Affordable Care Act Requires Americans Take a More Active Role in Health Care Decisions

TurboTax offers free online tool to help people understand impact of new health care reform

Published: Friday, Mar. 29, 2013 / Updated: Friday, Mar. 29, 2013 08:05 AM

SAN DIEGO —

In a series of nationwide focus groups conducted by Intuit TurboTax®, a majority of consumers who participated lacked awareness of their new health insurance options under the Affordable Care Act, sometimes referred to as “Obamacare”. In addition, a most of them did not know if they would qualify for financial assistance to help cover the cost of health insurance.

In October 2013, federal and state Health Insurance Marketplaces are scheduled to open and an estimated 30 million uninsured Americans will need to make healthcare decisions that will impact both their personal and financial well being.

TurboTax now provides a simple, free online health care calculator, available on the TurboTax Blog, that helps people understand whether they may be eligible to purchase insurance through the new Marketplaces and if they qualify for financial assistance.

“Consumers who take a more active role in their healthcare decisions get the best outcome for both their health and their wallet,” explains Jane Sarasohn-Kahn, Health Economist (www.healthpopuli.com) and Advisor to the American Tax & Financial Center at TurboTax. “We encourage Americans to be engaged in their healthcare decisions starting now. Research shows that Americans spend much more time researching the purchase of an automobile compared with seeking information on picking their personal physician. Isn’t it worth investing a few hours over the next few months to get the best health care for you and your family?”

 

Balancing care and out of pocket expenses

The need to engage now in healthcare is especially critical for individuals and families who will fund health insurance through a combination of government subsidy (delivered as a tax credit starting in 2015) and monthly out of pocket expenses.

Based on analysis by the American Tax & Financial Center at TurboTax, a family of four earning roughly $50,000 would be eligible for an estimated $7,500 subsidy beginning in 2014, which would cover approximately 70 percent of their insurance premium. In this case, the family would be responsible for paying the remaining monthly premium of approximately $282 per month.

“The majority of families need to understand this will likely impact their monthly budget in some way,” added Sarasohn-Kahn. “U.S. consumers need to take on the role of ‘health consumers’ as they assume more responsibilities for choosing health plans based on the level of services covered by a health plan compared to the costs of the premiums and copayments under the different plans being considered.”

For the estimated 40 percent of households living paycheck-to-paycheck, the additional monthly payment for healthcare may seem out of reach. However, families will need to weigh the benefits of preventive care, and the potential costs of emergencies and existing chronic conditions managed by people in their families. In 2010, the average cost of an emergency room visit was $1,349.

While implementations of the new health care law don’t begin until October, this is a good time to start understanding it and preparing. For more information on the Affordable Care Act and its financial impact, visit the American Tax & Financial Center at TurboTax.

About The American Tax & Financial Center at TurboTax

Established in November 2012, The American Tax & Financial Center at TurboTax provides objective and independent data and insights on tax and personal finance trends. The Tax Center is now available to provide taxpayers, policymakers and media with resources and expert commentary on the impact of taxes on U.S. consumers.

The center’s primary goal is to help Americans in understanding financial matters so they can make informed financial decisions. The center educates and advocates for individuals by helping them take ownership of their financial future. For more information, visit The American Tax & Financial Center at TurboTax at www.americantaxandfinancialcenter.com.

Article Link: http://www.fortmilltimes.com/2013/03/29/2586364/affordable-care-act-requires-americans.html

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CMS Approves California’s Dual-Eligible Plan, Nation’s Largest

Becker’s Hospital Review

Written by Jim McLaughlin | March 28, 2013

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CMS approved (pdf) California’s three-year plan to better coordinate coverage for 456,000 dual-eligible patients — who qualify for both Medicare and Medicaid due to their age, disability and income status — making it the largest of the now-five states green-lighted to insure such individuals with help from private plans.

Private insurers Health Net, Molina Healthcare and WellPoint will administer the policies for dual-eligibles.

A quarter of California’s Medicaid costs comes from dual-eligibles, even though they only make up about 14 percent of the state’s 1.1 million Medicaid beneficiaries.

 

Article Link: http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/cms-approves-californias-dual-eligible-plan-nations-largest.html

 

Some Healthcare Costs to Rise Under Affordable Care Act, Official Says

By Reuters

 

President Barack Obama’s top healthcare adviser acknowledged on Tuesday that costs could rise in the individual health insurance market, particularly for men and younger people, because of the landmark 2010 healthcare restructuring due to take effect next year.

March 27, 2013

 

WASHINGTON, March 26 President Barack Obama’s top healthcare adviser acknowledged on Tuesday that costs could rise in the individual health insurance market, particularly for men and younger people, because of the landmark 2010 healthcare restructuring due to take effect next year.

U.S. Health and Human Services Secretary Kathleen Sebelius said definitive data on costs will not be available until later this year when private health plans become authorized to sell federally subsidized coverage on new state-based online marketplaces, known as exchanges.

“Everything is speculation. I think there’s likely to be some shifting in the markets,” she told reporters at the White House.

The law, also known as “Obamacare,” eliminates discriminatory market practices that have imposed higher rates on women and people with medical conditions.

It also limits how much insurers can charge older people. But while the changes are expected to lower costs for women, older beneficiaries and the sick, men and younger, healthier people will likely see higher rates as insurers try to hedge against continued risks.

“Women are going to see some lower costs, some men are going to see some higher costs. It’s sort of a one to one shift … some of the older customers may see a slight decline, and some of the younger ones are going to see a slight increase.”

Insurance premiums could rise for some with individual plans, she said, as Obama’s Patient Protection and Affordable Care Act enhances the level of coverage and either eliminates or reduces the rate of price discrimination against people who are older, female or have preexisting medical conditions.

“These folks will be moving into a really fully insured product for the first time, so there may be a higher cost associated with getting into that market,” Sebelius said.

But those who qualify for federal subsidies through state healthcare exchanges would still get a better deal, she said.

Her remarks coincide with growing uneasiness about possible cost increases among lawmakers and executives in the $2.8 trillion U.S. healthcare industry.

A new study released on Tuesday by the nonpartisan Society of Actuaries estimates that individual premiums will rise 32 percent on average nationwide within three years, partly as a result of higher risk pools. Changes would vary by state, from an 80 percent hike in Wisconsin to a 14 percent reduction in New York.

Obama’s healthcare restructuring, the signature domestic policy achievement of his first term, is expected to provide coverage to more than 30 million people beginning on Jan. 1, 2014, both through the state exchanges and a planned expansion of the government-run Medicaid program for the poor.

Subsidies in the form of premium tax credits, available on a sliding scale according to income, are expected to mitigate higher costs for many new beneficiaries.

But the insurance industry, which is set to gain millions of new customers under the law, is warning of soaring premium costs next year because of new regulations that include the need to offer a broader scale of health benefits than some insurers do now.

That has raised concerns about people with individual policies not subject to subsidies and the potential for cost spillovers into the market for employer-sponsored plans, which according to U.S. Census data, cover about half of U.S. workers.

‘LITTLE IMPACT’

Sebelius dismissed the idea of significant change for employer plans, saying that market segment was “likely to see very little impact.”

Separately, a Democratic U.S. senator on Tuesday said the federal government has limited scope to help millions of people likely to remain without affordable health insurance under the new law.

Senator Ron Wyden of Oregon, a member of the Senate Finance Committee, released a report submitted to the panel by the administration that outlines an “employee choice” policy that would allow some employers to offer a wider range of coverage choices to their workers at reduced rates for 2014.

But Wyden said the approach would not help many of the nearly 4 million worker dependents who may have to forego subsidized private health coverage as a result of an IRS ruling.

“Even in the states that allow for employee choice, it will be limited to a small number of workers,” Wyden said.

The law would have most people with employer insurance remain under their current plans. Workers can opt for subsidized coverage if their employer plan is unaffordable, but only according to a narrow definition of what is affordable.

The IRS ruled in January that the cost of insuring a worker’s family will be considered unaffordable if the employee’s contribution to an individual coverage plan exceeded 9.5 percent of that person’s income. That rule ignores the fact that family coverage is far more expensive than individual coverage.

As a result, the nonpartisan Kaiser Family Foundation estimates that 3.9 million family dependents could be left unable either to afford employer-sponsored family coverage or to obtain federally subsidized insurance through an exchange.

In its report to the Senate committee, Sebelius’ department said some employers could claim a tax credit in 2014 to make coverage more affordable and offer workers a range of coverage plans through state-based exchanges.

(Writing by David Morgan; Editing by Fred Barbash and Paul Simao)

 

Copyright 2010 by Reuters. All rights reserved.

 

Article link: http://www.insurancetech.com/regulation/some-healthcare-costs-to-rise-under-affo/240151798

3 charts on sequestration, healthcare innovation and the Affordable Care Act

March 27, 2013 9:00 am by Deanna Pogorelc | MEDCITY News

On Monday, the sequestration cuts are set to touch down on Medicare, causing a 2 percent drop in reimbursement payments made to doctors, hospitals and other providers.

Dr. Paul Keckley, executive director for the Deloitte Center for Health Solutions, wrote in a memo earlier this month (PDF) that providers should expect the reductions to affect their Medicare and EHR Meaningful Use payments starting mid-April.

The so-called sequester – $85 billion worth of federal spending cuts for 2013 – will impact the implementation of the Affordable Care Act, but not as much as it will other areas of the government, Keckley wrote. $11 billion of the cuts will be to Medicare providers, but those reductions were capped at 2 percent. Medicaid, children’s health insurance programs and military benefits are not directly cut.

Here’s a look at some of the other areas where the ACA will feel the impact:

 

In terms of what that means for healthcare innovation, Keckley suggested that although the medical device, biotech and pharmaceutical industries will continue to pay user fees to the FDA, they may not receive the expected benefits, like timely product reviews and approvals.

 

The National Institutes of Health has said that cuts will likely trickle down to grantees who have been awarded research

funding. Keckley anticipates that could, in turn, create a riskier environment for private investors. Coupled with the potential for a slower regulatory approval process, that may push medical device and drug companies even more in the direction of streamlining their R&D, refocusing on emerging markets and seeking collaborations, he wrote.

But overall, these cuts are just more of what the healthcare economy has already been experiencing. ’It’s about the cumulative impact of cuts by employers, households, and the government’s health plans – Medicare, Medicaid, Children’s Health Insurance Program – that impact our system,” Keckley wrote.

For more in-depth coverage of the sequestration, check out the links below:

Medical research, FDA and mental health programs face budget bite

Sequestration and doctors: What you need to know

FDA chief: Sequester cuts threaten drug approval

Healthcare cuts from vaccinations to research

[Charts courtesy of Deloitte]

Read more: http://medcitynews.com/2013/03/3-charts-on-sequestration-innovation-and-the-affordable-care-act/#ixzz2OkJen9tl

Tennessee Race for Medicaid: Dial Fast and Try, Try Again

 

Nathan Morgan for The New York Times

John Orzechowski, a client advocate with the Tennessee Justice Center, called for more than an hour and was successful in advocating for six clients.

By
Published: March 24, 2013

NASHVILLE — Two nights a year, Tennessee holds a health care lottery of sorts, giving the medically desperate a chance to get help.

State residents who have high medical bills but would not normally qualify for Medicaid, the government health care program for the poor, can call a state phone line and request an application. But the window is tight — the line shuts down after 2,500 calls, typically within an hour — and the demand is so high that it is difficult to get through.

There are other hurdles, too. Applicants have to be elderly, blind, disabled or the “caretaker relative” of a child who qualifies for Medicaid, known here as TennCare. Their medical debt has to be high enough that if they paid it, their income would fall below a certain threshold. Not many people end up qualifying, but that does not stop thousands from trying.

“It’s like the Oklahoma land rush for an hour,” said Russell Overby, a lawyer with the Legal Aid Society in Nashville. “We encourage people to use multiple phones and to dial and dial and dial.”

The phone line opened at 6 p.m. on Thursday for the first time in six months. At 5:58, Ida Gordon of Nashville picked up her cordless phone and started dialing. Ms. Gordon, 63, had qualified for TennCare until her grandson, who had been in her custody, graduated from high school last spring. Now she is uninsured, with crippling arthritis and a few recent trips to the emergency room haunting her.

“I don’t ask for that much,” Ms. Gordon said as she got her first busy signal, hanging up and fruitlessly trying again, and then again. “I just want some insurance.”

Gov. Bill Haslam, a Republican, has indicated that he will decide this week whether to support an expansion of Medicaid to cover more low-income adults, as called for in the federal health care law. Doing so would add more than 180,000 people to the TennCare rolls by 2019, according to the state, most of them adults like Ms. Gordon whose incomes are within 138 percent of the federal poverty level.

Ms. Gordon said she and her husband, who was injured on the job decades ago and is on Medicare, live mostly on his disability check of about $780 a month.

TennCare already provides health coverage to 1.2 million people, more than half of whom are children, at a combined state and federal cost of about $9 billion a year. Many in the Republican-controlled legislature, which includes a strong Tea Party element, opposes its expansion even though the federal government has promised to pay the full cost for the first three years and 90 percent after that.

Opponents of the health care law here, as in other states, say Washington cannot afford to keep that promise. In Tennessee, the debate over expansion is particularly contentious because of TennCare’s tumultuous history. It was once among the most generous Medicaid programs in the country. But costs spiraled, and 170,000 people were cut from the rolls in 2005 under Gov. Phil Bredesen, a Democrat. It was a painful episode that Mr. Haslam said was “weighing on a lot of people’s minds.”

Ms. Gordon hopes to qualify for a program known as a “spend down” — in which a patient’s qualifying income is determined after they subtract their medical costs from their total earnings. The program covers only a tiny portion of TennCare recipients — about 1,000 people, at a cost of $32 million a year. It is also something of an anomaly: while other states have similar programs, most do not limit the enrollment period to brief and infrequent call-ins. Advocates for the poor say the frenzy for the spend-down program is a reminder of the acute need for health coverage everywhere.

“At the end of the day, huge numbers of desperately ill people are being left out in the cold,” said Gordon Bonnyman, the executive director of the Tennessee Justice Center, an advocacy group for families in need that focuses on access to health care. “And that is a story in every state.”

Kelly Gunderson, a TennCare spokeswoman, said that the spend-down program had enough money to cover 3,500 people, but that only about 1,000 were enrolled at any given time because the screening process was so complicated. The screeners, she said, must examine medical bills and records, among other duties.

About 500 people are found to be eligible for the program each time the state opens the phone line. The line has opened six times since the program started in 2010.

Technical glitches can thwart callers’ chances. According to the Tennessee Department of Human Services, which operates the phone line, callers did not start getting through until 6:38 p.m., and 2,500 calls, the maximum, had been received by 7:23. The department is investigating what caused the glitch, a spokeswoman said.

“People started calling here panicked and crying,” said Michele Johnson, a lawyer with the Tennessee Justice Center. “We told them, ‘Just hang on, keep trying.’ ”

Adrian Casteel of Nashville, who said he owed $6,000 in medical bills, said he repeatedly got a recorded message but kept dialing. Mr. Casteel, 55, has a heart condition and a steel plate in his back, the result of a car accident years ago that left him in constant pain and unable to work. He has been on Medicare for nine years because of his disability, he said, but about 20 percent of his expenses are not covered.

“When you see as many doctors as I do,” he said, “that’s quite a bit.”

In her small brick home on the city’s north side, Ms. Gordon also heard the recording that enrollment was closed. But she, too, persisted, never looking up from the phone in her hand. Dusk fell and the room grew dark; she was too focused to bother turning on a light.

She had called about 50 times when, at 6:40, she got through. The woman on the other end of the line asked for Ms. Gordon’s name, birth date, Social Security number, telephone number and address. Ms. Gordon wrote down a confirmation number, thanked her and hung up. The application, she was told, should arrive in a few weeks.

“I still don’t know if I’m getting in,” she warned her husband, Arthur. “If it’s meant to be, it’s meant to be.”

If she is rejected for the spend-down program, Ms. Gordon said she would wait until next year, when President Obama’s health care law is supposed to make insurance more accessible to millions of low- and middle-income Americans. She does not know specifics, like the possibility that she could be covered by an expansion of Medicaid or qualify for federal subsidies to help cover the cost of private coverage. But she said she would eagerly pay what she could for insurance if it was within her limited budget.

“I can’t pay no $200, $300, $400 a month,” Ms. Gordon said. “But I’ll figure out how to pay something if I got to. I’ll squeeze.”

Link:  http://www.nytimes.com/2013/03/25/us/tennessee-holds-health-care-lottery-for-the-poor.html?ref=abbygoodnough&_r=0

Will Health Exchanges Make Insurance Agents Obsolete?

By Lynn Hatter | wsfu.org

 

Insurance exchanges coming in 2014 will allow individuals and small businesses to compare and shop for health plans. This will be done online, and it means people can bypass traditional insurance agents and go straight to the product.  And that has health insurance agents concerned, because they make money on commissions – and they wonder what their role will be.

“Well, that’s a great question [laughs] and frankly, most of us don’t know the answer, in the context of the exchange,” says Kyle Ulrich, Senior Vice President of Public Affairs for the Florida Association of Insurance Agents.  

Right now, state-licensed agents work with consumers and businesses, earning commissions on what they sell. The federal health law outlines a different group of workers called “navigators” to do a similar task on the insurance exchanges, and that service is free for the shopper.

“That individual market place, for agents who occupy that space, it’s a scary time, because they see the typical distribution channel  through agents being troubled when we start talking about these exchanges and so forth, and the health insurance product becomes very commod-itized,” said Ulrich.

But health insurance agents say it’s not just about the money. They’ve have had extensive training. They have to be insured to make sure they don’t give bad advice, and if they do, they can be sued. That’s not true for navigators, and FAIA’s Urlich says the issue is largely about protecting consumers.

We don’t have a problem with navigators being there to help folks sign up for the exchange. That’s what they’re there for and that’s fine. What we firmly believe is that they’re not there to sell insurance. And to the extent that there might be conversations between a navigator and a consumer that goes outside that purview, we believe there should be an enforcement mechanism.”  

The insurance industry is pushing states to place additional regulations on the navigators. Even though Florida has decided to let the federal government run its exchange, Florida will still have a say on regulating the people who will work behind the scenes in those marketplaces.

“Our idea would be to let the Department of Financial Services to issue a license,” said Tim Meenan, with the National Association of Insurance and Financial Advisors, said in public testimony before the Senate Select Committee on the Patient Protection and Affordable Care Act.

“Make them take some training. If they do something untoward toward a customer, you can put them out of business. And frankly, we think they should be required to only talk to people who are uninsured.”  

Insurance agents want the navigators to defer to them when it comes to helping consumers make purchasing decisions, and they say they’re confident they’ll get some regulations in Florida. States like Virginia, Ohio and Utah have legislation pending that would place strict regulations on the navigators. But one area the state won’t have a say in, is who gets to sign up to be a navigator.

“The navigator program, it’s not that they’ll be selling insurance product. It’s designed to be an outreach assistant. To help people understand, to “navigate” the new system,” argued Karen Woodall, a lobbyist and Executive Director of the Florida Center for Fiscal and Economic Policy. 

She says it will be up to the federal government to pay for, and register, those navigators. And she disagrees with insurance agents who say the navigators should be subject to additional state rules and regulations, because they won’t be performing the same tasks.

“It is a program that will be monitored by the federal government.  You will have to apply. You will have the training, just as other people who are giving information through outreach,” she said.

“The intent is, we focus primarily on community-based organizations where people have a relationship and trust. It’s not something anybody signs up for and doesn’t have to have training, and that they’ll be trying to coerce or encourage people to buy a particular product.”   

Groups like local chambers of commerces, unions or consumer-advocacy organizations can sign up for the navigator program. Navigators will be paid through fees imposed on insurers through the exchanges. The federal government will give out grants to groups to fund the navigators. The health law says navigators can only be paid for helping with enrollment, and not on the commission-based pay system that insurance agents usually work on. And that means health insurance agents can’t sign up to be navigators, and navigators can’t be health insurance agents.

 

Article Link: http://news.wfsu.org/post/will-health-exchanges-make-insurance-agents-obsolete

Medicare-Medicaid Dual Eligibles: Measuring Quality of Special Needs Plans and State Demonstrations

 

Published on 21 March 2013

 

Medicare-Medicaid dual eligibles are often held up as a prime case for the need for better care management to reduce health costs and spending while improving quality.  But doing so can be challenging.  Most dual eligibles have multiple health conditions, whether a chronic disease, severe cognitive or physical disabilities, or some other condition or impairment that requires long-term care.  About 40 percent of dual eligibles have both a serious physical health diagnosis and a severe behavioral health condition, making care coordination and quality improvement all the more important and challenging.

Those interested in how current health insurance programs for dual eligibles measure quality can turn to a recent brief from the Center for Health Care Strategies (CHCS). You can read the full brief at the CHCS website – www.chcs.org – but here are some highlights.

 

Special Needs Plans for Dual Eligibles (D-SNP):

D-SNPs, part of Medicare Advantage, account for more than 80 percent of, or 1.2 million, Special Needs Plan (SNP) enrollees. A report last year from Government Accountability Office (GAO) pointed out that the Centers for Medicare and Medicaid Services (CMS) does not require D-SNPs to report a standardized set of outcomes.

Nonetheless, the CHCS brief pulls some helpful examples of different quality measures D-SNPs use:

 

Most of the data come from Healthcare Effectiveness Data and Information Set (HEDIS), though some come from the Agency for Healthcare Research and Quality’s (AHRQ) Consumer Assessment of Healthcare Providers and Systems (CAHPS), or from CMS directly.

 

Quality in Financial Alignment Demonstrations for Dual Eligibles:

The Affordable Care Act (ACA) health reform law opened the door for CMS and states to launch integrated Medicare-Medicaid health plan demonstrations. Long-term care use, mental health service use, quality of life, and care coordination are of particular importance in measuring quality of care demonstration programs provide.

Examples of quality measurements for the managed care integrated dual eligibles demonstrations include:

  • Success managing complex cases, evaluating access to case management, individualized care plans, satisfaction with case management, and identifying members who would benefit from case management.
  • Easing Care Transitions, which looks at how well health plans manage and improve care transitions from hospitals to long-term care, for example.
  • Coordination of Medicare and Medicaid benefits, which includes service coordination and network adequacy assessments.

 

Business Briefings for Health Plans on Integrated Care Demonstrations:

Sellers Dorsey recently hosted two helpful webinars on dual eligibles: one is a basic overview and the other describes business opportunities and risks for health plans in the large and growing dual eligibles market.

In the later, Mike Fox and Kip Piper of Sellers Dorsey provide a 90-minute briefing for health plan executives on the new demonstrations to integrate Medicare and Medicaid financing and care delivery for dual eligibles. Mike and Kip describe the current $350 billion dual eligibles marketplace, state plans to contract with health plans, steps health plans should take in assessing the business opportunities and risks of serving this market, and key considerations for entering the integrated Medicare-Medicaid health plan business. Watch the briefing online for free here on Vimeo.

 

Read more Piper Report posts on dual eligibles issues here.

 

Article Link: http://www.piperreport.com/blog/2013/03/21/medicare-medicaid-dual-eligibles-measuring-quality-special-plans-state-demonstrations/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+PiperReport+%28Piper+Report%29

U.S.: Healthcare reform saves seniors $6B

 UPI.com | Published: March. 21, 2013 at 6:37 PM

 

WASHINGTON, March 21 (UPI) — The U.S. Department of Health and Human Services said those on Medicare saved $6.1 billion on prescription drugs due to the healthcare reform.

HHS Secretary Kathleen Sebelius said in a release the Affordable Care Act made Medicare prescription drug coverage under Medicare Part D more affordable by gradually closing the gap in coverage — known as the doughnut hole — under which beneficiaries must pay the full cost of their prescriptions out of pocket.

“By making prescription drugs more affordable, the Affordable Care Act is improving and promoting the best care for people with Medicare,” Sebelius said.

Seniors on Medicare in the doughnut hole now receive discounts when they purchase prescription drugs at a pharmacy or order them through the mail, until they reach the catastrophic coverage phase, Sebelius said.

The law will provide additional savings each year until the doughnut hole is closed in 2020, Sebelius said.

This year, the healthcare law increased the discounts and savings to 52.5 percent of the cost of most brand name drugs and 21 percent of the cost of covered generic drugs, the secretary said.

 

Topics: Kathleen Sebelius, Healthcare Reform

© 2013 United Press International, Inc. All Rights Reserved. Any reproduction, republication, redistribution and/or modification of any UPI content is expressly prohibited without UPI’s prior written consent.
Read more: http://www.upi.com/Health_News/2013/03/21/US-Healthcare-reform-saves-seniors-6B/UPI-76251363905420/#ixzz2OHD3rD8Y

Unhealthiest counties lead in preventable hospital stays

Healthcare Business News

Unhealthiest counties lead in preventable hospital stays

By Paul Barr

Posted: March 20, 2013 – 12:01 am ET

Tags: Connecticut, Delaware, Hawaii, Medicare, Public Health, Quality, Rhode Island, Wisconsin

The unhealthiest counties in the nation have the highest rates of preventable hospital stays, smoking and adult obesity, according to the 2013 County Health Rankings, a joint effort of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The healthiest counties, meanwhile, had higher numbers of primary-care doctors.

The least-healthy counties experienced 82.8 preventable hospital stays per 1,000 Medicare enrollees, while in the healthiest counties the rate was 57.2 per 1,000. The rest of the nation’s counties experienced 74 preventable hospital stays per 1,000 Medicare enrollees.

The report’s authors also found that 24% of adults smoke in the least-healthy counties, compared with 16% in the healthiest and 21% in the other counties.

The differences in the rates of obesity were less pronounced, with 30% of adults in the unhealthiest counties being obese, while the rate was 23% in the healthiest counties. The rest of the nation’s counties had an obesity rate of 28%.

There was one primary-care physician for every 2,129 residents in the least healthy counties, and 1,491 residents for every primary-care doctor in the healthiest counties. The rest of the counties in the study had 1,978 people per primary-care physician.

The data yielded some unexpected results. The healthiest counties had a higher rate of excessive drinking at 17% when compared with the unhealthiest at 15% and the rest of the country at 14%.

This is the fourth year of the rankings, which were calculated using 25 factors, including those listed above, to rate counties in the equally weighted categories of length of life and quality of life. The healthiest and least healthy county data were calculated using the results of the states’ five most and least healthy counties, excluding 90 counties in which data were unavailable and 20 counties in four states that didn’t have at least 10 counties: Connecticut, Delaware, Hawaii and Rhode Island.

Read more: Unhealthiest counties lead in preventable hospital stays | Modern Healthcare http://www.modernhealthcare.com/article/20130320/NEWS/303209959#ixzz2O5US1ci1
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Health insurance exchange plans up for review in Washington DC

Written by: Stephen Vagus | Live Insurance News

Written on: March 19, 2013

 

Small businesses have a problem with DC health insurance exchange

Plans for a health insurance exchange in Washington D.C. has been facing some challenges in recent months, many of which are coming from small businesses. This week, the D.C. Health Benefit Exchange Authority reiterated that it was committed to establishing a working health insurance exchange for Washington D.C., noting that small businesses would be forced to purchase coverage from the exchange program. The committee did, however, announce that it would be working to delay the mandate requiring these small businesses to purchase their coverage.

 

Exchange board considering delaying requirements on small businesses 

Under current law, all small businesses in Washington D.C. must purchase coverage through the region’s health insurance exchange when open enrollment begins in October of this year. Small businesses have been somewhat opposed to this mandate due to concerns regarding the costs associated with the exchange system. While Washington D.C. is a special legislative district, it must still cover the costs of its health insurance exchange without relying entirely on federal assistance. This typically means that a surcharge must be levied on all policies sold through the exchange.

 

Some small businesses may not be required to participate in exchange until 2016

The D.C. Health Benefit Exchange Authority has taken note of the concerns that small businesses have and is currently considering delaying their mandatory inclusion into the health insurance exchange. If the committee decides to delay the mandate, a number of small businesses will not be forced to purchase coverage through the health insurance exchange until 2015. Some may not be forced to purchase coverage through the exchange until 2016.

 

Health insurance continues to cause strife throughout the US

Health insurance continues to be a problematic subject throughout much of the U.S. While lawmakers in Washington D.C. are eager to comply with the Affordable Care Act, they are also working to address the issues that small businesses have with the concept of an exchange. Many small businesses in Washington D.C. do not currently offer health insurance coverage to their employees, so being forced to do so by law is linked to major financial concerns for these companies.

 

Article Link: http://www.liveinsurancenews.com/health-insurance-exchange-plans-up-for-review-in-washington-dc/8521233/