Posts Tagged “Health Insurance”
ShowHide 3rd Party Papersbooz&co: The Future of Health Insurance Demise of Employer-Sponsored Coverage Greatly Exaggerated
Health Affairs: How Health Insurance Design Affects Access To Care and Costs, By Income, In Eleven Countries
Commonwealth Fund: Analysis shows that up to 16.6 million workers are in firms that would be eligible for the tax credit in 2010 to 2013.
AHIP: The Value of Provider Networks and the Role of Out-of-Network Charges in Risking Health Care Costs
National Institute for Health Care Reform: Health Coverage for the High-Risk Uninsured: Policy Options for Design of the Temporary High-Risk Pool
CommonwealthFund: Young adults between the ages of 19 and 29 represent one of the largest segments of the uninsured; approximately 13.7 million were uninsured in 2008.
Senate Commerce Committee: Most of the big publicly traded insurance companies spend less on medical care than the new health law will require of them
Pricewaterhouse Coopers: Employers have become less satisfied with their health insurers, according to a study released today by PWC
Kaiser Institute: Consumer’s Experience in Massachusetts: Lessons for National Health Reform
Brookings Insititute: Effective Steps to Address Long-Term Health Care Spending Growth
Urban Institute: How Will the Uninsured Be Affected by Health Reform?
Commonwealth Fund: Paying the Price: How Health Insurance Premiums Are Eating Up Middle-Class Incomes
Canopy Financial: Average HSA account balances increase for first time since 2008
Health Affairs: Should employers be required either to pay or subsidize their employees’ health insurance
Health Affairs: High-Deductible Health Insurance Plans: Efforts To Sharpen A Blunt Instrument
Health Affairs: Annual Medical Spending Attributable To Obesity
ShowHide Commentary
Health Reform and Part-time Workers
by Kevin Roche on Friday, May 24, 2013
A brief from the Employee Benefit Research Institute explores the extent to which companies appear to be switching employees to part-time status and what is happening with the health insurance for those part-time workers.
CDHP Enrollee Characteristics
by Kevin Roche on Wednesday, May 8, 2013
A report from the Employee Benefit Research Institute examines the characteristics of persons enrolled in consumer-driven and high-deductible health plans, which continue to show rapid growth.
The Oregon Medicaid Lottery
by Kevin Roche on Monday, May 6, 2013
Proponents of health care coverage for years have suggested that people literally died without it. New research in regard to the Oregon Medicaid lottery suggests that is highly unlikely to be true and that insurance coverage has little to do with real health outcomes.
Tags: Health Care Costs, Health Care Quality, Health Insurance, Medicaid
The Effect of Minimum MLR Requirements
by Kevin Roche on Friday, April 19, 2013
One of the supposed consumer protections in the reform law is the requirement that a minimum amount of premium be spent on medical costs. A paper from the American Action Forum explains how this requirement could actually increase costs and hurt consumers.
Employment-Based Health Insurance
by Kevin Roche on Friday, April 12, 2013
A Robert Wood Johnson report describes the ongoing decline in employment-based health insurance, driven by ongoing large premium increases and exacerbated by general declines in the work population resulting from the last recession.
Tags: Employers, Health Insurance
Exchanges and Navigators
by Kevin Roche on Friday, April 5, 2013
The department of Health and Human Services has issued rules regarding the role and use of “navigators” in the health insurance exchanges called for by the reform act.
Tags: Consumers, Health Insurance, Health Insurance Exchange
Society of Actuaries Weighs in on Rising Health Care Costs Under Reform
by Kevin Roche on Thursday, March 28, 2013
There has a been a flurry of similar reports recently, but none should have more credibility than the one from the Society of Actuaries stating that yes, claim costs and therefore insurance premiums will rise dramatically in the individual market in 2014.
Tags: Health Care Costs, Health Care Reform, Health Insurance
CMS Research on the Uninsured
by Kevin Roche on Monday, March 25, 2013
Supposedly the reform act will be fully implemented next January and millions of Americans will be getting health insurance for the first time. A brief from CMS discusses who the potential newly insured are, providing market research for interested parties.
Tags: Consumers, Health Care Reform, Health Insurance, Uninsured
How Much Will Premiums Go Up?
by Kevin Roche on Tuesday, March 19, 2013
When the reform law was being sold to a dubious public, we were told that premiums would actually be lower. That is obviously not going to be the case, but how much higher they will be is still a matter of debate.
Tags: Health Care Costs, Health Care Reform, Health Insurance
NBGH Survey
by Kevin Roche on Friday, March 15, 2013
The latest Towers Watson/National Business Group on Health survey of employers reveals information regarding strategies relating to the implementation of the health reform law. Much of what companies say they will do is not good for consumers, but that is what the law’s proponents should have anticipated.
Tags: Employee Benefits, Health Care Reform, Health Insurance
The Effect of Medicare Advantage Payment Cuts
by Kevin Roche on Wednesday, March 6, 2013
The Centers for Medicare and Medicaid Services recently released its initial cut at Medicare Advantage payment rates for 2014, indicating a likely low to mid-single digit decrease in reimbursement for most plans. A report sponsored by America’s Health Insurance Plans suggests that such a reimbursement cut would have untoward effects.
Where is Medical Cost Trend Going?
by Kevin Roche on Monday, February 18, 2013
Medical spending growth has been relatively quiescent for the last few years. Especially as full implementation of the reform law nears, there is great anxiety about whether that slow growth can or will continue. A Mark Farrah Associates report gives some insight on the question.
ADP Survey of Large Employers
by Kevin Roche on Wednesday, February 13, 2013
Many large employers may consider shifting more employees to part-time status as a result of the implementation of the reform law, according to a survey by ADP, and they may take other actions to minimize their costs under the law.
Tags: Employers, Health Care Costs, Health Care Reform, Health Insurance
AHIP on Out-of-Network Charges
by Kevin Roche on Monday, February 4, 2013
A new report from America’s Health Insurance Plans exposes the unbelievable ripoff charges that many providers place on out-of-network services. Much of these charges is paid by the insured person. Where are the regulators now!!
Managed Care Digest Part II
by Kevin Roche on Tuesday, January 22, 2013
Today is the second part of our review of this year’s Sanofi Managed Care Digest, with information of drug coverage and other aspects of health benefits.
Tags: Drugs, Health Care Costs, Health Insurance
New Federal Insurance Rules
by Kevin Roche on Wednesday, January 16, 2013
Now that it looks like the health reform law will be fully implemented, agencies are cranking out bushels of regulations. A Kaiser Family Foundation brief summarizes the provisions of three rules that relate to private health insurance and employment-related health benefits.
Impact of Reform Law on Age-Based Premiums
by Kevin Roche on Thursday, January 10, 2013
One of the things the new reform law does is limit the ability to adjust health insurance premiums on the basis of age. A study from Oliver Wyman examines the likely effect on premiums for younger people, who will be mandated to buy insurance. Not a pretty picture.
CDHP and Preventive Care
by Kevin Roche on Wednesday, January 2, 2013
A study published in Health Affairs examined consumers’ awareness of preventive care benefits in their high-deductible insurance plans, finding that many were unaware that these services were available without charge.
Tags: Consumer Directed Health, Consumers, Health Care Costs, Health Insurance, Wellness and Prevention
Health Insurance and Health Behavior
by Kevin Roche on Monday, December 31, 2012
A new paper from the National Bureau of Health Economics suggests that not allowing insurers to vary rates based on health status reduces incentives to be healthy, leading to an overall decline in population health, and, guess what, that leads to an increase in health spending.
2012 Potpourri XL
by Kevin Roche on Friday, December 28, 2012
Our last Potpourri for 2012 is the ultimate in health information, containing not lumps of coal but tasty nuggets of holiday goodies, including transition care from hospital to primary care, how to control health spending growth, use of market incentives to improve the health system, building a good health insurance exchange and Massachusetts’ experience with the uninsured after reform.
Tags: Care Management, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Health Insurance Exchange, Hospital Readmissions, Transitional Care
Employer Based Insurance Costs
by Kevin Roche on Wednesday, December 26, 2012
A Kaiser Family Foundation snapshot examines cost-sharing between employers and employees based on data from the KFF 2012 health benefit survey. In general public employees are getting a much better health benefit deal than are employees at private firms.
Private Health Insurance Facts
by Kevin Roche on Monday, December 24, 2012
The latest brief from the National Institute for Health Care Management describes facts about private health insurance, with a focus on what goes into the premiums charged by these companies. Another study that shows that rising health insurance premiums are driven by higher payments to providers, largely resulting from higher unit costs.
2012 Potpourri XXXIX
by Kevin Roche on Friday, December 21, 2012
Our penultimate Potpourri for 2012 is a festive blend of health data, including avoidance of health care due to costs, rates of expected spending increases in 2013, costs for younger versus older physicians, internet versus print health interventions, medical home results and poor health behaviors and health spending.
Tags: Consumers, Health Care Costs, Health Insurance, HIT, Medical Homes, Physicians, Wellness and Prevention
AHIP on Insurance Tax Hit
by Kevin Roche on Tuesday, December 18, 2012
The reform law begins to really kick in for 2013, with many new taxes and regulations. Unpleasant surprises abound and an Oliver Wyman report for America’s Health Insurance Plans examines the likely effect of the new health care coverage tax.
Tags: Health Care Costs, Health Care Reform, Health Insurance
Medicare Advantage and Traditional Medicare
by Kevin Roche on Wednesday, December 12, 2012
For reasons that are truly mysterious, the Medicare Advantage program has been controversial. New research published in Health Affairs shows that the program has better utilization and spending control than traditional Medicare and does not have significant favorable selection.
2012 Potpourri XXXVII
by Kevin Roche on Friday, December 7, 2012
Our latest Potpourri captures the excitement of the holidays with scintillating items on certificate of need program effects on utilization, the public’s views on health care costs and government’s role in health care, the cost of developing new drugs and a survey on physician compensation.
Tags: Drugs, Health Care Costs, Health Care Reform, Health Insurance, Physicians, Regulation
NCQA Annual Health Report
by Kevin Roche on Tuesday, December 4, 2012
The National Committee for Quality Assurance releases its annual report on the state of health care quality in America, based on its collection of various quality measures from health plans. One striking finding is the improvement in and level of quality in Medicare Advantage plans.
Mercer on 2013 Employer-based Health Benefits
by Kevin Roche on Tuesday, November 20, 2012
Employee benefits consulting firm releases results from its latest survey of employers on health benefits. While spending growth has moderated in recent years, it continues at an above inflation and GDP rate of increase and employers are using multiple strategies to shift cost to employees and contain spending.
Tags: Health Insurance, Workplace
2012 Potpourri XXXV
by Kevin Roche on Friday, November 16, 2012
Thanks be given for our last Potpourri before Thanksgiving, a table spread with delectable bites of information on hospital readmissions and quality measure performance, health plan enrollment growth, health price rises, use of deductibles in employer-based health insurance and trends in employment of physicians.
Tags: Consumers, Health Care Costs, Health Care Quality, Health Insurance, Hospital Readmissions, Medicare, Pay For Performance, Physicians
ACA Impact on Business
by Kevin Roche on Wednesday, October 24, 2012
A new report from the Urban Institute examines the controversial issue of the impact of the Patient Protection Act on businesses of various sizes, showing that for small businesses it may reduce cost, it likely increases the cost for mid-sized ones and is neutral to large companies.
Tags: Employers, Health Care Costs, Health Care Reform, Health Insurance
PWC on Health Insurance Exchanges
by Kevin Roche on Thursday, October 18, 2012
PriceWaterhouseCooper publishes a report on the status of health insurance exchanges and issues which states and employers are considering as exchanges slowly lumber toward reality.
2012 Potpourri XXX
by Kevin Roche on Friday, October 12, 2012
Another luminescent Potpourri, focusing on the ACA’s high-risk pool plan; controlling health spending in Massachusetts; what components of EHRs and HIEs may control costs; another survey of employers and dealing with hospital pricing power.
Tags: EHRs, Employers, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, HIT, Hospital
EBRI on Private Exchanges
by Kevin Roche on Wednesday, October 10, 2012
The Employee Benefit Research Institute releases a report looking at private health insurance exchanges and defined contribution plans, putting them in historical perspective and suggesting that adoption of these initiatives may not meet the objectives employers hope they will attain.
Tags: Health Care Reform, Health Insurance, Health Insurance Exchange
GAO on the PPACA and Employer-Provided Health Insurance
by Kevin Roche on Wednesday, September 26, 2012
The Government Accounting Office weighs in on the ongoing controversy over the effects of the Affordable Care Act on employment-based health insurance, reviewing a number of microsimulation models and employer surveys, finding that there is a wide range of estimates of a decrease or increase in the number of covered persons and substantial uncertainty in the accuracy of the predictions.
Aon Hewitt Employer Survey
by Kevin Roche on Thursday, September 20, 2012
Yet another survey of the employer market, this one from Aon Hewitt, which also reflects views of employees covered under their companies’ health plans. Aon Hewitt finds that employers are stepping up their level of action in regard to designing and operating health plans and other programs to encourage better health.
Tags: Consumers, Health Insurance, Wellness and Prevention, Workplace
The Kaiser Family Foundation Report on Health Care Coverage
by Kevin Roche on Monday, September 17, 2012
The Kaiser Family Foundation published its annual survey on Employer Health Benefits. While the rate of growth in both single and family health insurance premiums has slowed, it is still well above inflation, wage growth or GDP growth and while employee cost-sharing is relatively flat, the amount spent on health insurance by the average employee continues to grow far faster than income.
Tags: Consumers, Health Care Costs, Health Insurance, Workplace
2012 Potpourri XXVIII
by Kevin Roche on Friday, September 14, 2012
Another brilliant edition of our Potpourri, focusing on individual health insurance rate reform, variation in traumatic care costs, genetic counseling and diabetes, small business and health care costs and savings from wellness programs.
Tags: Consumers, Health Care Costs, Health Care Reform, Health Insurance, Regulation, Wellness and Prevention
Variation in Episode Cost in a Commercial Health Plan
by Kevin Roche on Thursday, September 13, 2012
Research based on data from UnitedHealth Group’s commercial health plans finds wide variation in episode of care costs across both selected procedures and chronic diseases. The research also showed that for care provided by physicians meeting certain quality and efficiency benchmarks, episode of care costs were generally lower than for care provided by other physicians.
Tags: Health Care Costs, Health Care Quality, Health Insurance, Providers
Consumers and their Health Care Coverage
by Kevin Roche on Wednesday, September 12, 2012
The Employee Benefit Research Institute has released a survey on consumers attitudes toward their health care coverage. Among three types of coverage, traditional, high deductible with no savings account and high deductible with a savings account, enrollees in high-deductible plans had similar overall levels of satisfaction to those in traditional plans, but greater dissatisfaction relating to cost-sharing.
Tags: Consumers, Health Insurance
Wellness and Benefits Administration Survey
by Kevin Roche on Tuesday, September 11, 2012
A study released by a private vendor evaluates wellness and benefit administration benchmarks in 2012.
Physician Survey on Payers
by Kevin Roche on Thursday, August 30, 2012
A survey from Revive Health examined hospital perceptions of payers, and other issues. Wellpoint is rated worst, many independent Blue Cross plans do poorly as well and UnitedHealth Group, while not highly ranked, is showing improvement. Hospitals are pessimistic about reform but undertaking a number of incented initiatives like ACOs and greater use of HIT.
Tags: Health Insurance, Hospital
AON Employer Survey
by Kevin Roche on Monday, August 27, 2012
AONHewitt has released its 2012 Health Care Survey, which largely reviews employer attitudes and actions toward health care coverage. The impacts of the health reform law are obviously foremost on companies’ agendas, with cost increases being the biggest challenge and one that is really unaddressed by the reform law.
2012 Potpourri XXVI
by Kevin Roche on Friday, August 17, 2012
Another sunny Potpourri, brightening your day with rays of data on hospital at home; Medicare care coordination programs; an employer survey on impacts of the reform law; a survey on health habits and employee productivity; first quarter health plan results and ER use and end-of-life care.
Tags: Care Management, End-of-Life Care, Health Care Costs, Health Care Reform, Health Insurance, Hospital, Medicare, Wellness and Prevention, Workplace
KPMG on Health Care Transformation
by Kevin Roche on Wednesday, August 15, 2012
KPMG releases a report on the ongoing transformation of the United States’ health care system, which affects payers, providers and patients. The firm gives its perspective on the forces driving the transformation and on what responses are needed by participants if they are to continue to be successful.
Will Employers Drop Coverage as 2014 Approaches?
by Kevin Roche on Monday, August 13, 2012
A study from Truven Health Analytics looks at likely outcomes from the reform law’s provide insurance or pay a penalty provisions, suggesting that few employers would likely drop coverage, but some assumptions in the model appear to have flaws.
2012 Potpourri XXV
by Kevin Roche on Friday, August 10, 2012
Another wonderful Potpourri, as lovely as a summer day, with information on small physician practices, medication adherence in Medicaid, access to care in Massachusetts, plan loyalty and PHRs, a survey regarding onsite health centers and hospital productivity in Massachusetts after reform.
Tags: Consumers, Drugs, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, HIT, Medicaid, Physicians
The Concentration of Health Care Spending
by Kevin Roche on Wednesday, August 8, 2012
It is well known that a relatively few people account for a very large proportion of American health spending, a fact reinforced by a recent brief from the National Institute for Health Care Management. What is most interesting is how much this fact is routinely ignored in reform discussions.
Tags: Health Care Costs, Health Care Reform, Health Insurance
Wellness Incentive Guidelines
by Kevin Roche on Tuesday, August 7, 2012
A group of health care organizations has produced a guidance for employer-sponsored wellness programs with incentives, published in the Journal of Occupational and Environmental Medicine. The statement is supportive of these programs, although expressing some reservations about incentive use.
Deloitte Employer Survey
by Kevin Roche on Tuesday, July 31, 2012
Deloitte surveyed a number of employers for their views on the US health care system. Most feel the system needs substantial improvement, particularly in regard to costs and most view the Affordable Care Act as a bad start to fixing the problems.
Rand on CDHP
by Kevin Roche on Wednesday, July 18, 2012
No matter how controversial they may be, consumer-directed health plans with their higher cost-sharing continue to spread rapidly. A Rand Corporation brief examines the evidence on the effect of these plans on the cost and use of health care.
Tags: Consumer Directed Health, Health Care Costs, Health Care Quality, Health Insurance
Retirement and Health
by Kevin Roche on Monday, July 2, 2012
One of the biggest issues facing retirees is health care costs, notwithstanding the availability of Medicare for many retirees when they retire and for all eventually. Stress over finances can also have a detrimental effect on retiree health. The Employee Benefits Research Institute issues a periodic survey on retirement-related trends which includes health questions. The [...]
AMA’s Report Card on Insurer Performance
by Kevin Roche on Thursday, June 21, 2012
The American Medical Association regularly assesses the administrative performance of the large health plans on issues relevant to physicians. This year’s report finds significant improvement in claims payment procedures and results.
Tags: Health Insurance, HIT, Physicians
EBRI Report on the CDHP Population
by Kevin Roche on Tuesday, June 19, 2012
Our next report related to consumer-directed, high deductible health insurance plans comes from the Employee Benefit Research Institute and describes the characteristics of people in these plans over the years 2005-2011.
Tags: Consumers, Health Insurance
AHIP on CDHP
by Kevin Roche on Monday, June 18, 2012
This week we will discuss several high deductible insurance plan reports. The first is from America’s Health Insurance Plans and gives information on details of enrolllment and plan types.
Tags: Consumers, Health Insurance
2012 Potpourri XIX
by Kevin Roche on Friday, June 1, 2012
Summer is heating up and our Potpourri is smoking too, with nuggets on a silly provision in the final MLR rule; research on causes of readmissions, some within hospital control, some not; why are some hospitals more costly in treating heart failure than others and an unintended consequence of a change in dialysis drug reimbursement.
Tags: Care Management, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Hospital, Medicare, Physicians, Readmissions, Reimbursement
Milliman on 2012 Health Care Costs
by Kevin Roche on Thursday, May 17, 2012
Milliman tracks the average cost of health care for a family and issues an annual report. The 2012 version is out, showing that average family costs are over $20,000 for the first time. That reform law sure is working well to hold down costs.
Tags: Health Care Costs, Health Care Reform, Health Insurance
2012 Potpourri XVI
by Kevin Roche on Saturday, May 5, 2012
This edition of our data-packed Potpourri focuses on hospital readmissions, use of computer physician order entry systems, what employers will do after 2014 when all of the health law kicks in, and hospital pay-for-performance programs.
Tags: Employers, Health Insurance, Health Insurance Exchange, HIT, Hospital, Hospital Readmissions, Pay For Performance
2012 Potpourri XIV
by Kevin Roche on Friday, April 20, 2012
More delightful health facts for your edification in our most recent Potpourri, including the cost of obesity, an employer survey on wellness programs, opportunities for hospitals to reduce costs, an employer survey on cost expectations in the coming year, Massachusetts’ and health spending control and incentives in health care.
Tags: Consumers, Health Care Costs, Health Care Reform, Health Insurance, Hospital, Wellness and Prevention, Workplace
A Primary Care Program That Reduced Spending
by Kevin Roche on Thursday, April 19, 2012
Improving primary care is viewed as a method to lower health spending while maintaining or even improving quality. A Health Affairs article reports on a Virginia program that appears to have successfully used primary care reforms to meet these objectives.
2012 Potpourri XII
by Kevin Roche on Friday, April 6, 2012
An early spring for much of the country and our latest Potpourri is in full bloom, with nuggets on health information exchanges, genetic testing guidelines, an employer survey on reform, EMRs and lab test ordering and the relationship between clinical quality and patient satisfaction.
Tags: Genomics, Health Care Quality, Health Insurance, HIT, HITECH, Patient Satisfaction, Workplace
Employer Views of Reform
by Kevin Roche on Wednesday, March 21, 2012
A crucial question in the next few years is what will happen with employer-sponsored health care coverage in the wake of the reform law’s full implementation. A new survey from Willis reports on some current attitudes and actions among companies in regard to health plan options.
Comparative World Health Spending
by Kevin Roche on Wednesday, March 7, 2012
A report from the International Federation of Health Plans compares prices for some common services and drugs across several developed countries. In all categories, physician services, hospital care and drugs, the United States pays average commercial plan prices that are much higher than any other country for almost every service.
High Deductible Health Plans and Care Receipt
by Kevin Roche on Tuesday, February 21, 2012
A survey of high-deductible health plan users finds that care is more likely to be deferred by enrollees in such plans as opposed to traditional ones, particularly low-income persons, but not for patients with chronic conditions. The survey has weaknesses, including the fact that it does not explore outcomes.
Tags: Consumer Directed Health, Health Care Quality, Health Insurance
Reform’s Effect on Health Insurance Premiums
by Kevin Roche on Tuesday, February 14, 2012
President Obama, his administration and Congressional Democrats sold the health “reform” law in large part by claiming it would reduce health insurance premiums for average Americans, by $2000 they said, and they persuaded “experts” to write papers supporting those claims. Now one of those experts has admitted his previous paid-for analysis was wrong.
Tags: Health Care Costs, Health Care Reform, Health Insurance
Big Health Care Issues
by Kevin Roche on Monday, January 30, 2012
The Wall Street Journal published a special section devoted to big health care issues, with a pro and con format on questions ranging from should there be a health insurance mandate to the potential for accountable care organizations to increase quality and lower costs.
Tags: ACO, Drugs, Health Insurance, HIT, Physicians
2012 Potpourri II
by Kevin Roche on Friday, January 13, 2012
Our latest Potpourri reveals details about causes of workplace injuries, the effect of raising the Medicare eligibility age, benefit levels in existing health policies, false claims prosecutions and off-label drug use, ICU staff perceptions of the appropriateness of care, and malpractice liability from clinical decision support systems.
Tags: Care Management, Drugs, Health Insurance, HIT, Medicare, Workplace
Medicare Advantage Marketing
by Kevin Roche on Wednesday, January 11, 2012
Research in the New England Journal of Medicine suggests that Medicare Advantage health plans use offering of certain non-required benefits, like fitness club memberships, to attract and retain healthier beneficiaries, thereby supposedly boosting their profits. The article is a weak-design piece of ideological hogwash.
Tags: Health Insurance, Medicare
2011 Wrapup
by Kevin Roche on Friday, December 30, 2011
Our final commentary of 2011 reflects on developments in health care for the year. Notably, support for the health reform law continues to be weak and health care cost growth continues to outpace both GDP and inflation.
Tags: Health Care Costs, Health Care Reform, Health Insurance
Commercial and Medicare Spending Variation
by Kevin Roche on Thursday, December 22, 2011
A study reported in the American Journal of Managed Care follows up on the comparative geographic variation in spending on Medicare patients and commercially insured ones in Texas, finding that the pattern of variation is similar for the two groups.
Physician Views of Health Care
by Kevin Roche on Wednesday, December 21, 2011
Physicians have felt under assault for decades, with managed care restrictions, low reimbursement and malpractice concerns leading the charge. A new survey from Deloitte’s Center for Health Solutions give doctors’ perspectives on health care reform and their profession.
Tags: Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Physicians
EBRI on CDHP
by Kevin Roche on Tuesday, December 20, 2011
Another excellent report from EBRI regarding consumer-driven health plans finds continued growth and continued evidence that members of these plans appear to be more engaged in their health and health care. The report is based on a survey of about 4700 adults under age 65 with commercial insurance.
2011 Potpourri XXXXVIII
by Kevin Roche on Friday, December 16, 2011
The holiday season is in full swing, as is the time for bad weather, but nothing can deter the delivery of our Potpourri of health stories, including this week the nocebo effect, use of imaging when a financial interest in the equipment is present, broker commissions and the MLR, present-on-admission indicators, selecting patients for use in performance measuring, and physicians views of health insurers.
Tags: Health Care Costs, Health Care Quality, Health Insurance, Hospital, Medical Care, Pay For Performance, Physicians
2011 Potpourri XXXXVII
by Kevin Roche on Friday, December 9, 2011
Another scintillating Potpourri, focused on the effect of copayments on prescription adherence, use of PHRs in the FEHBP plans, doctors use of cancer drugs after a Medicare reimbursement change, visiting physicians after a hospital discharge, consumers expectations regarding health insurance and early experience with bundled payments.
Tags: Consumers, Health Care Costs, Health Care Quality, Health Insurance, HIT, Hospital, Physicians, Readmissions
2011 Potpourri XXXXVI
by Kevin Roche on Friday, December 2, 2011
The holiday shopping season is in full swing but our Potpourri is free, filled with useful data on high-deductible health plans and utilization, Medicare Advantage plan Stars bonuses, drug complications and hospitalizations, physician office visit trends, premium increases, and patient expectations.
Tags: Consumer Directed Health, Drugs, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Medicare, Patient Satisfaction, Physicians
The Uninsured and the Price of Insurance
by Kevin Roche on Tuesday, November 22, 2011
How many people will enroll in the coverage offered via the reform law in 2014 either in Medicaid or commercial coverage? A new paper based on survey work suggests it will be a very high number of the uninsured, but there are several flaws in the reasoning and data.
2011 Potpourri XXXXV
by Kevin Roche on Friday, November 18, 2011
No Potpourri next week due to the holiday, so enjoy this festive collection of health care nuggets, including pay-for-performance in large physician groups, employer views on the effect of the reform law, the effect of physician financial interest in cardiac testing, experience with high deductible plans, medical homes and quality improvement and for-profit and non-for-profit hospital treatment of the uninsured.
Tags: ACO, Care Management, Consumer Directed Health, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Hospital, medical home, Pay For Performance, Physicians
Health Insurer Enrollment Trends
by Kevin Roche on Thursday, November 17, 2011
A Mark Farrah Associates release provides information on the enrollment and margin status of the largest health insurers. The data suggest that enrollment has begun to grow again, with self-funded commercial members accounting for most of that growth.
Tags: Health Insurance
2011 Potpourri XXXXIV
by Kevin Roche on Friday, November 11, 2011
The cold is approaching so curl up on the sofa and enjoy the warmth of our Potpourri, this week featuring results from a pay-for-performance program, the effect of the health insurance tax on premiums and employment, the evidence for a stroke treatment, collaborative care for heart disease and physicians views on their practices and health information tools.
Tags: Care Management, Consumers, Evidence-based care, Health Care Reform, Health Insurance, Medical Care, Pay For Performance, Physicians
Towers Watson Employer Survey
by Kevin Roche on Tuesday, November 8, 2011
The latest Towers Watson survey of employer intentions regarding health benefits indicates that significant changes may occur in the next two to three years, but the biggest danger may be firms’ willingness to play follow-the-leader when it comes to reactions to reform.
Cost-Shifting and Care
by Kevin Roche on Tuesday, November 8, 2011
Research reported in Health Affairs examines the Mayo Clinic’s experience after increasing cost-sharing for its employees. Reductions in the use of many discretionary services seem to have been sustained over a multi-year period, leading to overall spending restraint.
Tags: Consumer Directed Health, Consumers, Health Care Costs, Health Care Quality, Health Insurance
2011 Potpourri XXXXIII
by Kevin Roche on Friday, November 4, 2011
Winter nears but our Potpourri will distract you from the cold breezes, providing compelling nuggets on prostate screening recommendations, consumer use of technology for health, insurer medical cost trends, what to do about Medicare’s physician payments, heart failure hospitalization and mortality rates and rates of non-filling of new prescriptions.
Tags: Chronic Disease, Disease Management, Drugs, Health Care Costs, Health Insurance, HIT, Hospital, Medicare, Physicians, Telemedicine, Wellness and Prevention
2011 Potpourri XXXXII
by Kevin Roche on Friday, October 28, 2011
Another brilliant Potpourri, with scintillating health care gems, including revising the FDA’s 510(k) process, the essential benefits package for health exchanges, the future of Medicare Advantage, the lack of labor productivity in health care, variation in elective procedure rates and the OIG’s work plan.
Tags: Care Management, Devices, FDA, Government, Health Care Costs, Health Care Reform, Health Insurance, Medical Care, Medicare, Physicians
Insurance Market Competitiveness
by Kevin Roche on Monday, October 24, 2011
The Kaiser Foundation takes a look at the competitiveness of individual and small group health insurance markets on a state-by-state basis, finding that most are relatively concentrated. The report also examines the implications of this concentration for aspects of the reform law, particularly the exchanges and rate review.
Tags: Health Care Costs, Health Care Reform, Health Insurance
2011 Potpourri XXXXI
by Kevin Roche on Friday, October 21, 2011
Another Potpourri, with tidbits on the Medicare Star program results for 2012, pain management, blood pressure management, Massachusetts’ physicians’ views on work and health care, online error reporting and the FDA and CMS parallel medical device review process.
Tags: Care Management, Devices, FDA, Health Insurance, Malpractice, Medical Care, Medicare, Physicians, Telemedicine
Deloitte’s Latest Consumer Survey
by Kevin Roche on Thursday, October 20, 2011
The Deloitte Center for Health Solutions releases the latest edition of its annual survey of consumers on health issues and health care use. Americans are anxious about the financial effects of health care and think our system is not good, but are generally happy with the care they actually receive.
Tags: Consumer Directed Health, Health Care Costs, Health Insurance
Americans’ View of Health System
by Kevin Roche on Monday, October 17, 2011
An EBRI survey reveals current attitudes by Americans regarding the health system, their health care coverage, how they access care and reflects serious concerns by many Americans about whether the reform law will make the system, better or worse.
Pharmacy Benefit Trends
by Kevin Roche on Saturday, October 8, 2011
The Pharmacy Benefit Management Institute releases its most recent survey on prescription drug benefit design and cost issues. While drug spending growth has moderated, the size of the category means it still draws attention and employers and payers continue to refine their strategies for keeping utilization and cost under control.
Tags: Drugs, Health Insurance
2011 Potpourri XXXIX
by Kevin Roche on Friday, October 7, 2011
October already!! Our 39th Potpourri of the year has many autumnal pleasures including selections on CMS’ Comprehensive Primary Care Initiative, a proposed guidance for FDA to use for mHealth regulation, end-of-life care discussions, CMS’ multi-payer database award, expected 2012 medical trend, and delivery of unnecessary care by doctors.
Tags: Care Management, Comparative Effectiveness, End-of-Life Care, FDA, Health Insurance, HIT, medical home, Medicare, Physicians, Telemedicine
Kaiser Health Insurance Survey Part III
by Kevin Roche on Wednesday, October 5, 2011
The final look at the Kaiser employer health benefit survey examines findings on prescription drug coverage, wellness programs, retiree health plans, funding mechanisms and the effect of health care reform.
Tags: Consumers, Health Care Costs, Health Insurance, Workplace
Kaiser Health Insurance Survey II
by Kevin Roche on Tuesday, October 4, 2011
The second part of our review of the Kaiser employer health benefits survey discusses employee contributions to premiums and employee cost-sharing trends, along with developments in high-deductible plans with savings accounts.
Tags: Consumers, Health Care Costs, Health Insurance, Workplace
Kaiser Health Insurance Survey I
by Kevin Roche on Monday, October 3, 2011
The annual Kaiser Foundation report on employment-based health coverage finds a rapid growth in per person and per family costs in 2009, but relative stability in the number of persons who have access to health insurance at the workplace. High-deductible plans continue to show rapid enrollment increases.
Tags: Consumers, Health Care Costs, Health Insurance, Workplace
2011 Potpourri XXXIV
by Kevin Roche on Friday, September 2, 2011
A dazzling review of recent research and other health related nuggets is presented in this latest Potpourri, including potential problems with evidence-based medicine, physician dilemmas in controlling cost, workers’ compensation medical costs, reducing hospital infections, improving heart attack care and the growth of CDHPs.
Tags: Comparative Effectiveness, Consumers, Health Insurance, Hospital, Medical Care, Physicians, Workplace
Having Many Medicare Advantage Choices Has Its Disadvantages
by Kevin Roche on Thursday, September 1, 2011
The application of theories of consumer buying behavior to Medicare Advantage indicates that having too many plan or benefit design choices may create harder decision-making for seniors, especially those with cognitive difficulties.
Tags: Consumers, Health Insurance, Medicare
Towers Watson, NBGH Survey on Value in Health Spending
by Kevin Roche on Wednesday, August 17, 2011
Towers Watson and the National Business Group on Health released their latest Employer Survey on Purchasing Value in Health, which delineates actions being taken by many employers to try to limit health spending, while ensuring that employees receive good quality care.
Tags: Consumers, Health Care Reform, Health Insurance, Workplace
PPACA Projection Accuracy
by Kevin Roche on Tuesday, August 16, 2011
An NBER paper analyzes the accuracy of the CBO projections of the enrollment, insurance cost and health spending effects of the PPACA, using the similar Massachusetts reforms as a case study. The paper concludes that the projections are likely conservative, but the author is not likely to be unbiased and he ignores the last two years of experience in Massachusetts.
Tags: Health Care Costs, Health Care Reform, Health Insurance
2011 Potpourri XXXI
by Kevin Roche on Friday, August 12, 2011
Mercer issued a release on its survey of employers regarding issues relating to the reform law. Among the findings are that employers have already seen a 2% enrollment jump due to having to cover children up to age 26, and that over 40% of employers expect the full implementation of the law to raise their [...]
Tags: Health Care Costs, Health Insurance, Medicare, Physicians, Workplace
Geographic Variation in Commercial Health Spending
by Kevin Roche on Thursday, August 11, 2011
A new report from Thomson Reuters examines geographic differences in health spending among a commercially insured population. While there is significant variation among areas, the pattern is different from that found by analyses based on the Medicare population and changes among regions based on type of spending and age.
Physician Administrative Costs
by Kevin Roche on Tuesday, August 9, 2011
A study reported in Health Affairs finds that American physicians spend much more time at a much higher cost interacting with insurers than do Canadian physicians, who only have to deal with a single-payer system. The data, however, is based on surveys and uses somewhat dated cost comparisons.
Hospital Pricing Behavior and Market Characteristics
by Kevin Roche on Monday, August 8, 2011
Further evidence that hospitals with market power raise prices almost at will and disregard opportunities to cut costs is provided by research reported in Health Affairs. Hospitals in concentrated markets have enormous margins on their private insurers payments.
Tags: Health Care Costs, Health Insurance, Hospital, Medicare
2011 Potpourri XXX
by Kevin Roche on Friday, August 5, 2011
This week’s Potpourri features dropped malpractice claims, the quality benefits of EHRs, improper Medicare payments, health insurer customer satisfaction, the utilization and cost effects of using hospitalists, and determining if a patient has decision-making capacity.
Tags: Consumers, EHRs, Health Care Costs, Health Care Quality, Health Insurance, HITECH, Hospital, Malpractice, Medicare, Physicians
LA Times
by Vita Advisors on Wednesday, August 3, 2011
Nearly 18 months after passage of the national healthcare overhaul, American employers say they are providing health benefits for growing numbers of people as they extend coverage to their workers’ adult children
Tags: Employee Benefits, Health Care Reform, Health Insurance
Risk-Bearing by Providers
by Kevin Roche on Monday, August 1, 2011
A recent report from the Commonwealth Fund describes the status of plans to have accountable care organizations and other provider systems take on financial risk for their patients, finding that there is a gap between the plans and the providers capabilities to manage the risk.
Tags: ACO, Care Management, Health Care Costs, Health Insurance, Physicians
Early Massachusetts Experience With Global Payment
by Kevin Roche on Tuesday, July 26, 2011
Research published in the New England Journal of Medicine examines early results from the Massachusetts Blue Cross plan’s global budgeting program, finding very modest health spending reductions and small changes in quality.
Tags: ACO, Health Care Costs, Health Care Quality, Health Insurance, Physicians
Drug Week–Reports Part IV
by Kevin Roche on Thursday, July 14, 2011
Our final drug report post discusses releases from Express Scripts, the Pharmacy Benefit Management Institute and ESI’s PMSI division, which focuses on workers’ compensation pharmacy. Express Scripts emphasizes behavioral aspects of trend management and the PBMI report examines drug benefits from the employer perspective.
Tags: Drugs, Health Care Costs, Health Insurance, Workplace
Drug Week–Reports Part II
by Kevin Roche on Tuesday, July 12, 2011
Our next set of drug reports deals with specialty drugs, the most expensive and fastest growing category, and one which has bedeviled payers but many of the drugs are covered under medical benefits. The reports detail usage trends and describe payer management strategies in detail.
Tags: Drugs, Health Care Costs, Health Insurance
2011 Potpourri XXVI
by Kevin Roche on Friday, July 8, 2011
Our current Potpourri features Google’s dropping of its PHR, the AMA’s report on insurer claims paying, the role of health advocacy groups, employer’s intentions in regard to offering health coverage, drug approval in the US versus Europe and the use of a checklist to improve quality in the ICU.
Tags: Drugs, FDA, Health Care Costs, Health Care Quality, Health Insurance, HIT, Physicians
Employer Self-Insurance and the PPACA
by Kevin Roche on Thursday, July 7, 2011
A Rand report examines how self-insured employers might be affected by the PPACA, finding it unlikely that small employers will significantly shift to self-funding. The report also finds little reason to be concerned that self-funded plans are worse for employees.
2011 Potpourri XXVI
by Kevin Roche on Friday, July 1, 2011
Fireworks galore for the Fourth of July Potpourri, including dynamite excerpts on the effects of parent caregiving on caregivers’ financial status; health insurance exchanges; physician compensation; provider performance data gathering and use; hospital market concentration; use of HIT in nursing homes and teen use of health websites.
Tags: Consumers, Elder Care, Health Care Costs, Health Care Reform, Health Insurance, HIT, Hospital, Meaningful Use, Pay For Performance, Physicians, Telemedicine
2011 Potpourri XXV
by Kevin Roche on Friday, June 24, 2011
Summer waxes but no heat-induced torpor can stop us from producing our Potpourri of health snapshots, including the health care and health care coverage of young adults; malpractice incidence; Massachusetts health spending; online provider ratings; access to specialty care for children in public programs and options for dealing with the SGR mess.
Tags: Access, Consumers, Health Care Costs, Health Insurance, Malpractice, Medicaid, Medicare, Physicians
AHRQ on Employer-based Insurance
by Kevin Roche on Thursday, June 23, 2011
An AHRQ Statistical Brief looks at changes in employer-based insurance premiums from 2001-2009, finding large increases in premiums and even larger increases in the employees’ share of such premiums, particularly for employee plus one coverage.
Tags: Health Insurance, Workplace
The Effect of Competition on Health Care in England
by Kevin Roche on Tuesday, June 14, 2011
A working paper at the National Bureau of Economics reports on an analysis of the effects of England’s attempt to increase competition between hospitals on quality, finding that hospitals in more competitive markets had higher quality outcomes than those in more concentrated markets, without increasing the cost of care.
Tags: Consumers, Health Care Quality, Health Insurance, Hospital
Employer Reaction to Health Reform
by Kevin Roche on Monday, June 13, 2011
A new report from McKinsey finds that the federal reform law will have more of an effect on the market for employer-based health insurance than other studies suggested would occur. McKinsey believes many employers will drop coverage altogether.
Massachusetts Provider Price Variation
by Kevin Roche on Wednesday, June 8, 2011
A new report on prices paid by commercial insurers in Massachusetts shows great variation, which appears unrelated to providers’ costs or to the quality of care delivered. While the specific causes of the variation aren’t analyzed, a large opportunity to limit spending by reducing high-end payments is apparent.
Tags: Health Care Costs, Health Insurance, Hospital, Physicians
2011 Potpourri XXI
by Kevin Roche on Friday, May 27, 2011
Our Memorial Day Potpourri, celebrating health information such as the growth of high-deductible plans, physician starting salaries, benefit design for high-cost conditions, why emergency room physicians order tests, the use of telehealth for heart failure patients and sources of physician pay.
Tags: Care Management, Chronic Disease, Health Care Costs, Health Insurance, Malpractice, Physicians, Telemedicine
Health Care Spending Index
by Kevin Roche on Tuesday, May 24, 2011
An index that tracks medical spending shows that while per capita spending continues to rise, the rate of growth has slowed, particularly for Medicare. Hospital spending continues to be the fastest growing category.
Milliman’s Annual Health Care Cost Report
by Kevin Roche on Monday, May 16, 2011
The 2011 Milliman Medical Index was released, showing a 7.3% increase for a family of four covered by an employer sponsored PPO plan. Premium share and other out-of-pocket payments continue to rise faster than overall cost and unit prices, especially for hospital services, are the main source of the continued higher spending.
2011 Potpourri XVI
by Kevin Roche on Friday, April 15, 2011
Happy Easter and welcome to our spring kickoff potpourri, complete with a survey on technology use by consumers; brand drug pricing; how to get individuals to purchase health coverage; views of the Massachusetts reforms; hospital pay-for-performance and use of PHRs.
Tags: Consumers, Drugs, Health Care Reform, Health Insurance, HIT, Hospital, Pay For Performance
A Fool’s Potpourri XIV
by Kevin Roche on Friday, April 1, 2011
Every few years April 1st falls on a Friday, allowing us to put out our Potpourri on that day. As you might anticipate, one of our items this week is bogus, and it shouldn’t be too hard to figure out which one.
Tags: Care Management, Drugs, Health Insurance, Physicians, Telemedicine
GAO on Medicare Advantage Rates
by Kevin Roche on Wednesday, March 30, 2011
The General Accounting Office looks into the controversial topic of Medicare Advantage plan reimbursement compared to Medicare FFS spending and finds that there is probably room to pressure rates downward.
Tags: Health Insurance, Medicare
2011 Potpourri XII
by Kevin Roche on Friday, March 18, 2011
Our Ides of March Potpourri, featuring two studies of the impact of wellness programs; the link between hospital spending and mortality outcomes; HHS waiving the MLR requirement for Maine; bills to have CMS disclose physician practice patterns; and research on smoking cessation techniques.
Tags: Care Management, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Hospital, Medicare, Wellness and Prevention, Wireless
The Effects of HSAs
by Kevin Roche on Tuesday, March 8, 2011
High-deductible plans often have health savings accounts associated with them. New research looks at the effect of HSA-linked plans on utilization and spending, finding significant reductions, but concerns about use of preventive services.
Tags: Consumer Directed Health, Health Care Costs, Health Care Quality, Health Insurance
2011 Potpourri IX
by Kevin Roche on Friday, February 25, 2011
A positively presidential set of health care data points for your edification in today’s Potpourri, including examining correlations between hospital volume, quality and costs, improving quality program adherence, creating good insurance markets, the physician gender pay gap, the effects of the health reform law, and potential inconsistencies in HHS’ HIT incentive programs.
Tags: EHRs, Government, Health Care Quality, Health Care Reform, Health Insurance, HIT, HITECH, Hospital, Physicians
Health Status, Income and Use of Services in Canada
by Kevin Roche on Thursday, February 24, 2011
The leading reason advocates use for demanding universal coverage is that it will improve health and health outcomes for lower socioeconomic groups. New research from Canada indicates that this is not likely to be true.
Tags: Consumers, Health Care Costs, Health Care Reform, Health Insurance
Towers Watson Survey on Employee Engagement in Health
by Kevin Roche on Monday, February 21, 2011
A Towers Watson survey describes employee attitudes toward wellness programs and health engagement, with a surprising finding of declines in health as a priority and involvement in programs.
Tags: Consumer Directed Health, Consumers, Health Insurance, Wellness and Prevention
Age and Gender Differences in Health Spending
by Kevin Roche on Thursday, February 10, 2011
As would be expected, new research verifies that there are significant spending differences by age and by gender. The implications of this are unclear, particularly since the reform legislation limits how much insurance premiums can vary by these factors.
2011 Potpourri III
by Kevin Roche on Friday, January 14, 2011
Once more into the Potpourri breach, this week covering CBO’s scoring of a repeal of PPACA; a global wellness survey; Medicare’s failure to use its data to identify abusive providers; Canadians’ view of their health system; Walmart’s preventive care package; and use of electronic messages to improve cancer screening rates.
Tags: Health Care Reform, Health Insurance, HIT, Medicare, Physicians, Wellness and Prevention
Cost-Sharing and Outcomes
by Kevin Roche on Tuesday, January 11, 2011
Cost-sharing by consumers is an issue of the greatest importance in an era of increasing premium share, high deductibles, and coinsurance. A new report looks at the potential health consequences but is not without its biases.
More on Hospital Pricing
by Kevin Roche on Thursday, December 30, 2010
America’s Health Insurance Plans piles on hospitals in regard to their pricing, using data from Oregon and California. The analysis might be more persuasive if it weren’t coming from a trade association, but it is further evidence of a major source of health care cost increases.
Christmas Potpourri
by Kevin Roche on Friday, December 24, 2010
A very happy and relaxing Christmas Eve and Day to all our readers. To aid in the pursuit of that happiness and relaxation we offer up our scraps of enlightenment, this week covering EHR impact on productivity, e-prescribing systems, health insurance rate reviews, not-for-profit hospital executive compensation, Oregon’s state health plan and use of placebos to improve health.
Tags: Consumers, Drugs, Health Care Costs, Health Insurance, HIT, Hospital, Meaningful Use, Medicaid, Physicians
MGMA Survey on Payer Performance
by Kevin Roche on Monday, December 20, 2010
The Medical Group Management Association does an annual survey of how its members view various payers. In general, Medicare is viewed most favorably but its payment system is viewed as the worst and physicians want that system fixed.
Tags: Health Insurance, Physicians
EBRI Report on Consumer Engagement
by Kevin Roche on Tuesday, December 7, 2010
EBRI released results of its sixth annual survey on consumer engagement in health care, finding a steady increase in CDHP enrollment and continued trends of more cost-conscious and wellness-oriented behaviors among persons in those plans.
Turkey of a Potpourri
by Kevin Roche on Thursday, November 25, 2010
There you are, relaxing on a holiday and holiday weekend and for some reason you feel compelled to browse the internet and come across our Thanksgiving potpourri, hopefully not a turkey, but stuffed with edible data, including HHS’ final rule on MLRs; the AMAs survey on prior authorization; principles for ACOs, how to use research studies, Humana’s acquisition of Concentra and an explanation of why health care costs keep going up. Happy Thanksgiving!
Tags: Accountable Care Organization, Care Management, Health Care Costs, Health Insurance, HIT, M&A, MLR, Physicians, Workplace
2010 Potpourri XLII
by Kevin Roche on Saturday, November 20, 2010
Thanksgiving approaches and we are thankful for the continuing stream of news to fill our Potpourri, including the effect of malpractice liability on Illinois’ ability to retain physicians; the role of prices in health spending increases; comparative health and death rates in the US and England; employer health insurance costs; CBO review of a plan to reshape to Medicare; and end-of-life decision making.
Tags: Chronic Disease, Consumer Directed Health, Elder Care, Health Care Costs, Health Insurance, Malpractice, Medicare, Physicians
Characteristics of the Uninsured
by Kevin Roche on Tuesday, November 16, 2010
Concern about the growing number of uninsured Americans was one of the primary drivers of the health reform bill enacted earlier this year. Looking at the characteristics of the uninsured provides some interesting insights.
Tags: Health Insurance
TowersWatson Employee Survey
by Kevin Roche on Monday, November 15, 2010
A Towers Watson survey examined employees perspectives on their health plans. High cost sharing appears to be a major concern, but many employees are not taking proactive steps to help reduce those costs.
Tags: Consumers, Health Insurance
Cigna’s Report on High-Deductible Plans
by Kevin Roche on Friday, November 12, 2010
Cigna releases the latest of its annual reports on the experience of members in its high-deductible health insurance plans, finding that their medical costs continue to be lower in the first and following years, and they appear to receive as good or better medical care.
The Prevalence and Cost of Mandated Benefits
by Kevin Roche on Wednesday, November 3, 2010
The Council for Affordable Health Insurance puts out the latest in its series of reports on mandated benefits, looking at not just the number and type of mandates, but the incremental cost they add to insurance premiums; a cost which is ultimately borne by consumers.
2010 Potpourri XL
by Kevin Roche on Saturday, October 30, 2010
Is there anything scary about health care? Yes if you have to pay for it! Nothing scary about our Potpourri, just soothing health care nuggets, covering alternative therapies for back pain, CBO’s view on the reform law, peer interaction to help manage diabetes, diabetes prevalence, Massachusetts physician information, accountable care organizations, bias in clinical trial results and the effects of the health law on employer provided insurance.
Tags: Accountable Care Organization, Care Management, Chronic Disease, Disease Management, Health Care Costs, Health Care Reform, Health Insurance, Medical Care, Physicians, Workplace
2010 Potpourri XXXIX
by Kevin Roche on Saturday, October 23, 2010
The leaves disappear from the trees but our Potpourri is eternal, this week entertaining you on projected drug spending next year, prescription abandonment rates, avoiding hospitalizations for home care patients, anticipating the effects of the health law on employer-provided health insurance, the NAIC’s final action on the MLR and hospitals views on their ability to achieve the meaningful use incentives.
Tags: Care Management, Drugs, Health Care Reform, Health Insurance, HIT
2010 Potpourri XXXVII
by Kevin Roche on Saturday, October 9, 2010
The regular weekend lineup of health care news, including doctors trying to limit nurse anesthetists’ practices; text messaging for teenager dermatitis patients; Hewitt’s cost projections for 2011; physicians and the internet; how to calculate MLRs and use of incentive pay for physicians.
Tags: Health Care Quality, Health Insurance, Physicians, Regulation, Telemedicine
Kaiser Health Insurance Survey
by Kevin Roche on Tuesday, September 14, 2010
The Kaiser Foundation released results of its annual survey of health insurance costs among companies providing health benefits to workers. The most prominent finding is the continued shift of cost to employees.
Tags: Health Insurance, Workplace
CDHP Study by GAO
by Kevin Roche on Thursday, September 9, 2010
Fears have been expressed that increasing CDHP enrollment puts people at risk for skipping necessary health services. The GAO looked at this population and found healthier people enrolled and they spent less after enrollment than non-CDHP members.
Tags: Consumer Directed Health, Health Care Costs, Health Care Quality, Health Insurance
The Great MLR Calculation Debate
by Kevin Roche on Tuesday, August 31, 2010
The new health law attempts to dictate how much of insurance premiums insurers must spend on medical care, so of course there is now extensive haggling on defining the calculation. The NAIC has released its version, which now goes to HHS for review.
Employer Health Plan Changes for 2011
by Kevin Roche on Friday, August 27, 2010
Everyone is anxious to see the early effects of the reform law on health care costs. Another survey of large employer groups regarding their 2010 and 2011 expectations indicates that those costs are continuing to go up, probably at a faster pace.
State Variations in Health Insurance Costs
by Kevin Roche on Wednesday, August 18, 2010
AHRQ released a statistical brief looking at state differences in the cost of employment-based health insurance and how much of that cost is borne by employees. Follow-up research to understand factors contributing to the variation would be interesting.
Consumer-Directed Health Plans
by Kevin Roche on Tuesday, August 10, 2010
An EBRI report summarizes what seems to be known to date about the effects of consumer-directed health plans and provides statistics on their use. One clear conclusion is the need for more and better research.
2010 Potpourri XXVIII
by Kevin Roche on Saturday, August 7, 2010
Summer begins to wane, but not our Potpourris. Another one full of useful data, including health insurance costs for 2011, a new telehealth joint venture, use of kiosks in physician offices, prostate cancer screening, health care use cutbacks, teledermatology and sharing of physician notes with patients.
Tags: Consumers, Health Care Costs, Health Insurance, Monitoring, Physicians, Telemedicine, Wellness and Prevention
2010 Potpourri XXVI
by Kevin Roche on Saturday, July 24, 2010
More midsummer musings, covering possible replacements for AWP, the effect of Part D on heart failure drug use, the VA’s telehealth programs, venture capital activity, self-management of high blood pressure, and of course, more problems with health insurance costs in Massachusetts.
Tags: Drugs, Financings, Health Care Reform, Health Insurance, Telemedicine
Preventive Care Regulations
by Kevin Roche on Monday, July 19, 2010
HHS has issued its draft regulation on what preventive services health plans must cover without cost-sharing by the patient. Someone, of course, has to pay for all these “free” services, and it usually is the consumer.
Rhode Island Insurance Rates
by Kevin Roche on Tuesday, July 13, 2010
Struggling with the continuing rise in health insurance premiums, Rhode Island’s Insurance Commissioner takes some creative steps to attempt to slow the rise of hospital costs, which are a major contributor to the premium increases.
Fireworks Potpourri
by Kevin Roche on Saturday, July 3, 2010
We light up the sky with a scintillating selection of health care bombshells. Okay, maybe not that great, but some hopefully useful info on the VA’s health information system, MRIs and emergency cardiac care, business method and process patents, end-of-life care, actuaries’ views on how to control costs and, of course, more issues in Massachusetts.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Medical Care
Services With Increasing Costs
by Kevin Roche on Wednesday, June 30, 2010
Where does all that health spending go and what areas are incurring some of the largest increases? An AHRQ statistical brief looks at hospital costs from 2001 and 2007 and identifies the ten fastest growing diagnoses by cost in that period.
2010 Potpourri XXIII
by Kevin Roche on Saturday, June 26, 2010
Once more into the breach with the Saturday health care roundup, including medication adherence, monitoring patients’ health status in their homes, Massachusetts’ reform update and insurance costs, hospitals’ economic contribution, hospital cost shifting and consumers’ views on use of health IT.
Tags: Drugs, Health Care Costs, Health Care Reform, Health Insurance, HIT, HomeCare, Hospital, Monitoring, Telemedicine
AMA Rates Health Plans
by Kevin Roche on Thursday, June 24, 2010
The American Medical Association does an annual survey of claims processing and payment practices by large health plans. The AMA’s interpretation of the results needs to be taken with a grain of salt, given the definitions they use for appropriate payment.
Tags: Health Insurance, Physicians
PWC Report on Employer Health Costs
by Kevin Roche on Tuesday, June 22, 2010
PriceWaterhouseCooper has a Health Research Institute which periodically looks at medical cost trends. Consistent with other recent publications, PWC believes that costs are continuing to increase at a rate well above that of inflation or GDP growth.
2010 Potpourri XXII
by Kevin Roche on Saturday, June 19, 2010
Another weekend bonanza of health care items, including health insurance premium increases, genetic testing, remote patient monitoring, eye drug coverage by Medicare, emergency room use under the reform law and paying people to take their medicine.
Tags: Drugs, FDA, Health Insurance, Medical Care, Personalized Medicine, Telemedicine
Reform Law Will Force Most Employers To Change Their Health Plan
by Kevin Roche on Wednesday, June 16, 2010
The Administration has been caught again in how misleading its arguments in favor of the “reform” law were; this time in regard to how many employer-sponsored health plans will have to change as a result of the bill.
Retainer Services for Uninsured Persons
by Kevin Roche on Tuesday, June 15, 2010
Physicians are experimenting with retainer-like payments for uninsured patients. It appears that this may be attractive to many uninsured persons and may allow physicians to accrue more revenue than they do for a Medicaid patient.
Tags: Health Insurance, Physicians
Milliman Releases 2009 Health Cost Index
by Kevin Roche on Monday, June 14, 2010
Milliman issued its annual look at health care costs for a family of four, including employer payments and out-of-pocket. Costs continue to rise well-above the rate of inflation or GDP growth.
2010 Potpourri XXI
by Kevin Roche on Saturday, June 12, 2010
Another potpourri of health care items, including telemedicine, mergers and acquisitions, unnecessary medical care, Massachusetts struggle with health insurance rates and health costs, e-visits, and a different suggestion for reforming the system.
Tags: Health Care Reform, Health Insurance, HIT, M&A, Telemedicine
2010 Potpourri XX
by Kevin Roche on Saturday, June 5, 2010
More health care nuggets for the weekend, including personalized medicine, health reform, health insurance premiums, telemedicine, and community health centers.
Tags: Health Care Reform, Health Insurance, HIT, Medicaid, Medical Care, Personalized Medicine, Telemedicine
2010 Potpourri XIX
by Kevin Roche on Saturday, May 29, 2010
Summer is starting and you are just laying around at the beach or the lake, eager to get a few missed health care tidbits. Here they are! Telemedicine, health reform, employer provided health insurance, computers providing health care and a nice merger.
Tags: aquisitions, Health Care Quality, Health Care Reform, Health Insurance, HIT, Telemedicine
Who Uses the Emergency Room
by Kevin Roche on Wednesday, May 26, 2010
One alleged benefit of health reform would be less use of the emergency room by uninsured persons who had no other way to access care. A recent report from the CDC suggests that notion may have been a myth.
Tags: Health Insurance, Medical Care
2010 Potpourri XVII
by Kevin Roche on Saturday, May 15, 2010
Here we go again. The CBO now estimates that the health bill has a number of discretionary spending items in it which will likely add over $100 billion to the costs of the act. (CBO Letter) It is really interesting how a few weeks after the law is enacted, the government suddenly finds several new [...]
Tags: Health Care Reform, Health Insurance, Medical Care, Telemedicine
Group Health’s Medical Home Experience To Date
by Kevin Roche on Thursday, May 13, 2010
The patient-centered medical home is yet another highly touted solutions to health system problems. Several pilot programs of the concept have been underway. Health Affairs reports on the Group Health experience.
Tags: Health Insurance, Medical Care, Physicians
Hospital Charges to the Uninsured
by Kevin Roche on Monday, May 10, 2010
The plight of the uninsured was used as one justification for reform. AHRQ has put out a report on trends in hospitalizations for the uninsured over the last ten years, which highlights some interesting facts.
Tags: Health Insurance, Hospital
2010 Potpourri XV
by Kevin Roche on Saturday, May 1, 2010
The latest in our weekend selection of health news and research developments, including any willing provider laws, emergency room visits, the link between insurance and health outcomes, hospital rankings and rising insurance premiums.
Tags: Health Insurance, Hospital, Medical Care, Providers
Employer Reactions to Health Reform
by Kevin Roche on Monday, April 26, 2010
The new national health law poses a number of challenges for employers in regard to the health benefits they offer to their employees. A poll published in Business of Insurance gives some early insight into companies’ initial reaction to the new law.
2010 Potpourri XIV
by Kevin Roche on Saturday, April 24, 2010
Another thrilling collection of health care tidbits; including patient safety, malpractice claims, physician discipline, hospital costs and charges, venture financings, employer health costs and who makes good liars.
Tags: Financings, Health Insurance, Hospital, Malpractice, Physicians
Employee Benefit Trends
by Kevin Roche on Friday, April 16, 2010
MetLife publishes its annual Study of Employee Benefits Trends, revealing that employers are concerned with cost control and employee retention and workers value their benefits and are particularly concerned about retirement.
Tags: Consumers, Health Insurance, Workplace
2010 Potpourri XII
by Kevin Roche on Saturday, April 10, 2010
The latest collection of health care tidbits, including telemedicine, physician attitudes, medication adherence, retail clinics, physician value to hospitals and CDHPs.
Tags: Consumer Directed Health, Drugs, Health Insurance, Hospital, Physicians, Telemedicine
What! Massachusetts Again? Yep, With a Side of Maine and New York
by Kevin Roche on Friday, April 9, 2010
States that supposedly led the way on health care reform are finding out it was the bleeding edge that they were on. Insurers are always the easy target, but bashing them won’t solve the underlying cost problem. If the federal bill actually is implemented, the experience of these states will likely be replicated nationally.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance
2010 Potpourri XI
by Kevin Roche on Saturday, April 3, 2010
This week’s collection includes obesity, clinical trials results, how hospitals make money from physicians, strategic implications of reform, what reform is likely to do to young people’s insurance premiums and patents on genes. Enjoy!
Tags: Consumers, Health Care Reform, Health Insurance, Hospital, Physicians
2010 Potpourri IX
by Kevin Roche on Saturday, March 13, 2010
One more sampling of health care news, covering provider reaction to the EHR meaningful use rule, telemedicine, people’s perceptions of their health status and insurance coverage and hospital costs and prices.
Tags: Health Care Costs, Health Insurance, HIT, Hospital
EBRI Workshop on Employment-based Health Benefits
by Kevin Roche on Wednesday, March 3, 2010
EBRI held a workshop on the future of employment-based health benefits, bringing together experts from disparate constituencies to discuss the topic. As expected, there was significant disagreement about reform possibilities and what might happen in the absence of reform.
Tags: Health Insurance, Workplace
2010 Potpourri VII
by Kevin Roche on Saturday, February 27, 2010
The latest in our regular amalgamation of health care news items, including telehealth, how many people really die from not having health insurance, silent PPOs, progress in automating claims processing and more on individual insurance policy price hikes.
Tags: Health Care Costs, Health Care Reform, Health Insurance, Telemedicine
Competition Leads to Lower Hospital Costs
by Kevin Roche on Friday, February 26, 2010
Research indicates that commercial health insurance, while it has geographic variation in spending, does not vary in the same way as Medicare. A primary factor explaining private health plan geographic spending variation appears to be the state of competition for hospital services in different locales.
Tags: Health Care Costs, Health Insurance, Hospital, Medicare
Individual Premium Increase Brouhaha
by Kevin Roche on Monday, February 22, 2010
Health plans are receiving a lot of negative publicity regarding individual policy price increases. This development, however, should have been entirely expected in light of the recession and typical consumer behavior when not required to buy a product. That won’t stop politicians from trying to demagogue the issue.
Tags: Health Insurance
2010 Potpourri VI
by Kevin Roche on Saturday, February 20, 2010
Select from this menu of topics on health improvement incentives, genetic testing for cancer treatment, health plan collaboration on use of IT for administration, value-based insurance design and comparative effectiveness research.
Tags: Comparative Effectiveness, Health Insurance, HIT, Personalized Medicine
Value-Based Insurance Plan Design
by Kevin Roche on Thursday, February 4, 2010
Value-based insurance design attempts to use cost-sharing to maximize use of health services that lead to good health outcomes. Two recent analyses demonstrate that cost-sharing features of health care coverage can lead to good and bad outcomes.
Tags: Health Insurance, Incentives
Employers’ Views of Health Insurers
by Kevin Roche on Friday, January 22, 2010
PriceWaterhouseCoopers releases a survey on large and small employers’ perspective on their health insurers. The results show increasing dissatisfaction along several dimensions, with minor improvement on only one or two. Large employers are generally more satisfied than smaller ones.
Tags: Health Insurance
2010 Potpourri I
by Kevin Roche on Saturday, January 9, 2010
The tort lawyer lobby errand boys in Congress just don’t know when to stop. Even after Senator Rockefeller got his hand slapped for questioning CBOs analysis of potential savings from tort reform, Congressman Bruce Baley decided to go back for more. And sure enough, CBO gave him an even more detailed justification of the savings [...]
Tags: Health Care Costs, Health Insurance, Malpractice, Medicare, Personalized Medicine, Telemedicine
Potpourri VII
by Kevin Roche on Saturday, December 12, 2009
Mercer surveyed employers to ascertain their reaction to the proposed tax on high value insurance coverage. The majority said they would reduce benefits to avoid the tax. Seven percent said they would outright terminate insurance coverage. Of those saying they would reduce benefits, most would do so by raising deductibles and copays. Employers also narrowly [...]
Tags: Drugs, Health Care Reform, Health Insurance, Medical Care, Pay For Performance, Telemedicine
Reform Impact on Premiums
by Kevin Roche on Thursday, December 10, 2009
Two groups have put out statements suggesting that the CBO is underestimating the effect of the Senate reform bill on private health insurance premiums, probably by quite a bit. The relatively weak penalty for not having health insurance is likely to cause significant adverse selection among those who choose to buy rather than pay the penalty.
Does Insuring People Before Age 65 Save Money
by Kevin Roche on Tuesday, December 8, 2009
A study suggests that insuring currently uninsured adults could save Medicare money. Overall health spending, however, would clearly go up substantially and even the amounts Medicare might save are in doubt.
Tags: Health Insurance, Medicare
CBO Discusses Senate Bill Effect on Premiums
by Kevin Roche on Tuesday, December 1, 2009
The CBO estimates that the Senate reform bill will raise individual premiums by ten percent, although that will be offset by subsidies for many individuals. Overall the CBO finds group premiums would likely decline very slightly.
Thanksgiving Potpourri
by Kevin Roche on Thursday, November 26, 2009
No turkeys here, just stuffing you will relish. Don’t cramvery much into your brain at once!
Tags: Drugs, Health Insurance, Telemedicine, Wellness and Prevention
Weekend Potpourri IV
by Kevin Roche on Saturday, November 14, 2009
Another dose of weekend tidbits, covering PAP screenings, health insurer consolidation, Part D plan satisfaction, Rand’s look at the best methods to reduce health care costs, geographic variations in health spending and coughing into cell phones–yes you heard me right.
Tags: Drugs, Guidelines, Health Insurance, Medical Care, Medicare, Pay For Performance
Another Massachusetts Update
by Kevin Roche on Tuesday, October 20, 2009
The latest survey on the impact of reform in Massachusetts indicates that employers are continuing to offer good coverage, but costs, especially to small firms and their employees, are going up.
AHIP-Sponsored Report on Baucus Bill Impact on Premiums
by Kevin Roche on Thursday, October 15, 2009
AHIP commissioned PriceWaterhouseCoopers to do an analysis of the Baucus bill’s impact on insurance premiums. The report, which has been strongly attacked by reform proponents, concludes that the weak individual mandate and light penalties will drive costs higher; costs which will be borne by consumers and employers through higher insurance premiums.
More News on Medicare Advantage’s Advantages
by Kevin Roche on Friday, October 2, 2009
Another study demonstrates quality performance and better cost benefits from Medicare Advantage plans.
Tags: Care Management, Government, Health Insurance, Medicare
The Advantage of Medicare Advantage
by Kevin Roche on Friday, September 25, 2009
AHIP presents evidence on the value of Medicare Advantage plans in delivering more efficient and effective care.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Hospital
Counting the Uninsured
by Kevin Roche on Wednesday, September 23, 2009
Whoops! We may not be counting the uninsured correctly.
More Evidence of Continuing Cost Increases
by Kevin Roche on Tuesday, August 25, 2009
Aon has estimated that private insurers health costs will increase at over 10% next year.
AHIP Survey Illustrates Physician Fee Issues
by Kevin Roche on Wednesday, August 12, 2009
Insurers have been under sharp attack for causing many of the problems reform is designed to address. One response has been to shift the responsibility for these problems to other components of the health system; in this case physicians’ fees.
Tags: Health Care Costs, Health Insurance, Physicians, Providers
CBO Examines Health Insurance/Labor Market Relationship
by Kevin Roche on Monday, August 10, 2009
The Congressional Budget Office has another useful report looking at the impacts of changes in health insurance on employment.
Tags: Employers, Health Insurance
Large Insurers 2d Quarter Results
by Kevin Roche on Tuesday, August 4, 2009
The three largest health insurers have reported second quarter results.
Tags: Health Insurance, Payor
UHG, Cisco Plan TeleHealth Venture
by Kevin Roche on Tuesday, July 21, 2009
UnitedHealth Group and Cisco plan to create a large telemedicine venture.
Tags: Health Insurance, HIT, Telemedicine
Fraud and Abuse–Are We Doing Enough to Stop It?
by Kevin Roche on Wednesday, July 15, 2009
One of the most commonly identified areas for health cost savings is fraud and abuse, but has enough effort been devoted to stopping the practices?
Comparative Effectiveness Updates
by Kevin Roche on Thursday, July 9, 2009
A number of reports and commentaries have recently been issued on comparative effectiveness research.
Tags: Comparative Effectiveness, Government, Health Care Reform, Health Insurance
CDH Looks Pretty Good So Far
by Kevin Roche on Wednesday, July 8, 2009
An actuaries organization gives a favorable reading to consumer-directed health plan results.
UnitedHealth Proposes Administrative Cost Savings
by Kevin Roche on Wednesday, July 8, 2009
A new UnitedHealth Group report identifies $332 billion over ten years in administrative cost savings.
Tags: Administrative Costs, Government, Health Care Costs, Health Care Reform, Health Insurance
Physician Practice Administrative Costs
by Kevin Roche on Tuesday, July 7, 2009
A Health Affairs article reports a survey on the time and expense involved in physician interaction with health plans.
Tags: Administrative Costs, Health Insurance, Medical Care, Payor
Health Plan Medical Expenses Keep Rising
by Kevin Roche on Tuesday, July 7, 2009
A consulting firm study indicates that medical expenses for commercial health plans continue to rise at a rate far above inflation.
Tags: Health Care Costs, Health Insurance, Payor
Telemedicine Utility and Barriers
by Kevin Roche on Thursday, July 2, 2009
Experts are recommending greater use of telemedicine in stroke assessment and treatment. There are significant barriers, however, many imposed by government.
Tags: Care Management, Health Insurance, Medical Care, Telemedicine
Cancer Drugs Illustrate Cost Conundrum
by Kevin Roche on Wednesday, July 1, 2009
Expensive cancer drugs may not enhance outcomes for many people, raising questions about covering their use.
Tags: Health Insurance
Study Looks At Part D Impact on Drug and Medical Spending
by Kevin Roche on Tuesday, June 30, 2009
A study reported in the current issue of NEJM indicates that enrollment in Part D significantly increased drug spending for those persons who previously had no or a low level of drug coverage, but also led to a lower level of medical spending.
Tags: Health Care Costs, Health Insurance, Medicare, Pharmaceutical
Another Massachusetts Warning
by Kevin Roche on Tuesday, June 30, 2009
Massachusetts residents are not thrilled with their health care reform, according to a Rasmussen poll.
Maybe We Should Focus on Cost Control First
by Kevin Roche on Wednesday, June 24, 2009
Reality appears to have hit the health reform train head-on in the form of the costs of expanding coverage. Maybe we should focus on getting costs under control and then coverage extensions would be affordable.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Legislation
Shared Decision Making
by Kevin Roche on Tuesday, June 23, 2009
Shared decision-making for preference-sensitive conditions has the potential to improve quality and control spending. States are exploring required use of the technique and it should be considered in federal reform efforts.
Tags: Care Management, Consumers, Health Care Costs, Health Care Quality, Health Insurance
More Required Reading from the CBO
by Kevin Roche on Monday, June 22, 2009
The CBO’s June 16th letter to Senator Conrad is an excellent summary of health reform and cost control ideas and implementation issues.
Tags: CBO, Comparative Effectiveness, Government, Health Care Costs, Health Care Reform, Health Insurance
CBO Opines on Industry Cost-Saving Suggestions
by Kevin Roche on Thursday, June 18, 2009
Congressional Budget Office has responded briefly to the proposals by several health industry segments to create cost savings of up to two trillion dollars over ten years.
Tags: CBO, Government, Health Care Reform, Health Insurance
CBO’s Initial Reaction To Kennedy Plan
by Kevin Roche on Thursday, June 18, 2009
The Congressional Budget Office’s initial assessment of Senator Kennedy’s Affordable health Choices Act is that it would increase deficits by about one trillion dollars over the next ten years, but only increase the number of covered citizens by about a net 16 million people.
Tags: CBO, Government, Health Care Reform, Health Insurance, Uninsured
Once Again, Health Care Change is Hard
by Kevin Roche on Thursday, June 18, 2009
Many unions and some disease advocacy groups are objecting to the wellness and prevention provisions proposed in some health reform measures. In a USA Today article, the difficulties of our “system” once again point out the impediments to improvement.
Tags: Consumers, Health Insurance, Incentives, Wellness and Prevention
Safeway’s Health Care Prescription
by Kevin Roche on Monday, June 15, 2009
Safeway Inc. has received a great deal attention around its health care plan and apparent cost savings. The essence of the plan is putting employees and their dependents directly at financial risk for improvements in certain key health-related behaviors.
Public Plan Option Discussion Heats Up
by Kevin Roche on Friday, June 12, 2009
One of the controversial provisions in some health care reform proposals has been creation of a public plan, often analogized to Medicare, which would be an option offered alongside private insurance plans.
Tags: AMA, Government, Health Care Reform, Health Insurance, Payor
Cost Saving Suggestions
by Kevin Roche on Tuesday, June 9, 2009
Several prominent health industry segments have issued a follow-up statement identifying more specifically where they believe health care cost savings can be achieved.
Tags: AdvaMed, AHA, AMA, Government, Health Insurance, Medical Care, PhRMA
Who Does and Would Pay for the Uninsured?
by Kevin Roche on Tuesday, June 2, 2009
A not-for-profit group that has been a vigorous proponent of health care reform has released a report, Hidden Health Tax, on the costs of the uninsured and who ultimately bears that cost.
Tags: Cost Shifting, Government, Health Insurance, Uninsured
Another Massachusetts Update
by Kevin Roche on Monday, June 1, 2009
Massachusetts has become such a bellweather for health reform that every report analyzing the program’s outcomes is eagerly anticipated. Health Affairs, vol. 28, page w578 (May 2009), looks at some of the results as of the fall of 2008.
Large Health Plan Companies Weigh In on Health Reform
by Kevin Roche on Friday, May 29, 2009
Several of the country’s largest health plans have recently issued reports or statements relating to health care reform. While the source needs to be considered in reading any discussion of health reform, these plans do have a significant body of experience regarding coverage, cost and quality issues and they retain formidable lobbying weight.
Tags: Health Care Reform, Health Insurance, Payor
More Coverage = More Physician Visits = Less Cost?
by Kevin Roche on Thursday, May 21, 2009
A recent story in the Boston Globe raises intriguing questions about the effect of health coverage expansions on physician visits and other services and consequently, costs.
EEOC Working Hard to Help Improve Health and Control Costs—Not
by Kevin Roche on Thursday, May 21, 2009
In informal responses to inquiries about the use of health risk assessments and wellness incentives, the Equal Employment Opportunity Commission has indicated that it will use the Americans with Disabilities Act and its general powers to limit the ability of employers to enact programs designed to improve the health of employee populations and control health care costs.
Tags: Government, Health Insurance, HRAs, Incentives
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President Barack Obama is pushing to speed up insurance coverage for young adults in their twenties
Health insurers are girding for a fight over who should regulate the new the health-care exchanges