Group items tagged

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.

Operators of employer health-insurance marketplaces say many workers pick cheaper coverage than they previously had and that is one way the exchange approach can save money.

In an exchange run by Liazon Corp. that has around 60,000 people enrolled, about 75% of the workers have chosen less-expensive plans, accepting bigger deductibles and other out-of-pocket charges, as well as smaller choices of health-care providers and restrictions such as primary-care gatekeepers. "They want value for their money," said Alan Cohen, Liazon's chief strategy officer.

Accenture ACN +0.08% PLC projects that around a million Americans will get employer health coverage through such marketplaces next year, and the number will increase to 40 million by 2018.

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.

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.

"Fifteen years ago, pricing was not as important…[but] when the co-pay is coming out of a patient's pocket, they more often want to know what they're paying," said Moshir Jacob, medical director at the Toledo Clinic. The Ohio practice advertises that it offers lower prices than area hospita

Others doubt there has been a structural change. "We haven't done anything in the past three or four years that fundamentally altered the health-care system," said Gerard Anderson of Johns Hopkins University, who was the lead author of the "It's the Prices, Stupid" paper a decade ago. "And everything in Obamacare that tried to control cost was watered down."

The system now offers members a choice: Have your procedure at one of 51 hospitals that agreed to limit what they charge, or have the surgery elsewhere and pay any expenses above $30,000 out of pocket.

The best way to reduce health-care and insurance costs is if the price of treatment declines.

Starting in October, consumers shopping on the new exchange will be able to choose from bronze, silver, gold, platinum and catastrophic plans that offer a range of premiums, deductibles and co-pays depending on variables such as how many doctors you want included in your network.That's why Smithberger says it's important that consumers look at more than the bottom line when choosing plans. It may be the lowest priced plan, but it may have a very high deductible or only offer a limited number of doctors.

Health insurance costs ate 7.7 percent of total payroll expenses for private-sector employers in 2012, according to the NIHM study.

n 2013, individuals paid, on average, $5,900 in total annual premiums for employer-sponsored coverage. On average, family plans cost more than $16,300. “With employees’ costs for medical coverage growing much more quickly than general inflation, hourly earnings and family income, some workers are inevitably (being) priced out of coverage,” the study said.

2018, 40 million American employees will be enrolled in private exchanges