Posted: January 18, 2013
The Department of Health and Human Services (HHS) has awarded an additional $1.5 billion in grants to 11 states to develop their online health insurance exchanges.
HHS Secretary Kathleen Sebelius, in announcing the grants, said the money is intended to ensure the states have the resources necessary to build online marketplaces that meets the needs of their residents.
California, Delaware, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, and Vermont have all received portions of the Exchange Establishment Grants.
“These states are working to implement the health care law and we continue to support them as they build new affordable insurance marketplaces,” Sebelius said. “Starting in 2014, Americans in all states will have access to quality, affordable health insurance and these grants are helping to make that a reality.”
Beginning Jan. 1, 2014, Americans must be covered by health insurance as required by the Patient Protection and Affordable Care Act (PPACA). All exchanges must be operational by Oct. 1, 2013, to allow consumers to begin purchasing insurance online.
Delaware, Iowa, Michigan, Minnesota, North Carolina, and Vermont received awards today for Level One Exchange Establishment Grants, which are one-year grants states will use to build marketplaces.
California, Kentucky, Massachusetts, New York, and Oregon received Level Two Exchange Establishment Grants today. Level Two grants are multi-year awards to states to further develop their marketplaces.
PPACA requires all states to have an online insurance exchange.
A total of 19 states are operating their own exchanges, 25 defaulted and have passed the responsibility for creating and running their exchanges back to the federal government, and seven will operate as state-federal exchange partners.
By Tami Luhby CNN Money January 23, 2013: 10:15 AM ET
NEW YORK (CNNMoney)
Raising the Medicare eligibility age won’t just affect older workers … it could ripple all the way down the career ladder.
If senior citizens can’t sign up for Medicare until age 67, many will likely stay on the job longer so they can keep their health insurance. That means it could be tougher for mid-career workers to move up, which in turn could make it harder for younger workers to secure entry-level positions, economists say.
“The only way to free up jobs at the bottom for young people is for older workers to retire,” said Sung Won Sohn, an economics professor at California State University Channel Islands. “No one wants to retire without health care.”
Options for cutting Medicare costs are back on the table as the Obama administration and lawmakers seek ways to reduce the deficit. President Obama has said he’d be willing to make modest changes to Medicare as part of the debt ceiling negotiations, while House Republicans are looking to overhaul the troubled entitlement programs.
Raising the eligibility age to 67 has been kicked around for years. Advocates say that the program should reflect the increased lifespan that Americans now enjoy, as well as the fact that there are fewer workers to support retirees.
There’s already evidence that raising the entitlement age affects workers’ decisions to retire. A recent report from the Congressional Budget Office estimated that about half of the increase in the share of people age 62 or older who participated in the labor force during the 2000s can be attributed to the increase in the full retirement age of Social Security, which rose by one year to 66.
CBO expects a similar jump when the full retirement age for Social Security goes up to 67 in coming years. The share of men and women age 65 to 69 in the labor force should rise by 4 percentage points between 2012 and 2022, the report said.
Keeping senior citizens in the workforce could prove problematic for those down the career chain, particularly during weak labor conditions such as we’ve had in recent years.
During the Great Recession, older workers hung onto their jobs, exacerbating the tough market for younger ones, said Sarah Watt, economic analyst with Wells Fargo Securities.
The share of Americans age 65 and over in the labor market rose to 18.5% in 2012, up from 16.0% in 2007. At the same time, the share of those age 25 to 54 fell to 81.4%, from 83.0%.
A similar scenario played out in the higher education arena after 1994 when universities were barred from instituting a mandatory retirement age of 70, said Carl Van Horn, director of Heldrich Center for Workforce Development at Rutgers University. More older professors are staying on the job, making it harder for younger PhDs to get tenure track positions or mid-career faculty to advance.
“There just weren’t as many openings,” he said.
Have you had trouble finding work or moving up as a result of older workers staying on the job longer? Email email@example.com and you could be featured in an upcoming story.
First Published: January 23, 2013: 10:15 AM ET
By Ankita Rao
JANUARY 22ND, 2013, 4:03 PM
Kaiser Health News
A pilot program introduced by the U.S. Centers for Medicare and Medicaid Services to boost quality of care for seniors by developing community approaches to health problems could play a key role in bringing down costs, according to a new report in the Journal of the American Medical Association.
Quality Improvement Organizations, or QIOs, are private groups in each state and U.S. territory that contract with the government for three years to improve health services for Medicare patients. They are comprised of health care providers and other medical professionals, social services workers and other community members.
In Tuesday’s report, researchers found a 5.7 percent average reduction in 30-day hospital readmissions across 14 economically and demographically diverse communities over a two-year period. The number of patients admitted to the hospital within 30 days of a prior admission is one possible measure of efficiency, since the cost and burden of readmission can be preventable.
One in five Medicare patients returns to the hospital within 30 days of being discharged. The problem is an expensive one: in 2004, these readmissions cost Medicare $17.4 billion dollars.
The interventions used by the 14 community groups varied, but they included efforts to improve medication management and transitional care for patients leaving the hospital. Author Dr. Jane Brock, a coordinator at the Colorado Foundation for Medical Care’s Medicare quality improvement program, said that providing social services that can monitor and track patient treatment was one key to the project’s success.
Author Dr. Joanne Lynn, a director at the Altarum Institute, said the average community with 50,000 Medicare beneficiaries could have saved $4 million on readmissions alone if they used the various interventions that the QIOs practiced within their communities.
“Even those with low rates of readmissions had plenty [of hospitalizations] to be avoided,”Lynn said.
The report also included the results from patient satisfaction surveys, emergency room visits and mortality rates to screen for negative changes from the interventions. They found that other health factors remained stable or improved with the reduction of readmissions.
Brock said the successful outcomes would help expand the idea of community-based interventions.
“My hope is there is great recognition that this is the best purpose of the QIOs: We’re not competitors, we’re not regulatory, they really bring people together,” she said.
THIS ENTRY WAS POSTED ON TUESDAY, JANUARY 22ND, 2013 AT 4:03 PM.