iLoveBenefits: Industry News Blog

Emergency Doctor’s Perspectives on Getting and Paying for the Care of their Patients

As you look at this survey keep in mind who they are asking and how they are responding. For example, 8 out of 10 are seeing patients…who are foregoing or delaying medical care. While it seems to say that 80% of physicians are seeing at least one patient who is delaying health care, it is not providing the detail about how many patients on the whole are delaying medical care…

And what percent of patients understand their health insurance coverage and how it works?

According to a recent nation-wide survey of emergency physicians:

  • 96% said that emergency patients do not understand what their health insurance policies cover for emergency care
  • 8 in 10 are seeing patients with health insurance who have forgone or delayed medical care because of high costs
  • 62% say most health insurance companies provide less than adequate coverage for emergency care visits
  • Over 60% have had trouble finding in-network specialists to care for patients in the last year
  • A quarter of them say they have trouble finding in-network specialists on a daily basis

Source: “Insurance Companies Mislead Patients By Selling “Affordable” Policies That Cover Very Little,” American College of Emergency Physicians News Release, May 9, 2016,

Race/Ethnicity for persons without health insurance

According to data from the January–September 2015 National Health Interview Survey, after adjusting for age and sex, the percentage of persons without health insurance coverage by race/ethnicity was:

  • 19.5% for Hispanic persons
  • 6.3% for non-Hispanic white persons
  • 10.0% for non-Hispanic black persons

Source: “Early Release of Selected Estimates Based on Data From the January–September 2015 National Health Interview Survey,” National Center for Health Statistics, Centers for Disease Control and Prevention, February 2016,

February 25, 2016 | Categories: Benefits,healthcare,insurance | Tags: , , | Comments (0)

4 in 5 expect that by 2021, patients will compare ratings before choosing a hospital

Survey: Most Patients Will Belong to Incentivized Health Plans by 2021

The Society for Healthcare Strategy & Market Development recently conducted a survey on healthcare leaders’ thoughts on emerging trends in healthcare. Here are some key findings from the report:

  • 99% agreed that by 2021 patients will demand a greater role in treatment planning.
  • 4 in 5 expect that by 2021, patients will compare ratings before choosing a hospital.
  • 89% said that most of their hospital’s insured patients will belong to incentivized health plans by 2021.
  • Most practitioners (88%) predict that at least a quarter of chronic disease patients will receive it remotely.
  • Two-thirds of practitioners predict that most chronic illness patients will receive primary care that includes some type of psychotherapy service.

Source: Society for Healthcare Strategy & Market Development, January 26, 2016

US Healthcare Spending $3 Trillion

U.S. Healthcare Spending was $9,523 Per Capita in 2014

Health Affairs recently published a study on national health spending trends in 2014. Here are some key findings from the report:

  • U.S. health care spending increased 5.3% to $3.0 trillion in 2014.
  • Health spending was $9,523 per capita in 2014, 4.5% higher than in 2013.
  • The share of gross domestic product used for health care was 17.5%, up from 17.3% in 2013.
  • Retail prescription drug expenditures increased by 12.2% in 2014.
  • Medicaid spending growth increased at a rate of 11%, compared to 5.9% in 2013.
  • The federal government’s share of health spending increased from 26% in 2013 to 28% in 2014.

Source: Health Affairs, November 2015

Health Benefits Cost $11,635 Per Employee in 2015

Mercer recently conducted the annual National Survey of Employer-Sponsored Health Plans. Here are some key findings from the report:

  • Total health benefits cost averaged $11,635 per employee in 2015.
  • Large employers experienced a 2.9% increase, while smaller employers experienced a 5.9% increase.
  • One fourth of all covered employees are now enrolled in a CDHP.
  • Employers predict that in 2016 their cost per employee will rise by 4.3% after making plan adjustments.
  • 24% of employers provided transparency tools in 2015, up from 15% in 2014.
  • 1 in 4 large employers encourage employees to track physical activity with a ‘wearable’ device.

Source: Mercer, November 23, 2015

Shifting the cost of health care

According to a recent analysis, total health care costs covered by employers have fallen by about 1% per year since 2012. Source: “2015 Records Lowest U.S. Health Care Cost Increases in Nearly 20 years,” Aon Media Center, November 12, 2015,

1% might not sound like a lot, but consider that on a roughly right basis if the cost of individual health care is $10,000 and the employer had been picking up 80% and the employee 20% a 1% shift is $80 PLUS the amount of the annual increase. If the increase is 6% then that’s an increase of $600 (of which the employee is paying an additional $120. So the total increase including the shift is @$200. So where they were paying $2000 (20% of $10,000) they are now paying 21% of $10,600 or $2226. That is an 11.3% increase year over year.

NCQA Health Insurance Plan Ratings 2015–2016

Using a new methodology, NCQA has announced their Health Insurance Plan Ratings 2015–2016. NCQA studied 1,358 health plans and rated 1,016: 491 private (commercial), 376 Medicare and 149 Medicaid. The ratings align with the CMS Star Ratings of Medicare Advantage plans, and incorporate health outcomes and consumer satisfaction data. Click to continue.

AHRQ Stats: Health Care Coverage

The percentage of people without health insurance decreased from 22 percent in 2010 to 20 percent in 2013. The percentage of uninsured fell further, to 16 percent, in the first half of 2014. (Source: Agency for Healthcare Research and Quality, 2014 National Healthcare Quality and Disparities Report Chartbook on Access to Health Care.)

September 16, 2015 | Categories: Benefits,healthcare,insurance | Tags: , , , | Comments (0)

…and if there were medical services price transparency… what would the public think

Prescription Drug Cost Perceptions

Here are some key findings from the June Kaiser Health Tracking Poll regarding the public’s views on prescription drug costs:

  • Almost three quarters (73%) of the public say prescription drug costs are unreasonable.
  • 76% of those believe costs are unreasonable because pharmaceutical companies set the prices too high.
  • 1 in 10 say that insurance companies are responsible for the costs by requiring people to pay too much.
  • 10% say that both pharmaceutical companies and health insurance companies are to blame.
  • Three quarters (76%) say it is easy to afford their medicine, while a fifth say it is difficult.
  • 53% say there is not enough price-limiting regulation vs. 12% who say there is too much regulation.

Source: Kaiser Family Foundation, June 16, 2015

June 22, 2015 | Categories: Cost,drugs,healthcare,insurance | Tags: , , , , | Comments (0)

Health Plan Member Portals Are Coming of Age

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