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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

Government Mandates Don't Lower Health Care Costs - Forbes - 0 views

www.forbes.com/...s-dont-lower-health-care-costs

340B drugs hospitals health costs

shared by Mal Allison on 23 Jul 13 - No Cached
  • The costs of the 340B program exist of course.  They are initially imposed on insurance companies and pharmaceutical manufacturers.  But, the costs are not confined to just these industries.  The costs created by the 340B program are ultimately integrated into the overall health care system and are manifested through rising insurance premiums, declining insurance coverage, declining innovation and productivity (especially for pharmaceutical drugs), and higher medical costs in unrelated segments of the health care system.  Perhaps more troubling, the added noise created by the 340B cost shifting worsens the overall functionality of the U.S. health care system
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

Detroit wants to unload 19,389 retirees into Obamacare's marketplaces - 0 views

www.washingtonpost.com/...s-into-obamacares-marketplaces

Detroit retirees health costs ACA obamacare healthcare

shared by Mal Allison on 20 Jul 13 - No Cached
  • A good chunk of Detroit’s debt problem is a health-costs problem. The Detroit Free Press notes that the city has $5.7 billion in unfunded retiree health-care liabilities, nearly a third of the city’s debt.
  • . It plans to transition its 19,389 retirees into the health law’s new marketplaces, saving the city somewhere between $27.5 million and $40 million annually.
  • . One report from the Pew Center for the States looked at 61 cities across the country and found that, taken together, they had $126.2 billion in health benefits promised to retirees. Only 6 percent of that amount – $8 billion – currently has funding.
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  • econd, health-care costs have grown more rapidly than the rest of the economy (although they have slowed a bit in the past few years). That means some cities, such as Detroit, have an especially large bill to pay for retirees’ health-care benefits.
  • hicago announced plans in May to phase out retiree coverage, either moving workers into the exchanges or, if they’re old enough, having them rely entirely on the Medicare program. Detroit
Mal Allison

Health Insurance Within Reach - NYTimes.com - 0 views

well.blogs.nytimes.com/...health-insurance-within-reach

health insurance ACA changes

shared by Mal Allison on 16 Jul 13 - No Cached
  • All health plans offered on a state exchange must provide comprehensive coverage that includes doctors’ visits, lab work, hospital stays, emergency room services, maternity care, prescriptions, mental health services and children’s dental and vision care.
  • Policies with the most generous benefits will be “platinum” plans; they will have the highest monthly premiums but fewer out-of-pocket costs and lower deductibles. The “gold” and “silver” plans will be somewhat less generous, while those in the “bronze” category will have the cheapest premiums but may require high out-of-pocket costs and deductibles.
  • Be aware that the plans may have narrow provider networks — your favorite doctor or the hospital down the street may not be a participant. You’ll need to check to see if a certain provider is in the network, advised Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reform.
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  • Be prepared for sticker shock. A 40-year-old nonsmoker may be able to buy a plan for about $4,000 annually or less; someone in his or her 50s may pay double. “Health insurance is an incredibly expensive product,” Ms. Corlette warned.
  • People who earn up to four times the federal poverty level — roughly $45,960 a year for a single person and $94,200 for a family of four — can receive subsidies to help pay for the new coverage. Those earning 250 percent of the poverty level are eligible for additional cost-sharing subsidies.
  • Americans who work at minimum wage jobs, earning less than 138 percent of the federal poverty level, which is $15,856 for a household of one and $32,499 for a household of four, will qualify for free government coverage under Medicaid — but only if they live in a state that is expanding its Medicaid program.
  • Open enrollment on the new exchanges will run from October 1 through March 31. Y
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

Business Boondoggle: Shedding the Cost of Health Care | The Fiscal Times - 0 views

www.thefiscaltimes.com/...ggle-Shedding-Cost-Health-Care

business portability true cost of insurance

shared by Mal Allison on 19 Sep 13 - No Cached
  • he actions of these other employers don’t detract from the unique nature of Walgreens’ decision. Two months earlier, the retailer announced its partnership with the Department of Health and Human Services to extol the benefits of Obamacare to its employees and its customers. Their website still features the effort, and brochures continue to be distributed even while the corporation itself realizes that compliance must force it to abandon employer-provided health insurance for the people in the stores distributing the brochures to customers.
  • With the CBO predicting that rising health-care costs would increase at twice the rate of other federal spending, the same increase in costs will now be borne almost entirely by employees.  Finally, it appears that the private-exchange option will satisfy the employer mandate, which means that the employees cannot bail out of these private exchanges in order to qualify for federal subsidies, which prevents the employers from having to pay increasing fines for non-compliance.
  • limit the liability of the third-party payer.
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  • s opposed to the Independent Payment Advisory Board and its “death panel”-like power. 
  • nce, and now employees will get more than just one or two options at open enrollment, with twenty-five plans available in the Aon exchange.
  • This arrangement makes the consumer the customer of the exchanges from the very beginning.  A termination would only impact the subsidy, which the consumer/employee could negotiate as part of his compensation package with his next employer. 
  • is to restore price signals on health care back to the consumer through the elimination of third-party payers and middlemen. 
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

Hospital, providers to develop state's only member-owned health plan - Health & wellnes... - 0 views

www.bostonglobe.com/...story.html

member-owned insurance Tufts Medical Center minuteman Health Initiative

shared by Mal Allison on 15 Jul 13 - No Cached
  • The Minuteman plan would streamline billing processes to save on administrative costs and allow providers to work more closely with employers, organizers said. Information about smoking cessation or workers’ weight collected through employer wellness programs is not typically shared with doctors. “Imagine working closely with an employer who can help us gather data and, with employees’ permission, to be able to share that data with their primary care providers,” said Dr. Jeff Lasker, chief executive of the Tufts physician group, New England Quality Care Alliance.
  • Partners HealthCare last year announced plans to acquire Neighborhood Health Plan, which mostly serves low-income people. Steward Health Care has worked with Fallon Community Health Plan to develop plans offered at reduced prices through a small business cooperative created by the Retailers Association of Massachusetts.
Mal Allison

Texas is curtailing health costs with own program | www.statesman.com - 0 views

www.statesman.com/...nZft7

texas health costs ACA MEdicaid working poor

shared by Mal Allison on 29 Aug 13 - No Cached
  • Doctors complain, though, that the savings comes from cutting reimbursement rates, which discourages health care providers from accepting Medicaid patients. The Texas Medical Association also expressed disappointment that Gov. Rick Perry rejected proposals to expand the number of people on Medicaid to include the working poor.
  • But since the poor and uninsured often rely on expensive emergency room care, Lunsford said hospitals will continue to pass on those costs to the public when those patients don’t pay their bills.
Mal Allison

States experimenting to lower health care costs - 0 views

bigstory.ap.org/...enting-lower-health-care-costs

states lower health care

shared by Mal Allison on 04 Sep 13 - No Cached
  • "Look at any of the long-term projections for the federal budget or for state budgets," said Alan Weil, executive director of the National Academy for State Health Policy. "If we don't bring down health care costs, we're either going to be paying a whole lot more in taxes or we're going to stop spending money on other things we care about."
  • "It has to end eventually," said Larry Levitt, senior vice president of the Kaiser Family Foundation, "because we can't have an economy driven entirely by health care."
Mal Allison

Rip-Off: How Private-Sector Health Costs Are Killing the American Dream | Connecting th... - 0 views

billmoyers.com/...are-killing-the-american-dream

health costs american dream

shared by Mal Allison on 04 Nov 13 - No Cached
  • The federal government doesn’t have a deficit problem. Its fiscal issues are entirely related to the bloated cost of American health care. If we paid the same amount for health care per person as people do in other wealthy countries with longer average life expectancies, we’d have a balanced budget now and surpluses projected f
Mal Allison

Overcoming Fragmentation in Health Care - John Noseworthy - Harvard Business Review - 0 views

blogs.hbr.org/...tainable-model-for-health-care

health care Noseworthy Fragmentation

shared by Mal Allison on 15 Oct 13 - No Cached
  • But the ACA does little to address fragmentation, quality of care, and the sustainability of the financial model for U.S. health care — ho
  • At the foundation of our approach is a knowledge-management system — an electronic archive of Mayo Clinic-vetted knowledge containing evidence-based protocols, order sets, alerts and care process models
  • It is alarming to see more than a two-fold variation in health care quality across the country.
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  • One such resource is the work of Optum Labs, which we formed with Optum earlier this year. Optum Labs, an open R&D facility with a unique set of clinical and claims data, is being used to drive advances that will improve health care for patients and our country. We are now inviting others — providers, life science companies, research institutions, consumer organizations, and policy makers — to be part of Optum Labs. This opportunity to apply world-class analytical tools to both cost and quality will provide t
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

Slowdown in Health Spending Could Be at Risk - WSJ.com - 0 views

online.wsj.com/...4251504578581681123335950.html

ACA spending slow-down health costs technology

shared by Mal Allison on 15 Jul 13 - No Cached
  • Medicare covers all those treatment options. By law, it can't consider price when making coverage decisions. Nor can it insist that a new technology be significantly better than existing ones or encourage doctors or patients to seek less-costly alternatives. And once Medicare starts writing checks, private health plans generally follow, distorting the usual market mechanisms, says Arthur Kellermann, a physician and senior policy analyst at Rand Corp.
  • Another big driver of health-care costs is technology. In almost every other industry, innovation generally makes things more efficient and less costly. But in health care, it often brings higher costs with little added value.
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