iLoveBenefits: Industry News Blog

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

What provider network does your health plan offer?

Over 60% of health insurers have changed network strategy since 2014, with 53% using tiered and 42% using narrow networks, according to a recent report. Source: “Journey to Value: The State of Value-Based Reimbursement in 2016,” McKesson, June 2016, http://mhsinfo.mckesson.com/rs/720-XWV-189/images/McKesson-Journey-to-Value-State-of-VBR-2016.pdf

July 11, 2016 | Categories: Benefits,healthcare,insurance | Tags: , , , | Comments (0)

They may be ‘satisfied’ but are they getting the value they need?

Most Health-Insured Adults are Satisfied With Their Primary Care Physician

Salesforce recently released its 2016 Connected Patient Report on adults who have health insurance and a primary care physician. Here are some key findings from the report:

  • 91% of patients are satisfied with their primary care physician.
  • 3 in 4 patients (76%) use phones to communicate with their doctors and set appointments.
  • 62% of patients rely on their doctors to manage their data, while 29% keep their records at home.
  • Half of health-insured patients (48%) report having the same doctor for the past 10 years.
  • 1 in 3 patients feel their doctors would not recognize them walking down the street.
  • 62% of patients would be open to virtual care treatments as an alternative to in-office doctor visits.

Source: Salesforce, June 27, 2016

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