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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

Health Care Policy and Marketplace Review: Administration Delays the Employer Mandate--... - 0 views

healthpolicyandmarket.blogspot.com/...istration-delays-employer.html

employer mandate small business ACA

shared by Mal Allison on 03 Jul 13 - No Cached
  • These small group requirements are expected to increase the cost of small group coverage by an average of 15%––with wide variation by state and the average age of the group.
  • Why not do the same for small employers as well? And while they are at it, use the time to reconsider the impact many of these regulations are likely to have on the number of small employers continuing to offer coverage
Mal Allison

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

www.fiercehealthfinance.com/...2014-06-09

patient advocacy groups medical bills

shared by Mal Allison on 10 Jun 14 - No Cached
  • 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.
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

Medicare Announces Plans To Accelerate Linking Doctor Pay To Quality - Kaiser Health News - 0 views

www.kaiserhealthnews.org/...lue-based-pay-for-doctors.aspx

medicare announces plans linking doctor

shared by Mal Allison on 24 Jul 13 - No Cached
  • The current system, researchers say, financially encourages doctors to do more procedures and is one of the reasons health costs have escalated. The health law required Medicare to gradually factor in quality into payments for hospitals, nursing homes, physicians and most medical providers.
  • Medicare had already decided that large physician groups -- those with 100 or more doctors, nurses, social workers or other health professionals -- will gain or lose as much as 1 percent of their pay starting in 2015. Those incentives would double to 2 percent the following year under draft regulations Medicare released this month. The proposal also would phase mid-sized physicians groups—those with between 10 and 99 health professionals—into the program in 2016 instead of in 2017. While they would be eligible for bonuses up to 2 percent, they would be shielded from any penalties for that first year.
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

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

Walgreens Becomes 1st Retail Chain To Diagnose, Treat Chronic Conditions - Kaiser Healt... - 0 views

www.kaiserhealthnews.org/...ens-primary-care-services.aspx

Walgreens retail chain chronic conditions

shared by Mal Allison on 12 Jul 13 - No Cached
  • xpanding services to diagnosis and treatment of chronic conditions that affect millions of Americans is a logical step, because the clinics can not only grow their own business, but also partner with hospitals and doctors’ groups to gain new customers, said Ronald L. Hammerle, president of Health Resources, a Florida consulting firm.
Mal Allison

Analysis: Tenet stands out by experimenting with core model of Obamacare | Reuters - 0 views

www.reuters.com/...analysis-idUSBRE99119620131002

analysis tenet ACO pay for performance

shared by Mal Allison on 04 Oct 13 - No Cached
  • Most in the Pioneer group achieved quality improvements, but only 18 produced cost savings.
  • It remains to be seen whether it functions profitably or not," said Alan Miller, chief executive of Universal Health Services, which operates more than 200 hospitals, behavioral health facilities and outpatient centers."There has been a lot of discussion of moving away from fee- for-service to something like this, but we are a long way from there," Miller said.
  • The big opportunity for cost savings lies in getting preventive care for people before they land in the hospital with illnesses such as heart disease, diabetes and asthma,
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  • If it became necessary to do something to be competitive, we might change our mind, but right now we think we can continue to grow our business without spending the capital dollars and replacing what managed care companies can do well, just by contracting,"
  • which $14 million was returned to Montefiore."The way you make this work is not by denying care. The way you save money is by giving the right care to the right patients in the right setting,"
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.
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