Where some saw doom in federal health reform, Shaun Greene saw a business opportunity.
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Captivated by a little-known provision for health insurance cooperatives, he convinced a powerhouse group of industry leaders to start one in Utah.
For now, Aarches Community Health Care is a business plan, which its founders will unveil Wednesday at a community forum in Taylorsville.
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Like electric, farm and dairy co-ops in rural parts of America, health co-ops, or "Consumer Operated and Oriented Health Plans," provide an under-produced good or service — in this case, affordable health coverage.
The idea was championed by a bipartisan group in Congress as an alternative to a public option, or government-run health plan.
...
"We lost six months, but now we have a better business plan," said Greene, who will spend the next year traveling the state to promote it.
The group faces fierce competition considering Utah’s insurance market is already dominated by two nonprofits, SelectHealth and Regence BlueCross BlueShield.
But it will open for business in 2014, just as 300,000 uninsured Utahns will be shopping for the best insurance deals on state exchanges.
http://www.sltrib.com/sltrib/news/53754213-78/health-care-baker-public.html.csp
Hat Tip: The Salt Lake Tribune
Showing posts with label CO-OPs. Show all posts
Showing posts with label CO-OPs. Show all posts
Tuesday, March 20, 2012
Wednesday, March 7, 2012
CO-OPs- Nebraska: Health Care CO-OP Could Benefit
The Obama administration last month announced that it would bankroll formation of a nonprofit health care cooperative, similar to the farm co-ops familiar in rural states, to serve Nebraska and Iowa.
Midwest Members Health would give consumers something unusual in these parts -- welcome competition for the giant companies that dominate the market.
The American Medical Association last year ranked Nebraska the sixth least competitive market among the states.
The new cooperative is Iowa-centric in that its leaders are based in Iowa. Heading the new venture are former Iowa state insurance commissioner David Lyons, Cliff Gold, a former executive at Wellmark Blue Cross Blue Shield in Iowa, and Iowa venture capitalist Steve Ringlee.
The new co-op won a loan for $112,612,100 out of $640 million awarded to six plans for co-ops. Other states to be served by the new co-ops are Montana, New Jersey, New Mexico, New York, Oregon and Wisconsin.
The concept proposed by Midwest Members Health is particularly promising in several aspects.
Most importantly, the new co-op plans to utilize Midlands Choice, an existing network of doctors and hospitals, rather than embarking on the massive task of trying to create its own provider network. Midlands Choice already has contracts with all hospitals in Nebraska and Iowa, and 90 percent of physicians.
...
Past efforts to set up health co-operatives do not inspire confidence. Attempts in the 1990s to set up health cooperatives in Florida, Texas and Colorado were unsuccessful. The Government Accountability Office said in 2000 that small cooperatives did not have enough leverage to provide savings for consumers.
The Obama administration, in fact, predicted itself that 40 percent of the loans it just issued to set up new health insurance co-ops would not be repaid.
Lyons said that if the nonprofit insurance co-op couldn't work in Iowa and Nebraska, it probably wouldn't work anywhere. That may not be the most glowing endorsement one could make for the concept, but it has the ring of truth.
http://journalstar.com/news/opinion/editorial/columnists/editorial-health-care-co-op-could-benefit/article_7fc03a20-37f0-52b8-ad21-13536b93d9fa.html
Hat Tip: Lincoln Journal-Star
Midwest Members Health would give consumers something unusual in these parts -- welcome competition for the giant companies that dominate the market.
The American Medical Association last year ranked Nebraska the sixth least competitive market among the states.
The new cooperative is Iowa-centric in that its leaders are based in Iowa. Heading the new venture are former Iowa state insurance commissioner David Lyons, Cliff Gold, a former executive at Wellmark Blue Cross Blue Shield in Iowa, and Iowa venture capitalist Steve Ringlee.
The new co-op won a loan for $112,612,100 out of $640 million awarded to six plans for co-ops. Other states to be served by the new co-ops are Montana, New Jersey, New Mexico, New York, Oregon and Wisconsin.
The concept proposed by Midwest Members Health is particularly promising in several aspects.
Most importantly, the new co-op plans to utilize Midlands Choice, an existing network of doctors and hospitals, rather than embarking on the massive task of trying to create its own provider network. Midlands Choice already has contracts with all hospitals in Nebraska and Iowa, and 90 percent of physicians.
...
Past efforts to set up health co-operatives do not inspire confidence. Attempts in the 1990s to set up health cooperatives in Florida, Texas and Colorado were unsuccessful. The Government Accountability Office said in 2000 that small cooperatives did not have enough leverage to provide savings for consumers.
The Obama administration, in fact, predicted itself that 40 percent of the loans it just issued to set up new health insurance co-ops would not be repaid.
Lyons said that if the nonprofit insurance co-op couldn't work in Iowa and Nebraska, it probably wouldn't work anywhere. That may not be the most glowing endorsement one could make for the concept, but it has the ring of truth.
http://journalstar.com/news/opinion/editorial/columnists/editorial-health-care-co-op-could-benefit/article_7fc03a20-37f0-52b8-ad21-13536b93d9fa.html
Hat Tip: Lincoln Journal-Star
CO-OPs- New York: Union Clinic to be Model for Freelancer Care
As soon as this summer, the Freelancers Union plans to open a health clinic in Brooklyn which could eventually serve up to 100,000 self-employed New Yorkers. Yesterday, as part of an effort to bolster that plan, as well as pay homage to the union that inspired it, Council Speaker Christine Quinn toured a Hotel Trades Council-run health clinic.
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To aid the union with its plan, the City Council recently set aside $100,000 to go toward a flagship health center in Brooklyn. Freelancers Union founder Sara Horowitz said they’re still looking for space in Downtown Brooklyn, but they’ve already signed on Cambridge-based Iora Health to manage the facility. Iora is a for-profit company that has two clinics that serve restaurant workers in Las Vegas and another in New Hampshire for Dartmouth College employees.
Initially, the Freelancers’ Union, which has 93,000 members in the city, will support 3,000 people in the walk-in clinics. But according to the plan, it will eventually support as many as 100,000 patients enrolled in the Freelancers Insurance Company. Aside from having primary care and other specialized medical services, Horowitz said they’re also looking at alternative medicine and yoga.
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In a seperate initiative, the Freelancers Union last month got a $340 million federal grant to create Consumer Operated and Oriented Plans (CO-OPs) in New York, New Jersey and Oregon. Of that, $174 million will go to New York's plan. (The money comes from $3.8 billion in co-op funding set aside for in the 2010 national health care legislation.)
The freelancer co-ops would be independently run plans with their own leadership, but sponsored by the union. They would compete with private insurers and launch in 2014.
Horowitz pointed out that New York was the place where experiments in health, banks and insurance began.
http://www.capitalnewyork.com/article/politics/2012/03/5406676/quinn-tours-union-health-clinic-she-hopes-will-be-model-freelancer-
Hat Tip: Capital New York
...
To aid the union with its plan, the City Council recently set aside $100,000 to go toward a flagship health center in Brooklyn. Freelancers Union founder Sara Horowitz said they’re still looking for space in Downtown Brooklyn, but they’ve already signed on Cambridge-based Iora Health to manage the facility. Iora is a for-profit company that has two clinics that serve restaurant workers in Las Vegas and another in New Hampshire for Dartmouth College employees.
Initially, the Freelancers’ Union, which has 93,000 members in the city, will support 3,000 people in the walk-in clinics. But according to the plan, it will eventually support as many as 100,000 patients enrolled in the Freelancers Insurance Company. Aside from having primary care and other specialized medical services, Horowitz said they’re also looking at alternative medicine and yoga.
...
In a seperate initiative, the Freelancers Union last month got a $340 million federal grant to create Consumer Operated and Oriented Plans (CO-OPs) in New York, New Jersey and Oregon. Of that, $174 million will go to New York's plan. (The money comes from $3.8 billion in co-op funding set aside for in the 2010 national health care legislation.)
The freelancer co-ops would be independently run plans with their own leadership, but sponsored by the union. They would compete with private insurers and launch in 2014.
Horowitz pointed out that New York was the place where experiments in health, banks and insurance began.
http://www.capitalnewyork.com/article/politics/2012/03/5406676/quinn-tours-union-health-clinic-she-hopes-will-be-model-freelancer-
Hat Tip: Capital New York
Tuesday, February 28, 2012
Montana- Health Co-Op is a Good Idea for Uninsured Montanans
Critics of the 2-year-old Affordable Care Act don't like it — we're not sure they'd like anything that might actually work during a presidential election year — but it was heartening to see that Montana was on the short list of states to benefit from the first round of funding for health care co-ops.
Montana Health Cooperative got word last week that it would get $58 million in loans over a period of time to get started in the health insurance marketplace that will be created in the state and elsewhere in the next couple of years.
...
The recent Assets & Opportunity Scorecard of the states by the Corporation for Enterprise Development said the state ranks 40th overall in uninsured rate, 48th in uninsured low-income parents and 45th in uninsured low-income children.
Some of those folks are the ones who stand to benefit by creation of the co-op.
John Morrison, former state insurance commissioner who helped form the Montana co-op and now is president of the National Alliance of Health Cooperatives, said the Montana organization "will be consumer-governed and will be responsive to consumer needs."
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But lo and behold two years after passage of the act — and about nine months after the newly formed Montana Health Cooperative announced that it planned to seek financial assistance under the act — the state co-op joins similar organizations in seven other states as the first federal loan recipients.
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Critics don't like the injection of government money into the health insurance system, but we'd wager most of them are either wealthy or have decent insurance mostly paid for by their employers.
The Montana Health Co-op won't be able to serve a large portion of the thousands of uninsured Montanans, but it might help create a marketplace that will be more accessible to them.
http://www.greatfallstribune.com/article/20120228/OPINION/202280306
Hat Tip: Great Falls Tribune
Montana Health Cooperative got word last week that it would get $58 million in loans over a period of time to get started in the health insurance marketplace that will be created in the state and elsewhere in the next couple of years.
...
The recent Assets & Opportunity Scorecard of the states by the Corporation for Enterprise Development said the state ranks 40th overall in uninsured rate, 48th in uninsured low-income parents and 45th in uninsured low-income children.
Some of those folks are the ones who stand to benefit by creation of the co-op.
John Morrison, former state insurance commissioner who helped form the Montana co-op and now is president of the National Alliance of Health Cooperatives, said the Montana organization "will be consumer-governed and will be responsive to consumer needs."
...
But lo and behold two years after passage of the act — and about nine months after the newly formed Montana Health Cooperative announced that it planned to seek financial assistance under the act — the state co-op joins similar organizations in seven other states as the first federal loan recipients.
...
Critics don't like the injection of government money into the health insurance system, but we'd wager most of them are either wealthy or have decent insurance mostly paid for by their employers.
The Montana Health Co-op won't be able to serve a large portion of the thousands of uninsured Montanans, but it might help create a marketplace that will be more accessible to them.
http://www.greatfallstribune.com/article/20120228/OPINION/202280306
Hat Tip: Great Falls Tribune
Monday, February 27, 2012
CO-OPs- Montana: What is a Health Co-Op, and How Does it Work?
Come 2014, Montana will have a new health insurance company, funded with $58 million in loaned seed money from the federal government.
This company is the Montana Health Co-op, which will be owned by its "members," or customers, and run by the same — as it sells health insurance to individuals, small businesses and maybe even some larger businesses.
...
The co-op, which they'll spend the next 18 months putting together, will survive because it can create a good, affordable insurance product that focuses directly on patient needs and not profit, they say.
"When you have a member-governed organization that directly elects from their ranks a board of directors, it guards against any kind of inefficiencies," said John Morrison, the former state insurance commissioner and a co-op board member.
...
So how will this co-op actually work? And can it survive, prosper and pay back its loans?
Within a week or so, the Montana co-op gets the first installment of its $6.7 million start-up loan from the feds: $730,000, to fund its budget for the next six months.
...
The current board members have an extensive background in health care, insurance, law, marketing, public policy and private business.
Eric Schindler, a board member and Helena insurance executive, says the co-op will solicit proposals from contractors to process its claims, organize provider networks, run wellness and pharmacy programs, and perform functions that any good insurer must do.
It will get a license to operate from the state auditor's office — like any other insurer — and expects to be ready by October 2013 to start selling policies. It must offer policies on the new health insurance "exchanges," which are Internet marketplaces for insurance that begin in 2014, and plans to sell its products elsewhere, too.
The federal loans cannot be used to market their products or to finance any standalone clinic or medical staff that the co-op might want to establish.
Yet the co-op can get financing from private sources for those and other expenses, and Schindler says it already has talked to banks about this "outside capital."
...
The board "is going to be very vigilant at all times, on how to save money, from provider networks to administrative costs, to the way in which benefits are structured to discourage utilization," Morrison said. "What you have is faith that they're looking after their own interests."
http://billingsgazette.com/news/state-and-regional/montana/what-is-a-health-co-op-and-how-does-it/article_3bbeba9c-48d2-5ffe-95bb-832894a7c400.html#ixzz1nbTJP6rx
Hat tip: Billings Gazette
This company is the Montana Health Co-op, which will be owned by its "members," or customers, and run by the same — as it sells health insurance to individuals, small businesses and maybe even some larger businesses.
...
The co-op, which they'll spend the next 18 months putting together, will survive because it can create a good, affordable insurance product that focuses directly on patient needs and not profit, they say.
"When you have a member-governed organization that directly elects from their ranks a board of directors, it guards against any kind of inefficiencies," said John Morrison, the former state insurance commissioner and a co-op board member.
...
So how will this co-op actually work? And can it survive, prosper and pay back its loans?
Within a week or so, the Montana co-op gets the first installment of its $6.7 million start-up loan from the feds: $730,000, to fund its budget for the next six months.
...
The current board members have an extensive background in health care, insurance, law, marketing, public policy and private business.
Eric Schindler, a board member and Helena insurance executive, says the co-op will solicit proposals from contractors to process its claims, organize provider networks, run wellness and pharmacy programs, and perform functions that any good insurer must do.
It will get a license to operate from the state auditor's office — like any other insurer — and expects to be ready by October 2013 to start selling policies. It must offer policies on the new health insurance "exchanges," which are Internet marketplaces for insurance that begin in 2014, and plans to sell its products elsewhere, too.
The federal loans cannot be used to market their products or to finance any standalone clinic or medical staff that the co-op might want to establish.
Yet the co-op can get financing from private sources for those and other expenses, and Schindler says it already has talked to banks about this "outside capital."
...
The board "is going to be very vigilant at all times, on how to save money, from provider networks to administrative costs, to the way in which benefits are structured to discourage utilization," Morrison said. "What you have is faith that they're looking after their own interests."
http://billingsgazette.com/news/state-and-regional/montana/what-is-a-health-co-op-and-how-does-it/article_3bbeba9c-48d2-5ffe-95bb-832894a7c400.html#ixzz1nbTJP6rx
Hat tip: Billings Gazette
Tuesday, February 21, 2012
CO-OPs- National: Feds Loan $638M for Health Co-Ops in 8 States
Health care cooperatives that are being launched in eight states announced Tuesday they will receive a total of $638 million in loans from the Obama administration under the federal health insurance law.
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Critics, led by House Republicans who voted last year to repeal the health care law, immediately questioned the administration's decision. The House Ways and Means Committee called the loans a political reward to a friendly constituency.
Republicans noted that the recipient that received the largest loan - more than $340 million - was going to a group connected to the Freelancers Union, a nonprofit that serves independent contractors that are a growing segment of the workforce. Members are eligible for health insurance through a company owned by Freelancers.
...
"Freelancers Union clearly met the legal standards under the statute and federal regulations," said Brian Cook, a Centers for Medicare and Medicaid Services spokesman. "They are not an insurer, they are a nonprofit union of independent workers, sole proprietors, and entrepreneurs who do not receive insurance through an employer."
...
The new federal awards were announced for co-ops serving Montana, Iowa, Nebraska, New Jersey, New Mexico, New York, Oregon and Wisconsin. "It will be consumer-governed and will be responsive to consumer needs," said John Morrison, who is helping set up the cooperative in Montana.
http://hosted.ap.org/dynamic/stories/U/US_HEALTH_CARE_COOPERATIVES?SITE=NCKIN&SECTION=HOME&TEMPLATE=DEFAULT
Hat tip: The Associated Press
...
Critics, led by House Republicans who voted last year to repeal the health care law, immediately questioned the administration's decision. The House Ways and Means Committee called the loans a political reward to a friendly constituency.
Republicans noted that the recipient that received the largest loan - more than $340 million - was going to a group connected to the Freelancers Union, a nonprofit that serves independent contractors that are a growing segment of the workforce. Members are eligible for health insurance through a company owned by Freelancers.
...
"Freelancers Union clearly met the legal standards under the statute and federal regulations," said Brian Cook, a Centers for Medicare and Medicaid Services spokesman. "They are not an insurer, they are a nonprofit union of independent workers, sole proprietors, and entrepreneurs who do not receive insurance through an employer."
...
The new federal awards were announced for co-ops serving Montana, Iowa, Nebraska, New Jersey, New Mexico, New York, Oregon and Wisconsin. "It will be consumer-governed and will be responsive to consumer needs," said John Morrison, who is helping set up the cooperative in Montana.
http://hosted.ap.org/dynamic/stories/U/US_HEALTH_CARE_COOPERATIVES?SITE=NCKIN&SECTION=HOME&TEMPLATE=DEFAULT
Hat tip: The Associated Press
CO-OPs- Iowa & Nebraska: Health Insurance Co-Op Awarded Loan in Iowa
The Centers for Medicare & Medicaid Services just announced that a nonprofit entity in Iowa and Nebraska, Midwest Members Health,known under the Affordable Care Act as a Consumer Operated and Oriented Plan (or CO-OP), has received a loan award from the Department of Health and Human Services. More information can be found here: http://www.healthcare.gov/news/factsheets/2012/02/coops02212012a.html
...
All CO-OPs receiving loans were selected on a competitive basis through external and independent expert objective reviews and approval by CMS officials with private insurance expertise. Non-profits receiving the loans include: Freelancers CO-OP of Oregon, New Mexico Health Connections, Montana Health Cooperative, Midwest Members Health, Common Ground Healthcare Cooperative, Freelancers CO-OP of New Jersey, and Freelancers Health Service Corporation. Starting in 2014, these CO-OPs will operate in Oregon, New Mexico, Montana, Iowa, Nebraska, Wisconsin, New Jersey, and New York.
Today’s awardees will receive start-up and solvency loans to fund start-up activities required to become a health insurance issuer and enable them to meet State licensure, solvency and reserve requirements. Start-up loans must be repaid in 5 years and solvency loans paid back within 15 years. Like other plans, CO-OPs will meet State and federal standards for qualified health plans to sell coverage through the Exchanges and the State’s Small Business Health Option Programs (SHOP Exchanges).
http://thegazette.com/2012/02/21/health-insurance-co-op-awarded-loan-in-iowa-midwest-members-health-will-start-new-health-insurance-company/
Hat Tip: The Gazette
...
All CO-OPs receiving loans were selected on a competitive basis through external and independent expert objective reviews and approval by CMS officials with private insurance expertise. Non-profits receiving the loans include: Freelancers CO-OP of Oregon, New Mexico Health Connections, Montana Health Cooperative, Midwest Members Health, Common Ground Healthcare Cooperative, Freelancers CO-OP of New Jersey, and Freelancers Health Service Corporation. Starting in 2014, these CO-OPs will operate in Oregon, New Mexico, Montana, Iowa, Nebraska, Wisconsin, New Jersey, and New York.
Today’s awardees will receive start-up and solvency loans to fund start-up activities required to become a health insurance issuer and enable them to meet State licensure, solvency and reserve requirements. Start-up loans must be repaid in 5 years and solvency loans paid back within 15 years. Like other plans, CO-OPs will meet State and federal standards for qualified health plans to sell coverage through the Exchanges and the State’s Small Business Health Option Programs (SHOP Exchanges).
http://thegazette.com/2012/02/21/health-insurance-co-op-awarded-loan-in-iowa-midwest-members-health-will-start-new-health-insurance-company/
Hat Tip: The Gazette
CO-OPs: Montana- Secures $58M for New Non-Profit Health Insurance Agency
Montana has secured more than $58 million dollars toward the creation of a new non-profit health insurance agency, the Montana Health Cooperative.
The federal Affordable Care Act of 2009 created the new type of non-profit health insurer, known as Consumer Oriented and Operated Plans (CO-OP).
...
The CO-OP program offers low-interest loans to eligible nonprofit groups to help set up and maintain these issuers; to date, a total of seven non-profits offering coverage in eight states have been awarded $638,677,300.
The press release states that Montana has been awarded $58,138,300 for the Montana Health Cooperative, which is "sponsored by a coalition of small businesses and community leaders and plans to add a strong primary care capacity to Montana's rural and medically underserved communities. Montana Health Cooperative will provide health insurance coverage statewide."
http://www.krtv.com/news/montana-secures-58m-for-new-non-profit-health-insurance-agency-/
Hat tip: KRTV
The federal Affordable Care Act of 2009 created the new type of non-profit health insurer, known as Consumer Oriented and Operated Plans (CO-OP).
...
The CO-OP program offers low-interest loans to eligible nonprofit groups to help set up and maintain these issuers; to date, a total of seven non-profits offering coverage in eight states have been awarded $638,677,300.
The press release states that Montana has been awarded $58,138,300 for the Montana Health Cooperative, which is "sponsored by a coalition of small businesses and community leaders and plans to add a strong primary care capacity to Montana's rural and medically underserved communities. Montana Health Cooperative will provide health insurance coverage statewide."
http://www.krtv.com/news/montana-secures-58m-for-new-non-profit-health-insurance-agency-/
Hat tip: KRTV
Thursday, February 16, 2012
CO-OPs- Federal: IRS Provides More Guidance On Health Insurance Cooperatives
The IRS issued temporary rules on the recognition of healthcare cooperatives under Section 501(c)(29) of the IRC. See Reg. 13507-11, T.D 9574, Federal Register, Feb. 7, 2012, for more details. The IRS also issued a revenue procedure for the issuance of determination letters and rulings. See IRS Rev. Proc. 2012-11 scheduled for publication in Internal Revenue Bulletin 2012-7, Feb. 13, 2012.
The proposed and temporary rules provide that "qualified" nonprofit health insurers must apply for tax-exempt recognition with the IRS. The effective date of exemption will be the later of the date of application or March 23, 2010, the date of the enactment of the Patient Protection and Affordable Care Act.
As it has with other provisions of the act, the IRS looks to the rules that are being promulgated by the Centers for Medicare & Medicaid Services (CMS). See Legal Update dated March 15, 2011, " IRS Issues First Guidance on Exempt Health Insurance Entities."
Qualified Organizations
Once the Consumer Operated and Oriented Plan (CO-OP) qualifies under the CMS plan and CMS acts, then the CO-OP can apply for IRS tax exemption under Section 501(c)(29).
CMS issued final rules in December 2011 for eligibility to be part of the CMS program. These rules provided guidelines for the compensation of the board of directors, financial solvency requirements and loan requirement terms.
Revenue Procedure 2012-11
The IRS has provided additional rules in a revenue procedure for applications for tax exemption, including rules precluding private inurement of earnings to shareholders or individuals. Under these rules, private inurement will not result from the lowering of premiums, the improvement of benefits or the improvement of the quality of healthcare. There will also be proscriptions on substantial legislative activities and a prohibition on political activities.
The revenue procedure will require a copy of the notice of award issued by CMS together with the executed loan agreement accompanying the CO-OP's application for exemption.
http://www.mondaq.com/unitedstates/x/164758/IRS+HRMC/IRS+Provides+More+Guidance+On+Health+Insurance+Cooperatives
Hat tip: Mondaq
The proposed and temporary rules provide that "qualified" nonprofit health insurers must apply for tax-exempt recognition with the IRS. The effective date of exemption will be the later of the date of application or March 23, 2010, the date of the enactment of the Patient Protection and Affordable Care Act.
As it has with other provisions of the act, the IRS looks to the rules that are being promulgated by the Centers for Medicare & Medicaid Services (CMS). See Legal Update dated March 15, 2011, " IRS Issues First Guidance on Exempt Health Insurance Entities."
Qualified Organizations
Once the Consumer Operated and Oriented Plan (CO-OP) qualifies under the CMS plan and CMS acts, then the CO-OP can apply for IRS tax exemption under Section 501(c)(29).
CMS issued final rules in December 2011 for eligibility to be part of the CMS program. These rules provided guidelines for the compensation of the board of directors, financial solvency requirements and loan requirement terms.
Revenue Procedure 2012-11
The IRS has provided additional rules in a revenue procedure for applications for tax exemption, including rules precluding private inurement of earnings to shareholders or individuals. Under these rules, private inurement will not result from the lowering of premiums, the improvement of benefits or the improvement of the quality of healthcare. There will also be proscriptions on substantial legislative activities and a prohibition on political activities.
The revenue procedure will require a copy of the notice of award issued by CMS together with the executed loan agreement accompanying the CO-OP's application for exemption.
http://www.mondaq.com/unitedstates/x/164758/IRS+HRMC/IRS+Provides+More+Guidance+On+Health+Insurance+Cooperatives
Hat tip: Mondaq
Tuesday, February 14, 2012
CO-OPs- Oregon: New Health Care Model Makes Doctors Visits/ Prescriptions Affordable for Uninsured
We’re not waiting for political things to happen,” says Morgan Butler, membership services community organizer for Patient Physician Cooperatives Portland. “We’re creating our own thing, which seems to work a lot better and a lot faster.
“We want people to know they can have a primary care provider right now. And they won’t have to wait months for an appointment.”
Patient Physician Cooperatives Portland (PPCPdx) is not an insurance policy. It is a nonprofit that brings together physicians and patients outside of the traditional insurance model. To join the co-operative, patients pay $18 a month.
...
Just seven months old, PPCPdx is up and running with 30 health care providers and 80 members. On the providers list, so far, are two medical doctors and two family nurse practitioners, along with chiropractors and naturopathic doctors, acupuncturists and massage therapists.
Carr says most doctors haven’t yet heard about the co-op; word is just beginning to spread in medical circles. She was keen to sign up as a provider because she already sees many patients who have no insurance and pay cash for services.
“It made a lot of sense to me to sign up with this plan,” she says. “It’s a pretty reasonable model of care. When I was starting out I thought a lot about how I wanted to practice, and this fits nicely with giving providers work and giving patients a good opportunity for access to health care.”
...
Former health industry executive Don McCormick launched Patient Physicians Cooperatives in Houston, Texas, 8 years ago. After working with physicians groups for 40 years, he agreed to help a clinic reorganize, and came up with the idea of a co-op. The Houston co-op now offers services from 49 diverse doctors. And in Hickory, N.C., the Apollo Healthcare Cooperative, opened in 2009, has grown to 600 members and offers a seven-day a week urgent care clinic.
...
Size matters, however, when it comes to what the co-ops can offer. The Houston co-op has partnered with hospitals, an imaging center and specialists, as well as with individual doctors. It also offers a low cost insurance that covers hospital care.
Portland’s co-op needs to add members so it can offer these kinds of valuable extra benefits, Butler says.
Low-cost legal services are available now, and other optional extras can be added, as the number of members grows.
“I’d like to have 300 members signed up, because at that point we can do a whole lot more,” he said. “We have a lot more buying power and people will start coming to us.”
Butler says he gets a lot of questions about how co-ops work, when people get a serious illness such as cancer.
“If you do get cancer, we will advocate for you to get Medicare rates for your treatment,” he says. “We can help you apply to state of the art cancer centers, like the Anderson Clinic in Houston. And if you are signed up with a primary care provider, you will have a far more personal care experience.”
...
Butler sees the co-op as a good step toward making medical care available to everyone. “Some people say they won’t get involved with anything less than a single-payer system, he said. “But anyone who knows how health care is set up, knows that we couldn’t put in a single-payer system tomorrow if we wanted to. Patient/Physician Cooperatives can be part of that transition. We are definitely part of the solution.”
http://theskanner.com/article/New-Health-Care-Model-Makes-Doctors-Visits-Prescriptions-Affordable-for-Uninsured-2012-02-13
Hat tip: The Skanner/ ppcpdxcoop.org
Editorial Note: This legal framework was created outside the provisions of the ACA.
“We want people to know they can have a primary care provider right now. And they won’t have to wait months for an appointment.”
Patient Physician Cooperatives Portland (PPCPdx) is not an insurance policy. It is a nonprofit that brings together physicians and patients outside of the traditional insurance model. To join the co-operative, patients pay $18 a month.
...
Just seven months old, PPCPdx is up and running with 30 health care providers and 80 members. On the providers list, so far, are two medical doctors and two family nurse practitioners, along with chiropractors and naturopathic doctors, acupuncturists and massage therapists.
Carr says most doctors haven’t yet heard about the co-op; word is just beginning to spread in medical circles. She was keen to sign up as a provider because she already sees many patients who have no insurance and pay cash for services.
“It made a lot of sense to me to sign up with this plan,” she says. “It’s a pretty reasonable model of care. When I was starting out I thought a lot about how I wanted to practice, and this fits nicely with giving providers work and giving patients a good opportunity for access to health care.”
...
Former health industry executive Don McCormick launched Patient Physicians Cooperatives in Houston, Texas, 8 years ago. After working with physicians groups for 40 years, he agreed to help a clinic reorganize, and came up with the idea of a co-op. The Houston co-op now offers services from 49 diverse doctors. And in Hickory, N.C., the Apollo Healthcare Cooperative, opened in 2009, has grown to 600 members and offers a seven-day a week urgent care clinic.
...
Size matters, however, when it comes to what the co-ops can offer. The Houston co-op has partnered with hospitals, an imaging center and specialists, as well as with individual doctors. It also offers a low cost insurance that covers hospital care.
Portland’s co-op needs to add members so it can offer these kinds of valuable extra benefits, Butler says.
Low-cost legal services are available now, and other optional extras can be added, as the number of members grows.
“I’d like to have 300 members signed up, because at that point we can do a whole lot more,” he said. “We have a lot more buying power and people will start coming to us.”
Butler says he gets a lot of questions about how co-ops work, when people get a serious illness such as cancer.
“If you do get cancer, we will advocate for you to get Medicare rates for your treatment,” he says. “We can help you apply to state of the art cancer centers, like the Anderson Clinic in Houston. And if you are signed up with a primary care provider, you will have a far more personal care experience.”
...
Butler sees the co-op as a good step toward making medical care available to everyone. “Some people say they won’t get involved with anything less than a single-payer system, he said. “But anyone who knows how health care is set up, knows that we couldn’t put in a single-payer system tomorrow if we wanted to. Patient/Physician Cooperatives can be part of that transition. We are definitely part of the solution.”
http://theskanner.com/article/New-Health-Care-Model-Makes-Doctors-Visits-Prescriptions-Affordable-for-Uninsured-2012-02-13
Hat tip: The Skanner/ ppcpdxcoop.org
Editorial Note: This legal framework was created outside the provisions of the ACA.
CO-OPs- Massachusetts: Small-Business Health Co-Op Will Slash Rates
Thousands of small businesses will be offered discounts of at least 20 percent on health insurance rates under a new group purchasing cooperative, formed by the Retailers Association of Massachusetts, that will begin enrolling members this week.
The co-op is the first permitted to do business under a 2010 Massachusetts law that allows small employers to band together in large groups and negotiate for better-priced health coverage. On Friday, the state Division of Insurance authorized it to offer about 4,000 small businesses a half-dozen health plans that are far less expensive than what the businesses had been paying on their own.
...
In addition to about 3,500 members from the retailers association, ranging from restaurants to hardware stores to dry cleaners, the co-op also can cover about 500 members of the Massachusetts Package Stores Association.
....
The co-op’s alliance with Steward and Fallon, if successful, would drive more patients to the 10 community hospitals in Eastern Massachusetts run by Boston-based Steward, which already operates another limited network for small employers in collaboration with Tufts Health Plan. In such plans, members are restricted to Steward’s hospitals and its 2,200 affiliated doctors, but pay significantly less than those enrolled in broader-network plans.
...
The state’s insurance commissioner, Joseph G. Murphy, said his office is reviewing applications from other potential co-ops and has certified a second one, the Massachusetts Association of Chamber of Commerce Executives.
The 2010 law restricts total enrollment in all co-ops to 85,000. Extending the lower-cost insurance to all small businesses, which together employ about 500,000 people, would require legislative action.
http://www.bostonglobe.com/metro/2012/02/14/small-business-health-will-slash-rates/ZTUTfgxMLEOaOcg0KxxkkJ/story.html
Hat tip: Boston Globe
Editorial Note: This legal framework was created outside the provisions in the ACA.
The co-op is the first permitted to do business under a 2010 Massachusetts law that allows small employers to band together in large groups and negotiate for better-priced health coverage. On Friday, the state Division of Insurance authorized it to offer about 4,000 small businesses a half-dozen health plans that are far less expensive than what the businesses had been paying on their own.
...
In addition to about 3,500 members from the retailers association, ranging from restaurants to hardware stores to dry cleaners, the co-op also can cover about 500 members of the Massachusetts Package Stores Association.
....
The co-op’s alliance with Steward and Fallon, if successful, would drive more patients to the 10 community hospitals in Eastern Massachusetts run by Boston-based Steward, which already operates another limited network for small employers in collaboration with Tufts Health Plan. In such plans, members are restricted to Steward’s hospitals and its 2,200 affiliated doctors, but pay significantly less than those enrolled in broader-network plans.
...
The state’s insurance commissioner, Joseph G. Murphy, said his office is reviewing applications from other potential co-ops and has certified a second one, the Massachusetts Association of Chamber of Commerce Executives.
The 2010 law restricts total enrollment in all co-ops to 85,000. Extending the lower-cost insurance to all small businesses, which together employ about 500,000 people, would require legislative action.
http://www.bostonglobe.com/metro/2012/02/14/small-business-health-will-slash-rates/ZTUTfgxMLEOaOcg0KxxkkJ/story.html
Hat tip: Boston Globe
Editorial Note: This legal framework was created outside the provisions in the ACA.
Monday, February 13, 2012
CO-OPs- Illinois: Update--Small Business Advocacy Council Announces Introduction of Health Care Cooperative Legislation
The Small Business Advocacy Council (SBAC) announced introduction of House Bill 3976, sponsored by Representative Karen May (D-Highwood), and Senate Bill 2885, sponsored by Senator Kwame Raoul, to authorize health care cooperatives in Illinois in an effort to stabilize health care costs for small business owners.
A health care cooperative (coop - consumer owned and operated plan) is a state-chartered, nonprofit, membership organization comprised of individuals and small employers joined together to operate as a health insurance issuer.
"The growth of small businesses and the economy continues to be undermined by the lack of affordable health care," said Elliot Richardson, SBAC President. "Too often small businesses are held hostage to large insurance companies imposing increasing or wildly-fluctuating rates without explanation or full disclosure of how their premium dollars are truly being spent."
The SBAC, a non-partisan, not-for-profit political organization, was established in 2010 to give small business owners, their employees and those with whom they conduct business with a voice in local, state and federal politics. The group represents more than 400 small businesses in the Chicagoland area.
http://www.marketwatch.com/story/small-business-advocacy-council-announces-introduction-of-health-care-cooperative-legislation-2012-02-09?reflink=MW_news_stmp
Hat tip: MarketWatch/ Wall St. Journal
A health care cooperative (coop - consumer owned and operated plan) is a state-chartered, nonprofit, membership organization comprised of individuals and small employers joined together to operate as a health insurance issuer.
"The growth of small businesses and the economy continues to be undermined by the lack of affordable health care," said Elliot Richardson, SBAC President. "Too often small businesses are held hostage to large insurance companies imposing increasing or wildly-fluctuating rates without explanation or full disclosure of how their premium dollars are truly being spent."
The SBAC, a non-partisan, not-for-profit political organization, was established in 2010 to give small business owners, their employees and those with whom they conduct business with a voice in local, state and federal politics. The group represents more than 400 small businesses in the Chicagoland area.
http://www.marketwatch.com/story/small-business-advocacy-council-announces-introduction-of-health-care-cooperative-legislation-2012-02-09?reflink=MW_news_stmp
Hat tip: MarketWatch/ Wall St. Journal
Wednesday, February 8, 2012
CO-OPs- Illinois: Small-Biz Advocacy Group Pushes Health Insurance CO-OPs Idea in Springfield
At least one organization in Illinois, the Metropolitan Chicago Healthcare Council (MCHC) — an advocacy group for hospitals and other area health providers including Northwestern Medical Center, the Advocate Health Care Network, the University of Chicago Medical Center, Rush University Medical Center and more — has applied for a federal CO-OP grant. Meanwhile, the Small Business Advocacy Council, a Chicago group run by attorney (and erstwhile congressional candidate) Elliot Richardson, is proposing state legislation to establish a health insurance co-op aimed at small-business owners.
The SBAC has sponsors in the state House and Senate for its proposal. Mr. Richardson spoke to Crain's about his goals for co-ops, which he said would stabilize health insurance costs while making the process of shopping for better rates more transparent.
http://www.chicagobusiness.com/article/20120208/BLOGS06/120209826
Hat tip: Chicago Business/ Crain's Blogs/ Meg McSherry Breslin
The SBAC has sponsors in the state House and Senate for its proposal. Mr. Richardson spoke to Crain's about his goals for co-ops, which he said would stabilize health insurance costs while making the process of shopping for better rates more transparent.
http://www.chicagobusiness.com/article/20120208/BLOGS06/120209826
Hat tip: Chicago Business/ Crain's Blogs/ Meg McSherry Breslin
Thursday, February 2, 2012
Montana-Doctor Sees CO-OPs as One Solution to Health Care Mess
The chairman of the fledgling Montana Health Cooperative laid out a dismal picture of the American health care system during a presentation in Billings on Wednesday.
...
Roberts, president of the Western Montana Clinic in Missoula, thinks one answer is health care co-ops. The Affordable Care Act of 2010 authorized the creation of health care cooperatives, and Congress ultimately appropriated $3.4 billion to provide them with start-up loans.
The Montana co-op is being organized by a group of doctors and people with experience in health insurance, state and local government, private business, labor and education.
Like co-ops elsewhere in the country, the Montana organization would be owned and operated by its members and would provide health insurance to individuals and small employers who have trouble finding affordable coverage.
...
Roberts declined to say how big a loan the Montana co-op applied for, but he estimated start-up costs at $5 million. Larger future loans would be “solvency loans,” which the co-op would have to park in a bank in the form of required reserves.
He said the co-op hopes to begin offering coverage by January 2014, elect a full board of directors by 2016, repay its start-up loans by 2018 and pay off all its loans by
...
Roberts, president of the Western Montana Clinic in Missoula, thinks one answer is health care co-ops. The Affordable Care Act of 2010 authorized the creation of health care cooperatives, and Congress ultimately appropriated $3.4 billion to provide them with start-up loans.
The Montana co-op is being organized by a group of doctors and people with experience in health insurance, state and local government, private business, labor and education.
Like co-ops elsewhere in the country, the Montana organization would be owned and operated by its members and would provide health insurance to individuals and small employers who have trouble finding affordable coverage.
...
Roberts declined to say how big a loan the Montana co-op applied for, but he estimated start-up costs at $5 million. Larger future loans would be “solvency loans,” which the co-op would have to park in a bank in the form of required reserves.
He said the co-op hopes to begin offering coverage by January 2014, elect a full board of directors by 2016, repay its start-up loans by 2018 and pay off all its loans by
2028.
Friday, January 27, 2012
CO-OPs-Massachusetts: May Spell Savings In Health Insurance
For years, the Retailers Association of Massachusetts and small-business members of local chambers of commerce have teamed up with other businesses to use their group purchasing power to buy workers’ compensation coverage, electricity, natural gas and pay for other expenses.
Simply put, when businesses pool together to buy in bulk, they lower their costs.
But until recently, small businesses were not allowed to collaborate to buy health insurance, which Jon Hurst, president of the retailers’ group, said is ironic: That’s the highest cost most businesses have besides salaries.
That is, until the state’s Division of Insurance approved two group purchasing cooperatives in December. As of Jan. 1, small businesses can team up and buy health insurance to get more attractive rates. The retailers’ association and a statewide group representing local chambers of commerce will run the program.
...
“Small businesses have been in the very difficult position of being required to offer and provide health insurance for employees and families, yet their increases have been three times the size that big businesses and government have seen,” said Hurst, of the retailers’ group. “That is a situation that is unacceptable economically, politically and legally.”
In fact, according to a state study, insurance rates for small businesses have risen faster than those of larger businesses. From 2008 to 2009, which is the most recent data the state’s Division of Health Care Finance and Policy has, the small group market saw an average premium increase of 9.5 percent. Meanwhile, the mid-size market saw an average 7.6 percent hike and the large-group market, 5.4 percent.
http://www.wbjournal.com/news50607.html
Hat tip: Worcester Business Journal
Simply put, when businesses pool together to buy in bulk, they lower their costs.
But until recently, small businesses were not allowed to collaborate to buy health insurance, which Jon Hurst, president of the retailers’ group, said is ironic: That’s the highest cost most businesses have besides salaries.
That is, until the state’s Division of Insurance approved two group purchasing cooperatives in December. As of Jan. 1, small businesses can team up and buy health insurance to get more attractive rates. The retailers’ association and a statewide group representing local chambers of commerce will run the program.
...
“Small businesses have been in the very difficult position of being required to offer and provide health insurance for employees and families, yet their increases have been three times the size that big businesses and government have seen,” said Hurst, of the retailers’ group. “That is a situation that is unacceptable economically, politically and legally.”
In fact, according to a state study, insurance rates for small businesses have risen faster than those of larger businesses. From 2008 to 2009, which is the most recent data the state’s Division of Health Care Finance and Policy has, the small group market saw an average premium increase of 9.5 percent. Meanwhile, the mid-size market saw an average 7.6 percent hike and the large-group market, 5.4 percent.
http://www.wbjournal.com/news50607.html
Hat tip: Worcester Business Journal
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