Tag: "Health Care Costs"

Variation in Spending Due to Variation in Health Status

The idea that uneven Medicare health care spending around the country is due to wasteful practices and overtreatment — a concept that influenced the federal health law ― takes another hit in a study published Tuesday. The paper concludes that health differences around the country explain between 75 percent and 85 percent of the cost variations…

Their conclusions are based on the wide differences in spending, which in 2011 ranged from an average of $14,085 per Medicare beneficiary in Miami, to $5,563 per beneficiary in Honolulu, even after Medicare’s cost of living and other regional adjustments — but not health status — were taken into account….

The new paper is one of the sharpest attacks yet on the work of the Dartmouth Institute for Health Policy & Clinical Practice, whose three decades of research has popularized the theory that the unexplained regional differences in spending are due to the aggressiveness of some physicians to do more, in large part because it enriches them. The theory, popularized by a 2009 New Yorker article on high spending in McAllen, Texas, has divided health policy experts. (KHN)

May 29, 2013 | 16 comments | by John Goodman

Why Your Health Insurance Benefits May Be Shrinking

The trend is accelerating. The percentage of employers revising their plans as a result of the [Cadillac] tax has increased to 17 percent this year from 11 percent in 2011, according to a survey of United States companies released this month by the International Foundation of Employee Benefit Plans.

Although the tax does not start until 2018, employers say they have to start now to meet the deadline and they are doing whatever they can to bring down the cost of their plans. Under the law, an employer or health insurer offering a plan that costs more than $10,200 for an individual and $27,500 for a family would typically pay a 40 percent excise tax on the amount exceeding the threshold. (NYT)

May 28, 2013 | 11 comments | by John Goodman

How Small Business May Escape the Effects of ObamaCare

UnitedHealth Group Inc. and Humana Inc. will begin offering smaller employers — including firms with as few as 10 members in UnitedHealth’s case — the option of so-called self-insurance in some markets later this year. Self-insured businesses pay their workers’ medical costs directly, instead of joining a traditional managed-care plan. Usually, they hire benefits firms or insurance companies just to administer their plans.

Most big companies choose the approach, because it gives them more control over benefits and can lower costs.

For small businesses, being self-insured would let them avoid new requirements under the law that call for traditional small group plans to include richer benefits, such as mental-health and maternity care. Self-insured companies can also avoid changes to pricing rules that could increase costs for groups of healthy workers. (WSJ)

May 28, 2013 | 11 comments | by John Goodman

Family Medical Costs Still Rising, and Other Links

The typical cost to cover a family of four now exceeds $22,000, including the amount paid in insurance premiums and out-of-pocket costs, according to Milliman.

Can dyslexia be good for you?

An iPhone application lets users check levels of blood, protein and other substances in their urine. (I’m trying to imagine how that would work?)

May 24, 2013 | 18 comments | by John Goodman

Will Longer Life Expectancy Bankrupt Medicare?

Health Care Expenditures in the Last Two Years of Life

As this graph shows, the total cost of nursing home care during a person’s last two years is extremely sensitive to that person’s longevity and rises steadily as that persons attained age increases. But the cost of that patient to Medicare during those final two years actually decreases. As the article concluded, “longevity after the age of 65 has a larger effect on the costs of nursing home care […] than on the costs of services covered by Medicare.” Thus, the increasing number of persons eligible for Medicare in the future will certainly increase that program’s costs, but their increasing longevity is itself a benign factor. Or as Harvard economist David Cutler concluded, “longer life in itself will not add to Medicare costs.”

Richard Kaplan at the Health Care Blog.

May 24, 2013 | 16 comments | by John Goodman

RAND Evaluates Integrated Care in the UK

There were 16 pilot programs in all. Overall, patients were less happy. Staff was happier. And:

We found no significant overall reduction in costs, though in case management sites there was an overall 9 per cent reduction in hospital costs.

Study abstract here.

May 23, 2013 | 12 comments | by John Goodman

The Case against Universal Medicare

We are already hearing reports of doctors who do not take Medicare patients. In a 2010 survey of 9,000 physicians, the American Medical Association reported that 17 percent of doctors restricted the number of Medicare patients; among primary care physicians, a whopping 31 percent did. With universal Medicare, is the population really going to accept, and would Congress really allow, the continued reductions in prices?…

By some estimates, the Medicare program loses a staggering $60 billion to fraud each year. This amounts to 11 percent of the Medicare budget and would be enough to double Federal spending on primary and secondary education. No private company would ever tolerate this abuse. Imagine the fraud if Medicare covered 300 million Americans.

From Dana Goldman and Adam Leive at the Health Affairs Blog. Entire post is worth reading. See also, my Health Affairs Blog post with Tom Saving, Is Medicare More Efficient than Private Insurance?, and the NCPA study, Health Care Reform: Do Other Countries Have the Answers?

May 23, 2013 | 13 comments | by John Goodman

We-Have-To-Pass-It-To-Find-Out-What’s-In-It Fact of the Day

A chain of events would create a two-month period during which a family has medical coverage but no insurer must pay its claims.

Nonpayment of premiums for subsidized policies would trigger the oddity: Federal law provides a three-month grace period before cancellation – but insurers are responsible only for the first month.

Doctors say the liability might keep many physicians from participating in next year’s program. A single prostate cancer patient’s course of treatment can cost $93,000, they say.