iLoveBenefits: Industry News Blog

National Health Spending Increased 4.3% in 2016

December 12, 2017

The CMS Office of the Actuary recently released national health expenditures for 2016. Here are some key findings from the report:

• In 2016, overall national health spending increased 4.3%.
• Retail prescription drug spending increasing 1.3% to $328.6 billion in 2016.
• Private health insurance spending increased 5.1% to $1.1 trillion in 2016.
• Medicare spending grew 3.6% to $672.1 billion in 2016.
• Spending growth for Medicaid slowed in 2016, increasing 3.9% to $565.5 billion.
• Out-of-pocket spending grew 3.9% to $352.5 billion in 2016.

Source: CMS Office of the Actuary, December 6, 2017

Recent data about the US population from the CDC

  • POPULATION: The U.S. population grew from 216.0 million to 321.4 million between 1975 and 2015.
    • The number of Americans aged 65 and over increased from 22.6 million to 47.8 million during 1975–2015.
    • In 1980, 20.1% of the population identified as racial or ethnic minorities; by 2015, 38.4% of the population identified as racial or ethnic minorities.
    • During 1975–2015, children under 18 were more likely to live in poverty than adults aged 18-64, and adults 65 and over.
    • The rural (nonmetropolitan) share of the population declined between 1970 and 2015, while the suburban share of the population increased.
  • LIFE EXPECTANCY: Between 1975 and 2015, life expectancy increased by 6.2 years for the total population and increased for males and females.
  • INFANT MORTALITY: The infant mortality rate decreased 63%, from 16.07 to 5.90 deaths per 1,000 live births between 1975 and 2015.
  • CAUSES OF DEATH: Heart disease and cancer were the top two causes of death in the U.S. throughout the past 4 decades.
  • CIGARETTE SMOKING: Between 1974 and 2015, the age-adjusted prevalence of current cigarette smoking among persons aged 25 and over decreased from 36.9% to 15.6%. In 2015, men and women aged 25 and over with no high school diploma were more than four times as likely to smoke as those with a bachelor’s degree or higher.
  • OBESITY: The age-adjusted percentage of adults aged 20 and over with obesity increased steadily from 22.9% in 1988–1994 to 37.8% in 2013–2014.
  • PRESCRIPTION DRUGS: For all adult age groups, the percentage taking one or more prescription drug in the past month increased between 1988–1994 and 2013–2014. Among adults aged 65 and over, use of five or more prescription drugs in the past 30 days increased from 13.8% to 42.2% in same time period.
  • HEALTH INSURANCE: Between 1978 and September 2016 (preliminary data), the percentage of children under age 18 who were uninsured decreased from 12.0% to 5.0%; the percentage with Medicaid coverage increased from 11.3% to 39.2%; and the percentage with private coverage decreased from 75.1% to 53.5%.

Health, United States 2016” with “Chartbook on Long-term Trends in Health” is available on the NCHS web site at: http://www.cdc.gov/nchs/hus.htm.

26% of Californians Were Covered By Medicaid/CHIP in 2015

Some simply amazing data. How can this be?

Kaiser Family Foundation recently updated state fact sheets on Medicaid spending. Here are some key findings from the report on Medicaid in California:

• In FY 2015, Medicaid spending in CA was $85.4 billion.
• 26% of people in CA were covered by Medicaid/CHIP in 2015.
• 4 in 5 Medicaid enrollees in CA are in families with a worker.
• 34% of Medicaid spending in CA is for Medicare beneficiaries.
• One-fifth of state general fund spending in CA is for Medicaid.
• 58% of all federal funds received by CA is for Medicaid.

Source: Kaiser Family Foundation, January2017

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

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.

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

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)

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/

Putting a Positive Spin on a Critical Problem

53% of Exchange Consumers are Satisfied With Their Health Plan

Deloitte recently published their 2016 Survey of US Health Care Consumers. Here are some key findings from the report:

  • More than half (53%) of exchange consumers are satisfied with their health plan overall.
  • 54% of those with employer insurance and 74% of those with Medicare are satisfied.
  • 7 in 10 exchange consumers say they had no financial difficulty paying out-of-pocket costs last year.
  • 34% of exchange consumers feel prepared to handle future health care costs compared with 16% in 2015.
  • Nearly half of exchange consumers (45%) say they feel confident about being able to get affordable care.
  • 67% of exchange consumers looked online for help selecting a policy vs. 30% with employer coverage.

Source: Deloitte, May 11, 2016

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