We posted some data tools from the Robert Wood Johnson Foundation for the health reform beat and AHCJ’s New York chapter recently got to hear about them in more detail with some help from RWJF. If you’ve done stories using this data, we’d love to see them and learn about how you used the data. Send them to email@example.com.
Kentucky, a southern state implementing the ACA, has gotten a fair amount of media attention and we’ve highlighted some of the coverage.
But, in impoverished rural areas that stood to gain the most from the greater access to care that the ACA promised, many residents remained fiercely opposed to the law and the president who pushed it.
Given the recent discussion on the AHCJ discussion list and elsewhere about the right balance between covering the politics of the Affordable Care Act versus the policy of the ACA, I thought it would be a great time to showcase a reporter who does both.
David Ramsey of the Arkansas Times has been all over the story of Arkansas’ “private option” Medicaid expansion. That’s definitely been a political story – Arkansas legislators have slugged it out for two sessions and it’s going to happen again next year, with the fate of Medicaid expansion always on the line. But Ramsey (@arkdavey) recently did a long and readable piece on the faces of Arkansas health care expansion. He matched the politics, the policy and the people. And he did more than present their faces. He captured their voices. Continue reading
Rural areas have a disproportionate need for primary care physicians but, according to a panel of physicians at Rural Health Journalism 2014, that need is not being met.
In fact, 44 percent of rural areas in the U.S. are experiencing a shortage of primary care practitioners, said Andrew Bazemore, M.D., M.P.H., director, Robert Graham Center for Policy Studies in Family Medicine and Primary Care, American Academy of Family Physicians.
This sobering statistic illustrates what Mark A. Richardson, M.D., MScB, M.B.A., dean, School of Medicine, Oregon Health & Science University, called “geographic maldistribution” — urban areas having more active doctors per 1,000 people than rural areas.
Bazemore emphasized the importance of primary care, noting that in comparison to 10 other developed nations, the U.S. ranked lowest in both primary care and health outcomes.
Richardson drove the point home with some sobering information on the state of primary care in the U.S.: While there are 249 patient care physicians for every 100,000 Americans, there are only 106,000 primary care physicians. Almost 27 percent of those providers are over age 60, so their numbers are only expected to drop in the coming years.
So how can rural primary care get a boost?
Insurers are preparing to announce their premium rates for 2015. To learn how insurers set rates, Families USA and Consumers Union (the policy and advocacy arm of Consumer Reports) will host a national conference call on Thursday at noon ET for health care journalists.
Premium rates will be one of the biggest stories of the year because so much depends on whether they will rise by double digits or stay at about 10 percent, as they have in recent years. If rates rise much above double digits, Republicans in congressional midterm races are likely to use that information against Democrats who support the Affordable Care Act. If rates are at 10 percent or below, Democrats may be able to fend off such criticism.
Last week, Kelly Kennedy reported in USA Today that health insurance premiums grew an average of 10 percent annually in the three years before the ACA was enacted. She cited a report (PDF) from The Commonwealth Fund, “Growth and Variability in Health Plan Premiums in the Individual Insurance Market Before the Affordable Care Act” that explained the recent history of insurance rate increases. Continue reading
Ideastream’s Sarah Jane Tribble took a look at how small businesses that voluntarily cover their workers could be in for some premium shocks.
She focused on Paul Siperke, co-owner of Fat Head’s, a Cleveland brew club. It’s a small business and, with fewer than 50 employees, there is no requirement to cover workers. But the owners do voluntarily.
And the costs keep rising – sometimes double digits, sometimes only as little as 3 percent.This year, Tribble reported, rates soared by 20 percent under the ACA, even though most of the workers are young and healthy.
She explains why: Continue reading
We’ve had a few members wonder whether “essential coverage” and “essential benefits” are one and the same.
They aren’t – and we’ve done a tip sheet to explain the difference in more detail.
But here’s the quick version:
If someone has minimum essential coverage it means he or she has a health plan that complies with the individual mandate. It means that there will be no penalty when 2014 taxes are filed. A lot of health plans qualify, including the exchange plans, most plans in the individual and small group market, employer-based health plans, Medicare, Medicaid.
Limited plans such as workers’ compensation or dental-only plans do not qualify as mandate-meeting minimum essential coverage.
Essential health benefits are the 10 categories of benefit s – hospitalization, prescription drugs, maternity care, etc. – that the exchange plans and the ACA-compliant off-exchange plans must cover. (After the brouhaha about plan cancellations, the administration gave states the option of extending the noncompliant plans for a few more years. They can be minimum essential coverage – but they don’t have essential health benefits.)
So health spending is going up. Big time.
But health costs are still growing at historically slow rates.
And the Affordable Care Act gets credit for both – and neither.
Spending and costs aren’t the same thing. Health care costs, including Medicare, have been rising very slowly for several years, way lower than the historical trends. (Although individually we may be paying more, especially if we get insurance at work and our employers are shifting costs to us through higher premiums deductibles and co-pays)
Health spending is what we’re utilizing. Maybe an MRI has only gone from $500 to $505. But if we’re buying 10 MRIs when last year we only bought eight, spending is increasing. Continue reading
A new report from Milliman, the actuarial firm, shows employers’ health care costs rose only 5.4 percent since last year. The report also showed how employers are changing their employee benefit plans to control costs.
Here are a few highlights from the 2014 Milliman Medical Index (MMI) report:
- The 5.4 percent rate of growth from last year to this year was the lowest annual change since Milliman produced its first MMI in 2002 and is down from 6.3 percent last year. The 5.4 percent is still higher than the rate of growth in the consumer price index (CPI). Continue reading
The American health care system wastes an estimated $750 billion a year, according to the Institute of Medicine. At a recent AHCJ chapter event in Chicago, four panelists discussed one source of that waste: unnecessary tests and procedures.
Moderated and organized by AHCJ member Kevin B. O’Reilly, senior editor of CAP Today, the panel looked at the issue through the lenses of doctors, journalists, health system executives and academics.
Holly Humphrey, M.D., dean for medical education at the University of Chicago Pritzker School of Medicine and vice chair of the American Board of Internal Medicine Foundation’s board of trustees, discussed the foundation’s Choosing Wisely campaign. Continue reading