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Wednesday, October 13, 2010

Oregon Health Insurance CEO Forum: Lame and Lamer

Last year I attended, the Oregon Health Insurance CEO Forum and noticed some excitement in the air around some new developments such as cost transparency, value-based benefit design, and the importance of caring for children. This year, despite their very industry being turned upside down, they talked about popular health care topics from the 80's and 90's. That was the lame part. The lamer part was four CEO's including the CEO from local Blue Cross, Regence, which used to have the largest market share, didn't attend. Considering the unpopular decisions their plans were making around not providing access to insurance for children, it was not very likely that their absence was because they were receiving humanitarian awards elsewhere.

First, the Lame:
  • The popular topics from the 80's were around capitated arrangements with providers where the primary care physician manages medical costs and how 10% of the population uses 70% of health care costs. The Cigna Northwest Region CEO, Chris Blanton, still wanted to talk about how employer groups should play an active role in driving health insurance change. The only thing that was missing from his 90's flashback was flannel as employer groups are either currently pushing the innovation to the limits of what their employees will accept or scrambling to understand the post-health reform environment.
  • To further underscore the stock shorting performance of Cigna's Blanton, he did a poor job of hiding the smirks on his face when questions were asked such as what did everyone think about Health and Human Service's (HHS) assessment that health reform would only increase insurance prices by 1%-2%.
  • Robert Pallari, the former CEO of the Portland-based Legacy Health System and architect of the Oregon Health Plan was the moderator. He was also formerly colorful and bombastic as he lobbed soft ball questions like "Look into your crystal ball and tell me what you see in the future?", "How will health reform influence your organization", and "What type of partnerships are you pursuing with providers?"
  • Actually Pallari did blatantly insult the Kaiser Permanente CEO, Andy McCulloch, by pointing out that the Kaiser system has been as much about setting up barriers to health care as it is about providing care. Perhaps, McCulloch was too distracted by Banton's smirking or thinking about who play 3rd base for the Cleveland Indians in the 80's since his expression didn't change at all. Nor did he respond.
  • During this forum, the battle for the future of the individual insurance market was raging, the payment process for Medicare and Medicare Advantage is being completely revamped, and the new health reform provisions had been effective for 5 days. Three of the CEO's were trying to decide if their individual plans should remain open to children while Cigna and their Chief Smirking Officer had already decided to close their plan to children. Yet not one question was asked about insurance for children. Last year, CEO's couldn't talk enough about how important it was. I badly wanted to ask the question but I recognized that it would a CLM (Career Limiting Move). Next year, I'll find a plant in the audience to ask questions like this one.
There were some bright spots:
  • ODS CEO Robert Gootee did have the great line of pointing out that we "can't drink our bath water and call it champagne" about some of the more egregious performances.
  • Gootee also called the Secretary of HHS and Middle Finger Extending Kathleen Sebelius by the name, "Kathleen Celibate". That would explain a lot. Actually, I talked with someone who worked at HHS who did vouch for Celibate's er I mean Sebelius's administrative skill. That person also pointed out that just because she has been launching the political attacks doesn't mean that she wrote them or necessarily believes in them. It's just politics.
  • My main conclusion from last year's forum was that we should let our children grow up to be actuaries. This conclusion was proven again by the presence of the PacificSource Chief Operating Officer, Sujata Sanghvi, who is a Harvard educated actuary!
And the Lamest Aware goes to:
  • While the CEO's that did show up gave lame performances, at least they came. Well, Cigna's Blanton could have just sent a 12 year old boy to smirk for him so I don't give him credit for attending.
  • On the other hand, Lifewise, Health Net, United, and Regence sent no representatives. They all have announced that they are no longer offering child only coverage in the individual market in the last few days so their lack of attendance is probably not a coincidence.
  • Lifewise's membership has been dropping like acid at Woodstock, Regence has lost their 2 largest group accounts in the last 2 years and 40% of their group enrollment, Health Net is trying to sell itself, and United is well, still United. Given how badly these plans are currently doing, I can't imagine that they would have many great ideas to share. Perhaps it's best that they did not attend.


Anonymous said...

Amazingly enough, Regence is still the biggest in this market even after losing PEBB and OEBB members -- see page 34. This cool state report holds loads of info in health insurers. Next edition should be out soon.

Deadhedge said...

That is an excellent report that you posted but the data is only through 2008. It does not reflect the loss of PEBB for Regence (although it does reflect the loss of OEBB).

The Oregon Insurance Division posts current market share information on their website (although 2010 is not up yet). I did get some 2010 data through request and Kaiser now has the largest market share in employer groups.

Anonymous said...

True, but given that at the time of the report, Regence had 40% of the market and Kaiser as nearest competitor had 18%, AND that Kaiser did not woo either of those big accounts lost, it stands to reason none of the other competitors would have made up enough ground to be #1.

Too, all the insurers are losing membership because of the recession. And, the report appears to count only underwritten business, not self-insured.

The next report will tell. Wonder why the state lags so far behind, given that insurers report this data quarterly.

Deadhedge said...

Hi Anonymous,

Just to be clear, I have the state data that indicates Kaiser has the largest employer insured market share (26% compared to Regence's 19%). Regence has lost even more membership than PEBB and Kaiser has lost little membership despite the rescession.

I can send it to you if you email me at dongrunt At gmail dot com. Your math makes sense but I have the data. If you are interested, I can let you know what info I have and share since it's all public.

The Oregon Insurance Division shares more data than a lot of other state insurance divisions. Yeah, there is a big lag but it's probably the old story of overworked, underresourced, etc.

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