"Health & Medical News"

Washington — Higher-than-expected costs and enrollment in Massachusetts’ health reform program are translating into higher premiums and co-payments for enrollees and a concern physicians will face pay cuts.

The Connector Authority, the board overseeing the state’s comprehensive health system reform program, unanimously agreed on March 20 to raise monthly premiums by 10% for its subsidized health plans starting July 1, the beginning of the state’s 2009 fiscal year.

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Washington — There’s a four-letter word on the lips of the people in charge of Massachusetts’ health system reform: cost.

Unexpectedly large health plan enrollment numbers, an influx of high-cost beneficiaries and high health care costs in general are leading the Connector Authority, manager of the reform program, to search for ways to cut back. Possibilities include prodding health insurers to limit premium increases and reducing physician pay under certain health plans.

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A California appeals court dealt another blow to health plans over their policy cancellation tactics.

The 4th District Court of Appeal unanimously said insurers have a responsibility to make sure patients’ policy applications are complete and accurate before issuing coverage — not after expensive claims come in the door. Judges said plans cannot revoke patients’ policies unless they fully investigate pre-enrollment forms up front or insurers show patients intentionally misled them.

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Doctors agree on the basic tenets of medical professionalism, but they frequently fail to live up to those ideals in practice, according to a survey of more than 1,600 physicians in the Dec. 4 Annals of Internal Medicine.

Nearly all of the physicians surveyed agreed doctors should use medical resources appropriately, tell patients the truth, minimize disparities, see patients regardless of their ability to pay, maintain board certifications, evaluate peers’ care, avoid sex with patients, work on quality initiatives, disclose conflicts of interest, report impaired or incompetent physicians, and report medical errors.

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Washington — Kelly Tondo and her husband have had health insurance on and off for several years, beginning in 2001 when he left his job to start an espresso machine company.

The Tondos, of Methuen, Mass., tried a family policy through their local chamber of commerce, but the monthly price nearly doubled from $932 in 2004 to $1,735 this year. They tried catastrophic coverage, but it only took care of emergencies.

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Popularity: 5% [?]