Hancock, Boston, a unit of Manulife Financial Corp., Toronto (TSX:MFC), says it believes fixed annuity buyers may be interested in interest rates that vary along with the Consumer Price Index-Urban.

The insurer can protect itself against extreme inflation risk by setting a cap on how high the inflation-adjusted rate can rise when the contract is issued, Hancock says.

In other insurance ideas news:

- America’s Health Insurance Plans (AHIP), Washington, says Aparna Higgins, an AHIP vice president, and other AHIP staffers have published an article on early experiences at accountable care organizations (ACO) in the September issue if Health Affairs, a health care finance and delivery academic journal.

Government officials and other policymakers are hoping that ACOs – efforts to use payment structures to create health care provider teams that can deliver care on a whole-patient basis, rather than on a service-by-service basis – will help control the cost of care and increase the quality.

The AHIP staffers suggest that some providers may need technical help from health plans to participate in the ACO arrangements.

In the real world, health plans have had to adjust ACO arrangements to suit the needs of providers and patients, rather than taking a one-size-fits-all approach, the AHIP staffers say.

- Health Affairs, Bethesda, Md., also has published two other interesting articles in its latest issue.

In one, Charles Roehrig and David Rousseau conclude that health care spending is high in the United States more because the cost of care is high than because the amount of care delivered is increasing.

Between 1996 and 2006, growth in cost per case seems to have accounted for about 75% of inflation-adjusted per-capita health spending, Roehrig and Rousseau say.

In a second article, Miriam Laugesen and Sherry Glied suggest that the high fees paid to U.S. physicians seems to account for the fact that physician spending is higher in the United States than in other developed countries.

Some have speculated that U.S. physicians may charge more because they pay much more for their education and for certain practice costs, such as medical malpractice insurance, than physicians in other countries.

Laugesen and Glied compared physicians’ fees paid by public and private payers for primary care office visits and for hip replacements in Australia, Canada, France, Germany, the United Kingdom and the United States.

The researchers also compared physicians’ incomes net of practice expenses, differences in financing the cost of medical education, and the relative contribution of payments per physician and of physician supply in the countries’ national spending on physician services.

Private payers paid 70% more for primary care office visits in the United States than in other countries and 120% for the orthopedic physician office visits.

“We conclude that the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher U.S. spending,” the researchers say in the article abstract.

- Allison Bell

Other ideas coverage from National Underwriter Life & Health: