Obamacare’s Death of a Thousand Rate Hikes

August 25, 2014

A new analysis from PricewaterhouseCoopers projects that average premiums for policies sold through Obamacare’s exchanges will increase 7.5 percent in 2015.In nearly one-third of the 29 states that PwC investigated, premiums will rise by double digits. In Indiana, the average increase will be 15.4 percent. In Kansas, it’s 13.6 percent. Florida’s insurance commissioner says premiums are set to climb 13.2 percent.

via Obamacare’s Death of a Thousand Rate Hikes.


Medicare Star Ratings Allow Nursing Homes to Game the System – NYTimes.com

August 25, 2014

an examination of the rating system by The New York Times has found that Rosewood and many other top-ranked nursing homes have been given a seal of approval that is based on incomplete information and that can seriously mislead consumers, investors and others about conditions at the homes.The Medicare ratings, which have become the gold standard across the industry, are based in large part on self-reported data by the nursing homes that the government does not verify. Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers. The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value.

via Medicare Star Ratings Allow Nursing Homes to Game the System – NYTimes.com.


You Think Financing U.S. Health Care Is Bizarre? Check Out 340B Drug Pricing

August 22, 2014

Indeed, it can be said that in no other country is as much oversight necessary—and performed—as it already is in the U.S. Here hospitals spend hundreds of millions, possibly billions, every year to be in compliance with government regulations, and government auditors and the Inspector General’s offices cost hundreds of millions more. Every U.S. hospital now has some executive vice president in charge of compliance, has a board subcommittee dealing with compliance and has a sizeable compliance department and confidential hotline for whistle blowers. There are a growing number of compliance consulting firms helping hospitals and clinics to remain in compliance with U.S. federal and state regulations, earning a fine living from the process—all at patients’ expense, of course. I have never encountered anything like it in other countries whose health systems I have studied.

via You Think Financing U.S. Health Care Is Bizarre? Check Out 340B Drug Pricing.


Transcending Obamacare: An Introduction To Patient-Centered, Consumer-Driven Health Reform

August 14, 2014

Today, the Manhattan Institute is publishing my 20,000-word, 68-page health reform proposal entitled “Transcending Obamacare: A Patient-Centered Plan for Near-Universal Coverage and Permanent Fiscal Solvency.” It represents a novel approach to health reform: neither accepting Obamacare as is, nor requiring the law’s repeal to move forward. And yet its ambition is to permanently solve our health care entitlement problem, while also expanding coverage for the uninsured.

via Transcending Obamacare: An Introduction To Patient-Centered, Consumer-Driven Health Reform.


Arkansas Private Option’s Latest Boondoggle: “Health Independence Accounts” Increase Dependence and Increase Costs

August 12, 2014

Like so many of the promises ObamaCare expansion advocates have made, however, this promise turned out to be false.Not only did the Private Option lack any kind of meaningful “skin in the game” requirements, it actually reduced cost-sharing to below what Medicaid allows.It’s these cost-sharing provisions, which have enrollees pay a portion of their own health care costs, which can incentivize enrollees to be more responsible health care consumers. Yet more than 80 percent of Private Option enrollees currently have no cost sharing whatsoever.

via Arkansas Private Option’s Latest Boondoggle: “Health Independence Accounts” Increase Dependence and Increase Costs.


SSDI: Time for Reform | Cato Institute

August 12, 2014

The just-released Social Security Trustees’ annual report projects that Social Security’s Disability Insurance SSDI component will become insolvent sometime during 2016 — leaving not much time for reform deliberations. Recent instances of SSDI fraud have concentrated the minds of lawmakers in Congress. Beyond combating SSDI fraud, however, Congress can use this opportunity to adopt sensible SSDI reforms to improve the lives of individuals with disabilities.

via SSDI: Time for Reform | Cato Institute.


Churn and the ACA | The Health Care Blog

August 12, 2014

Different eligibility criteria for different populations can also cause a churn challenge, especially for families. Most states have different Medicaid eligibility limits for children than for adults. This means that if a family’s income increases, or a child ages out of CHIP coverage, the eligibility for the parents may change, while the eligibility for the children may not. This scenario results in split families, wherein the children have one type of coverage and adults have a different type. In many states, this means understanding the details, benefits and cost structures of two types of coverage, often from different companies, in the same household.

So what can we do to safeguard consumers from these disruptions? Fortunately, states have resources in their toolkits to mitigate the impacts of churn. They can work to maintain continuity of care for individuals, and they can make sure that insurance remains affordable when people jump from one coverage source to another.

via Churn and the ACA | The Health Care Blog.