In this week’s summary, you’ll find info on hospital structuring in NY, how ACA will help the “retired but not elderly” population, new vaccines in development stages and more!
State Health Transformation
The New York Times ran this article about hospital restructuring. Although largely focused on struggling Brooklyn hospitals, the article describes the state’s thinking on transforming its hospital system so that facilities are self-sustaining and consumers have access to the care they need. This will undoubtedly be a major issue in the upcoming legislative session in Albany.
Rochester spends less on Medicare than any other location in the county, according to a report by the Institute of Medicine. This is largely due to aggressive health planning that restricts unnecessary hospital expansions and redundant technology upgrades. The Rochester model is being carefully reviewed by the Cuomo Administration as a model for the rest of the state.
Affordable Care Act/Health Insurance Exchanges
The Affordable Care Act as bridge to Medicare is discussed in this article by the New York Times. For persons who retire early and experience an insurance coverage gap between coverage they had on the job and Medicare eligibility, Obamacare may be an important source of coverage. For people with pre-existing medical conditions, insurers can no longer deny them coverage. Approximately nine million Americans between the ages of 50 and 64 are uninsured. There remain challenges, such as low public awareness of the new law and widespread misunderstanding on how the law will affect individuals. Still, Obamacare has the potential to be a real boon to this in-between population.
Health Affairs explains ‘Cadillac’ health plan changes in the new health care law. Obamacare imposes a Cadillac or excise tax on high cost, employer based health coverage. The tax is designed to accomplish three things: to help finance health care reform; to decrease overall health care costs; and, to equalize the tax benefit of excluding from taxes the value of health insurance, which is thought to encourage companies to provide generous benefits. Questions remain on if the tax will work as intended. The tax is scheduled to take effect in 2018.
Kaiser Health News has this subsidy calculator to help people determine eligibility for premium assistant for coverage in the insurance exchanges.
The Department of Health has released the July 2013 Medicaid Global Cap Report which reveals that spending for the month was 0.3% or $17 million below projections. This is, in part, due to lower fee for service spending, including $10 million below projections for pharmacy. Medicaid managed care spending is about 1% above projections, likely due to quicker than anticipated enrollment of targeted populations. Medicaid total enrollment has increased by 86,000 people of 1.6% since March and Medicaid managed care enrollment has increased by 95,700 people or 2.6% during the same time frame.
Over 270 new vaccines are in development according to a new report. All are either in clinical trial stages or undergoing Food and Drug Administration (FDA) review and include vaccines for cancers, infectious diseases, neurological disorders and allergies.
-Jaime Venditti, 9/13/13