Tag: "Uninsured"

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)

Being Uninsured is Better than Being on Medicaid to Get a Doctor’s Appointment

doc-with-patientPosing as patients, researchers made almost 13,000 calls to doctors’ offices in ten states, seeking appointments for a variety of ailments. For those posing as privately insured patients, they got appointments 85 percent of the time. For those posing as patients on Medicaid, they only got appointments 58 percent of the time. Researchers also posed as uninsured patients who were willing to pay in full at the time of the appointment.

The result? 78 percent were successful (for appointments costing more than $75) — 36 percent better than those posing as Medicaid patients and quite close to those posing as privately insured.

What Are the Mortality Risks of Being Uninsured?

This is from Chris Conover:

Since the evidence is equivocal at best, let us — for purposes of discussion — average the point estimates from 4 studies…and compare this relative mortality risk (1.22) to other factors that elevate the annual probability of death.

546

CBO’s Increasing Pessimism

cbouiprojections

Source: Chris Conover at Forbes.

Uninsured Trauma Patients Get Better Care than Insured

Why? Perhaps because non-trauma community hospitals would prefer to have insured rather than uninsured patients. So, uninsured patients are more likely to be transferred to trauma centers, where they are likely to get better care.

According to Kit Delgado, and colleagues, presenting research results in JAMA Surgery, both privately insured and Medicaid patients were significantly more likely (11 percent and 14 percent more) to be admitted to a non-trauma hospital than transferred.

Their conclusion:

Patients with severe injuries initially evaluated at non-trauma center EDs were less likely to be transferred if insured and were at risk of receiving suboptimal trauma care. Efforts in monitoring and optimizing trauma inter-hospital transfers and outcomes at the population level are warranted.

A Tale of Two Surveys: ObamaCare Having Minimal Impact on Increasing Coverage

Two recently released surveys (both conducted in February) show that ObamaCare is having a trivial impact on health insurance coverage.

The Gallup Heathways survey concludes that the “uninsured rate continues to fall,” which is correct in a narrow sense. The uninsured rate fell to 15.9 percent from 16.3 percent in the first quarter of 2013. But this small improvement is overshadowed by the 2008 uninsured rate, which was under 15 percent. February’s improvement is likely the result of the slow recovery, not expanded ObamaCare coverage.

McKinsey’s survey, which surveys only people eligible for ObamaCare subsidies, shows that ObamaCare’s health insurance exchanges are primarily crowding out previous coverage. Only ten percent of previously uninsured respondents signed up for Obama (up from three percent in January) and only 53 percent of those paid their premiums. In sum, only five percent of uninsured respondents actually paid premiums for an ObamaCare policy. The reason? “Affordability challenges.” (See Avik Roy’s coverage here.)

McKinsey: Only 14% of Enrollees Were Previously Uninsured

Of the ObamaCare sign-ups, only 27 percent had been previously uninsured in 2013. And of the 27 percent, nearly half had yet to pay a premium. (By contrast, among the 73 percent who had been previously insured, 86 percent had paid.)

Put all those percentages together, and you get two key stats. Only 19 percent of those who have paid a premium were previously uninsured. Among those that the administration is touting as sign-ups, only 14 percent are previously uninsured enrollees: approximately 472,000 people as of February 1.

Survey. HT: Avik Roy.

Hits and Misses

zzzzzzzSurgery center of Oklahoma eliminates the $100 aspirin.

Curious factoid: About 20 percent of hospice patients are discharged alive.

Is there anything wrong with distinguishing between the “deserving” and the “undeserving” poor?

Nation’s third largest for-profit hospital chain expects only 15% of uninsured patients to get ObamaCare coverage.

Oliver Wyman actuaries estimate Medicare Advantage payment cut of $65-$145 per member per month in 2014 & 2015.

Creative destruction: Closed New Jersey hospitals reopen as for-profit medical complexes.

How Many People Really Have Bought Insurance in the Exchange?

Bob Laszewski:

bildeMy informal survey can’t be too precise, but I can say with pretty good confidence that based upon the drop-outs so far, about 20% of the 3.1 million people the administration has said have enrolled through January are not going to stick. That means the real number is closer to about 2.5 million.

Some of this attrition is due to people not paying their bill because they decided not to buy after all. Some to people signing-up twice and just paying once — Healthcare.gov can’t handle duplicate enrollments! Some of it may be due to people wanting coverage but they never got their invoice in all of the January administrative mess. Until the dust settles we really won’t know.

How many are newly insured verses re-enrolling?

In an earlier post I told you that published reports that put the number of reenrollments at about two-thirds of the ObamaCare exchange enrollments sounded about right given my own discussions with carriers. Two weeks later I haven’t heard anything to change that assessment.

Headlines I Wish I Hadn’t Seen

UPINoBamaCareWellPoint: Surge in doctor visits prior to Jan 1 because of worries about the effects of ObamaCare.

Did Sen. Coburn lose his cancer doctor because of ObamaCare?

Julie Applebee calls out the president on his claim that 9 million people have signed up for health insurance.

39% of the uninsured: ObamaCare has made us worse off.