Consumer-Oriented Communications: The Key to Advancing Health Care Consumerism
Health care consumerism is premised on personal responsibility, individual ownership, self-reliance, convenience, choice, and transparency. Eventually, more patients will take ownership of their health, as they are more confident in their ability to make smart decisions. As of now, we can make the most headway toward broad-based health care consumerism by improving the way health care providers, brokers and Human Resources (HR) communicate.
Preventive Care: It's Free, Except When It's Not
Bill Dunphy thought his colonoscopy would be free. His insurance company told him it would be covered 100 percent, with no copayment from him and no charge against his deductible. Then the bill arrived: $1,100. Turns out Dunphy's doctor removed two non-cancerous polyps during the colonoscopy. So while Dunphy was sedated, his preventive screening turned into a diagnostic procedure. As Dunphy found out, colonoscopies can go from free to pricey while the patient is under anesthesia.
MLR Regulation Creates Challenges for Future of Affordable Coverage
The final medical loss ratio (MLR) regulations will likely create a vacuum for affordable coverage that cannot be filled by Bronze plans under the state insurance exchanges. If the “essential benefits” and “actuarial value” requirements are equally as discriminatory, there will be no affordable options available and the cost of subsidies will skyrocket. As a result, millions of Americans that have policies today that could have qualified as Bronze plans will be forced to change their coverage or drop coverage because they can no longer afford it.
2011 will mark the last year that a majority of America's physicians own their own medical practices and operate their own offices or clinics. The notion of the newly minted doctor who rents an office and hangs out his or her own shingle is a quaint reflection of a Normal Rockwell era that has expired. In its place, medicine is undergoing industrialization, where doctors are becoming owned commodities of large hospitals and health plans.
More workers will have to pay higher deductibles before their health benefits kick in next year — and insurance experts say that soon will become the norm. Corporate employers, small businesses and nonprofit organizations are increasingly requiring their workers to spend between $1,200 and $5,000 before filing a health insurance claim. Employers save money on premiums. They share those savings so take-home pay often goes up for workers. Health costs go down because people spend less on doctor visits and drugs when the money’s coming out of their own pockets.
The New Year is now just weeks away and with it will come the phone calls and emails from your clients asking about the new contribution limits for health savings accounts (HSA). This year, get out ahead of the inquirers and send a link to this article to your clients who have HSAs. They will thank you for it.
Indiana’s State Workers Enjoy Consumer-Directed Reforms
Indiana state employees have had the option of participating in consumer-directed health plans (CDHPs) since 2006. Over the past five years, enrollment has increased dramatically, and next year, some 90 percent of state workers will be covered by CDHPs. Indiana saved at least $20 million in 2010 as a result of this high HSA enrollment, according to Gov. Mitch Daniels. The Mercer consulting firm calculates the state's total costs as being reduced by 11 percent.
HHS recently issued its final standards on how to rebate money from insurance carriers that fail to reach the Medical Loss Ratio (MLR) standards for 2011. This has sparked a new flurry of attention to the MLR issue. If monopoly leads to lower administrative expenses, and hence higher MLRs, due to low marketing costs, the opposite is likely to happen as well — a requirement for higher MLRs will lead to monopoly.
Health Care Hearing Before U.S. Supreme Court Scheduled for March 26-28
The U.S. Supreme Court said it will hear arguments on President Barack Obama’s health-care law over three days, from March 26 to March 28. The justices left room to expand the 5-1/2 hours they already allotted for argument.
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Mission:Healthcare Choice Coalition believes in protecting the freedom of citizens to choose their own health care, strengthening their relationship with their personal physician, and preserving the free market so that consumer-driven health care can flourish and remain viable under any regulatory regime.