Tag Archives: benefits

Employers are tweaking benefits to control costs

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

shrinking-costsA 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

Despite ‘essential’ designation, dental benefits lacking under ACA

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

State and federal policymakers should take steps to make dental benefits less costly and more widely available under the Affordable Care Act (ACA) according to a panel of experts convened by the nonprofit National Academy for State Health Policy.

While oral health advocates were heartened to see pediatric dental benefits included among the health reform law’s essential health benefits (EHB), the task of making them available on state marketplaces and getting consumers to buy them has proven to be complicated.

Dental benefits have traditionally been sold separately from other types of health insurance, and the “ACA and subsequent federal guidance treat pediatric dental benefits differently from the other EHB categories, creating unique challenges in implementing the vision of a guaranteed pediatric dental benefit,” concludes the experts’ report, released today. Continue reading

Experts warn against ‘one-size-fits-all’ health care, benefits

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo by Truthout.org via flickr.

Photo by Truthout.org via flickr.

So many health care strategies are aimed at controlling costs that we may be missing the point about value. The trouble inherent in focusing on low cost is that it does not necessarily equal better care.

This point is one health policy experts are starting to deliver to the federal Centers for Medicare & Medicaid Services and to other health care payers, such as managed care companies and health insurers. Focusing on low-cost strategies may be doing a disservice to patients and health plan members, they say.

Writing in The Hill newspaper on April 22, Kenneth Thorpe, Ph.D., chair of the Department of Health Policy & Management in the Rollins School of Public Health at Emory University, criticized a recent proposal from the Medicare Payment Advisory Commission, which advises Congress, on using the “least costly alternative” when making policy decisions. Doing so puts patients into a “one-size-fits-all” model of care delivery, he explained.

Survey: Employers expect health benefits to cost more; small companies consider dropping coverage

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Image courtesy of Mercer

Image courtesy of Mercer
Click to enlarge.

Here are two issues to watch in the coming year: How many employers will drop health insurance coverage in the next five years and how much will employers’ health benefit costs rise in 2014?

These issues jumped out from the results of the annual survey by benefits consultant Mercer. Within five years, 31 percent of small employers believe they will drop health insurance coverage, the survey showed. Mercer defines small employers as having 10 to 499 workers. The 31 percent level is up from the 22 percent of responding small employers who said last year they planned to drop health insurance coverage and up from the 19 percent who said they would drop health benefits in 2011, Mercer said.

Beth Umland, Mercer’s director of research for health and benefits, offered more detail. “While 31 percent of employers with 10 to 499 employees say it’s likely they will terminate, when we look at just those companies with 50 to 499 employees, that number falls to 21 percent,” she said. “The smaller the employer, the more likely they are to say they will drop. Continue reading

Health reform: Another poll, another confused public

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Every month, we all get those embargoed Kaiser Family Foundation tracking polls in our email. As I open it, I ask myself, “Now what did Americans forget they used to like about health reform this month?”

Or (and you may have heard me say this before – but it sums it up well, so allow me to repeat it) when are Americans going to figure out that this unpopular law is the sum of its popular parts?

What questions do you have about health reform and how to cover it?

Joanne KenenJoanne Kenen (@JoanneKenen) is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.

Remember these polls are about opinions about a law that isn’t, by and large, in effect yet. So people hear all sorts of things about it, but they aren’t actually experiencing most of it yet. We don’t know what will happen in 2014 when – if the law survives the political process and the courts – the public may finally reach the “try it you’ll like it” stage.

That brings us to a recent survey from EBRI (Employee Benefits Research Institute) and Mathew Greenwald & Associates, Inc., a Washington, D.C., market research firm. The 2011 Health Confidence Survey, which looks at trends in employer- and union-sponsored health coverage, came out a few weeks ago, based on a telephone survey conducted in May and June.

A press release and EBRI article came out a few weeks ago, but when I looked for more details and data, I found some dated September. Because I’m going to write in pretty broad brush strokes here, including a smattering of numbers without inundating you with them, you can find more specific figures in the press release here, the November article here, and a longer discussion from September here.

Guess what? People were confused – or at least amazingly contradictory – about what they have now, as well as what they expect in the future.

For instance, people were quite satisfied with their own health coverage (amongst those that had coverage) both in terms of their health insurance plan and the actual medical care they receive. But they also thought the whole system is a mess.

Sixty percent were extremely or very satisfied with their plan (a number which surprised me given how much time people – even outside our health policy world – spend complaining about health care) and 29 percent were somewhat satisfied. People also rated the actual care they had received quite high. But more than half say the system is poor or fair; a quarter think it’s good. Only 12 percent deemed it very good and only 5 percent grade it at excellent. Naturally people were not too happy about the costs, either.

They are less confident about the future of employer- or union- provided health benefits than they used to be (NOTE: This slide began, and was sharpest, quite a few years before health reform was enacted. It’s definitely not because of the new law, in case someone tries to spin you that way).

People think that if they lose access to work-related health benefits or their employer/union stops providing them, they will have a really tough time affording their own insurance – even if they are subsidized by the employer or union.

Yet – despite those high unaffordability scores – two-thirds said they would be able to buy it. (You still with me?)

On health reform, those surveyed basically had no idea what a health insurance exchange is – which doesn’t stop them from declaring that the government can’t run them.

Just 1 percent of respondents reported that they were “extremely familiar” with health insurance exchanges in the new law. Double that amount, a whopping 2 percent, was “very familiar” “Somewhat familiar” scored 15 percent (and they can’t all be in Massachusetts). Nearly two thirds – 62 percent – said they weren’t at all familiar.

But guess what. That didn’t stop them from having strong opinions on the inability of either the state or federal government – or even private insurers – to run them.

I wonder, if they go into the exchanges in 2014, will they report being “highly satisfied” with them – and still convinced the government can’t run them? Maybe it will be a variant of “get the government hands off my Medicare.”

Which reminds us – the poll didn’t find a lot of confidence in the future of Medicare either. For what it’s worth.