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.
Tags: Health Care Costs, Health Insurance, Regulation
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.
Tags: Health Care Costs, Health Insurance, Workplace
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.
Tags: Health Care Costs, Health Insurance
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.
Tags: Consumer Directed Health, Health Insurance
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
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
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.
Tags: Government, Health Insurance, Wellness and Prevention
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.
Tags: Health Care Costs, Health Insurance
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
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.
Tags: Health Care Costs, Health Insurance, Hospital
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
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
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.
Tags: Health Care Costs, Health Insurance
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
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.
Tags: Health Care Reform, Health Insurance
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
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.
Tags: Health Care Costs, Health Insurance
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
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
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
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
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
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
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
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
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.
Tags: Health Care Reform, Health Insurance, Workplace
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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.
Tags: Health Care Reform, Health Insurance
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
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.
Tags: Health Care Reform, Health Insurance
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
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
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.
Tags: Government, Health Care Reform, Health Insurance
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.
Tags: Government, Health Care Reform, Health Insurance
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
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
by Kevin Roche on Wednesday, September 23, 2009
Whoops! We may not be counting the uninsured correctly.
Tags: Health Care Reform, Health Insurance, Uninsured
by Kevin Roche on Tuesday, August 25, 2009
Aon has estimated that private insurers health costs will increase at over 10% next year.
Tags: Health Care Costs, Health Insurance
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
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
by Kevin Roche on Tuesday, August 4, 2009
The three largest health insurers have reported second quarter results.
Tags: Health Insurance, Payor
by Kevin Roche on Tuesday, July 21, 2009
UnitedHealth Group and Cisco plan to create a large telemedicine venture.
Tags: Health Insurance, HIT, Telemedicine
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?
Tags: Health Care Costs, Health Insurance
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
by Kevin Roche on Wednesday, July 8, 2009
An actuaries organization gives a favorable reading to consumer-directed health plan results.
Tags: Consumer Directed Health, Health Insurance, Payor
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
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
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
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
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
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
by Kevin Roche on Tuesday, June 30, 2009
Massachusetts residents are not thrilled with their health care reform, according to a Rasmussen poll.
Tags: Health Care Reform, Health Insurance
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
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
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
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
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
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
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.
Tags: Health Insurance, Incentives, Wellness and Prevention
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
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
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
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.
Tags: Government, Health Care Reform, Health Insurance
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
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.
Tags: Health Care Costs, Health Insurance, Medical Care
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