September 18th, 2014
A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) looks at health coverage choice for employees of small businesses. Unlike large organizations, small businesses have been less likely to provide comprehensive health insurance or a choice of plans, and their employees are more likely to be uninsured or underinsured.
To address this insurance gap, the Affordable Care Act (ACA) created the Small Business Health Options Program (SHOP) Marketplaces in each state. (Note: The SHOP exchange was the subject of an earlier Health Policy Brief.) These Marketplaces (eighteen run by state exchanges, thirty-three by the federal government) will provide “one stop shopping,” for small businesses to compare health plans and enroll their employees.
To make SHOP Marketplaces more attractive to small businesses, the ACA required SHOP Marketplaces to offer a feature known as employee choice, in which employers can offer their employees a choice from multiple health insurance plans. While the majority of state-based SHOP Marketplaces have chosen to offer access to multiple plans, employee choice will not be mandatory until 2016. This Health Policy Brief examines the issue of employee choice, the status of its implementation, and whether the concept is successfully attracting more small businesses to offer coverage through SHOP Marketplaces. Read the rest of this entry »
September 15th, 2014
In the September Health Affairs Narrative Matters essay, when a family caregiver becomes injured, she learns the difficulties—and costs—of caring for herself and her chronically ill husband at the same time. Suzanne Geffen Mintz’s article is freely available to all readers, or you can listen to the podcast. Read the rest of this entry »
September 12th, 2014
At Health Business Blog, David Williams is not ashamed to be a wonk in his September 11 edition of the Health Wonk Review. David highlights many great posts, including “The 125 Percent Solution,” suggested by Jonathan Skinner, Elliott Fisher, and James Weinstein on Health Affairs Blog, which would give consumers and insurers the option of paying 125 percent of the Medicare price for any health care service. Read the rest of this entry »
September 12th, 2014
Posts on payment and delivery reform head the Health Affairs Blog top-fifteen list for August. Suzanne Delbanco and David Lansky’s post on accountable care organizations was the most-read post, followed by Tom Williams and Jill Yegian’s post on bundled payment, written in response to an article published in the August issue of Health Affairs.
Next is Health Affairs’ Editor-in-Chief Alan Weil’s post on the five engagements that will define the future of health, drawn from his keynote presentation at the 2014 Colorado Health Symposium. This is followed by Rosemarie Day and coauthors’ post on the private health insurance exchange system.
The full list is below. Read the rest of this entry »
September 11th, 2014
A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) looks at the ongoing problem of drug shortages in the United States. From 2005 to 2010, the number of reported drug shortages almost tripled.
Today, newly reported drug shortages overall are decreasing, but the total amount of drug shortages continues to increase, reflecting just how long it can take to rectify a shortage. Generic sterile injectable drugs, a vital component for patients fighting cancer, combatting an infection, or about to undergo surgery, are in especially short supply.
One of the most cited reasons for generic sterile injectable drug shortages is low reimbursement rates from Medicare Part B that came about after a change in law in 2003. These changes incentivized both physicians and manufacturers to switch to higher-cost drugs, reducing investment in cheaper generic drugs and causing “growing market concentration,” and eventual drug shortages. Read the rest of this entry »
September 10th, 2014
Average annual premiums for employer-sponsored family health coverage reached $16,834 this year, up 3 percent from last year, continuing a recent trend of modest increases, according to the Kaiser Family Foundation (KFF)/Health Research & Educational Trust (HRET) 2014 Employer Health Benefits Survey released today. Workers on average pay $4,823 annually toward the cost of family coverage this year. A Health Affairs Web First article published today contains select findings from the KFF/HRET report.
This year’s increase continues a recent trend of moderate premium growth. Premiums increased more slowly over the past five years than the preceding five years (26 percent vs. 34 percent) and well below the annual double-digit increases recorded in the late 1990s and early 2000s. This year’s increase also is similar to the year-to-year rise in worker’s wages (2.3 percent) and general inflation (2 percent).
Annual premiums for worker-only coverage stand at $6,025 this year. Workers on average contribute $1,081 toward the cost of worker-only coverage this year.
“The relatively slow growth in premiums this year is good news for employers and workers, though many workers now pay more when they get sick as deductibles continue to rise and skin-in-the-game insurance gradually becomes the norm,” Foundation President and CEO Drew Altman, said. Read the rest of this entry »
September 9th, 2014
A recent Institute of Medicine report has stirred controversy by proposing to significantly reshape the way Medicare graduate medical education funding is distributed. However, before the panel that wrote the report grappled with how the federal government should fund GME, it had to decide whether the federal government should be involved in the area at all.
“We struggled with the rationale [for a federal role] from the first meeting to the last time we convened,” Gail Wilenksy, who co-chaired the panel with Don Berwick, said in a recent interview with Health Affairs Blog. After all, she said, the federal government “is not in the business of funding undergraduate medical education or other health care professions in any similar way, or funding other professions that are believed to be important to society and in shortage,” such as engineers, mathematicians, or scientists.
GME funding has been discussed at length in the pages of Health Affairs and will be the subject of a briefing sponsored by the journal tomorrow, Wednesday September 10. (Live and archived webcasts will be available for those who cannot attend in person.) Wilensky will offer opening remarks at the briefing. A summary of the GME report is provided in an earlier Health Affairs Blog post by Edward Salsberg, who will also participate in the briefing. Read the rest of this entry »
September 8th, 2014
The September issue of Health Affairs emphasizes lessons learned from developing and industrialized nations collectively seeking the elusive goals of better care, with lower costs and higher quality. A number of studies analyze key global trends including patient engagement and integrated care, while others examine U.S.-based policy changes and their applicability overseas.
This issue was supported by the Qatar Foundation and World Innovation Summit for Health (WISH), Hamad Medical Corporation, Imperial College London, and The Commonwealth Fund. Read the rest of this entry »
September 5th, 2014
Please join us on Monday, September 8, when Health Affairs Editor-in-Chief Alan Weil will host a briefing to discuss our September 2014 thematic issue, “Advancing Global Health Policy.” In an expansion of last year’s theme, “The ‘Triple Aim’ Goes Global,” we explore how developing and industrialized countries around the world are confronting challenges and learning from each other on three aims: cost, quality, and population health.
A highlight of the event will be a discussion of international health policy—led by Weil—featuring former CMS and FDA administrator and current Brookings Institution Senior Fellow Mark McClellan and Lord Ara Darzi, surgeon, scholar, and former UK Health Minister. Additional panels will look at how countries are transforming chronic care, lowering costs, and redesigning delivery systems.
Monday, September 8, 2014
9:00 a.m. – 12:30 p.m.
National Press Club
529 14th Street NW
Washington, DC, 13th Floor
Follow Live Tweets from the briefing @Health_Affairs, and join in the conversation with #HA_GlobalHealth.
If you can’t come in person (we hope you will!), you can watch the webcast of the event.
Read the rest of this entry »
September 3rd, 2014
Insurance Coverage, Population Aging, and Economic Growth Are Main Drivers of Projected Future Health Spending Increases
New estimates released today from the Office of the Actuary at the Centers for Medicare and Medicaid Services project a slow 3.6 percent rate of health spending growth for 2013 but also project a 5.6 percent increase in health spending for 2014 and an average 6.0 percent increase for 2015–23. The average rate of projected growth for 2013–23 is 5.7 percent, exceeding the expected average growth in gross domestic product (GDP) by 1.1 percentage points.
Increased insurance coverage via the Affordable Care Act (ACA), projected economic growth, and population aging will be the main contributors of this growth, ultimately leading to an expected 19.3 percent health share of nominal GDP in 2023, up from 17.2 percent in 2012. This compares to the Office of the Actuary’s 2013 report, published in Health Affairs, predicting an average growth rate of 5.8 percent for 2012–22.
Every year, the Office of the Actuary releases an analysis of how Americans are likely to spend their health care dollars in the coming decade. The new findings appear as a Health Affairs Web First article and will also appear in the journal’s October issue. Read the rest of this entry »