group renewal, VentureNet members and providers have one contact to answer questions, one claims submission point and one logo. Network Representatives are also available to help employers evaluate the healthcare needs of their workforce and assist with making program adjustments as their needs change.   

VentureNet Healthcare provides the perfect balance between quality service and products for its members. Continue reading to discover how VentureNet's depth and breadth of products and services can provide innovative solutions for employers.

No matter where business may take them or how their needs may change, VentureNet members have access to reliable, cost-effective healthcare networks. Get started.