Friday
Feb232018

The State of the Uninsured and Health Insurance Coverage

The State of the Uninsured and Health Insurance Coverage
 

by Clive Riddle, February 23, 2018

 

The National Center for Health Statistics has just released updated health insurance coverage estimates from selected states using 2017 National Health Interview Survey data.  Here are seven things to know about their findings for the first 9 months of 2017:

 

1.     28.9 million (9.0%) persons of all ages were uninsured, not significantly different from 2016, but 19.7 million fewer persons than in 2010.

2.     12.7% of adults aged 18–64, were uninsured, 19.5% had public coverage, and 69.3% had private health insurance coverage.

3.     4.4%  of adults aged 18–64 (8.6 million) covered by private health insurance plans obtained their coverage through the federal or state-based exchanges.

4.     Adults aged 25–34 were almost twice as likely as adults aged 45–64 to lack health insurance coverage (17.3% compared with 9.2%)

5.     4.9%  of children aged 0–17 years, were uninsured, 41.9% had public coverage, and 54.6% had private health insurance coverage.

6.     The percentage uninsured decreased significantly for all age groups from 2013 through the first 9 months of 2017, ranging from –6.2 percentage points for ages 45–64 to –10.7 percentage points for ages 18–24.

7.     43.2% of persons under age 65 with private health insurance were enrolled in a high-deductible health plan (HDHP) compared to 39.4% in 2016

 

However, as a warning sign that 2018 may see slippage in these insurance coverage, the Minnesota Department of Health just issued an ominous press release, indicating that “last year Minnesota saw one of its largest, one-time increases in the rate of people without health insurance since 2001. The uninsured rate rose from 4.3 percent in 2015 to 6.3 percent, leaving approximately 349,000 Minnesotans without coverage.”
 
Friday
Feb232018

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition
 

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Ten ERs In Colorado Tried To Curtail Opioids And Did Better Than Expected

One of the most common reasons patients head to an emergency room is pain. In response, doctors may try something simple at first, like ibuprofen or acetaminophen. If that wasn’t effective, the second line of defense has been the big guns.

Kaiser Health News

Friday, February 23, 2018

Evaluations Of Medicaid Experiments By States, CMS Are Weak, GAO Says

With federal spending on Medicaid experiments soaring in recent years, a congressional watchdog said state and federal governments fail to adequately evaluate if the efforts improve care and save money.

Kaiser Health News

Friday, February 23, 2018

HHS deletes budget request for $11.5 billion in risk-corridor funding

The HHS walked back a request for more than $11.5 billion to fund the Affordable Care Act's risk-corridor program after health insurers suing for those payments said the budget item strengthened their cases.

Modern Healthcare

Thursday, February 22, 2018

Advocacy groups say better data sharing, consistent privacy laws will help control opioid prescribing

A wide array of technology can help limit the impact of the opioid epidemic, according to the College of Healthcare Information Management Executives (CHIME), but only if certain policy changes address long-standing concerns like patient matching and telehealth reimbursement.

Fierce Healthcare

Wednesday, February 21, 2018

Trump proposal boosts skimpy insurance plans, again undercutting Obamacare

The Trump administration is proposing to expand the availability of short-term health insurance plans that some deride as “junk insurance” — an effort that could give consumers cheaper coverage options but undermine Obamacare's marketplaces and popular protections for pre-existing medical conditions.

Politico

Tuesday, February 20, 2018

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 
Friday
Feb162018

It's About Time

It's About Time
 

By Kim Bellard, February 16, 2018

 

Chances are, the sun isn't directly overhead for you when it is for me.  That's why for most of human existence time was a local matter.

Nowadays, we have time zones that span the globe, and we have clocks so accurate that satellites have to 
take into account relativistic time-dilation effects. Technology made the change possible, and necessary. 

Health care should learn from this.

 

It used to be that local time was good enough.  The village clock served your purposes.  It was the railroads that made this impractical.  People wanted to know when trains would arrive, and when they'd leave.  More importantly, if they weren't coordinated, trains traveling in different directions might -- and did -- run into each other.

We treat health care much like we used to treat time. That is, it is largely local.  How it is practiced in one community may not be how it is practiced in the next community, or even the next hospital or physician practice within a community. . 

The care you get will depend on, of course, what is wrong with you, but also on 
which physician you see.  Very few dispute that there is significant variation in care, or that it is probably bigger than it should be.  But there's not much evidence that it is getting any less. 

We accept these variations because, well, that's how it has always been.  We accept them because we think our personal situation is unique.  We accept them because we trust our local experts.   

We accept them for all the same reasons we used to accept that time should be local. Technology has made it both necessary and possible that we move away from this attitude.

It is necessary because the scope of the problem is clear.  As Propublica put it in a 
recent expose of unnecessary procedures: "Wasted spending isn’t hard to find once researchers — and reporters — look for it." 

 

Almost twenty years ago the Institute of Medicine estimated as many as 98,000 hospital deaths annually due to medical errors.   More recently, medical errors have been estimated to be the third leading cause of death in the U.S. 

Yes, moving away from "local" health care is necessary.

The good news is that it is possible.  We have the technology to consult with physicians who don't happen to be local, such as through telemedicine.  It is possible to get the "best" doctor for our needs, not just the closest. We have artificial intelligence that can analyze all that data plus all those medical studies that no human can possibly keep up with.  It is possible to come up with the "right" recommendations for us.   

We have to stop thinking of health care as local.  The information it is based on is not.  The people who are best able to apply that information to our situation may not be.

If I get a driver's license, I don't have to get another one when I drive to another state.  If I get on a plane, the pilot doesn't have to have a pilot's license from each state he/she lands in, or flies over.  But if I want to use a doctor who is in a different state (or country), that doctor needs a license from my state.    

We've always justified such licensing by states wanting to ensure the safety of their citizens, but drivers and pilots can put those citizens at risk too.  It's not really about risk; it's 
more about controlling competition

There is irrefutable evidence that local health care is rarely what is going to be best.  It might not be bad care, but most likely it's only going to be average. 

Maybe we're willing to settle for that.  I'm not.

Time for a change.

 

This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting

 
Friday
Feb162018

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Trump health chief supports CDC research on gun violence

Secretary of Health and Human Services Alex Azar said Thursday that he would allow his department to conduct research into the causes of gun violence, a major Democratic priority.

The Hill

Friday, February 16, 2018

HHS May Nix Reporting Requirements for Value-Based Care Program, Azar Says

Health and Human Services Secretary Alex Azar told the Senate Finance Committee Thursday that he wants to reduce or possibly eliminate reporting requirements for physicians to participate in the Merit-based Incentive Payment System, also known as MIPS.

Morning Consult

Thursday, February 15, 2018

US spending on health care estimated to reach $5.7 trillion in 2026

Spending on health care in the U.S. will grow faster than the overall economy for the foreseeable future, according to a government report released Wednesday.

The Hill

Wednesday, February 14, 2018

Idaho Blue Cross Jumps Into Controversial Market For Plans That Bypass ACA Rules

It’s barely been two weeks since Idaho regulators said they would allow the sale of health insurance that does not meet all of the Affordable Care Act’s requirements — a controversial step some experts said would likely draw legal scrutiny and, potentially, federal fines for any insurer that jumped in.

Kaiser Health News

Wednesday, February 14, 2018

Cost Of U.S. Opioid Epidemic Since 2001 Is $1 Trillion And Climbing

The opioid epidemic has cost the U.S. more than a trillion dollars since 2001, according to a new study, and may exceed another $500 billion over the next three years.

NPR

Tuesday, February 13, 2018

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday
Feb092018

Employees Feel Their Own Health Plan is Better Than Most Others

Employees Feel Their Own Health Plan is Better Than Most Others
 

By Clive Riddle, February 9, 2018

Surveys have consistently shown over the years that the public generally ranks Congress low in esteem, but their personal Congressman is held in higher regard. Health Plans, like Congress, have been a favorite target as well, but similarly – people tend to like their personal coverage more than how they view health plans overall.

AHIP has just released a 42-page report of findings from their national survey “The Value of Employer Provided Coverage” that not only reinforces this phenomenon – in which respondents rank their own plan higher than their overall view how health care is covered, but also makes the case that consumers place employer provided coverage in higher regard than the nation’s health coverage system as a whole. On top of that, there is perhaps less angst about the nation’s health insurance system overall than one might have thought.

63% were satisfied with the nation's current health insurance system, and 31% were dissatisfied. 71% were satisfied with their own health plan, and 19% were dissatisfied. 60% felt their personal cost was reasonable and 29% felt the cost was unreasonable, while 66% felt the cost was unreasonable for Americans as a whole. 52% described their deductible as reasonable, while 36% said it was unreasonable. However, for those dissatisfied with their plans, 82% cited costs as the main reason.

72% say they are adequately informed about health insurance benefits under their plan, yet only 20% understand that employers average paying above 75% of the total costs.

In other findings from the survey:

·         71% remain concerned the cost of health care will continue to rise

·         56% prioritize comprehensive benefits while 41% prioritize affordability of plans.

·         46%said health insurance was a deciding factor in choosing their current job

·         56% support keeping employer provided coverage tax free, and 13% oppose

·         58% prefer increased market competition while 42% support increased government involvement to address costs

·         Prescription drug coverage (51%), preventive care (47%), and emergency care (47%) rank among the benefits that matter most.