iLoveBenefits: Industry News Blog

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

Patient spending increases as costs are shifted to deductibles and coinsurance

According to a recent blog in the Wall Street Journal by Kaiser Family Foundation’s Drew Altman, while worker’s wages increased 32% from 2004 to 2014, here’s what happend to patient spending during that time period:

  • patient spending on deductibles increased 256%
  • patient spending on coinsurance increased 107%
  • patient spending on copays decreased 26%

Source: “The Next Big Debate in Health Care,” The Wall Street Journal/Think Tank, June 30, 2016, http://blogs.wsj.com/washwire/2016/06/30/the-next-big-debate-in-health-care/

Drug prices continue to rise

According to a recent survey by Consumer Reports, almost one-third of Americans said they had experienced a drug price hike in the past year. Source: “Consumer Reports Finds: Nearly One-Third of Americans Experiencing Price Hikes for Meds; Pricey Pills Impacting Retirement Plans, Family Life, Overall Health,” Consumer Reports Press Release, June 21, 2016, http://pressroom.consumerreports.org/pressroom/2016/06/consumer-reports-finds-nearly-one-third-of-americans-experiencing-price-hikes-for-meds-pricey-pills-impacting-retirement-pl.html

June 30, 2016 | Categories: Cost,drugs,healthcare | Tags: , , | Comments (0)

Diabetes Spending Reached $16,021 Per Capita in 2014

The Health Cost Institute recently released a study on healthcare spending for diabetes patients. Here are some key findings from the report:

  • Spending on people with diabetes reached $16,021 per capita in 2014, an $897 increase from 2013.
  • Health care spending for people with diabetes rose 6% compared to 3.2% for people without diabetes.
  • The number of ER visits among people with diabetes rose 8.1% annually from 2012-2014.
  • People with diabetes had 7x more filled days of cardiovascular drugs than those without diabetes.
  • Young adults (19-25) with diabetes had 4x more hospital admissions for mental health and substance use.
  • In 2014, insureds with diabetes spent $1,944 out of pocket compared to $752 for those without diabetes.

Source: Health Cost Institute, June 20, 2016

The high cost of health care is about the prices

The price of cancer drugs in the US is vastly higher than in other nations, according to new research that shines a light on how the cost of treating the life-threatening disease differs considerably depending on where the patient lives.

In the US, the median monthly price of branded cancer drugs, which are still protected by patents, was almost $8,700, compared with about $2,600 in the UK, $2,700 in Australia and $3,200 in China, according to the study, one of the largest of its kind.

http://www.cnbc.com/2016/06/06/financial-times-price-of-cancer-drugs-vastly-higher-in-us-according-to-study.html

June 11, 2016 | Categories: Cost,drugs,healthcare | Tags: , , , | Comments (0)

What are the long term implications to longevity

1 in 3 Adults Have Not Planned for Long-Term Care Needs

The Associated Press recently published their 2016 Long-Term Care Poll on attitudes and preparedness for long-term care. Here are some key findings from the report:

·         4 in 10 American adults over age 40 expect to rely on Medicare to pay for their long-term care needs.

·         One-third say they have done no planning at all for their own long-term care needs.

·         More than three quarters would prefer to receive care for themselves in their own home.

·         67% would prefer for their loved ones to receive care in a home setting.

·         Half of older Americans support government-administered long-term care insurance programs.

·         72% support state paid family leave programs to help Americans providing care to a loved one.

Source: Associated Press, June 1, 2016

50% in Four Years – The Increase in Surgical Admissions

According to a recent report, the average price of a surgical admission for a child in 2010 was $35,423, but by 2014 it had risen to $53,372 – a more than 50% price increase. Source: “Higher Prices for Children’s Health Care Drove Spending Growth in 2014, While Use of Services Declined,” Health Care Cost Institute Press Release, May 16, 2016, http://www.healthcostinstitute.org/news-and-events/higher-prices-children%E2%80%99s-health-care-drove-spending-growth-2014-while-use-services-d

What is the avg. cost per prescription for specialty drugs?

 

 

2015 Cost, By Condition, Of Specialty Drugs Based On Avg. Price Per Prescription

 

  1. Hepatitis C – $17,090.18
  2. Sleep Disorders – $8,928.96
  3. Oncology – $7,158.53
  4. Cystic Fibrosis – $6,441.27
  5. Multiple Sclerosis – $4,549.22
  6. Pulmonary Hypertension – $3,892.31
  7. Inflammation – $3,035.95
  8. HIV – $1,272,01

 

Notes: Mercer 2015 national survey of employer sponsored health plans & express scripts 2015 drug trend report

 

Source: Mercer

Superior Customer Experience Correlates to 50% Higher Hospital Margins

Superior Customer Experience Correlates to 50% Higher Hospital Margins

Accenture recently published an analysis on customer satisfaction from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Here are some key findings from the report:

  • Hospitals that deliver “superior” customer experience have 50% higher net margins than average hospitals.
  • The margin increase at urban hospitals is roughly eight times that of rural hospitals.
  • Academic hospitals had a 2.1% margin increase per 10% increase in HCAHPS score in 2013.
  • Margin increase correlated to a 10% consumer experience improvement grew 70% from 2008-2013.
  • Among the top 20% of patient experience performers, revenues grew 10.9% and costs grew 7.8% in 2013.
  • For profit hospitals had a 3.3% margin increase per 10% increase in HCAHPS score in 2013.

Source: Accenture, May 11, 2016

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