iLoveBenefits: Industry News Blog

62% of Exchange Plans Will Be HMOs in 2017

 

 

McKinsey & Company recently released an analysis of 2017 exchange plan designs across the U.S.

Here are some key findings from the report:

 

HMOs will comprise 62% of all plans for 2017.
68% of consumers will have access to competitively priced managed plans only.
The lowest-price silver plan premium will increase 9% for managed plans in 2017.
82% of consumers will have access to both managed and unmanaged plans in 2017.
For unmanaged plans, the lowest-price silver plan premium increase will be 18%.
97% of national plans will be managed in 2017, up from 62% in 2014.

 

 

Source: McKinsey & Company, August 2016

10% of organizations are considered ‘ahead of the curve’ in data maturity

 

According to a recent Vanson Bourne Global Data Protection Index:

10% of organizations are considered ,ahead of the curve, in data maturity.
8% of U.S. businesses are ,ahead of the curve,, the study found.
56% of organizations keep the IT environment on premise, while 29% use a public cloud.
27% of respondents indicated they would use backups for data protection.
20% indicated it would be easier to achieve backup and service-level agreements for disaster recovery.
The U.S. is ranked 14 of 18 countries when it comes to data maturity.
Source: U.S. Healthcare Industry Lagging on Data Protection, Healthcare IT News, August 22, 2016

Will you participate in the Precision Medicine Initiative?

According to a recent survey, 79% of respondents supported the proposed Precision Medicine Initiative’s planned national cohort study, which aims to tailor targeted treatments to specific diseases, and 54% said they would definitely or probably participate if asked. Source: “A Survey of U.S Adults’ Opinions about Conduct of a Nationwide Precision Medicine Initiative® Cohort Study of Genes and Environment,” PLOS One, August 17, 2016, http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0160461

Innovations to Reduce Non-Urgent Use of Emergency Services

The Agency for Healthcare Research and Quality (AHRQ) announces the August 17 issue of the Health Care Innovations Exchange (https://innovations.ahrq.gov/node/8388).

  • The featured Innovations describe how an ambulance provider redesigned its emergency medical services system to create new care and referral pathways for 911 callers not facing true emergencies; a community paramedic program that significantly reduced unnecessary 911 calls from a local shelter and enhanced access to primary care for shelter residents; and a city EMS program that used a multipronged strategy to reduce unnecessary ambulance transports and ED visits, connecting non-emergent patients to primary care.
  • The featured QualityTools include resources for reducing inappropriate emergency department use and tools to support community paramedicine programs.
  • The featured Perspective, Convening a Learning Community to Reduce Non-Urgent Use of Emergency Services, describes the collaborative work of the Innovations Exchange Emergency Services Learning Community, based on an interview with its champion and expert faculty. https://innovations.ahrq.gov/perspectives/convening-learning-community-reduce-nonurgent-use-emergency-services

Drug spending growth rate declines

Between May 2015 and May 2016, the growth in spending on prescription drugs dropped to 5.2%, down from 12.2% in 2014. Source: “CSHS Health Sector Economic Indicators Briefs: July 2016 Health Sector Economic IndicatorsSM Briefs,” Altarum Institute/Center for Sustainable Health Spending, July 2016, http://altarum.org/our-work/cshs-health-sector-economic-indicators-briefs  

Health care Premium Increases and Exchange Participation

    • Premium increases in the health insurance marketplaces created under the Affordable Care Act (ACA) will likely be higher in 2017 than in recent years. Kaiser Family Foundation analysis of proposed rates in states that make the information publicly-available shows an average premium increase in the benchmark second-lowest-cost Silver plan in 17 major cities of 9% in 2017, compared to an average increase of 2% in these cities in 2016.
    • Aetna CEO Mark Bertolini announced Tuesday (Aug. 2) that while the company is pleased with its overall second-quarter results, it will not enter exchanges in additional states in 2017 as planned and is revisiting its current position in 15 states.

“Buying Into” Medicare

Health care issuers are already interested in a proposal that would allow Americans age 55 and older to “buy into” Medicare, according to Chris Jennings, a longtime health policy expert and adviser to Democratic presidential nominee Hillary Clinton. Jennings spoke on a panel during the Democratic National Convention featuring several prominent health policy players, including former Senate Majority Leader Tom Daschle (D-SD), Center for American Progress President Neera Tanden, Families USA Executive Director Ron Pollack and former head of the White House health reform office Nancy-Ann DeParle.

Should wellness programs be sponsored by your employer

According to a recent survey, only 48% of employees had participated in an employer-sponsored program to help them improve their physical health. Source: “Employees Report High Satisfaction with Health and Well-being Programs, but More Personalization is Needed,” National Business Group on Health Press Release, July 20, 2016, https://www.businessgrouphealth.org/pressroom/pressRelease.cfm?ID=280

Can anyone create a understandable explanation of benefits (EOB)

According to a recent survey, 95.5% of respondents had received a medical bill from a doctor, hospital, or health care provider in the past 12 months. Of those, 60.5% rated their medical bills as confusing or very confusing. Their frustrations included the following:

  • The relationship between bills from provider and the statements from insurance company: 50.6%
  • Not sure if the total owed was correct: 49.4%
  • The amount owed was a surprise: 48.8%
  • Unexpected expenses that were thought to be covered by insurance: 46.1%
  • Not sure if the insurance company had paid yet: 43.2%
  • The bill arrived a long time after the date of service: 42.3%
  • The relationship between the bill and insurance deductible: 35.1%
  • Didn’t understand the language on the bill: 23.5%
  • Wasn’t sure if everything listed on the bill really happened: 22.0%

Source: “A BILL YOU CAN UNDERSTAND RESEARCH REPORT,” Mad*Pow, May 6, 2016, http://static1.squarespace.com/static/5715100cf8baf3c79d443859/t/5730e1c4f699bbe627603424/1462821330491/DesignChallenge_ResearchReport.pdf

90% of Strokes are Preventable

The Lancet recently published a study on the modifiable risk factors behind strokes. Here are some key findings from the report:

  • 10 controllable risk factors account for 90% of all strokes.
  • Eliminating high blood pressure was estimated to reduce risk by 48%.
  • High blood pressure causes 39% of strokes in North America, Australia and western Europe.
  • 60% of strokes in Southeast Asia are caused by high blood pressure.
  • Eliminating physical inactivity was estimated to reduce stroke risk by 36%.
  • Stroke risk is reduced by an estimated 23% when a poor diet is improved.

Source: The Lancet, July 15, 2016

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