Catalysts for the inevitable price POP, page-19

Hi Acclivity and Megamao,
Thanks for all the great recent posts.
Re Kaiser Permanente - Wikipedia states,
"Kaiser Permanente is made up of three distinct, but interdependent groups of entities -Kaiser Foundation Health Plan and its regional subsidiaries, Kaiser Foundation Hospitals and the regional medical groups." I think this means that KP is both an IDN and a private payor. The IDN may have introduced a few SOZO 's, but the private payor is not officially paying for them yet. If KP the "Kaiser Foundation Health Plan" were officially paying, it would have been announced with great fanfare.

Of course, there may have been cases where KP paid under the CAP, but not official reimbursement. From memory, only one (or perhaps two) payor/s is/are providing coverage, and even that is not the same as official reimbursement. MB explained the difference - that a payor could provide coverage on an unofficial basis, and then just decide to stop providing coverage. When a payor agrees to official reimbursement, this has to be registered with a state body (state insurance commission?) ,and then the payor cannot decide to stop paying.(MB was telling me in February about the progress they had made with the regional payors; perhaps a national payor has to register with a national body).

As a worrier, I will be on tenterhooks until the announcements of reimbursement start coming. Unlikely as it is, perhaps some private payors will choose to ignore the NCCN guidelines and the Prevent trial, and base a refusal to pay on some older, now irrelevant studies (irrelevant now because in older studies Impedimed was using a different cut-off point to trigger intervention - >10, instead of the now more sensitive >6.5.
All the best, Mirri