What medical conditions are driving employer healthcare costs?
Do you know which medical conditions are driving your healthcare cost? Check out this great article from Employee Benefits Advisor about the cost associated with your employer healthcare by Phil Albinus
Healthcare costs surrounding diabetes reached $101 billion in diagnoses and treatments over the past 18 years — and the cost grew 36 times faster than the cost of ischemic heart disease, the leading cause of death in the U.S. Further, out of 155 medical conditions, only 20 accounted for half of all medical spending, according to a JAMA analysis of 2013 healthcare costs.
The third-most expensive medical condition, low back and neck pain, primarily strikes adults of working age while diabetes and heart disease is primarily found in people 65 and older.
The JAMA study found total health spending for these conditions totaled $437 billion in 2013. Diabetes, heart disease, low back and neck pain, along with hypertension and injuries from falls, comprise 18% of all personal health spending. All in all, 20 conditions make up more than half of all spending on healthcare in the U.S.
These stark figures shed light on the rising healthcare costs that employers pay when addressing their workforce’s ailments.
According to Francois Millard, senior vice president and chief actuarial officer for Vitality Group, one of the study’s sponsors, this is the first study to dig into the details of the leading ailments of the U.S. and its costs to employers and families as they deal with the conditions.
“In absolute terms, most money for care is in the working age population,” he says. “It impacts households and employers and contributes to the financial burden of families.”
“What we see is the financial burden increases as the disease increases, and while the paper doesn’t go into detail, we already have a significant knowledge of diabetes and heart condition. It is related to modifiable behavior.”
The JAMA study noted the differences between public health program spending from personal health spending, including individual out-of-pocket costs and spending by private and government insurance programs.
“While it is well known that the U.S. spends more than any other nation on healthcare, very little is known about what diseases drive that spending,” said Dr. Joseph Dieleman, lead author of the paper and assistant professor at the Institute for Health Metrics and Evaluation at the University of Washington, in a press statement. “IHME is trying to fill the information gap so that decision-makers in the public and private sectors can understand the spending landscape, and plan and allocate health resources more effectively.”
Despite using figures from 2013, the information can help employers as they identify where their healthcare dollars are going.
“Given the biggest increases in healthcare spending on impact working age populations, it requires employers to improve their work environments and facilitate good health. And [this study can] help increase the transparency of health within their populations,” says Millard.
“Employers need to think what they do that impacts beyond the four walls of the employers and create a symbiotic relationship with health within their societies,” he adds.
The study can also boost transparency into the healthcare data. “This study is also an accountability and outcome of the money they are spending on health treatment,” Millard says. “Is it sufficient to still pay for services or can we push for more accountability for health outcomes? The other thing this facilities is that employers get the adequate level of data. They can ask the right questions and determine accountability for the huge amounts of healthcare.”
He adds, “With all the uncertainty around 2017, perhaps this transparency will give employers a voice to all of the money that they are spending.”
The top 10 most costly health expenses in 2013:
1. Diabetes – $101.4 billion
2. Ischemic heart disease – $88.1 billion
3. Low back and neck pain – $87.6 billion
4. Hypertension – $83.9 billion
5. Injuries from falls – $76.3 billion
6. Depressive disorders – $71.1 billion
7. Oral-related problems – $66.4 billion
8. Vision and hearing problems – $59 billion
9. Skin-related problems, such as cellulitis and acne – $55.7 billion
10. Pregnancy and postpartum care – $55.6 billion
See the original article here.
Source:
Albinus P. (2017 January 12). What medical conditions are driving employer healthcare costs?[Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/what-medical-conditions-are-driving-employer-healthcare-costs?brief=00000152-1443-d1cc-a5fa-7cfba3c60000
Health Law Sleepers: Six Surprising Health Items That Could Disappear With ACA Repeal
Does ACA repeal have you worried? Look into this great article from Kaiser Health News about some of things that could disappear with ACA repeal by Julie Appleby and Mary Agnes Carey
The Affordable Care Act of course affected premiums and insurance purchasing. It guaranteed people with pre-existing conditions could buy health coverage and allowed children to stay on parents’ plans until age 26. But the roughly 2,000-page bill also included a host of other provisions that affect the health-related choices of nearly every American.
Some of these measures are evident every day. Some enjoy broad support, even though people often don’t always realize they spring from the statute.
In other words, the outcome of the repeal-and-replace debate could affect more than you might think, depending on exactly how the GOP congressional majority pursues its goal to do away with Obamacare.
No one knows how far the effort will reach, but here’s a sampling of sleeper provisions that could land on the cutting-room floor:
CALORIE COUNTS AT RESTAURANTS AND FAST FOOD CHAINS
Feeling hungry? The law tries to give you more information about what that burger or muffin will cost you in terms of calories, part of an effort to combat the ongoing obesity epidemic. Under the ACA, most restaurants and fast food chains with at least 20 stores must post calorie counts of their menu items. Several states, including New York, already had similar rules before the law. Although there was some pushback, the rule had industry support, possibly because posting calories was seen as less onerous than such things as taxes on sugary foods or beverages. The final rule went into effect in December after a one-year delay. One thing that is still unclear: Does simply seeing that a particular muffin has more than 400 calories cause consumers to choose carrot sticks instead? Results are mixed. One large meta-analysis done before the law went into effect didn’t show a significant reduction in calorie consumption, although the authors concluded that menu labeling is “a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories.”
PRIVACY PLEASE: WORKPLACE REQUIREMENTS FOR BREAST-FEEDING ROOMS
Breast feeding, but going back to work? The law requires employers to provide women break time to express milk for up to a year after giving birth and provide someplace — other than a bathroom — to do so in private. In addition, most health plans must offerbreastfeeding support and equipment, such as pumps, without a patient co-payment.
LIMITS ON SURPRISE MEDICAL COSTS FROM HOSPITAL EMERGENCY ROOM VISITS
If you find yourself in an emergency room, short on cash, uninsured or not sure if your insurance covers costs at that hospital, the law provides some limited assistance. If you are in a hospital that is not part of your insurer’s network, the Affordable Care Act requires all health plans to charge consumers the same co-payments or co-insurance for out-of-network emergency care as they do for hospitals within their networks. Still, the hospital could “balance bill” you for its costs — including ER care — that exceed what your insurer reimburses it.
If it’s a non-profit hospital — and about 78 percent of all hospitals are — the law requires it to post online a written financial assistance policy, spelling out whether it offers free or discounted care and the eligibility requirements for such programs. While not prescribing any particular set of eligibility requirements, the law requires hospitals to charge lower rates to patients who are eligible for their financial assistance programs. That’s compared with their gross charges, also known as chargemaster rates.
NONPROFIT HOSPITALS’ COMMUNITY HEALTH ASSESSMENTS
The health law also requires non-profit hospitals to justify the billions of dollars in tax exemptions they receive by demonstrating how they go about trying to improve the health of the community around them.
Every three years, these hospitals have to perform a community needs assessment for the area the hospital serves. They also have to develop — and update annually — strategies to meet these needs. The hospitals then must provide documentation as part of their annual reporting to the Internal Revenue Service. Failure to comply could leave them liable for a $50,000 penalty.
A WOMAN’S RIGHT TO CHOOSE … HER OB/GYN
Most insurance plans must allow women to seek care from an obstetrician/gynecologist without having to get a referral from a primary care physician. While the majority of states already had such protections in place, those laws did not apply to self-insured plans, which are often offered by large employers. The health law extended the rules to all new plans. Proponents say direct access makes it easier for women to seek not only reproductive health care, but also related screenings for such things as high blood pressure or cholesterol.
AND WHAT ABOUT THOSE THERAPY COVERAGE ASSURANCES FOR FAMILIES WHO HAVE KIDS WITH AUTISM?
Advocates for children with autism and people with degenerative diseases argued that many insurance plans did not provide care their families needed. That’s because insurers would cover rehabilitation to help people regain functions they had lost, such as walking again after a stroke, but not care needed to either gain functions patients never had, such speech therapy for a child who never learned how to talk, or to maintain a patient’s current level of function. The law requires plans to offer coverage for such treatments, dubbed habilitative care, as part of the essential health benefits in plans sold to individuals and small groups.
See the original article Here.
Source:
Appleby J., Carey M. (2017 January 12). Health law sleepers: six surprising health items that could disappear with ACA repeal [Web blog post]. Retrieved from address https://khn.org/news/health-law-sleepers-six-surprising-health-items-that-could-disappear-with-aca-repeal/?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=40532225&_hsenc=p2ANqtz-8vl0H_K8CNgaURbqgYS5m3isu1NUGrj0FRIdsUX8JCwcifTDRV-UvKdu6lZGvB06FTyhENvPFLaOMOsIrr2IBVBTNWQg&_hsmi=40532225
Kaiser Health Tracking Poll: Health Care Priorities for 2017
Great article from the Kaiser Family Foundation about Americans thoughts on ACA repeal by Ashley Kirzinger, Bryan Wu, and Mollyann Brodie
KEY FINDINGS:
- The latest Kaiser Health Tracking Poll finds that health care is among the top issues, with the economy and jobs and immigration, Americans want President-elect Donald Trump and the next Congress to address in 2017. When asked about a series of health care priorities for President-elect Trump and the next Congress to act on, repealing the ACA falls behind other health care priorities including lowering the amount individuals pay for health care, lowering the cost of prescription drugs, and dealing with the prescription painkiller addiction epidemic.
- When presented with two general approaches to the future of health care in the U.S., six in ten (62 percent) Americans prefer “guaranteeing a certain level of health coverage and financial help for seniors and lower-income Americans, even if it means more federal health spending and a larger role for the federal government” while three in ten (31 percent) prefer the approach of “limiting federal health spending, decreasing the federal government’s role, and giving state governments and individuals more control over health insurance, even if this means some seniors and lower-income Americans would get less financial help than they do today.”
- As Congressional lawmakers make plans for the future of the ACA, the latest survey finds the public is divided on what they would like lawmakers to do when it comes to the 2010 health care law. Forty-nine percent of the public think the next Congress should vote to repeal the law compared to 47 percent who say they should not vote to repeal it. Of those who want to see Congress vote to repeal the law, a larger share say they want lawmakers to wait to vote to repeal the law until the details of a replacement plan have been announced (28 percent) than say Congress should vote to repeal the law immediately and work out the details of a replacement plan later (20 percent). However, the survey also finds malleability of attitudes towards Congress repealing the health care law with both supporters and opponents being persuaded after hearing counter-messages.
Top Issues for President-elect Trump and Congress
The latest Kaiser Health Tracking Poll finds health care among the top issues Americans want President-elect Donald Trump and the next Congress to address in 2017. When asked which issue they would most like the next administration to act on in 2017, one-fourth of the public mention the economy and jobs (24 percent), followed by immigration (20 percent), and health care (19 percent). Among Democrats and independents, the economy and jobs is the top issue (23 percent and 24 percent, respectively) while the top issues for Republicans are immigration (30 percent) and economy and jobs (29 percent). Among all partisans, health care ranks among the top three issues that the public wants the next administration to act on in 2017.
The top issue for voters who supported President-elect Donald Trump are similar to those among Republicans: economy and jobs (31 percent) and immigration (31 percent), followed closely by health care (27 percent).
When asked to mention which health care issue they would most like President-elect Trump and the next Congress to act on in 2017, about one-third of the public mention the Affordable Care Act (ACA) but attitudes are mixed between wanting the next administration to act on repealing the 2010 health care law (14 percent), improving/fixing the law (11 percent), or keeping/expanding the law (8 percent).
LOWERING OUT-OF-POCKET COSTS IS A TOP PRIORITY FOR AMERICANS
When asked about a series of health care priorities for President-elect Trump and the next Congress to act on, repealing the ACA falls behind other health care priorities. Two-thirds of the public (67 percent) say lowering the amount individuals pay for health care should be a “top priority” for President-elect Trump and the next Congress. This is followed by six in ten (61 percent) who say lowering the cost of prescription drugs should be a “top priority,” and nearly half (45 percent) who say dealing with the prescription pain killer addiction epidemic should be a “top priority.”
Smaller shares say repealing the 2010 health care law (37 percent), decreasing how much the federal government spends on health care over time (35 percent), and decreasing the role of the federal government in health care (35 percent) should be top priorities.
LOWERING OUT-OF-POCKET COSTS TOPS PRIORITIES REGARDLESS OF PARTISANSHIP
While about two-thirds of Democrats, Republicans, and independents say lowering the amount individuals pay for health care should be a “top priority,” partisans differ in how they prioritize other health care issues. Most notably, while 63 percent of Republicans say repealing the 2010 health care law should be a top priority – this view is shared by much smaller shares of independents (32 percent) and Democrats (21 percent). Similarly, Republicans (50 percent) are more likely than independents (34 percent) or Democrats (26 percent) to place a top priority on decreasing the role of the federal government in health care. By contrast, Democrats and independents are somewhat more likely than Republicans to place a top priority on lowering the cost of prescription drugs (67 percent, 61 percent, and 55 percent, respectively) and on dealing with the epidemic of prescription painkiller addiction (51 percent, 46 percent, and 39 percent, respectively).
CONFIDENCE IN PRESIDENT-ELECT TRUMP’S ABILITY TO REDUCE HEALTH CARE COSTS
Lowering out-of-pocket health care costs is a top priority for Americans, and this was also a campaign promise from Donald Trump during his 2016 presidential campaign. When asked how confident they are in President-elect Trump’s ability to deliver on this campaign promise that Americans will get better health care at a lower cost than they pay now, Americans are split with similar shares saying they are either “not too confident” or “not at all confident” (51 percent) as saying they are “very confident” or “somewhat confident” (47 percent).
Confidence in President-elect Trump’s promise that Americans will get better health care at a lower cost is largely divided by party identification and 2016 vote choice with nearly nine in ten Republicans (85 percent) and Trump voters (86 percent) saying they are either “very” or “somewhat” confident in the next administration’s ability to deliver on this campaign promise. This is compared to 81 percent of Democrats and 86 percent of Clinton voters who say they are either “not too confident” or “not at all confident” that the next president will deliver on this promise.
Americans’ Attitudes on the Future of Health Care in the U.S.
Throughout the 2016 presidential election, it became clear that the two major political parties in the U.S. have competing views on the future of health care. When given two competing approaches to the future of health care, six in ten Americans (62 percent) prefer “guaranteeing a certain level of health coverage and financial help for seniors and lower-income Americans, even if it means more federal health spending and a larger role for the federal government” while about one-third (31 percent) prefer “limiting federal health spending, decreasing the federal government’s role, and giving state governments and individuals more control over health insurance, even if this means some seniors and lower-income Americans would get less financial help than they do today.”
There are also partisan differences, with about half of Republicans (53 percent) preferring the approach that Republican leaders have coalesced around – limiting federal health spending, decreasing the federal government’s role, and giving states and individuals more control; this approach is preferred by much smaller shares of independents (27 percent) and Democrats (15 percent). The majority of Democrats (79 percent) and independents (65 percent) prefer guaranteeing a certain level of coverage for seniors and lower-income Americans – even if it means a larger role for the federal government and increased federal spending.
ATTITUDES TOWARDS THE FUTURE OF THE AFFORDABLE CARE ACT
The future of the Affordable Care Act has been at the forefront of the political agenda since the 2016 election with President-elect Trump and Republican lawmakers in Congress saying they will quickly move to repeal the health care law in 2017. The latest survey finds public opinion towards the law is divided with similar shares of the public saying they have an unfavorable opinion (46 percent) as say they have a favorable opinion (43 percent) of the law, which is largely stable from previous months.
REPEALING AND REPLACING THE AFFORDABLE CARE ACT
As Congressional lawmakers make plans for the future of the ACA, the latest Kaiser Health Tracking survey finds that – similar to overall attitudes towards the law – the public is also divided on what they would like lawmakers to do when it comes to the 2010 health care law.
Overall, 49 percent of the public think the next Congress should vote to repeal the law and 47 percent say they should not vote to repeal it. Of those who want to see Congress vote to repeal the law, a larger share say they want lawmakers to wait to vote on repeal until the details of a replacement plan have been announced (28 percent) than say Congress should vote to repeal the law immediately and work out the details of a replacement plan later (20 percent).
HOW FLEXIBLE ARE AMERICANS’ OPINIONS OF REPEALING THE ACA?
The survey examines the malleability of attitudes towards Congress repealing the health care law and finds that both supporters and opponents of Congress voting to repeal the law can be persuaded after hearing counter-messages. After hearing pro-repeal arguments, the share of the public supporting repeal can grow to as large as 60 percent, while counter-messages against repeal can decrease support to 27 percent.
Among those who originally said Congress should not vote to repeal the 2010 health care law, about one-fifth (22 percent) change their opinion after hearing that some consumers around the country have seen large increases in the cost of their health insurance – which is similar to the share who shifted their opinion after hearing that the country cannot afford the cost of providing financial help to individuals to purchase health insurance.
On the other side of the debate, some of those who originally said they support Congress voting to repeal the health care law are also persuaded by hearing arguments often made by opponents of the repeal efforts. The survey finds that a share shifts their opinion after hearing that some people with pre-existing conditions would no longer be able to get health coverage and after hearing that some of the roughly 20 million Americans who got health insurance as a result of the law would lose their coverage.
PERCEIVED EFFECTS OF CHANGES TO HEALTH CARE SYSTEM
Overall, large shares of Americans say their own health care will “stay about the same” if lawmakers vote to repeal the 2010 health care law. More than half of Americans say the quality of their own health care (57 percent) and their own ability to get and keep health insurance (55 percent) will stay about the same if the law is repealed. Fewer (43 percent) say the cost of health care for them and their family will stay about the same if the law is repealed. In each of these cases, about equal shares believe their own situation will get better as say it will get worse.
INDIVIDUALS WITH A PRE-EXISTING CONDITION
After being read a definition of “pre-existing condition,” just over half (56 percent) of U.S. adults say that they or someone in their household would be considered to have such a condition. Overall, these individuals are more likely than those without a pre-existing condition to say their access, quality, and cost of health care will get “worse” if the ACA is repealed. However, about one in five of these individuals say their access, quality, and cost of health care will get “better” if the ACA is repealed.
One-third of individuals who have someone in their household with a pre-existing condition say the cost of health care for them and their family will get worse if the ACA is repealed, compared to about one in five of those living in a household without someone with a pre-existing condition. Larger shares of those with a pre-existing condition also say their ability to get and keep health insurance will get worse than those without a pre-existing condition (24 percent vs. 17 percent), and the quality of their own health care will get worse (21 percent vs. 15 percent).
In addition, individuals with a pre-existing condition in their household also report being more worried about health-care related issues than those without a pre-existing condition. Slightly more than half (54 percent) of those with a pre-existing condition say they are either “very worried” or “somewhat worried” about not being able to afford the health care services they need, compared to 43 percent of those without a pre-existing condition. Similarly, 43 percent of those with a pre-existing condition are worried (either “very” or “somewhat”) about losing their health insurance compared to 30 percent of those without a pre-existing condition.
Kaiser Health Policy News Index
The latest Kaiser Health Tracking Poll finds President-elect Donald Trump’s transition and cabinet appointments was the most closely followed news story during the past month with seven in ten (68 percent) Americans closely following news about his transition. Other stories that captured the attention of Americans include the conflict involving ISIS in Mosul, Iraq (64 percent), the CIA’s report of Russia interfering in the 2016 presidential election (64 percent), and the top health policy story this month – Republican plans to repeal the ACA (63 percent). Other health policy stories followed by Americans this month include the ongoing heroin and prescription painkiller addiction epidemic in the U.S. (57 percent), Republican plans for the future of Medicare (51 percent), and the passing of the 21st Century Cures Act (37 percent).
See the original article and charts Here.
Source:
Krizinger A., Wu B., Brodie M. (2017 January 06). Kaiser health tracking poll: health care priorities [Web blog post]. Retrieved from address https://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-health-care-priorities-for-2017/
Obamacare Enrollment Is Beating Last Year’s Early Pace
Great article from Kaiser Health News about ACA enrollment by Phil Galewitz
Despite the Affordable Care Act’s rising prices, decreased insurer participation and a vigorous political threat to its survival, consumer enrollment for 2017 is outpacing last year’s, according to new federal data and reports from state officials around the country.
Americans’ anxiety about how a new Republican-controlled Congress and President-elect Donald Trump will repeal and replace the health law is helping fuel early enrollment gains in the online marketplaces that sell individual coverage, state exchange officials and health consultants said.
Healthcare.gov, the federal marketplace which handles coverage for 39 states, enrolled6.4 million people from Nov. 1 through Monday, about 400,000 more than at the same time a year ago, the Health and Human Services Department said Wednesday. Monday was the deadline in those states to sign up for coverage starting Jan. 1, but open enrollment will continue until Jan. 31 for 2017 coverage.
“The marketplace is strong … and now we know the doomsday predictions about the marketplace are not coming true,” HHS Secretary Sylvia Burwell said in a press briefing.
The surge in sign-ups on the federal marketplace mirrors activity on several state-run Obamacare exchanges, according to figures obtained from states independently by Kaiser Health News. Minnesota, with more than 54,000 enrollees as of Monday, doubled the number of sign-ups it had at the same time last year. Colorado, Massachusetts and Washington had enrollment growth of at least 13 percent compared to a year ago.
“Because of the new administration and the high likelihood of changes coming to the ACA, it is creating a sense of urgency” for people to enroll, said Michael Marchand, director of communications for the Washington Health Benefit Exchange. Enrollment exceeded 170,000 customers on the Washington exchange as of this week, up 13 percent compared to same time a year ago.
Other state exchanges saw moderate increases: Connecticut, 3 percent; Idaho, 4 percent; Maryland, 1 percent. California’s enrollment is about same as a year ago. Rhode Island’s enrollment dropped to 27,555 from 31,900 for the same period last year. State exchange officials cited a drop in customers who were automatically renewed because UnitedHealthcare dropped out.
About 12.7 million people enrolled in the state and federal exchanges for 2016 coverage at the end of the previous enrollment season. HHS predicted in October that an additional 1.1 million people would sign up for 2017 coverage. Burwell said Wednesday that her department is sticking with that projection, even though “the headwinds have increased” since the election.
Obamacare, now in its fourth open enrollment season, took some heavy blows this year after several big insurers — including UnitedHealthcare, Humana and Aetna — withdrew from many marketplaces for 2017 because of heavy financial losses. At the same time, remaining insurers increased premiums by 25 percent on average.
All of that, plus a changed political climate in Washington, was expected to dampen enrollment. While the surprise presidential election outcome may have been the primary force for changing those expectations, other factors also have fueled enrollment growth this fall, state officials pointed out in interviews.
More people who don’t qualify for government subsidies are buying health plans on the exchanges because it’s an easier way to compare available plans in one place. Noting that trend, Premera Blue Cross in Washington recently stopped selling individual coverage off the exchange.
In Minnesota, higher government subsidies — which reduce premiums for people with lower incomes — is the main reason why more people have signed up, according to Allison O’Toole, CEO of MNsure, the state-run exchange. The subsidy amount is tied to the cost of the second-lowest silver plan on the exchange, so as premiums rise for that plan, the subsidy rises too. Premiums soared by an average 50 percent in Minnesota for second-lowest silver.
Another factor driving earlier enrollment in that state was caps set by several Minnesota insurers on the number of new enrollees they would accept. People signed up earlier to make sure they could get the plan they wanted, according to O’Toole.
Minnesota’s growth is surprising because one of its biggest carriers, Blue Cross and Blue Shield of Minnesota, stopped selling its most popular health plan on the exchange. That forced about 20,000 people to change insurers or switch from Blue Cross’ PPO, which has a broad provider network, to its HMO plan with a narrower network.
In Colorado, the 18 percent increase in enrollment so far has exceeded officials’ expectations, said Luke Clarke, the spokesman for Connect for Health Colorado, the state exchange. “We had an office pool and no one picked a number that high,” he said. “It was a healthy surprise,” particularly because premiums increased in the state by about 20 percent on average.
Conservatives warn it’s still too early for Obamacare supporters to celebrate.
“I suspect that some states saw big increases because local advocacy groups were able to tell their constituents that they should enroll before Trump is sworn in and Republicans take over Congress — thereby pretty much guaranteeing that they get a full year’s coverage regardless of what Republicans might do on repeal,” said Joe Antos, a health economist with the American Enterprise Institute, a conservative think tank.
Under that scenario, large enrollment increases this fall might be followed by a dropoff in January over the 2016 numbers and the final enrollment tally could end up similar this year’s, he said. Antos noted the true enrollment figures will be known once people pay for their coverage and stay enrolled for the full year.
“As with everything related to ACA,” Antos said, “it’s easy to find a happy story if you squint hard enough and don’t wait for the enrollment process to complete — or the plan year to end.”
See the original article Here.
Source:
Galewitz P. (2016 December 21). Obamacare enrollment is beating last year's early pace [Web blog post]. Retrieved from address https://khn.org/news/obamacare-enrollment-is-beating-last-years-early-pace/
What’s employers’ No. 1 concern in 2017?
Does the new year have you worried? Check out this great article from Employee Benefits Advisor about employers concerns in 2017 by Phil Albinus
In the aftermath of President-elect Donald Trump’s surprise victory last month, the top employee benefit concern among employers remains their role on the Affordable Care Act. According to a survey of 800 employers conducted by brokerage solution provider Aon, nearly half — 48% — responded that the employer mandate is their biggest concern for the new administration.
According to J.D. Piro, head of the Aon’s law group, the concern stems from whether or not Trump will repeal and replace Obamacare and what plans the 115th Congress has for Medicare.
“It’s all of those [issues] and the employer mandate which has the reporting obligations, the disclosure obligations, 1094 and 1095 forms and the service tracking ... all of that goes into the ACA. The concern is, is it going to be dropped, expanded or modified in some way?” Piro tells EBN.
“Employers have all sorts of questions about that,” he adds.
The employer mandate was by far the top employer concern, according to the Aon survey, which was administered after the election. “Prescription drug costs” received 17% of responses and the “excise tax” received 15% of respondents’ attention. “Tax exclusion limitations on employer-sponsored healthcare” garnered 10% of votes while “paid leave laws” and “employee wellness programs” trailed at 8% and 2%, respectively.
The results didn’t surprise Piro. The employer mandate “is something employers had to get up to speed on and learn how to administer in a very short period of time. It was so complex that it was delayed for a year. It’s not yet part of the framework, and people are still addressing how to comply with it,” he says.
Looking ahead
While Piro declined to make any predictions about what the new administration will accomplish in terms of healthcare, he does think Congress will act quickly, if at least symbolically.
“I think something will happen in 2017. The most likely scenario is Republicans will pass some sort of repeal bill in the first 100 days of the new administration, but they will put off the effective date of the repeal until 2018 or 2019,” he says. “It will be somewhere down the road so they can decide when and what the replacement is going to be.”
The sheer complexity of ACA and Medicare will not make its repeal an easy matter for either the new Trump administration or Congress.
“This is an interconnected web of laws and rulings and the ACA affects every sector of healthcare. It’s thousands of pages of regulations,” Piro says. “Repealing it is not as easy as turning off a light switch or unplugging a computer and plugging it back in again.”
“A lot of people are affected by ACA and you have to consider what the impact is going to be.”
See the original article Here.
Source:
Albinus P. (2017 January 04). What's employers' no. 1 concern in 2017 [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/news/whats-employers-no-1-concern-in-2017?utm_campaign=eba%20daily-jan%204%202017&utm_medium=email&utm_source=newsletter&eid=909e5836add2a914a8604144bea27b68
10 ways to promote the value of a private exchange
Great article from Employee Benefits Advisor about 10 different ways to promote private exchanges by Sima Reid
Our world has changed so much and quickly — take the evolution of cell phones in the last decade, for example — but how we approach offering employee benefits is moving at a snail’s pace in comparison. To stay current and modern, employee benefits must evolve.
Many employers see the value in structuring their employee benefit programs to meet the needs of their multi-generational employee population. A private exchange brings all the elements together, creating value for the employer and the employee.
Offering a private exchange to employees is not just about moving to a defined contribution model or promising a silver bullet to reduce benefit costs. A private exchange should bring value to the employer and their employees independent of the products or pricing of those products.
The value proposition of a private exchange:
1) Paternalism. For employers who understand the value of giving up some of the benefit decisions to their employees, a private exchange provides a way to give employees more options — using tools that help them make good decisions based on their wants and needs.
2) Meaningful choice. More choice is good, too much choice is not better. It is important to include options that make sense for each particular workforce, including traditional medical, dental, vision, etc. as well as voluntary benefits. A meaningful line up of benefit options will help employees fill gaps they may have in the areas such as legal services, ID theft, chiropractic care, additional life insurance or disability, and so on.
3) Proper plan election. When employees are allowed to select plans that make sense for them from a benefit/cost perspective, many employers see a right-sizing of their benefit program. This provides them with savings. If an employer only offers one health plan that has low out of pocket, they are over paying for many employees. If an employee would rather pay less per paycheck but more when they have services, choice allows them to do so. This brings value to the employee and the employer.
4) Self-insured and fully insured plans. Being self-insured does not mean eliminating employee choice. For many employers, self-insured plans make more sense than a fully insured plan. A private exchange should be able to accommodate either financing mechanism.
5) Streamlined benefits education and administration. A private exchange is not just a benefits administration system. Private exchange technology provides critical education and tools available to employees for all the plans and programs offered. Gone are the days of trying to include all the information in an employee enrollment communication that the employees likely won’t read. The process for HR is streamlined through the private exchange using a modern, inviting and attractive online platform.
6) 24/7 access. How companies engage and retain employees has changed. The need exists for a year-round platform focused on life’s experiences and challenges. Tools to help employees work on wellness, whether it is health or financial, will provide value to the employee. Messaging employees during the year encourages them to go to the private exchange outside of open enrollment.
7) Decision support. While decision support helps personalize employee decisions, it is important for a private exchange to help people not just pick which medical or dental plan they’d like, but also voluntary benefits offered. If you ask most people how much life insurance they should have, not many can tell you. A tool that helps someone calculate, based on their circumstances, how much life insurance they may need so they can decide if they want to buy additional life insurance above what the company provides can be valuable to many employees.
8) Comparison shopping. How many consumer purchases today have us searching online for information telling us the best products at the best cost? More and more employees find value in this same approach for their benefits. Private exchanges providing employees with side by side comparisons in summary and in detail along with costs can bring value to the employee.
9) Employee experience. Many employers value a positive, friendly platform for the delivery of their employee benefit program. A private exchange brings modern technology to education and enrollment of benefits. How many employees within a company do you think watch YouTube? Whether we think this is an acceptable method of communication or not, it is a powerful, current method of communication. Using videos and other educational tools on the private exchange adds value for many employees.
10) The shopping experience. Allowing employees to shop for their benefits takes the insurance enrollment process to a very different level. It bridges the often disjointed, confusing process of benefit enrollment with our normal daily activities of how we approach buying goods and services. A private exchange allows employees to walk down the aisle of a virtual store of benefits.
A private exchange makes life easier for the employer and their employees by using technology, a modern approach, enhanced educational tools and resources to focus on the employee experience. Private exchanges are the present and the future of employee benefits.
See the original article Here.
Source:
Reid S. (2017 January 3). 10 ways to promote the value of private exchange [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/10-ways-to-promote-the-value-of-a-private-exchange
Financial wellness: Here’s what employees want, need in 2017
Great article from our partner, United Benefit Advisors (UBA) by
Recent research into individuals’ financial resolutions for 2017 can tell you whether your financial wellness initiatives are giving employees what they want. It can also tell you whether to expect employees to increase their retirement contributions next year.
Personal finance company LendEDU recently asked 1,001 Americans about their financial goals for 2017, as well as what their biggest concerns are. The results were published in LendEDU’s “Financial Resolution Survey & Report 2017,” which can help employers determine if their financial programs are on point.
Here are some of the more interesting Q&A’s from the research:
What’s your most important financial resolution in 2017?
- Save more money — 52.85% of respondents selected this
- Pay off debt — 35.56%
- Spend less money — 11.59%
Takeaway for employers: Improving savings should be front and center in any financial wellness strategy.
What’s your top financial resolution?
- Make and stick to a budget — 21.38%
- Save for a large purchase like a down payment, household upgrade, or car, etc. — 19.28%
- Pay down credit card debt — 18.88%
- Place money aside for an emergency — 16.58%
- Save for retirement — 13.69%
- Pay down student loan debt — 7.29%
- Save for college — 2.90%
Takeaway for employers: Employees need the most help creating a budget they can stick to.
What’s your top financial concern?
- Unexpected expenses — 53.25%
- Healthcare costs — 23.98%
- Higher interest rates — 9.69%
- The labor market — 7.79%
- Stock market fluctuations — 5.29%
Takeaway for employers: Helping employees manage healthcare costs can be a key add-on to any financial education program.
Do you think you’re better off financially in 2017 than in 2016?
- Yes — 78.32%
- No — 21.68%
Takeaway for employers: Employees’ financial state of mind is on the upswing, which is good. But it could make increasing participation in wellness initiatives more challenging.
Do you make financial resolutions with your spouse or significant other?
- Yes — 84.83%
- No — 15.17%
Takeaway for employers: When it comes to finances, very few people go it alone, so invite spouses to be a part of your wellness offerings.
What would make you stick to a financial resolution?
- Having a reward for reaching the goal — 37.56%
- Segmenting a longer term goal into smaller bit sized pieces — 20.08%
- Technology that helps you save money or monitor goals in real-time — 19.38%
- The encouragement of family and friends — 13.99%
- Having a consequence for not reaching the goal — 8.99%
Takeaway for employers: Incremental rewards and incentives, can help drive participation and success in 2017 financial wellness initiatives.
Do you think you’ll increase your retirement savings contributions this year?
- Yes — 63.24%
- No — 36.76%
Takeaway for employers: This could be a good year to really push employees to bump up retirement plan contributions.
See the original article Here.
Source:
Author (Date). Title [Web blog post]. Retrieved from address https://www.hrmorning.com/financial-wellness-heres-what-employees-want-need-in-2017/
SHRM Study: Health Care Remains Key Benefit for All Employee Groups
Check out this interesting article from Workforce about the most recent SHRM benefits study by Andie Burjek
See the original article Here.
Source:
Burjek A. (2016 December 1). SHRM study: health care remains key benefit for all employee groups[Web blog post]. Retrieved from address https://www.workforce.com/2016/12/01/shrm-study-health-care-remains-key-benefit-employee-groups/
Health insurers willing to give up a key ACA provision
Great article about new changes to the ACA from BenefitsPro by Zachary Tracer
U.S. health insurers signaled Tuesday that they’re willing to give up a cornerstone provision of Obamacare that requires all Americans to have insurance, replacing it with a different set of incentives less loathed by Republicans who have promised to repeal the law.
Known as the “individual mandate,” the rule was a major priority for the insurance industry when the Affordable Care Act was legislated, and also became a focal point of opposition for Republicans.
In a position paper released Tuesday -- the first since President-elect Donald Trump’s victory -- health insurers laid out changes they’d be willing to accept.
“Replacing the individual mandate with strong, effective incentives, such as late enrollment penalties and waiting periods, can help expand coverage and lower costs for everyone,” AHIP said.
That also includes openness to Republican ideas such as an expanded role for health-savings accounts and using so-called high-risk pools to cover sick people.
In return, insurers are asking Republicans to create strong incentives to buy insurance, and to ensure the government continues to make good on payments it owes insurers under the ACA. The paper was released by America’s Health Insurance Plans, or AHIP, the main lobby for the industry.
“Millions of Americans depend on their current care and coverage,” AHIP said in the document outlining its positions. The group called on lawmakers to “ensure that people’s coverage -- and lives -- are not disrupted.”
Republican replacement
Now that they’re set to gain control of the White House, Republican lawmakers are working to define their vision for replacing the law after years of attempts to repeal it. Obamacare brought insurance coverage to about 20 million people via an expansion of Medicaid and new insurance markets, and repealing the law without a replacement would leave those individuals without coverage.
Trump has said that repealing and then replacing the law will be one of his first priorities. Republicans in Congress, however, have signaled that they’ll need time to write a replacement -- potentially via a years-long delay between passing a repeal and implementing it -- to craft a replacement.
And AHIP on Thursday said insurers will need at least 18 months to create new products and get them approved by state regulators, if Republicans change the market. It could take even more time to educate consumers and change state laws, AHIP said.
“It’s taken six years to get where we are now and to demonstrate the failure of Obamacare, so it’s going to take us a little while to fix it,” said Senator John Cornyn of Texas, a member of the Republican leadership in the chamber.
Medicaid changes
Republicans may also make substantial changes to Medicaid, by turning the joint state-federal program into one where the U.S. sends “block grants” to the states, which exert more control. Vice President-elect Mike Pence said on CNN Tuesday that the Trump administration will “develop a plan to block-grant Medicaid back to the states” so they can reform the program. Some Medicaid programs are administered in part by private insurers.
AHIP said any such plans should ensure that payments are adequate to meet the health needs of individuals in Medicaid coverage. And they should ensure that when enrollment increases in an economic downturn, funds are available to help states deal with the increased demand, AHIP said.
AHIP is open to working with Congress on replacement plans for the ACA, said Kristine Grow, a spokeswoman for the lobby group. The document is the first detailed look at AHIP’s priorities.
Big insurers like UnitedHealth Group Inc. and Aetna Inc. are already scaling back from the ACA’s markets, because they’re losing money. At the same time, remaining insurers are boosting premiums by more than 20 percent on average for next year.
Trump’s election increased the level of uncertainty in the market, and a repeal bill without something to replace the law could destabilize it further. To shore up insurance markets, AHIP says lawmakers should fund a program, known as reinsurance, designed to help insurers with high costs, through the end of 2018, and avoid cutting off cost-sharing subsidies for low-income individuals.
See the original article Here.
Source:
Tracer Z.(2016 December 7). Health insurers willing to give up a key ACA provision[Web blog post]. Retrieved from address https://www.benefitspro.com/2016/12/07/health-insurers-willing-to-give-up-a-key-aca-provi?ref=mostpopular&page_all=1
Family caregivers pay hefty price to care for loved ones
An exciting article about family caregivers from Benefits Pro by Marlene Y. Satter
It’s not just the late hours, the extra work or the emotional strain. Family caregivers are paying a big price to take care of loved ones who can’t adequately care for themselves, and part of the cost could be their retirement.
According to a new report from AARP, 78 percent of caregivers are incurring out-of-pocket costs as a result of caregiving. The 2016 report “Family Caregivers Cost Survey: What They Spend and What They Sacrifice” estimates that on average, family caregivers are spending roughly $7,000 per year ($6,954) on out-of-pocket costs related to caregiving in 2016.
If that statistic isn’t depressing enough, the report’s financial strain measure, consisting of annual caregiver expense divided by their annual income, shows that caregivers are spending, on average, nearly 20 percent of their income on caregiving activities.
Considering that, it should come as no surprise that many family caregivers have to cut back on other spending, “which can undermine the family caregiver’s future financial security,” the study said.
Sixteen percent have reduced contributions to their retirement savings, and approximately half have cut back on leisure spending (45 percent said they’ve cut down on eating out or vacations because of caregiving expenses).
So where and how are they spending this money?
Household expenses account for the lion’s share of family caregivers’ out-of-pocket spending, eating up 41 percent of it.
This can encompass everything from rent/mortgage payments to home modifications and other household expenses.
Medical expenses make up the second largest chunk, eating up 25 percent of caregivers’ spending on such items as assisted living or skilled nursing facilities, insurance costs and other medical expenses.
And while long-distance caregivers (defined as family caregivers living more than one hour from the care recipient) paid the highest out-of-pocket costs ($11,923), it was no bargain for caregivers living with their care recipient, who also incurred high costs ($8,616).
And if the recipient is older (more than 50 years old) or has dementia, their caregiver will be paying more, too: costs of $7,064 for a recipient older than 50, compared with $5,721 for one younger than the half-century mark, and costs of $10,697 for a recipient with dementia, compared with costs of $5,758 for adults who do not have dementia.
See the original article Here.
Source:
Satter, M. (2016 November 14). Family caregivers pay hefty price to care for loved ones [Web blog post]. Retrieved from address https://www.benefitspro.com/2016/11/14/family-caregivers-pay-hefty-price-to-care-for-love?ref=hp-top-stories