Healthcare insurance companies are actively fighting to keep drug costs low for their members and for their own bottom lines. Now a new policy brief offers state policymakers tips on how to shift more of the costs to payers in an effort to protect consumers.
The brief (.pdf) from the National Association of Insurance Commissioners outlines several regulations policymakers can adopt to ease consumers’ cost burdens, including:
As the 2016 presidential election approaches, analysts and experts are advising healthcare executives to watch and monitor certain issues, such as pharmaceutical spending and healthcare reform, which will surely impact the health insurance industry. Here’s a look at what they recommend keeping a close eye on in particular.
As high deductible health plans become more common, patients are becoming the new payers. This puts responsibility back in the hands of the provider to provide a consumer-friendly billing experience and collection strategy to maintain the speed of the revenue cycle management process.
At the Becker’s 2nd annual CIO/HIT + Revenue Cycle Conference in Chicago, the following five panelists discussed the top three challenges of consumerism and how RCM can meet those challenges: Steve Collins, vice president of business development at Zotec Partners; J. Wade Shields, owner and managing partner of Practice Partners; Susan Hawkins, executive director of revenue cycle at Hoag Memorial Hospital Presbyterian in Newport Beach, Calif.; Amanda Cancelliere, vice president of operations and business performance services at McKesson Technology Solutions; and Brooke Murphy, writer/reporter with Becker’s Healthcare.
All five members of the Wadstein family have Covered California’s most comprehensive — and expensive — level of health insurance, even though the two youngest children are the only ones who need that kind of plan.
Zachariah, 8, and Zoey, 2, have a serious metabolic disorder, but the El Cajon family was told it couldn’t purchase a benefit-rich plan for them and a separate, cheaper policy for the other three, said their mom, Christine Wadstein.
That’s about to change. This month, Covered California began making it easier for families like the Wadsteins to choose different health plans for different members of the family.
The battle continues to rage between drug companies that are trying to make as much money as possible and insurers trying to drive down drug prices. And consumers are squarely in the middle.
That’s because, increasingly, prescription insurers are threatening to kick drugs off their lists of approved medications if the manufacturers won’t give them big discounts.
The cost of getting your health insurance through work will go up an average of 5 percent next year, according to a new survey of large employers by the National Business Group on Health.
The cost for employers will go up 6 percent. This is the third consecutive year that employers’ health costs have risen by 6 percent. While that’s still more six times the current rate of inflation, it’s likely a smaller increase than will be experienced by consumers who purchase insurance through the public exchanges.
While those plans vary widely by state, the average plan is expected to cost 10 percent more in 2017, according to Kaiser. Last year, the price of the average silver level plan on public exchanges increased 12 percent.
For employers, the biggest driver of the cost increases is the price of specialty drugs. Other factors included high-cost claims and long-term conditions, according to the NGBH survey.
http://bigstory.ap.org/article/a6c6a83bd9f7435ca6f79423f1240c4d/why-it-matters-health-care
About 9 in 10 Americans now have health insurance, more than at any time in history. But progress is incomplete, and the future far from certain. Millions remain uninsured. Quality is still uneven. Costs are high and trending up again. Medicare’s insolvency is two years closer, now projected in 2028. Every family has a stake.
Patients from all over the world come to America for treatment. U.S. research keeps expanding humanity’s ability to confront disease. But the U.S. still spends far more than any advanced country, and its people are not much healthier.
Obama’s progress reducing the number of uninsured may be reaching its limits. Premiums are expected to rise sharply in many communities for people covered by his namesake law, raising concerns about the future.
The health care overhaul did not solve the nation’s longstanding problem with costs. Total health spending is picking up again, underscoring that the system is financially unsustainable over the long run. Employers keep shifting costs to workers and their families.
No one can be denied coverage anymore because of a pre-existing condition, but high costs are still a barrier to access for many, including insured people facing high deductibles and copayments. Prescription drug prices — even for some generics — are another major worry.
The election offers a choice between a candidate of continuity — Clinton — and a Republican who seems to have some core beliefs about health care, but lacks a coherent plan.
If the presidential candidates do not engage the nation in debating the future of health care, it still matters.
She’s one of a growing number of doctors who have cut loose from what she calls the “assembly-line, volume approach” and is now using a health care delivery model called direct primary care. She has scaled back the number of patients she sees and takes longer with the ones she does. She doesn’t take insurance and deals mostly in cash; she charges each time she sees a patient, but most direct primary care doctors charge a monthly fee for unlimited visits. In her previous practice, (Lorraine) Page says, the pressure to see more patients in less time wore her down, as did the need for an army of support staff to process the copious paperwork required by insurance companies.
HENRY KOTULA 