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Chafee's $43-million cut in Medicaid program touches many sectors of health care in Rho... - 0 views

  • Then it will be up to the insurers to decide how to manage with less money — so the effects of this cut are hard to predict.
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With Change Coming, Aetna Targets Employers - NYTimes.com - 0 views

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

  • 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.
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Patient advocacy groups cut medical bills by tens of millions - FierceHealthFinance - H... - 0 views

  • and nearly half have less than $1,000 on hand to deal with such expenses, according to a recent study by the disability insurer Aflac.
  • ut-of-pocket costs continue to rise even as healthcare inflation remains low.
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'Wildfire' Growth Of Freestanding ERs Raises Concerns About Cost - Kaiser Health News - 0 views

  • Several hospital chains are driving the boom – including HCA Inc., which will open its seventh ER later this year in Florida, and Wake Med Health and Hospitals, which will add its fourth next month in the Raleigh, N.C., metro area. They regard the facilities as a way to expand into new markets, generate admissions to their hospital and reduce crowding at their hospital-based ERs.
  • reater Houston has 150 emergency rooms — twice the number as greater Miami -- even though its population is only slightly bigger, according to a KHN analysis.
  • While the ERs charge insurers double or triple the amount per patient as an urgent care center or doctor's office, patients use them for routine care that could be provided in less costly settings, Ho says. That is the case with standard ERs as well. Yet, insured patients have little incentive to drive past the more expensive, freestanding ERs because their co-payment is only $50 or $100, just modestly more than what it might cost for a visit to an urgent care center or doctor’s office. Their insurers pay the balance generally.
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  • The main reason they are more costly than urgent care is that they charge a "facility fee" on top of a fee for the physician's time—just like traditional ERs. The facility fee was originally intended as a way to help hospitals recoup overhead costs
  • In an effort to protect consumers, Texas in 2009 passed a law to license freestanding ERs that are not owned by hospitals. The law requires facilities be open 24 hours, always have doctors on site and give everyone a medical screening regardless of their ability to pay – all requirements that apply to hospital-based ERs. Many of the clinics, though, don’t accept Medicaid or Medicare and the law did not change that.
  • orried that insurers will eventually cut payments to those unaffiliated with hospitals, Emerus has started converting its facilities into "micro hospitals," with a few beds that treat patients such as those needing drug detox or hospice. The company has also recently partnered with Baylor Health System to jointly operate eight such "micro hospitals" in the Dallas area.
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    "You can never have too much care for patients," says Rhonda Sandel, CEO of Texas Emergency Care Center.
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