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The Value Of Preventive Care

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[…] I found this article by Dr. Lucy Hornstein to be particularly interesting. Dr. Hornstein takes the view that preventive care does not save money in the long run, and wonders if the provision in the PPACA to provide preventive care to everyone – with no copays or deductibles – is a wise idea. The discussion is made even more interesting with a comment from Maggie Mahar (who was referenced in the article) noting that some preventive care is more worthwhile than others. […]

Most Employers Have Not Enrolled In Early Retiree Reinsurance Program

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[…] a Robert Wood Johnson Foundation report indicates that the majority of employers who offer retiree health insurance benefits have not yet signed up for the program, scheduled to last until the end of 2013. The RWJF study notes that in addition to the many small employers who offer retiree health insurance benefits, there are also about 24,000 large employers who do so. Obviously, most employers have not enrolled in the early retiree reinsurance program yet, and it’s unclear whether they plan to do so or not. […]

The Future Of Employer Based Health Insurance

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[…] I can’t imagine huge numbers of people simply opting to be uninsured if employers stop offering coverage, especially once individual health insurance is guaranteed issue and pre-existing conditions are no longer an issue. I would guess that in 2014 we will see at least some shift away from employer-sponsored coverage in favor of individual health insurance, but I imagine that plenty of employers will continue to offer at least some level of coverage as a way to attract and retain quality employees.

Thoughts On The Postponed Medicare Payment Cuts

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[…] While these changes might not have been warmly welcomed, they will ultimately help to make the system sustainable in the long term. The same could be said for the rest of the health care industry if similar cuts are implemented in other areas. Although the physician reimbursement cuts are unpopular with most doctors, they may be the only way to keep Medicare as a viable payer for seniors’ health care needs. And ultimately, it’s in the best interest of both doctors and seniors to keep Medicare around.

Most Americans Do Not Get To Make Their Own Health Insurance Choices

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This article is not the first I’ve seen that calls into question whether Obama was being truthful when he said that health care reform would be structure so that people would still be able to keep their existing health insurance if they wanted to. And it would seem that his statements did amount to a bit of over-promising. But even before the PPACA came up for a vote, many Americans weren’t in control of whether or not they got to keep their existing health insurance. […]

Grand Rounds Submissions

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We’re honored to be hosting the next Medical Grand Rounds on November 30th. Grand Rounds is a weekly gathering of the best health and medical articles written by doctors, nurses, students, patients, and others in health care related professions.

Please submit your favorite articles to Louise at louisen78 [at] gmail [dot] com before 10:00pm MST of November 29, 2010.

Please include the authors name, article title, url, and a brief description of the article.

This week, enjoy the first Grand Rounds to ever be hosted on Facebook by Amanda Brown DVM

Capping Profits And Admin Costs Across The Healthcare Industry

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[…] Time will tell, but it seems that as long as doctors, hospitals, medical device makers, and pharmaceutical companies are exempt from any rules concerning profits and administrative costs, the MLR rules might not have much long term impact on the actual cost of health insurance. Premiums will keep rising (at a pace similar to what we’ve seen over the last several years) as long as the cost of healthcare continues to climb at the same rate it has for the last decade or so.

How US Healthcare Compares With Other Developed Countries

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[…] While many studies comparing health care around the world tend to look at generalized data like life expectancies and total cost of healthcare, this one was more focused on how healthcare in each country impacts individual people, and whether people are satisfied with their health insurance, personal medical costs, and access to care. […]

430 People Already Enrolled In GettingUsCovered

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[…] Even when policies are free or very low cost (such as Medicaid or Child Health Plan Plus), a significant number of eligible individuals continue to go without coverage, for a myriad of reasons. So it stands to reason that plenty of uninsured people who are eligible for GettingUsCovered won’t apply. Some likely aren’t aware of the availability, and many others simply can’t afford to pay the premiums. But apparently Colorado is enrolling people at a fairly fast pace – as of November 1, there were 20 states that had fewer than 50 people enrolled in their newly-created high risk pools.

Funding Cover Colorado

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For nearly two decades, Cover Colorado has been providing health insurance to people in Colorado who don’t have access to group health insurance coverage and have pre-existing conditions the make them uninsurable (or unable to get coverage without exclusion riders or rate increases that put their premium above that offered by Cover Colorado) in the individual health insurance market. While we’re lucky to have such a resource, it doesn’t come cheap […]

Diabetes Accounts For Nearly A Quarter Of US Hospital Costs

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Diabetes now accounts for nearly a quarter of all hospital spending in the US – about $83 billion a year in hospital fees. The report from the Agency for Healthcare Research and Quality was released in August, but I just came across it today, and the details are staggering. The vast majority – 95% – of all diabetes cases are Type 2 diabetes, which is nearly always caused by poor diet and/or a sedentary lifestyle. In addition, 70% of hospital stays for diabetics are paid for by government health insurance: 60% by Medicare and 10% by Medicaid. […]

Health Reform Not Having Much Impact On Colorado Premiums

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Although the increases we’ve seen this year are similar to what we’ve seen over the last several years, there have been more questions since the PPACA was signed into law in March about whether federal health care reform is the driving factor for this year’s increases. To clarify, the Colorado Division of Insurance has released a statement noting that federal health reform is responsible for less than 5% of the total health insurance premium increase in Colorado this year. […]

Amendment 63 Defeated In Colorado Despite False Advertising

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Three states had ballot initiatives this week that attempted to outlaw the mandate in the PPACA that requires everyone to have health insurance starting in 2014. Colorado was the only state that did not approve the measure. Voters in Colorado defeated Amendment 63, which would have made it illegal for the state of Colorado to force people to buy health insurance. Even if it had been approved by voters, it would have been a symbolic measure, as the mandate requiring all of us to have health insurance coverage as of 2014 is a federal law, and thus supersedes state laws. […]

Workers’ Comp Rates In Colorado Among The Lowest In The Nation

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[…] We work with individual health insurance, so my knowledge of workers’ comp issues are generally limited to what I read on Julie’s blog. But I find it interesting that workers’ comp is relatively inexpensive here, given that our health insurance premiums put us right in the middle of the national ranking in 2009, and group health insurance premiums here are currently rising faster than the national average.

Group Premiums In Colorado Increasing Faster Than National Average

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A survey conducted by the Lockton Benefit Group found that premiums for employer-sponsored group health insurance policies in Colorado were increasing by an average of 14.4% for 2011, which was “significantly higher than reported nationally.” This was the tenth year in a row that premiums saw double digit increases, but the current increase is the largest in five years, and most employers surveyed (more than 73%) plan to make plan changes or increase employee contributions to offset the large rate increases. […]

How The Colorado Division Of Insurance Reviews Rate Filings

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[…] The Division of Insurance has recently released an extensive FAQ page detailing how the review process works. The page includes data about health insurance premiums in Colorado, how they compare with the rest of the country, and specifics about how the Division of Insurance reviews rate increase proposals from carriers. […]

Funding Health Care Reform

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For months now, one of the main arguments against the PPACA is that it doesn’t address health care costs or provide a means to pay for the reforms that it includes. Opponents of the reform law have used the money argument to drum up support for their cause, and – along with opposition to the individual mandate requiring everyone to have health insurance starting in 2014 – it remains one of the first things that people will mention when asked why they oppose the PPACA. […]

High Risk Pool Eligibility

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[…] There is another significant difference between Cover Colorado and GettingUsCovered, in terms of eligibility. Both plans allow eligibility for applicants who have one of several specific medical conditions, and both plans accept applicants who have either been declined by a private insurance company or offered coverage with a pre-existing condition exclusion. But while Cover Colorado also allows people to enroll if they have been offered a private policy with a rate that is higher than a comparable Cover Colorado plan, GettingUsCovered does not allow this option. […]

Some Mini-Med Policies Are Better Than Others

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This week’s Grand Rounds included an article by David Williams about mini-med plans that I thought was worth sharing. David explains that although he’s not a fan of mini-med policies, sometimes they are indeed better than nothing. Mini-med policies come in all shapes and sizes, and David’s article describes policies with $25,000 or $50,000 benefit maximums… a far cry from the $2,000 maximum policies that I wrote about earlier this month. […]

Mega And Mid-West Being Investigated Again

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A west coast legal firm has launched an investigation into the market conduct of Mega Life and Health Insurance Company and Mid-West National Life Insurance Company. Their parent company, HealthMarkets, Inc., is also being investigated, along with the two shareholders (Blackstone Group, L.P. and Goldman Sachs Group, Inc.) who purchased HealthMarkets in 2006 for $850 million. […]

The Wisdom Of Evidence Based Medicine

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David mentioned that “…ideologues would call this rationing.” I couldn’t agree more, and I think that research like this is the best defense against those who criticize any sort of evidence-based medicine that results in less treatment – but better or equally good outcomes. The word rationing has a bit of a negative connotation in our culture. It conjures up images of people standing in line for hours to get a loaf of bread, or only being allowed to buy five gallons of gasoline at the pump. It makes us think of hardship and having to do without things that we need. I believe that people who are opposed to scientific, evidence-based medicine are capitalizing on the public’s general dislike of the concept of rationing […]

NAIC Considering Transitional Period For New MLR Requirements

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The National Association of Insurance Commissioners is meeting this week to figure out the specifics of how the new medical loss ratio (MLR) rules should be implemented, and they’ll be voting on the issue tomorrow. Basically, health reform law calls for health insurance carriers to be spending 80 – 85% of premium dollars on medical care as of January 1, 2011. But the insurance industry would prefer to see the increased MLRs phased in gradually. They say that they can meet the new MLR requirements over the next few years, but that trying to do so all at once by the first of the year will only serve to drive some carriers out of business entirely. […]