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Mal Allison

HEALTH REFORM: Expect Pluses, Minuses for Those With Job-Based Coverage - iVillage - 0 views

www.ivillage.com/...4-a-547763

ACA employer-based insurance

shared by Mal Allison on 01 Oct 13 - No Cached
  • Beginning in 2014, for instance, the reform package prohibits employer-sponsored health plans from excluding people from coverage based on pre-existing health conditions
  • It also makes larger employers responsible for offering medical coverage. Beginning Jan. 1, 2015, businesses with more than 50 workers must offer health insurance to full-time workers and dependents or pay penalties.
  • annual limits will be banned completely in 2014.
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  • Also, if you have an adult child under age 26 and your employer health plan offers coverage for dependents, the plan must allow your son or daughter to enroll. Spiro called th
  • The law also requires most employer health plans to offer certain preventive services at no cost to the employee.
  • Effective Jan. 1, 2014, the law allows employers to boost rewards and penalties (such as premium discounts or surcharges) to 30 percent of the total plan premium, up from 20 percent.
  • ne in five employers has boosted employees' share of health plan premiums,
  • HealthCare Advocates, which helps consumers resolve health insurance problems. "I think at the end of the day, everybody's going to be paying more," he said.
  • e IFEBP survey also estimates that about 16 percent of employers are trimming worker hours to part-time status so fewer employees will qualify for health-plan benefits.
  • Beginning in 2015, large employers -- those with at least 50 full-time workers -- must provide health insurance to employees who log an average of 30 or more hours a week or pay penalties.
  • A study published earlier this year by the University of California, Berkeley Center for Labor Research and Education found that 2.3 million workers nationwide -- particularly retail and restaurant workers -- are at risk of losing hours as a result of the new law.
  • A growing number of midsize and large employers -- 25 percent in 2014 and 44 percent in 2015 -- are also saying they're likely to discontinue health coverage for Medicare-eligible retirees, a new Towers Watson & Co. survey found.
  • Starting in 2018, the law imposes a steep tax on employer plans with premiums exceeding $10,200 for an individual and $27,500 for a family -- plans that are typically offered to high-wage earner
  • About 17 percent of employers are redesigning their high-cost plans to avoid this so-called "Cadillac tax," while 40 percent are considering i
  • The percentage of Americans receiving health insurance on the job or through a family member's job slipped from 69.7 percent in 2000 to 59.5 percent in 2011,
  • Staggering increases in health insurance premiums also contributed to the decline, resulting in fewer employers offering coverage and fewer employees accepting it.
  • Congressional Budget Office estimates suggest that as many as 7 million people will lose job-based coverage by 2017 a
  • But just 26 percent are confident that they will be offering health-care benefits a decade from no
  • r Center, has summarized provisions of the Affordable Care Act affecting employer-sponsored insurance.
  • To read part one of the series, how to navigate the new health insurance exchanges, click here.
  • Mal Allison on 01 Oct 13
     
    Experts say smaller companies that employ 50 or more workers and currently provide health insurance may drop coverage because it would be cheaper to pay fines than maintain coverage for all of their workers. Most large employers (with more than 1,000 employees) remain committed to providing health benefits for the next five years, according to an employer survey by Towers Watson/National Business Group on Health. But just 26 percent are confident that they will be offering health-care benefits a decade from now. Meanwhile, a number of large employers are eyeing private health insurance exchanges as a way to continue providing job-based coverage while controlling spending on health benefits. Much like the public exchanges under the Affordable Care Act, private exchanges represent a new way for employees and families to shop for group health coverage and other benefits. Instead of offering a limited number of health plans, the employer would give workers a set amount of money to buy their own coverage. Kaiser, who works in Gallagher Benefit Services' Mount Laurel, N.J., office, anticipates a slow migration toward private exchanges. "I don't think it's going to be a mass disruption of employer-sponsored plans where they all go, 'I'm out of the game,'" he said. More information The University of California, Berkeley Labor Center, has summarized provisions of the Affordable Care Act affecting employer-sponsored insurance.
Mal Allison

With Change Coming, Aetna Targets Employers - NYTimes.com - 0 views

www.nytimes.com/...g-aetna-targets-employers.html

Aetna ACO ACA patient data

shared by Mal Allison on 03 Sep 13 - No Cached
  • Mr. Mead cited a report by the Institute of Medicine that tallied more than $760 billion in health care “waste” created annually as a result of consumer fraud, unnecessary procedures and excessive administrative costs.
  • r. Mead said the campaign also stressed the need for health care providers to shift to a model known as “accountable care,” which shifts their reimbursement models for health care professionals from being paid for the volume of services they perform to being paid based on the outcomes of patient care. Accountable care systems are usually linked to technologies that help health care providers measure performance and manage patient data. Aetna has 27 accountable health care agreements with hospitals and other health care providers around the country.
  • Bertolini said in the video. “If we fix just 20 percent of it, we could pay for the Affordable Care Act. We could insure everyone without increasing taxes.”
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  • The fee-for-service model is broken,” Mr. Mead said. “The Affordable Care Act encourages the system to move to accountable care,” he added. “The challenge with that is that doctors and hospitals need technology and support to make that work.”
  • He noted how costs could vary widely depending on where a person lived and who their insurer was. “It shouldn’t vary that much,” Mr. Huckman said.
  • Mal Allison on 03 Sep 13
     
    Aetna, one of the largest of the companies, will introduce a new campaign on Tuesday aimed at those groups. It will highlight the company's goal of cutting billions of dollars of expenditures through so-called Big Data, electronic health records and other technologies as well as encouraging better coordination among health care providers. The campaign, called "Our Healthy," will run online, in print and on mobile devices through the end of 2013.
Mal Allison

Hospitals evolving to meet health care law demands : Health - 0 views

herald-review.com/...5a-11e3-823a-001a4bcf887a.html

hospitals health care law evolving

shared by Mal Allison on 02 Oct 13 - No Cached
  • Under the Affordable Care Act, health care providers may be rewarded if they demonstrate better health outcomes at lower costs.
  • “In the old world, doctors and hospitals were paid more if they did more,” Kannaday said. In the new model, doctors and hospitals that demonstrate they are providing quality care at a lower cost are rewarded financially, she said.
  • decline in charity care and bad debt with more patients
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  • “The health care system clearly was not sustainable,” she added. “By partnering with physicians and hospitals and payers, we can create a health care system to propel us the right way into the future.”
Mal Allison

Should Mental Health Be a Primary-Care Doctor's Job? : The New Yorker - 0 views

www.newyorker.com/...-primary-care-doctors-job.html

mental health primary care

shared by Mal Allison on 25 Oct 13 - No Cached
  • It’s estimated that seventy per cent of a primary-care doctor’s practice now involves management of psychosocial issues ranging from marriage counselling to treatment of anxiety and depression.
  • Fewer medical students are going into psychiatry, partly because psychiatrists, like primary-care doctors, earn among the lowest salaries of all physicians. Those who do choose psychi
Mal Allison

The Health Care Law Guru vs. the Conservative who Inspired It | The Business Desk with ... - 0 views

www.pbs.org/...uru-of-obamacare-vs-the-c.html

ACA individual Market Gruber

shared by Mal Allison on 02 Oct 13 - No Cached
  • "Fine. A big group, we can understand the overall risk. We can model that. We're happy. But individuals, we're not so sure, and that's why the individual insurance market, which is a market where Americans who don't get insurance from their employer or the government have to turn, that's why that market is so screwed up all around the country and why we needed the Affordable Care Act.
  • First, it was not primarily intended to push people to obtain protection for their own good, but to protect others. Like auto damage liability insurance required in most states, our requirement focused on "catastrophic" costs -- so hospitals and taxpayers would not have to foot the bill for the expensive illness or accident of someone who did not buy insurance.
  • Mal Allison on 02 Oct 13
     
    We can model that. We're happy. But individuals, we're not so sure, and that's why the individual insurance market, which is a market where Americans who don't get insurance from their employer or the government have to turn, that's why that market is so screwed up all around the country and why we needed the Affordable Care Act.
Mal Allison

Health Care Policy and Marketplace Review: The Affordable Health Care Act's Launch On O... - 0 views

healthpolicyandmarket.blogspot.com/...e-health-care-acts-launch.html

health care Obamacare Exchanges sustainable Laszewski

shared by Mal Allison on 30 Sep 13 - No Cached
  • We often hear that the administration's first-year objective is to sign-up 7 million people––of which 2.4 million need to be aged 18-34, in order to get a sustainable mix.
  • But, buyer beware. Consumers need to be very thorough here. A Silver plan is not a Silver plan is not a Silver plan.
  • he 2015 exchange rates and health plans will have to be developed by the participating insurance companies in mid-2014 so they can go through the approval process and be put on the exchange in time for the next year's October 1 open enrollment
Mal Allison

The Health-Care Debate: Are Stents Overused? : The New Yorker - 0 views

www.newyorker.com/...red-treatment-in-medicine.html

stent overuse

shared by Mal Allison on 25 Oct 13 - No Cached
  • Stories in the Times give additional credibility to the assumption, driving many of the payment reforms of the Affordable Care Act, that if you pay doctors for “value,” rather than for volume, we will stop treating patients with care they do not need. If so-called “unnecessary care” were simply the consequence of profit-driven doctors overtreating patients, the reforms are a perfect solution.
Mal Allison

Rush is on to get health care under old insurance plans - 0 views

www.usatoday.com/...3500107

HDHP employers health insurance shopping for healthcare

shared by Mal Allison on 12 Nov 13 - No Cached
  • A national survey by Aon Hewitt consultants suggests that the Affordable Care Act's taxes and fees add 1% to 2% in direct costs to employers.
  • The Aon Hewitt survey found that 44% of companies are considering offering workers just one health-insurance plan — a high-deductible plan — rather than offer a high-deductible plan plus a more traditional plan that covers 70% to 80% of medical costs.
  • But those people will not get government subsidies if their company offers affordable health insurance, defined as costing less than 9.5% of income.And such employees would lose their employer's contribution to their plan unless the company agreed to provide such a payment in lieu of coverage.
Mal Allison

Employers Turn to Private Health Exchanges to Cut Costs - Bloomberg - 0 views

www.bloomberg.com/...lth-exchange-to-cut-costs.html

employers exchanges private

shared by Mal Allison on 19 Feb 14 - No Cached
  • One-third of U.S. employers plan to move their workers’ health-care coverage to a private exchange in the next few years, a survey found, following the le
  • Health spending in the U.S. is expected to increase more than 6 percent this year and 6.2 percent annually from 2015-2022 as the Patient Protection and Affordable Care Act takes full effect and millions of Americans gain insurance, according to the Centers for Medicare and Medicaid Services.
  • Under Obamacare, companies that don’t offer coverage for their employees will be fined $2,000 per employee. Employers spend $6,000 per employee on average, so d
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  • They found that 5 percent of the companies surveyed may drop employee health-care coverage in the next three to five years, an increase from 1 percent now
  • About 38 percent of the companies surveyed by Aon said they would offer no benefits to part-time workers within the next three to five years.
  • Only 25 percent of large employers offer subsidized retiree health benefits, Aon said, down from about 50 percent in 2004.
Mal Allison

Bare Bones Health Plans Expected To Survive Health Law - Kaiser Health News - 0 views

www.kaiserhealthnews.org/...alth-insurance-health-law.aspx

bare bones health plans mini med ACA

shared by Mal Allison on 26 Aug 13 - No Cached
  • Proposed and final rules issued this spring surprised many by failing to bar large employers from offering insurance policies that could exclude benefits such as hospitalization. Offering bare-bones policies may result in some fines, but that expense could be less than the cost of offering traditional medical coverage. For large employers, "the feds imposed no minimum standard on how skimpy that coverage can be other than to say, in essence, it's got to be more robust than a dental plan or a vision plan," said Ed Fensholt, a senior vice president at insurance broker Lockton Companies. "We had customers looking at offering some relatively inexpensive and skimpy plan designs to satisfy the individual mandate at modest cost.”
  • The bare-bones plans cannot be offered to small businesses with fewer than 50 workers, or to individuals buying coverage through new online marketplaces that open for enrollment Oct. 1. But benefit experts expect some larger firms that buy outside the marketplaces or that self-insure to consider them. 
  • Skimpy insurance under the Affordable Care Act won’t be quite the same as it is now. Under the new rules, capping the dollar value of annual benefits isn't allowed, but excluding entire categories from coverage - such as hospital stays - is permitted, say benefit consultants. That's another way of keeping costs down.
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  • he law says only that large-employer policies must cover preventive care such as blood pressure tests or vaccines with no co-pays for consumers. So the plan could cover dental, vision and preventive cancer screenings, but possibly not the treatment or hospital care a patient could need if diagnosed with an illness.
  • rue, the health act requires policies to include coverage for 10 broad categories of “essential health benefits,” such as hospitalization and mental health services, but that provision applies only to plans sold to small businesses and individuals.  Larger firms and self-insured employers are exempt.
  • .” Employers offering these sorts of plans do face some risks, experts said. If a large employer doesn’t offer “minimum essential coverage,” it’s potentially liable for fines of $2,000 per full-time worker after the first 30 workers.
  • they must pay $3,000 for each worker who receives subsidies to buy coverage.
Mal Allison

Union Leaders Seek Changes to Affordable Care Act - WSJ.com - 0 views

online.wsj.com/...4694904578602202857109898.html

union leaders ACA changes subsidies multi-employer plans

shared by Mal Allison on 15 Jul 13 - No Cached
  • making unionized workers less competitive and potentially causing unionized employers to drop the plans that cover more than 20 million people.
  • To offset the expected rising costs of these "multiemployer" plans, several union groups want their lower-paid members to be able to remain on the plans wh
  • "will shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class," the union officials wrote.
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  • Unions argue that several other parts of the health-care law would disadvantage "multiemployer" health plans administered by unions and employers. For instance, the law's lack of penalties for employers with less than 50 employees could force companies to drop insurance in heavily unionized sectors like construction, unions argue. In general, unions say the health plan's impact on multiemployer plans needs to be clarified.
Mal Allison

Under Obamacare, more mental health coverage for workers - The Washington Post - 0 views

www.washingtonpost.com/...3-94a2-6c66b668ea55_story.html

obamacare mental health coverage

shared by Mal Allison on 18 Sep 13 - No Cached
  • Under the Affordable Care Act, insurance plans offered in the new marketplaces will have to cover a core set of services called “essential health benefits.” Included on the list of 10 benefits are mental-health and substance-use disorder services, which include behavioral health treatment, counseling and psychotherapy. Specifically, as part of what’s considered preventive services, plans will also cover alcohol-misuse screening and counseling, depression screening for adults and adolescents, domestic and interpersonal violence screening for women, and behavioral assessments for children.
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