Alaska Health Policy Review

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A Team Approach to Care

In the newest “States of Innovation” blog series put together by Community Catalyst and CCF, new strides to help make Medicaid sustainable and accessible are highlighted from Camden, New Jersey:

Camden, New Jersey is one of the nation’s poorest cities and has one of the highest crime rates in the nation. Homelessness, drug trafficking, high unemployment, and sky rocketing health care costs are a fact of life in this city of just 79,000. Between 2002 and 2008, 978 patients made 3,882 visits to emergency departments in the city – a majority of the visits were for preventable conditions that could be treated by a primary care doctor.

In this dire situation a family practice physician, Dr. Jeffrey Brenner, pioneered a successful approach to reducing hospital readmissions and health care costs of the sickest and most vulnerable populations. A recent episode of PBS’s Frontline highlighted Dr. Brenner and his innovative work and praised his initiative as a new model of care. The work of the Camden Coalition of Healthcare Providers, the practice that Dr. Brenner set up, laid the groundwork for the “Garden State” to adopt this model, the Medicaid Accountable Care Organization (ACO) Demonstration Project, which was signed into law by Governor Christie last week.

[Read the rest of the article under the cut or in the original here.]

Read the rest of this entry »

Filed under: Insurance related, Of interest

Consumers Union’s Work on Health Insurance Disclosure

For over a year, the Consumers Union has been working towards improving the health insurance disclosures that will be required as part of the Affordable Care Act. Starting in 2012, consumers will receive a standard issue form: “Summary of Benefits and Coverage.”

Thanks to cooperation between senior policy analyst Lynn Quincy, the California HealthCare Foundation, the Commonwealth Foundation, the NYS Health Foundation, and the Missouri Foundation for Health, prototype forms were shown to consumer groups to help gauge reactions among individuals. The results yielded in these tests were taken into account on the final forms.

Click here to read what the New York Times had to say, and here for the Washington Post. For access to the final documents produced, click here.

Filed under: Insurance related

Most uninsured unable to pay hospital bills according to new HHS report

A report released by the U.S. Department of Health and Human Services (HHS) shows that few families without health insurance have the financial assets to pay potential hospital bills.  On average, uninsured families can only afford to pay in full for approximately 12-percent of hospital stays they may experience – and even higher income uninsured families are unable to pay for most potential hospital stays.  Hospital stays for which the uninsured cannot pay in full account for 95-percent of the total amount hospitals bill the uninsured.  Other studies have estimated that the bills for all types of health care that the uninsured cannot pay – the uncompensated cost of care – is up to $73 billion a year, a significant portion of which is shifted into higher costs for Americans with insurance and their employers.

[Continue reading the full report from the U.S. Department of Health and Human Services.]

Filed under: Insurance related, Of interest

The Growing Financial Burden Of Health Care: National And State Trends, 2001–2006

The financial burden of health care—the ratio of total out-of-pocket spending for health care services and premiums to total family income—continues to increase nationally. As a result of this trend, more people have been exposed to high costs and lack essential services. This study examines trends nationally and among selected states between 2001 and 2006.

The results show considerable state-to-state variation associated mainly with differences in family income and, to a lesser extent, out-of-pocket spending for insurance premiums. Nationally, middle- and higher-income people with private insurance experienced the largest increases in financial burden. Moreover, almost 30 percent of the U.S. population either had a high financial burden of health costs or were uninsured. These facts underscore that escalating health care costs affect all socioeconomic strata, not just the poor. Read the rest of this entry »

Filed under: General, Insurance related, Of interest

Why We Must Reduce Health Care Costs

Health care costs continue to rise, with no end in sight. But many people aren’t aware of what accounts for those costs and where the money goes. However, such awareness is key to finding ways to bring costs down.

Where does the money go?

Here are the major categories of health care costs in the U.S. as reported in 2007:

  • Hospitals: 32%
  • Health insurance administration and profits: 13%
  • Medications: 10%
  • Physician income: 9%
  • Physician expenses: 7%
  • Clinical laboratory services: 5%

Read the rest of this entry »

Filed under: Insurance related, Of interest

Federal Unions Release Two Reports on the Detrimental Impact of the Senate Excise Tax on FEHBP Health Plans

Reports find that excise tax will have reduce benefits and raise costs for employees

WASHINGTON – Two reports released December 8, 2009 by federal unions found that the so-called “Cadillac” tax on higher-cost health plans contained in the U.S. Senate health care bill would actually affect average plans like those under the Federal Employees Health Benefits Program (FEHBP). The reports suggest that the excise tax would result in significant health benefit cuts and shifting of costs to employees, as plans try to avoid the tax.

The reports were released by the American Federation of Government Employees (AFGE), American Postal Workers Union (APWU), National Association of Letter Carriers (NALC) and the Communications Workers of America (CWA). They were joined by Rep. Chris Van Hollen (D-Md.) and Rep. Gerry Connolly (D-Va.).

“These studies show us that the excise tax will further drive up the skyrocketing health care costs and will make it impossible for federal workers to achieve the health security they need.  Read the rest of this entry »

Filed under: Insurance related, Legislature related, Of interest

Health Insurance “Middle-Class Time Bomb”

December 29, 2009

Op-Ed Columnist
A Less Than Honest Policy
By BOB HERBERT

The New York Times

There is a middle-class tax time bomb ticking in the Senate’s version of President Obama’s effort to reform health care. The bill that passed the Senate with such fanfare on Christmas Eve would impose a confiscatory 40 percent excise tax on so-called Cadillac health plans, which are popularly viewed as over-the-top plans held only by the very wealthy. In fact, it’s a tax that in a few years will hammer millions of middle-class policyholders, forcing them to scale back their access to medical care. Which is exactly what the tax is designed to do. [continued]

See the full article at: http://www.nytimes.com/2009/12/29/opinion/29herbert.html?_r=2

Filed under: Insurance related

Navigating Health Insurance Data Just Got Easier

New Online Tool Allows Easy Access to Health Coverage Estimates and the Ability to Build Customizable Charts and Graphs

Using currently available sources of health insurance data can be time consuming and cumbersome for both policymakers and researchers. In addition, tracking these estimates over time is an outright challenge. A new web-based tool, developed by researchers at the State Health Access Data Assistance Center (SHADAC), allows quick and easy access to health insurance coverage estimates and trends. The SHADAC Data Center, being released today, allows users to:

  • access U.S. Census Bureau data quickly and easily;
  • utilize coverage trend data from 1987 to present, available for the first time using SHADAC’s exclusive enhanced estimates;
  • translate data into customized tables and graphs that can be easily downloaded; and
  • export data for use quickly, without the hassle of downloading new software.

Filed under: General, Insurance related

Navigate the Maze of Medical Bills and Debt

Even as Congress debates health care reform proposals, millions of Americans—with and without health insurance—struggle to pay medical bills, and their numbers continue to grow.

Today, Families USA released three new pieces to help consumers navigate the maze of medical debt. These new consumer guides offer strategies, tips, and warnings to consumers as they struggle to manage medical debt and to avoid bankruptcy.

Your Medical Bills: A Consumer’s Guide to Coping with Medical Debt, details the legal rights and primary actions consumers should take to deal with rising medical expenses. The consumer-friendly guide offers step-by-step instructions on dealing with medical bills, beginning with the vital first step of reviewing each bill and learning how to appeal charges that may be inappropriate or should be covered by insurance. Read the rest of this entry »

Filed under: Insurance related, Of interest

State Consumer Protections in the Individual Health Insurance Market

This study was completed last year, but I was compelled to post it because it is so important in the current environment.  ~~ldw

Key Findings

In the vast majority of states, insurance companies are permitted to reject individuals for coverage based on their health status, occupation, or even their recreational activities.

  • Only five states prohibit all insurance companies from cherry-picking the healthiest consumers and excluding everyone else.

If an insurance company does accept an individual’s application for coverage, few states significantly limit how much an insurer can increase an individual’s premiums based on what the insurer deems to be health risks (which can include anything from cold sores to hobbies to below average height).

  • In 35 states and the District of Columbia, there are no limits on how much insurers can vary premiums based on health status. An additional six states have limits that still allow dramatic variations in premiums.

Read the rest of this entry »

Filed under: Insurance related

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