Insurers ‘spinning’ some data to shape health reform

Insurers sometimes cherry-pick facts to make their case against certain aspects of reform efforts, including a public plan, The Washington Post reports.

Karen Ignagni, president of America's Health Insurance Plans, argued that the Obama administration should be careful because "77 percent of Americans are satisfied with their existing health insurance coverage," but "The poll Ignagni was citing actually undercuts her position: By 72 to 20 percent, Americans favor the creation of a public plan, the June survey by the New York Times and CBS News found. People also said that they thought government would do a better job than private insurers of holding down health-care costs and providing coverage.

"In addition, data from a Kaiser Family Foundation poll last year, compiled at the request of The Washington Post, suggest that the people who like their health plans the most are the people who use them the least ... The level of satisfaction expressed with private insurance was essentially the same as that with Medicare, the government program for the elderly and disabled."

"AHIP has produced a stack of glossy reports describing health insurers' efforts to improve care. In recent testimony, Ignagni said private health plans serving the elderly have been highly successful in reducing hospital admissions and readmissions for patients with diabetes and heart disease. Yet one of the AHIP reports says that in an Aetna Pathways to Excellence hospital incentive program, 'readmission rates did not improve significantly'" (Hilzenrath, 7/22). (note: KHN is a program of the Kaiser Family Foundation).

President Obama's budget director, Peter Orszag, recently asked Aetna what insurers are offering to improve health care quality and drive down costs, The Washington Post reports in a separate story: "In response, Aetna pointed to evidence of progress through information technology. But the research Aetna cited wasn't entirely encouraging. The report, describing an experiment conducted in 2001, found that the software reduced consumption of medical services by 6.1 percent. Almost all of the savings were in the hospital setting."

"[Aetna chief medical officer Lonnie] Reisman gave Orszag a study published last year in the Journal of Health Economics analyzing a controlled experiment conducted years ago on a population of 40,000 HMO patients. The experiment involving software developed by a company called ActiveHealth Management, which Reisman co-founded and formerly headed. Reisman was also a co-author of the study.

"The software analyzes patients' medical records and alerts doctors if it finds reason to stop a drug, add a drug, or do a test. 'Our findings suggest that the experiment did not reduce all professional charges, but only those associated with hospitalization,' the study said. … Orszag was so impressed with the study that he urged Reisman to show it to the CBO, Reisman said. In contrast to a multitude of studies offered by various parties to advance their cause, this one was designed to meet the most rigorous scientific standards, Reisman said" (Hilzenrath, 7/21).