STRONGER ECONOMY AND NEW APPROACHES TO COST-CONTAINMENT NEEDED - Health Care Specialists Expect Number of Uninsured To Increase Again In Spite of Recent Progress
ATLANTA, Ga. - December 4, 2001

While the number of individuals covered by health insurance rose slightly last year, the recent softening of the economy may reverse that trend, says Sean Smith, chief executive officer of Coalition America, Inc. (CAI).

"Until 1999, those individuals without insurance had risen continuously since 1988," Smith said. "Then, a strong economy and success by managed care organizations in controlling costs made health insurance coverage more affordable. Unfortunately, the weak economy and expected double-digit premium increases by managed care organizations will probably setback efforts to expand medical coverage in the U.S."

The 2000 data reported by the Census Bureau covers a period when the economy was still vigorous. The positive news from the Census Bureau report included:

• The number of uninsured declined by 1.7 million to 42.6 million - decreasing to 15.5 percent of Americans;
• The number of individuals receiving employer provided health coverage rose by 3.4 million to 172 million, which accounted for 85 percent of the overall increase;
• The number of uninsured children declined to 10 million from 11.1 million or 13.9 percent;
• The proportion of the population covered by government health insurance programs stayed steady at 24 percent;

"There is a direct link between the strength of the economy and the number of families who can obtain private health coverage," Smith said. "To maximize the number of people covered by our health care system we need both a strong economy and new approaches to controlling the rising cost of health insurance."

As one of the country’s fastest growing health care cost-containment and savings companies, Atlanta-based Coalition America is focusing its efforts on new solutions for curtailing health care costs.

Organizations like Coalition America reduce health care costs by offering self-insured organizations and local or regional managed care companies three types of cost-containment services: 1) developing primary PPO management programs across multiple locations; 2) offering access to lower-cost supplemental networks for managing out-of-network costs; and 3) direct negotiations with health care providers where no PPO contract exists.

"With everyone in the health care delivery system facing renewed cost pressures in an under performing economy, everyone must look for new approaches for reducing costs," Smith said. "This is particularly important in helping corporations preserve a vital employee benefit."To help both managed care firms and health care providers (doctors, hospitals, etc.) better control costs, companies like Coalition America are developing new technologies to lower costs by finding and eliminating bottlenecks and unnecessary costs. Their efforts are focused on steps that reduce claim losses, improve efficiency, expedite claims adjudication and accelerates payments.

By searching for new cost savings, Smith says, the primary beneficiaries may be those most vulnerable right now-families at the bottom of the economic ladder.

For example, the Census figures show that Hispanics are more likely to be uninsured than any other major ethnic or racial group. Further, males are most likely to be without insurance. Among youths ages 18 to 24, the uninsured rate is 29 percent-the highest of any age group.

"Given the expected increases in insurance premiums for 2002, it will take cooperative efforts by everyone-employers, insurance firms and health care professionals-to maintain high-quality, affordable health care in this country," Smith said.

About CAI

Coalition America, Inc. (CAI) is a leader in healthcare cost-containment and preferred provider organization (PPO) network management services emphasizing transactional excellence. The Atlanta-based healthcare technology company offers one source for PPO network access and administration, while assisting companies in controlling their medical healthcare expenses.

The range of services offered by CAI includes cost containment, primary PPO network integration and management, electronic data interchange (EDI), Internet repricing and data-entry options and out-of-network bill negotiations through supplemental network relationships and negotiations on all claims. For more information on Coalition America, please visit www.coalitionamerica.com.

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