Group items tagged

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

The Obama administration said in April it was scaling back the complexity of the small-business marketplace by delaying by one year a feature to allow employees of such businesses to pick from a range of plans, instead of the company selecting one on workers' behalf.

Business owners will be allowed to submit a paper application using a PDF form starting Tuesday, but they won't be able to complete an electronic application until a few weeks later, the official said. A call center for businesses will open Tuesday for employers who want help completing the paper application.

As Dr. Rushika Fernandopulle states, “they are putting wings on cars and calling them airplanes.” Instead, creative physicians such as Dr. Fernandopulle have developed models such as Iora Health that are built from the ground up NOT to optimize around billings, but to optimize around health. Iora Health has proven that they can deal with the toughest patient populations and reduce costs while greatly improving outcomes

Keep in mind these exchanges were at the crux of health care reform — a key component that garnered the support of many who were fighting on behalf of small businesses. 

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.

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.

Next year, Massachusetts will be allowed to take into account two-thirds of its soon-to-be-disallowed rating factors. It can use one-third of the disallowed factors in 2015.

that requires the state to formally request a waiver from the federal government from the ratings factor provision. Democratic Gov. Deval Patrick signed the bill on Friday, and the state is working to comply with the waiver request provision.

The law provided the ONC with $2 billion to support development of a nationwide electronic health information system. Th

On the positive side, providers are clearly aware of and responding to the availability of incentives. Internal CMS surveys show that as of April 2011, 78% of physicians and 96% of hospital executives were aware of the meaningful-use program (Trudel K: personal communication). As Figure 1Figure 1Provider Registrations for Meaningful-Use Payments. shows, more than 114,000 eligible providers, or 21%, had registered for meaningful-use payments by the end of September 2011.11

The relatively small share of PDP enrollees who switched plans at some point between 2006 and 2010 were more likely than those who did not switch to end up in a plan that lowered their premiums.  Nearly half (46 percent) of enrollees who switched plans saw their premiums fall by at least 5 percent the following year, compared to 8 percent of those who did not switch plans.  But those who switched plans were only slightly more likely than those who did not switch to face lower out-of-pocket costs for drugs during the year