Steve Rowe

Here to learn about healthcare. Or health care. IDK none of you ppl. can agree on it. Writing at

[Steve Rowe @Steve__Rowe]

@DenverWater I get we've got the lowest snowpack in years, etc., and want to do my part...but if things are dire why isn't tier 3 pricing up 300% or access is just cut at a certain point?

Perhaps things aren't as bad as I think? I can water normally for just $76 more per year?

[Steve Rowe @Steve__Rowe]

@DenverWater would love some clarity on the drought. I've found the mismatch between the messaging ("It's a drought, use only what you need") and the pricing (only 30% surcharge on tier 3 usage) confusing.

[Steve Rowe @Steve__Rowe]

@EryDayImRusslen @nikillinit The best way to prove one’s identity, as we all know, is to simply ask over the phone how much is left in one’s deductible, what their plan’s specific coinsurance rate is, the OOPM, and whether GLP-1s are covered.

[Steve Rowe @Steve__Rowe]

@brian_blase @zachweinberg Zach retweeted this so there must be something smart here I’m missing. Good that these ppl had coverage, no? I presume millions in the employer EOB also don’t file claims. That’s how a real insurance market should work, right? Not dunking, curious to hear your response.

[Steve Rowe @Steve__Rowe]

My small contribution to the fertility discourse: V1 of a tool to help pregnant women choose the health plan that will minimize out-of-pocket + premium costs.

Link below. Vibe coding a website next.

https://t.co/2w4q23YxCA

@MoreBirths @lymanstoneky @Noahpinion

[Steve Rowe @Steve__Rowe]

https://t.co/girkWp9D5i

[Steve Rowe @Steve__Rowe]

What happens to payers if ICHRA catches on? Full article below.

[Steve Rowe @Steve__Rowe]

When I published my report last week on how AI will change access to care, I embellished what Verily is doing as a directional example of using a chatbot as a patient acquisition strategy. But General Medicine just nails it here.

[TJ Parker⚡️ @tjparker]

Who needs AGI when you have GAI

[TJ Parker⚡️ @tjparker]

Who needs AGI when you have GAI

[Steve Rowe @Steve__Rowe]

@mcuban I'm intrigued by Centers of Excellence models where top providers (by payers' total cost of care data) agree to FFS discounts in exchange for no PAs and prompt payment.

At some point you teased launching a TPA for self-insured employers. Still exploring that?

[Steve Rowe @Steve__Rowe]

@antonhowes *pushes glasses up* actually that IS the moment the Shire's GDP began to take off: Sarumon driven away, Sam replanting w/Galadriel's gift, 1420 the best harvests etc!

The original poster was trying to post when Sarumon was in charge but the image is of his downfall!

[Steve Rowe @Steve__Rowe]

@nikhilrxddy @nikillinit All good points. Unfortunate reality is the fragmented risk pools (even w/in ESI w/ ASO) are a game of how much healthy groups subsidize unhealthy. Total spend remains unchanged, just who pays shifts

Been thinking of supply-side levers, you may enjoy:

https://t.co/Uk6xYSntTd

[Steve Rowe @Steve__Rowe]

@nikillinit Would probably end up like life insurance w/multi-year termed plans. E.g., at 25 I buy MSK plan w/ a 40 yr term, but wait to buy 10-yr prostate cancer plan until I'm 55 to bridge to Medicare. Probs not workable b/c so many conditions + diagnosis source of truth. disagreements

[Steve Rowe @Steve__Rowe]

@nikillinit The high deducible is the filter for "catastrophic." But would be fascinating in a deregulated and post ICHRA world (ppl. choosing plans directly) if carriers offered plans for specific conditions. E.g., 28 year old buys MSK plan, don't buy cancer or T2D plan.

[Steve Rowe @Steve__Rowe]

@nikhilrxddy @nikillinit It's all risk-pool games, isn't it? Generally I like the idea of under 30s being in their own risk pool at expense of higher costs for ppl. 30-65 on commercial plans. Too many young --> old wealth transfers given future demographic realities.

[Steve Rowe @Steve__Rowe]

@binarybits @lymanstoneky Knew you knew that, I was more alluding to some of the replies / how this convo gets framed more broadly. And yes, the initial OC framing wasn't as clear.

[Steve Rowe @Steve__Rowe]

@binarybits @lymanstoneky This convo is tricky b/c we're beyond financial analysis and are talking about what's most enjoyable: adulting like never before or getting to raise kids like never before.

It's an emotional bias, and I suspect what @lymanstoneky is really trying to convey is that kids are fun!

[Steve Rowe @Steve__Rowe]

@binarybits @lymanstoneky Fully understand your point. And I may be confused on OC, but couldn't you argue that the opportunity costs of NOT having kids are now much higher than the opportunity costs of having kids?

E.g., missing out on taking your 6 yr. old to mexico is > missing an adult trip there

[Steve Rowe @Steve__Rowe]

@binarybits @lymanstoneky That could be flipped, which is @lymanstoneky's point: doing stuff with your kids is more fun than a fancy dinner, and there's more stuff than ever to do w/your kids.

Your points aren't wrong; the issue is most ppl. in the replies assume time w/kids is less fun than adulting.