Source: “Addiction and Mental Health vs. Physical Health: Widening disparities in network use and provider reimbursement,” Milliman, November 2019.In a recent report on the level of parity between care for patients with mental health versus physical health conditions, actuaries from Milliman reported which states (shown in white and light blue) have the highest rates of parity and which states have the lowest rates (darker and deep blue). One of the strengths of the report is that it has data on parity for each state.
A recent report indicates that health insurers are failing to comply with mental health parity laws for people with employer-sponsored health coverage and their families.
In the report, “Addiction and Mental Health vs. Physical Health: Widening disparities in network use and provider reimbursement,” actuaries from the consulting firm Milliman document wide disparities in access to behavioral health care services for employees, family members and retirees with health insurance through an employer.
The report shows that disparities between physical and behavioral health care for both in-network access and provider reimbursement rates are making it harder for Americans to find affordable and available mental health care and addiction treatment. Continue reading
As large insurers, such as United Healthcare, Humana and Aetna, drop out of the Healthcare.gov marketplace, consumers are left with fewer and fewer choices, especially in certain geographic areas.
Sarah Kliff, Sarah Frostenson and Soo Oh of Vox gathered the data to show us just how little competition there will be:
“There are currently 687 counties on the Healthcare.gov marketplace with just one insurer signed up to sell in 2017 — nearly four times the 182 counties that had one insurer this year.”
Source: Adrion ER, Ryan AM, Seltzer AC, Chen LM, Ayanian JZ, Nallamothu BK. Out-of-Pocket Spending for Hospitalizations Among Nonelderly Adults. JAMA Intern Med.Published online June 27, 2016. doi:10.1001/jamainternmed.2016.3663.Researchers from the University of Michigan’s Center for Healthcare Outcomes and Policy studied the cost of hospitalizations for insured consumers and found that costs rose sharply from 2009 to 2013.
Two new studies indicate that out-of-pocket costs of health care are rising sharply.
The share of costs that consumers are paying rose by 13 percent from 2014 to 2015 according to a new report from TransUnion Healthcare. What’s more, the report shows that as these costs rose, patients had fewer resources to pay those increased expenses because their amount of revolving credit had declined.
Out-of-pocket costs are a combination of what patients pay in deductibles, coinsurance and copayments for covered services. Coinsurance is a percentage of the total bill and a copayment is usually a fixed amount due at the time of service. Consumers pay for these costs until they reach the out-of-pocket maximum when insurance starts paying. Continue reading
One important question to ask about any health insurance merger is how will the deal will affect the local market.
It’s said that all politics is local and the same is true in health care. That’s why antitrust regulators will look closely at Anthem’s proposed acquisition of Cigna and Aetna’s proposed deal to buy Humana, which we covered earlier this month. Continue reading
Recently in this blog I suggested that reporters examine insurance companies’ record of controlling health care costs for older adults. And Mark Miller of Reuters decided to do just that.
In a just-published column, Miller looked at Medicare Advantage – a private insurance option that covers hospital and doctor services – and Medicare Part D, a prescription drug program run entirely by insurance companies.
“There’s already plenty of competition in Medicare and it has not resulted in lower costs, according to recent evidence. In addition, the competition hasn’t pushed seniors to shop effectively for low-cost options.”
Miller turned up important new research from George Washington University that sheds light on this topic. The key finding from that soon-to-be-published study: Continue reading