7/25/08

Booming business helps patients navigate medicine

Health advocate firms are popping up across the country, helping clients pay bills, find care


NORCROSS, Ga. (AP) -- After three surgeries, Judy Sherer still had chronic pain in her left shoulder. She'd lost faith in her doctors, and in despair tried a new health benefit offered by her employer.

The service, Health Advocate, is a call-in center that helps customers find the right doctor, haggle over insurance coverage and manage other medical system headaches.

An advocate helped Sherer find a new surgeon -- one who found metal shavings left in her shoulder by a previous doctor. The advocate also negotiated the charge for her physical therapy down to $40 per visit from the $200 she was told initially.

"It saved me a ton of money," said Sherer, 63, of Norcross, Ga. "I'm very, very pleased."

Health Advocate is one of a growing number of U.S. companies offering some form of advocacy services to medical consumers. Revolution Health -- the Web-based medical consumer services company overseen by AOL co-founder Steve Case -- has been considering getting into the same business.

"It's a really interesting industry that's just taking off," said Carol Fischer, a spokeswoman for Pennsylvania-based Health Advocate, a 12 million-member organization.

Currently, the health advocacy business is an industry with about $50 million to $75 million in annual revenue but only about a half-dozen companies of any significant size, said Richard Rakowski of Intersection LLC, a Connecticut-based investment and development firm that has researched the field.

But those numbers have grown from a few years ago, and it may be on track to become a $1 billion industry based on the demand for the service, said Rakowski, the firm's principal.

The field is blossoming in the wake of cutbacks in corporate health benefits, an overhaul of Medicare and other changes that have forced medical consumers to shop more for medical care.

More than ever, people need help negotiating the medical system, said Jessica Greene, a University of Oregon health policy analyst.

"We're asking consumers to make more complicated decisions, but the numeracy and health literacy skills of many consumers are not at the level needed to handle this new responsibility," Greene said.

Though some consumers are savvy enough to beat a billing overcharge or probe doctors' litigation histories, they don't have the time for such labors, experts said.

Indeed, the largest customers of health advocacy services are companies, not individuals. "The employers are interested because it means their employees are not on the phone taking care of doctor's visits" during work hours, Fischer said.

The companies grouped into the health advocacy business range from small regional firms operating out of home offices to companies with national call centers the size of football fields. No one seems to have an exact count, but Flagship Global Health, Care Counsel and Enhanced Care Solutions are among the more visible names.

Health Advocate claims to be the largest. Founded in 2001, it now has more than 3,500 companies, unions and other organizations as clients, including Johnson & Johnson, American Express and The Home Depot Inc.

Altogether, about 2.6 million employees, or members, are signed up with Health Advocate. But the number who can use it is actually higher: Members can share the call-in number with spouses, children, parents and parents-in-law -- including elderly kin who need help picking a Medicare prescription drug plan, finding a nursing home or arranging transportation for health care. With all relatives added in, Health Advocate's membership as roughly 12 million, Fischer said.

About 180 advocates staff Health Advocate's call center in suburban Philadelphia. It's usually registered nurses who talk to the patients, and each patient gets an advocate who stays with the case and is the recurring contact. The staff also includes behind-the-scenes workers who help with insurance claims and other administrative questions.

"I'd say 80 percent of (our) people call Health Advocate because they have trouble with billing," said Andrew May, a human resources vice president for Wells Real Estate Funds, the Georgia-based company that employs Sherer.

Initially, May said, he doubted Wells employees would use Health Advocate, thinking they would instead continue to come down to human resources for help rather than turn to a 1-800 number.

But some of Wells' 400 employees started using it and having great experiences, he said. Company executives appreciated the help, calling the $5,700-a-year cost a good deal.

"We're not billing specialists. We're not registered nurses. To have that resource is much more powerful -- it gets to the bottom of things quicker," said Susanna Johnson, a Wells human resources manager.

Health Advocate in May began to sell its services straight to individuals, as a $365-a-year service.

Some other companies have always focused on individuals, especially rich ones.

One example is $10,000-a-year PinnacleCare, founded in 2002 by John Hutchins, who created a concierge-like service at the Cleveland Clinic. He later used his connections to build a national network of doctors for his private health advisory start-up.

The Baltimore-based company is essentially a club for millionaires and billionaires that puts nurses and social workers in touch with members. Not only will they help members find top-level care, they will get them moved to the head of the line. PinnacleCare advisers will even meet the patient at a doctor's office or hospital.

PinnacleCare has about 1,700 member-families. One satisfied customer is Kirk Posmantur, 45, the founder and chairman of Axcess Luxury & Lifestyle. His Atlanta-based company markets handmade watches, private jets and other luxury items to the affluent.

"It's a no-brainer for those who've got net worth of $5 million or more," he said. "You've got people who advise you on your taxes. You've got people who advise you on how to manage your money. But what's more important than your health?"

Not every health advocacy group is a for-profit business.

The Patient Advocate Foundation provides free help to people with chronic, debilitating and life-threatening conditions. Founded in 1996, the Virginia-based organization has 113 employees and an annual budget of about $8.5 million. It handled nearly 45,000 cases in 2007 -- most of them cancer patients.

The organization's founders initially expected many clients to be uninsured. As it turns out, about 80 percent have at least some health insurance but are dealing with pre-approval authorizations, medical debt from incomplete coverage or other problems, said Nancy Davenport-Ennis, the group's chief executive and co-founder.

Companies like PinnacleCare are a blessing "for those consumers that can afford to have a boutique service," she said.

She wishes, however, that companies would provide more pro bono service. "The concern is those that need help and can't afford something like that," Davenport-Ennis said.

Health Advocate: http://www.healthadvocate.com

PinnacleCare: http://www.pinnaclecare.com

Patient Advocate Foundation: http://www.patientadvocate.org

(This version CORRECTS to number of companies to "half-dozen," rather than "dozen" in the seventh paragraph.)

Oil rises as eyes back on Iran-Israel row

SINGAPORE (Reuters) - Oil rose on Tuesday after slipping from a record above $143 a day ago, as tension surrounding Iran's nuclear program returned to focus and outweighed concerns over eroding U.S. demand.

U.S. crude rose 39 cents to $140.39 a barrel by 0201 GMT, while London Brent crude rose 76 cents to $140.59.

Fears of oil supply and flow disruption in the Middle East, as the Iran-Israel row over Tehran's nuclear developments escalates, had helped pushed oil to a $143.67 peak on Monday.

"The market has been worried about the tensions involving Iran and that remains a supportive factor for the oil price," said David Moore, a commodities analyst at the Commonwealth Bank of Australia in Sydney.

In a war of words between the Iranian and U.S. military, Iran's Revolutionary Guard said Tehran would impose controls on shipping in the Middle East Gulf and Strait of Hormuz if it were attacked.

The U.S. Navy's Fifth Fleet said the United States and its allies would not allow Iran to hamper shipping in the Gulf.

Roughly 40 percent of the world's traded oil moves through the narrow waterway separating Iran from the Arabian Peninsula.

The ongoing dispute in the Middle East countered concerns over falling demand in the world's top oil consumer, the United States, as the impact of soaring fuel costs sets in.

The U.S. Energy Information Administration revised downward U.S. April oil demand by 863,000 barrels per day (bpd) to 19.77 million bpd -- 3.9 percent below year-ago levels.

The revision, which showed April demand was the lowest for the month since April 2002, came even before gasoline prices surged to new records in June.

Oil prices have jumped around seven-fold since 2002 as part of a broader commodities rally sparked by surging demand from emerging economies like China and India, but have also driven inflation higher around the world.

On Monday, official data showed that euro zone inflation leapt to a record 4.0 percent in June, cementing expectations that the European Central Bank will raise interest rates when it meets on Thursday.

Analysts said the move would drive the U.S. dollar lower and trigger more cash injections into crude from investors seeking to hedge against the slumping U.S. currency.

Speculative hedge fund inflows have already helped lift oil prices more than 40 percent higher this year.

Saudi Oil Minister Ali al-Naimi reiterated his country's position that oil prices were being driven mostly by speculation and said the OPEC kingpin was prepared to supply all the oil its customers needed.

But the heads of some of the biggest oil companies said at an oil conference in Madrid that fundamentals, not investor flows, were the main driver of prices.

On Wednesday, traders will be eyeing weekly U.S. oil inventory data, which was expected to show a drop in crude stocks and a build in distillates and gasoline for the week ending June 27.

(Reporting by Chua Baizhen, Editing by Michael Urquhart)

Oil rises as eyes back on Iran-Israel row

SINGAPORE (Reuters) - Oil rose on Tuesday after slipping from a record above $143 a day ago, as tension surrounding Iran's nuclear program returned to focus and outweighed concerns over eroding U.S. demand.

U.S. crude rose 39 cents to $140.39 a barrel by 0201 GMT, while London Brent crude rose 76 cents to $140.59.

Fears of oil supply and flow disruption in the Middle East, as the Iran-Israel row over Tehran's nuclear developments escalates, had helped pushed oil to a $143.67 peak on Monday.

"The market has been worried about the tensions involving Iran and that remains a supportive factor for the oil price," said David Moore, a commodities analyst at the Commonwealth Bank of Australia in Sydney.

In a war of words between the Iranian and U.S. military, Iran's Revolutionary Guard said Tehran would impose controls on shipping in the Middle East Gulf and Strait of Hormuz if it were attacked.

The U.S. Navy's Fifth Fleet said the United States and its allies would not allow Iran to hamper shipping in the Gulf.

Roughly 40 percent of the world's traded oil moves through the narrow waterway separating Iran from the Arabian Peninsula.

The ongoing dispute in the Middle East countered concerns over falling demand in the world's top oil consumer, the United States, as the impact of soaring fuel costs sets in.

The U.S. Energy Information Administration revised downward U.S. April oil demand by 863,000 barrels per day (bpd) to 19.77 million bpd -- 3.9 percent below year-ago levels.

The revision, which showed April demand was the lowest for the month since April 2002, came even before gasoline prices surged to new records in June.

Oil prices have jumped around seven-fold since 2002 as part of a broader commodities rally sparked by surging demand from emerging economies like China and India, but have also driven inflation higher around the world.

On Monday, official data showed that euro zone inflation leapt to a record 4.0 percent in June, cementing expectations that the European Central Bank will raise interest rates when it meets on Thursday.

Analysts said the move would drive the U.S. dollar lower and trigger more cash injections into crude from investors seeking to hedge against the slumping U.S. currency.

Speculative hedge fund inflows have already helped lift oil prices more than 40 percent higher this year.

Saudi Oil Minister Ali al-Naimi reiterated his country's position that oil prices were being driven mostly by speculation and said the OPEC kingpin was prepared to supply all the oil its customers needed.

But the heads of some of the biggest oil companies said at an oil conference in Madrid that fundamentals, not investor flows, were the main driver of prices.

On Wednesday, traders will be eyeing weekly U.S. oil inventory data, which was expected to show a drop in crude stocks and a build in distillates and gasoline for the week ending June 27.

(Reporting by Chua Baizhen, Editing by Michael Urquhart)

Auto Insurance?

I recently bought a car and I have no idea what auto insurance is good and has great deals. Can anyone help me? Keep in mind I'm on a budget. Does anyone know what is a good company for me?

You can try:

Freeway Insurance
Esurance
Progressive
The General
Dashers

These are all cheaper insurance brokers. In the end it will mostly depend on the coverage you need, where you live, you're driving record, etc.

Some of the better but more expensive companies are:

AllState
AAA
Farmers
State Farm

Auto insurers benefit as people drive less - Fewer fender benders take place as surging gas prices keep cars parked

SAN FRANCISCO (MarketWatch) -- Surging gas prices have been cruel to most financial-services firms this year, with investors fretting that borrowers have less money to repay debt.
But auto insurance, dominated by companies including Allstate Corp. (ALL:The Allstate Corporation
News, chart, profile, more
Last: 45.34-0.83-1.80%

4:05pm 07/24/2008

Delayed quote dataAdd to portfolio
Analyst
Create alertInsider
Discuss
Financials
Sponsored by:
ALL 45.34, -0.83, -1.8%) and Progressive Corp. (PGR:The Progressive Corporation
News, chart, profile, more
Last: 19.59-0.43-2.15%

4:01pm 07/24/2008

Delayed quote dataAdd to portfolio
Analyst
Create alertInsider
Discuss
Financials
Sponsored by:
PGR 19.59, -0.43, -2.1%) , may be one of the few financial-services sectors to benefit.
Americans drove 1.4 billion fewer miles on the highway in April compared with a year ago, according to the U.S. Transportation Department. In March, people drove roughly 4.3% fewer miles than they did a year before. That was the biggest yearly drop since the department's Federal Highway Administration started keeping records in 1942.
As Americans drive less, the number of car accidents may be falling, limiting the frequency of auto-insurance claims.
Allstate, one of the largest auto insurers in the United States, said late Wednesday that the frequency of claims involving damage to cars and other property fell 4.2% in the second quarter. The frequency of claims involving injuries dropped 7.6% in the period compared with a year earlier.
If such a trend becomes strong enough, auto-insurance premiums may be pressured.
"If gas prices remain high and economic activity slows further, we believe that improved auto-loss trends will continue in the future, leading to stronger underwriting profitability, and therefore multiple expansion for auto-insurance stocks," Bijan Moazami, an analyst at Friedman, Billings, Ramsey, wrote in a note Thursday.
Allstate shares have dropped roughly 12% so far this year, partly because the company has large investment exposures to mortgage-related securities that have slumped in value as the housing crisis deepens. See story on Allstate's quarterly results.
However, that's much better than the 27% slump in the S&P Insurance index in 2008.
Progressive shares are up more than 4% this year. Shares of Mercury General Corp. (MCY:mercury genl corp new com
News, chart, profile, more
Last: 48.87-0.50-1.01%

4:01pm 07/24/2008

Delayed quote dataAdd to portfolio
Analyst
Create alertInsider
Discuss
Financials
Sponsored by:
MCY 48.87, -0.50, -1.0%) , another auto insurer, are down less than 1% so far in 2008, while rival State Auto Financial Corp. (STFC:State Auto Financial Corp
News, chart, profile, more
Last: 27.05+2.21+8.90%

4:00pm 07/24/2008

Delayed quote dataAdd to portfolio
Analyst
Create alertInsider
Discuss
Financials
Sponsored by:
STFC 27.05, +2.21, +8.9%) is up 0.4%.
Travelers Group (TRV:travelers companies inc com
News, chart, profile, more
Last: 42.88-2.72-5.96%

4:02pm 07/24/2008

Delayed quote dataAdd to portfolio
Analyst
Create alertInsider
Discuss
Financials
Sponsored by:
TRV 42.88, -2.72, -6.0%) reported modestly favorable frequency trends in its auto-insurance business when it reported solid second-quarter profit on Wednesday.
State Auto hasn't seen any improvement in the frequency of auto claims yet, but Kyle Anderson, a spokesman for the company, said it would not be surprising to see such a trend take hold.
If such a trend becomes strong enough, auto-insurance premiums may be pressured, he added.
However, Anderson also noted that there are a lot of other factors that go into setting auto-insurance rates, such as the cost of repairing crashed vehicles and buying new parts.
Indeed, if rising oil prices end up fueling broader inflation, the cost of settling auto claims could rise, analysts say.
In the second half of this year, high steel and plastics prices will increase the cost or severity of auto-insurance claims involving physical damage, said Brian Meredith, an analyst at UBS, on Thursday.
Alistair Barr is a reporter for MarketWatch in San Francisco.

Vehicle insurance solution to benefit Vehicle and Asset Finance

As auto sales across South Africa continue in a spiral decline, the ripple effect is being keenly felt across all auto-related and support industries. The South African motor and insurance industries report they have seen a remarkable increase in insurance policy cancellations as consumers cut back on fixed expenses to keep up with the necessities of everyday life.

While insurance is obligatory and therefore instituted at the time of vehicle financing, it is often cancelled after a few installments, increasing the risk to the credit provider. In the incidence of financed vehicles, the spill-over impact for the vehicle and asset finance sector could potentially run into millions of rands worth of losses.

In an effort to mitigate this risk, TransUnion, working with the vehicle and asset finance and insurance industries, developed a solution that compares vehicle finance data with insurance information. Using integrated data files, TransUnion’s Asset Monitoring Solution, compares and monitors changes to insurance policies, helping the industry effectively manage changes to existing policies and track cancelled ones. Now, vehicle and asset finance houses will have the advantage of knowing when a policy has been cancelled, upgraded from third-party to comprehensive insurance or reduced from comprehensive to third-party insurance.

“This is a powerful solution that will help to streamline alerts on vehicle insurance defaulting in an increasingly dynamic environment. Vehicle and asset finance houses will be afforded more control over the process, faster responses and reduced losses over the long-term,” says Chris van Rensburg (pictured above right), TransUnion Executive: Insurance and Direct to Consumer.

Policy information on the Insurance Data System* facilitates the monitoring of financed vehicles. If there is a match found between the financed vehicle and the policy information, participants are alerted to the change, enabling them to take the appropriate corrective action. These alerts can be issued on a monthly basis, allowing participants to react quicker and more efficiently when a finance contract has been breached.

* The Insurance Data System, developed under the auspices of the South African Insurance Association, is a database of all personal lines claims, policy and vehicle information, pooled by participating members of the short-term insurance industry. Managed by TransUnion, in collaboration with the insurance industry, the Insurance Data System holds information on over 4,9 million claim records and 1,4 million policies.