Tag: "consumer driven health care"

Consumer-Driven Health Care Round Up

Lots going on in the Consumer-Driven space these days.

AHIP released its latest version of the annual HSA enrollment census. The results are impressive, though still understated since they only received responses from 71% of the companies. It finds enrollment growth of about 15% every year, now reaching 17.4 million. Perhaps the most interesting aspect is the state-by-state breakdown of market penetration. The old Red State/Blue State divide does not hold up when it comes to market behavior. Some of the states with low enrollment include Mississippi, Alabama, and South Carolina, while some of the highest enrollments are found in Minnesota, Illinois, and Maine.

AHIP also released, along with the American Bankers’ Association, a report on HSA account activity. One notable tidbit from this report is the size of the contributions, both personal and from employers. The average personal contribution in 2012 was $2,337, and the average employer contribution was $1,142. Also interesting is that only 19% of all the accounts had $0 balances at the end of the year, indicating that most people are retaining funds in their accounts at least for future use, if not for long-term savings.

Dr. Ben Carson has become a passionate advocate for HSAs, seeing them as a viable alternative to much of Obamacare. An op-ed he wrote has been widely circulated.

Canadian Health Care’s War on Women: Waiting for Treatment Increases Female Deaths

UntitledCanada’s growing wait times for health care may have contributed to the deaths of 44,273 Canadian women between 1993 and 2009…The estimated 44,273 deaths between 1993 and 2009 represent 2.5 percent of all female deaths in Canada during that 16-year period, or 1.2 percent of Canada’s total mortality (male and female).

More specifically, during that same 16-year period, for every one-week increase in the post-referral wait time for medically necessary elective procedures, three female Canadians died (per 100,000 women).

No significant relationship between wait times and male mortality rates was found.

Source: Fraser Institute.

Patient Power Works: Significant Savings for Employers and Beneficiaries

We previously discussed the executive summary of CIGNA’s 8th annual Choice Fund experience study, which reports outcomes from 2.6 million beneficiaries of CIGNA’s consumer-driven employer-based health plans (that is, plans which are paired with a Health Savings Account or Health Reimbursement Arrangement). CIGNA has just released a much more detailed presentation of the results.

The presentation clarifies that the improved outcomes control for health status. That is, they compare “apples to apples”, and the results are not due to healthier people choosing consumer-driven plans and sicker people staying in traditional plans. Newly shared outcomes include:

  • Choice Fund customers increase their compliance with recommended care in the second year, even more than in the first year;
  • They improve their health-risk status by six percent;
  • Medical cost trend goes down 12 percent versus traditional plans;
  • The improvement persists over time, up to $7.900 savings by fifth year;
  • The improvement occurs in low-risk, medium-risk, and high-risk patients; and
  • Because employers contribute to HSAs and HRAs, employees spend less money out of pocket than peers in traditional plans!

VA Secret Waiting Time Cover-Up is Snowballing

people-in-waiting-roomThe number of VA facilities under investigation after complaints about falsified records and treatment delays has more than doubled in recent days, the Office of Inspector General at the Veterans Affairs Department said late Tuesday.

A spokeswoman for the IG’s office said 26 facilities were being investigated nationwide. Acting Inspector General Richard Griffin told a Senate committee last week that at least 10 new allegations about manipulated waiting times and other problems had surfaced since reports of problems at the Phoenix VA hospital came to light last month.

(AP via Christian Science Monitor)

The Numbers Are In: Obama Failed to Recruit “Young Invincibles” Into ObamaCare

President Obama declared that 35 percent of enrollees in the exchanges are under the age of 35. However, his statement is a piece of lawyerly evasion, as first identified by Glenn Kessler of the Washington Post.

Five college students.Under 35″ includes children, and that is not who is needed in the exchanges. Most of them would have enrolled with their parents in a family health plan. Those minors add very little to the premium of a family plan. The young people needed in the exchanges are the so-called “Young Invincibles”, who are between the ages of 18 through 34. These comprise only 28 percent of enrollees in ObamaCare — almost one third fewer than the 40 percent needed.

And even the Young Invincibles who signed up for coverage in ObamaCare’s exchanges did not do it in response to the celebrated efforts by Obama’s re-engaged political machine to turn out the hipsters. Instead, a large share of them went to a non-ObamaCare website to enroll.

Hospital Price Transparency: More Toothless Regulation

The Administration continues to promulgate ineffective regulations that are supposed to help patients understand how much money they owe their hospital. Here is this month’s proposed rule updating the hospital Inpatient Provider Payment Services (IPPS) schedule for 2015:

Hospitals are responsible for establishing their charges and are in the best position to determine the exact manner and method by which to make those charges available to the public. Therefore, we are providing hospitals with the flexibility to determine how they make a list of their standard charges public. Our guidelines…are that hospitals either make public a list of their standard charges (whether that be the charge master itself or in another form of their choice), or their policies for allowing the public to view a list of those charges in response to an inquiry.

It is hard to imagine how this is going induce hospitals to present good-faith charges to patients, whether they are insured or not. A better solution would rely on common law, not federal regulation.

Advances in Personalized Medicine

An article published Thursday in the journal Science describes the treatment of a 43-year-old woman with an advanced and deadly type of cancer that had spread from her bile duct to her liver and lungs, despite chemotherapy.

Researchers at the National Cancer Institute sequenced the genome of her cancer and identified cells from her immune system that attacked a specific mutation in the malignant cells. Then they grew those immune cells in the laboratory and infused billions of them back into her bloodstream.

The tumors began “melting away,” said Dr. Steven A. Rosenberg, the senior author of the article and chief of the surgery branch at the cancer institute.

…[T]he report is noteworthy because it describes an approach that may also be applied to common tumors — like those in the digestive tract, ovaries, pancreas, lungs and breasts — that cause more than 80 percent of the 580,000 cancer deaths in the United States every year. (New York Times)

See our previous posts here and here.

What If Premiums in the Exchange Go Down Next Year?

Everyone’s expecting them to go up. But what if they go down? Many families could be worse off.

money-crossroadsIf a family of four headed by two adults in their mid-30s is making $59,625 per year, then the ObamaCare subsidies will make it so the second-lowest cost silver plan costs no more than 8.15 percent of its income, or $4,860.

In Marion County, the two cheapest silver plans are sold by Anthem Blue Cross and Blue Shield. The cheapest plan costs $7,700 a year and the second-cheapest costs $8,040.

To make that second-cheapest plan cost only $4,860, ObamaCare applies a tax credit of $3,180. So that is the subsidy available for any family of four making $59,625 — NO MATTER WHICH HEALTH PLAN that family purchases in the ObamaCare exchange. It can be a bronze plan or a gold plan. It can be more or less expensive. No matter, that family will receive a subsidy equal to $3,180.

But what happens if another insurer — such as UnitedHealthcare, which sat on the sidelines this year, or MDwise Inc., offers a silver plan in 2015 that’s just a little bit cheaper than the cheapest Anthem plan, say, for $7,500 per year?

We’re Looking More and More like Canada

doctor-mom-and-sonPatients — and physicians — say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements. It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes. And the problem may worsen as millions of consumers who gained health coverage through the Affordable Care Act begin to seek care — some of whom may have seen doctors rarely, if at all, and have a slew of untreated problems.  (KHN)

Good News for the Uninsured

Uninsured patients who seek trauma care at a Healthcare Corporation of America hospital will no longer be charged a special trauma fee, which sometimes added as much as $30,000 to their bills…

“Even so, waiving the trauma fees for uninsured HCA patients might have little impact. Hospitals generally collect only a portion of what they bill patients. And the amount collected from uninsured patients — compared to those covered by auto or health insurance policies — can be tiny.”

HCA told the newspaper that their hospitals collect $300 on average from uninsured patients. (More)