Tag: omnia

Experts agree; insurance companies must change their patient incentives to eliminate another Opioid crisis.

Experts agree; insurance companies must change their patient incentives to eliminate another Opioid crisis. There is growing evidence that insurance companies and doctors are responsible for the current opioid crisis.   60 minutes covered this in their three part investigation showing that drug companies willfully supplied new businesses with opioids that addicted thousands of people in Florida.   Some doctors profited handsomely from their prescriptive practices, while others just wanted to help.  Some of those doctors lost their licenses and others were jailed for their role in this fiasco. More evidence is showing that in order to resolve chronic problems such as neck Read More »

NJ healthcare costs rise again, so where does all the money go?

NJ healthcare costs rise again, so where does all the money go? Most healthcare providers on the front lines such as internists, chiropractors and pediatricians have been accustomed to insurers doing things to further decrease their reimbursements and their roles in healthcare, which reduced cost. Recently, a friend of mine who is a local Doctor of Osteopathy was talking about how United set their fee schedule so low that he would only allow his PA to see these patients.  He also told me about how they stopped paying him for two months because they said he was removed from their Read More »

Horizon Omnia reduces competition, provider access and raises healthcare costs; here’s how.

Horizon Omnia to reduces competition, provider access and raises healthcare costs; here’s how. The headline read “Confidential documents suggest Horizon misled public on how it picked hospitals for OMNIA program”.   Was Horizon  interested in saving costs by developing Omnia, or picking winners and losers in the hospital systems, as well as in other parts of their network to increase our costs and their profits? In 2015, Horizon announced Omnia that offered the promise of revolutionizing health care options in the state.    Horizon Omnia was to offer a lower premiums in exchange for a network that was based on cost and value using a Read More »

Blue Cross Chutzpah in Michigan, Is Horizon Omnia doing the same thing using a tiered system with criteria they are secretive about?

Blue Cross Chutzpah in Michigan, Is Horizon Omnia doing the same thing using a tiered system with criteria they are secretive about? A number of hospitals and large medical interests have challenged the Horizon Omnia plans for a good reason; they are enriching the largest hospital monopolies in NJ, while offering a small discount to the public buying these plans. The truth is, the public does not know what they are buying and many are finding out their favorite doctors are Tier 2, which are doctors who are in Horizon’s network that the plan made more expensive, by front loading them Read More »