Friday
Mar102017

Your Seven Step Homework Guide for Studying the American Health Care Act

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 By Clive Riddle, March 10, 2017

 

1.       Don’t sweat all the granular details yet. Who knows for certain where the political process will take this proposed Act from here?
 

2.       Watch for the CBO “score” on the Act, which will soon peg estimated cost and volume numbers to what’s being proposed. The CBO score will likely shape discussions from that point forward. The portal for CBO healthcare analysis is www.cbo.gov/topics/health-care.  Here’s two articles about the upcoming CBO score:  Obamacare replacement is hard to score, budget experts say (Washington Examiner) and Nonpartisan Scorekeeper in Hot Seat for GOP’s Obamacare Repeal (Bloomberg).
 

3.       Keep some original sources handy – including a summary from the House’s Energy and Commerce Committee and the s Ways and Means Committee. Also, here’s Paul Ryan’s press release announcing the Act. 
 

4.       Looking for a nice, quick summary of key provisions of the Act? Check out the Association of Health Care Journalists article by Unpacking some key provisions of GOP’s health care bill by Joanne Kenan. Kaiser Health News also has a succinct listing of five key points in comparison to the ACA - Five Ways the GOP Health Bill Would Reverse Course From the ACA by Julie Rovner.
 

5.       Looking for thoughtful analysis of the Act? Check out the Timothy Jost – the oft quoted in national press expert on such matters – in his Health Affairs Blog: Examining The House Republican ACA Repeal And Replace Legislation.
 

6.        Understand some key opposition points from public interest groups: AARP isn’t happy about the increased premium load older individuals would bear in the market, or about Medicare changes. The AMA and AHA don’t like the ultimate reductions in Medicaid and other coverages. Families USA says the only the Healthy and Wealthy will benefit from the bill and also take major issue with the per-capita caps in Medicaid.
 

7.       Getting too tired to read any further? Here’s six selected videos from major organizations discussing the Act.

Friday
Mar102017

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:

 

To Save On Drug Costs, Insurer Wants To Steer You To ‘Preferred’ Pharmacies

Kaiser Health News reports: One of California’s largest insurers has proposed a change in the benefits of commercial plans next year that would require consumers to pay more for drugs at pharmacies outside an established network.

Kaiser Health News

Friday, March 10, 2017

 

What Hospitals Waste

ProPublica reports: Just outside Portland, Maine, there’s a 15,000-square-foot warehouse that’s packed with reasons the U.S. health care system costs so much: Shelves climb floor to ceiling, stacked with tubs overflowing with unopened packages of syringes, diabetes supplies and shiny surgical instruments that run hundreds of dollars apiece.

ProPublica

Thursday, March 9, 2017

 

Ryan brings out slideshow to sell GOP healthcare bill

The Hill reports: Jacket off and sleeves rolled up, Speaker Paul Ryan (R-Wis.) on Thursday ditched the podium and delivered a 25-minute TED Talk-like presentation on why the new GOP health bill represents the best, and perhaps only, chance to repeal ObamaCare.

The Hill

Thursday, March 9, 2017

 

Lawmakers take up Obamacare revision without an independent scorekeeper

The Washington Post reports: Two committees in the Republican-led House have begun drafting sweeping health legislation without the benefit of an objective estimate of its impact from the Congressional Budget Office (CBO) — a reckless move, critics say, considering that they are dealing with the well-being of tens of millions of Americans and an industry that accounts for close to one-fifth of the economy.

The Washington Post

Wednesday, March 8, 2017

 

Three Key Senators Ask GAO to Investigate Possible Abuses Of The Orphan Drug Act

Kaiser Health News reports: Building on weeks of mounting pressure to address high prescription drug prices, three influential U.S. senators have asked the government’s accountability arm to investigate potential abuses of the Orphan Drug Act.

Kaiser Health News

Tuesday, March 7, 2017

 

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.

 

Thursday
Mar092017

Inaccurate Provider Directories Have a Direct Impact on Patients

By Claire Thayer, March 8, 2017

Provider directories are important tool for consumer engagement with health plans and provider networks. And in many instances, the provider directory is the vehicle for the patients’ first impressions of providers and the network they represent.  The consequences of directory inaccuracies create barriers to care as well as impact patient satisfaction. And while state and regulatory agencies are imposing stiff fines for non-compliance, a new report from the California Department of Managed Care finds that most insurers still have a ways to go in this regard as many have directories that contained “data inaccuracies significant enough to render them unusable.”

A recent special edition of the MCOL Infographic, co-sponsored by LexisNexis Risk Solutions, highlights the impact of directory inaccuracies on patients:

 

 

 

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.

Friday
Mar032017

2017 Employer Health Care Strategies and Trends

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By Clive Riddle, March 3, 2017

 

DirectPath and CEB have just released their 2017 Medical Plan Trends and Observations Report, “which analyzed more than 975 employee benefit health plans, highlights the top ten trends in employers’ 2017 health care strategies across three categories – plan design, cost savings mechanisms and care options.”

 

The 11-page report tells us that “employers are incorporating solutions like health savings accounts (HSAs), wellness incentives, price transparency tools and alternative care options to reduce costs.”

 

The ten trends they discuss include:

1.     Annual Deductibles Leveling Out

2.     Marginal Change in Prevalence of HDHPs

3.     HSAs Continue to Remain Popular

4.     Specialty Medication to Become More Expensive

5.     Contribution Surcharge Amounts Vary

6.     Wellness Incentives Continue to Increase in Prevalence and Amounts

7.     Plan Comparison Tools Lead to More Savings

8.     Alternative Care Options Remain Affordable

9.     Barriers to Employee Use of Telemedicine

10.  Focus on Higher Quality Health Care

 

Major findings from their surveys cited in the report include:

·         51 percent of employers offer a price transparency tool to help employees choose the service or product best for them, and 18 percent plan to add such tools in the next three years

·         In a review of price comparison requests, these services resulted in an average employee savings of $173 per procedure and average employer savings of $409 per procedure.

·         While the percentage of organizations with spousal employee contribution surcharges remained static (26 percent in 2017, as compared to 27 percent in 2016), average total surcharge amounts increased dramatically to $152 per month, a more than 40 percent increase from 2016.

·         More than a third of organizations offer telemedicine, but over 55 percent of employees in these companies are not aware of telemedicine availability, and nearly 60 percent of employees who have telemedicine programs do not feel they are easy to access, according to a separate survey recently conducted by CEB.

·         The average cost of specialty drugs that treat rare and complex conditions increased by more than 30 percent for employers surveyed.

·         67 percent of employers surveyed offer HSAs, compared to 15% offering Health Reimbursement Arrangements (HRAs). Employer contributions to HSAs increased almost 10 percent.

·         58 percent of 2017 employer plans offer some type of wellness incentives, up from 50 percent in 2016.

 

While we’re on the subject of wellness incentives, Humana just released their 2017 Humana Wellness Trends Report, a 20-page document that discusses five trends:

1.     The “connected experience 2.0” revolutionizing wellness strategies: “…As wellness programs begin to integrate these devices and employers gain access to the data, employers will gain insight into what’s driving organizational health costs and how to resolve them.”

2.     Older workforce leads to health, caregiving burdens: “…The U.S. workforce is getting older and retiring later due to the stress of financial burdens, caring for older loved ones and increasing health care costs.”

3.     Financial stress affects productivity: “….Americans identify money as their top stressor, which can reduce employee productivity and contribute to absenteeism, presenteeism and poor health. Research states 37 percent of full-time employees deal with financial issues while working.

4.     Poor sleep leading to errors, low morale: “…Among workers age 30 and older, 74 percent say lack of sleep affects their work performance.”

5.     Workers benefit from mindfulness techniques: “…Research has found a mindful approach may help ease the “effects of stress, anxiety and other negative emotions.”

Friday
Mar032017

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’s nominee to run Medicare and Medicaid advances

The Associated Press reports: President Donald Trump’s nominee to run Medicare and Medicaid won committee approval Thursday, clearing her for a final floor vote in the Senate.

AP via The Washington Post, March 2, 2017

 

Faring Better Than Many ACA Insurers, Molina Backs Health Law ‘Tuneup’

Kaiser Health News reports: Some large health insurance companies have suffered losses under the Affordable Care Act, leading to a few high-profile exits from the online marketplaces. Humana is just the latest, announcing in January that it will stop offering health insurance on the ACA health exchanges at year’s end.

Kaiser Health News,  March 2, 2017

 

High-Risk Pools Another Sticking Point Among Republicans

Morning Consult reports: Sen. Rand Paul on Wednesday expressed opposition to House GOP leaders’ plan to cover people with pre-existing conditions, highlighting another division that Republicans must overcome to repeal the Affordable Care Act.

Morning Consult, March 1, 2017

 

Insurers pay twice as much as hospitals for hip and knee implants

Stat News reports: Imagine this: You go to buy a car, but you don’t know who makes it, how other customers feel it’s performing, or how its price compares to other cars in its class.

Stat New, February 28, 2017

 

Hospitals, Both Rural And Urban, Dread Losing Ground With Health Law Repeal

Kaiser Health News reports: More than a year ago, she lost her job at a nearby rural hospital after it closed and, as Republicans work to dismantle the Affordable Care Act, wonders whether she’ll soon be out of work again.

Kaiser Health News, February 28, 2017

 

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. 

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