In this week’s summary: The LA Times examines the growing trend of high-deductible health plans and what this means for consumers; the FDA is cracking down on the use of tanning beds by teens; plus we have the latest news on the Affordable Care Act and much more
Affordable Care Act
Many health care experts in the country agree that the implementation of the Affordable Care Act will cause premiums in the individual market to rise. The increase is generally through to be the result of insurance plans being required to cover Americans with potentially costly, pre-existing conditions. However, New YorkState is bucking the national trend and is expected to see the cost of coverage in the individual market drop. A recent study prepared by Deloitte for the New York Health Benefits Exchange shows that the even when adjusted for New York population estimates and health status, the estimated potential savings are significant across both the individual and small group markets. The major forces behind the changes in cost appear to be the number and the health status of those uninsured New Yorkers who will be electing health insurance coverage under the Exchange.
Despite the rumors of implementation delays and roadblocks, the federal government is confident that it is prepared to roll out the Affordable Care Act. USA Today reports that federal officials are assuring stakeholders it has met its deadlines, tested its system and collected insurance plan information critical to rolling out the Affordable Care Act (Kennedy, 5/9).
Reports and Investigations
According to a report in the New York Times , there is little consistency in the billing practices of hospitals around the country. New data released this week by the Center for Medicare and Medicaid Services shows that hospitals charge Medicare very differing amounts — sometimes 10 to 20 times what Medicare typically reimburses — for the same procedure. The data for 3,300 hospitals shows wide variations not only regionally but among hospitals in the same area or city (Creswell,Meier, McGinty, 5/8).
The Los Angeles Times profiles the increasing popularity of high deductible insurance plans with consumers. High-deductible plans are typically recommended for younger policyholders who are in good health and have less need for doctor visits and prescription drugs, and for people with incomes high enough to cover the cost of routine medical care. But patients like Francis opt for it anyway, despite the risks. She pays just $123 a month, but if she gets sick she’ll have to shell out $3,300 to meet her deductible before insurance helps her pay the bills. As a result, Francis says she does whatever she can to avoid the doctor (Zamosky, 5/5).
The U.S. Department of Justice has renewed an investigation into the New York State Department of Health and the SUNY Research Foundation regarding allegations that both institutions changed Medicaid audits to show a lower rate of Medicaid overpayments. The Times Union reports that the new probe centers on allegations outlined in a federal complaint that was filed in U.S. District Court in Albany three years ago by a group of former Research Foundation employees. The complaint alleges that low-level auditors were pushed by upper-level Health Department and Research Foundation managers to manipulate data to show a lower percentage of ineligible people receiving benefits (Lyons, 5/9).
The Wall Street Journal reports on efforts by the Food and Drug Administration to install cancer warning labels on tanning beds. Federal health regulators moved to tighten oversight of tanning beds and said people younger than age 18 shouldn’t use the beds at all. The move comes amid growing evidence that indoor tanning is linked to melanoma, the most deadly form of skin cancer, in young people. Tanning beds continue to be used by millions of teenagers (Dooren, 5/6).
Two new economic analyses suggest a recent slowdown in health-spending growth may reflect lasting change due to fundamental shifts in how health care is delivered and paid for. The findings of the two most recent studies are in this month’s journal of Health Affairs . The studies find that the growth in health spending has slowed and that it is likely unrelated to the recession and instead linked to increased efficiency among health-care providers.
The Daily News reports that Governor Cuomo has penned a letter to U.S. Department of Health and Human Services Secretary Kathleen Sebelius in support of New York’s pending Medicaid waiver. Governor Cuomo urged Secretary Sebelius to approve the pending waiver so that it can reinvest Medicaid savings in the efforts to restructure outdated health facilities. The Governor’s letter specifically references the dire financial circumstances of four Brooklyn hospitals that are in danger of closing without financial assistance. The four hospitals are Long IslandCollegeHospital, InterfaithMedicalCenter, BrookdaleMedicalCenter and SUNY Downstate Brooklyn (Lovett, 5/9).