Word: aetna
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...circumventing cumbersome insurance regulations. Some doctors and dentists give patients inflated bills in exchange for slightly higher than normal fees. The patient collects his own kickback in the form of a bigger insurance refund. Some hospitals and doctors bill for treatment they did not provide. In a survey of Aetna Life & Casualty customers, 4 out of 10 consumers said their doctors had cheated insurance companies...
...Other experts, including former U.S. Surgeon General C. Everett Koop, believe the cost is several times that high. Some reformers think juries in malpractice cases share the blame by punishing doctors not only for shoddy practice but also for their human limitations. "Medical care is not always successful," says Aetna's Kelly. "But that doesn't mean the doctor should have to pay huge awards for pain and suffering...
...overtreat patients simply because they have a blank check to do so under many insurance programs. As much as 20% of all medical procedures and treatment is completely unnecessary, contends Dr. Robert Brook, director of health sciences for the Rand Corp. Cost of the waste: $132 billion a year. Aetna estimates that as much as 30% more ($198 billion) is discretionary care that may not solve the problem under treatment...
...crisis of confidence surrounding the insurance industry became worse in the past two weeks when the Wall Street research firm of Moody's suddenly downgraded the ratings of nine of the nation's biggest life insurers: Aetna, Kemper, John Hancock, Home Life, Massachusetts Mutual, Mutual Life of New York, New England Mutual, Travelers and Principal Mutual. A similar rating drop this spring triggered a run on Mutual Benefit from which the insurer never recovered...
...Companies are saying, 'I'm tired of paying simply for time,' " notes John Hamm, vice president for compensation and benefits at Aetna Life and Casualty. "Now they are saying, 'I want to pay for production.' " So many are saying it that 35% of the FORTUNE 500 are experimenting with some form of pay- for-performance program, according to the consulting firm Sibson & Co. -- up from 7% 10 years...