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Between ACA and Medicare, some Americans may have too much health coverage

Ever since the Affordable Care Act’s insurance marketplaces opened for business in 2014, the Obama administration has worked hard to get Americans to sign up. Yet officials now are telling some older people that they might have too much insurance and should cancel their marketplace policies.

Each month, the Centers for Medicare and Medicaid Services (CMS) is sending emails to about 15,000 people with subsidized marketplace coverage. The message arrives a few weeks before their 65th birthday, which is when most become eligible for Medicare.

“In most cases you won’t want to keep your Marketplace plan because once your Medicare coverage starts, you’ll no longer be eligible for any premium tax credits or other cost savings you may be getting,” says the email, which goes to enrollees in the 38 states using the federal HealthCare.gov. “To avoid an unwanted overlap in Marketplace and Medicare coverage . . . tell us you want to end your Marketplace plan.”

And last month, CMS also began mailing letters to people already covered by Medicare as well as enrolled on the marketplace and getting financial assistance. That notice, required under the health-care law, says that they can keep dual coverage — without subsidies — but urges them to discontinue their marketplace policy since in most cases it duplicates their Medicare benefits.

Enrollees who do not follow that advice — and only the individual can terminate marketplace coverage in this situation — will have their subsidies cut. Inaction also means paying back any coverage assistance received after they should have joined Medicare.

 The 13 state-operated marketplaces also must find and alert people with such overlapping coverage, although they are not required to contact beneficiaries nearing Medicare eligibility.

A CMS official said the agency has found a small number of consumers with double coverage by comparing marketplace and Medicare enrollment data but declined to say how many.

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For Most Americans, Healthcare Costs Aren’t Skyrocketing

The rising cost of healthcare was a brief topic of conversation at Sunday night’s presidential debate, with Donald Trump bemoaning the high cost of premiums under Obamacare and Hillary Clinton talking about how to fix what we already have.

But as Clinton pointed out, the vast majority of Americans get their health insurance through their workplace. So they have little to do with the plans on the state exchanges that were created through the Affordable Care Act. But those Americans still have huge concerns about rising costs.

Most of this country’s 170 million workers will see cost increases when they get their 2017 open enrollment packets this fall. But this year’s costs increases are lower than in previous years, industry analysts say. And employees are bearing less of the burden of those increases, although they are still running ahead of inflation.

Benefits consultant Mercer found that cost growth is stable at 4 percent for 2017, while inflation is running under 2 percent. The National Business Group on Health, a non-profit trade group, pegged that number at 5 percent.

 These numbers are the cost increases after you account for measures that employers take to cut costs. Otherwise, the costs increases would be even higher. Tops on the lists of strategies: raising deductibles or switching carriers, which usually means smaller networks and reduced benefits like out-of-network coverage.
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Insurance Premiums Stable, but Out-of-Pocket Health Costs Rising

The good news for consumers is that the cost of premiums for employer-sponsored health insurance rose only modestly in 2016, in keeping with recent trends, a new health care economic study shows.

But the bad news is that the low price is often now being offset by rapidly rising out-of-pocket costs as more and more workers are steered into high-deductible plans that force them to pay thousands of dollars upfront before their coverage kicks in, according to findings in the Kaiser Family Foundation 2016 Employer Health Benefit Survey, released Wednesday.

“We’re seeing premiums rising at historically slow rates, which helps workers and employers alike, but it’s made possible in part by the more rapid rise in the deductibles workers must pay,” said Drew Altman, president and CEO of the foundation, which has released an annual snapshot since 1999.

The average overall price of family premiums rose 3 percent in 2016 to $18,142 per year. On average workers contributed $5,277 to ward that premium, typically through payroll deduction. Last year, the cost of comparable premiums increased 4 percent, reflecting a general flattening from past years when the costs were spiraling upward quickly. The study showed, for instance, that premiums shot up 63 percent between 2001 and 2006.

Yet during those years a new insurance product shifting more health care costs onto workers was becoming popular.

In 2016, 29 percent of the nation’s workers were in high-deductible plans, often connected to health savings accounts. In 2006, only 4 percent were in such plans.

High-deductible plans keep premiums lower, but they also are designed to force employees to have “more skin in the game,” making them more cost-conscious as they seek medical care, Altman said Wednesday.

This year, 83 percent of workers have some kind of deductible as part of their employer-sponsored health plan.

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Premier Inc. Releases Recommendations to Improve Healthcare Policy

Premier Inc., a leading healthcare improvement company, today released nine categories of recommendations designed to enhance the current framework for healthcare policy. These reforms are designed to provide a holistic approach to achieving a high-quality, cost-effective healthcare system.

“While we have come a long way on our journey toward a reformed delivery system with value-based payment models, we’ve also uncovered some unintended consequences,” said Blair Childs, senior vice president of public affairs at Premier. “Some current policies, while well-intended, are overlapping, confusing and sometimes unfair. Premier’s recommendations present a more comprehensive framework that removes barriers standing in the way of higher quality, more efficient and coordinated care.”

In its work with thousands of hospitals, health systems and physician groups across the country, Premier has actively tested, measured and scaled value-based care delivery models that enable innovation, cost reduction and continuous quality improvement. A number of large-scale, data-driven healthcare initiatives, including Premier’s accountable care, bundled payment and QUEST® collaboratives, have allowed Premier to understand what works for different patient populations. Based on these valuable insights, Premier recommends the following public policy changes be implemented in combination or as stand-alone reforms.

Read the full article here.

Workers Pay More for Health Care as Companies Shift Burden, Survey Finds

State health insurance exchanges created under the new health care law are in turmoil. By contrast, the employer market — where the majority of Americans still get their coverage — seems like a bastion of stability.

An analysis by the Kaiser Family Foundation released on Wednesday shows that the share of employers offering coverage remained steady this year, and that the cost of premiums for health plans remained largely unchanged.

“We see historic moderation in premiums and health spending and costs,” said Drew Altman, the chief executive of the Kaiser foundation, a nonprofit in Menlo Park, Calif., that closely tracks the health insurance markets.

But underneath some of those figures, some important changes are underway. The biggest shift is that workers continue to pay an ever-greater share of their medical bills, a trend for several years now. That is why Mr. Altman said that despite the overall moderation in costs, “it doesn’t feel that way to average people.”

Kaiser’s annual survey of employer health benefits represents a yearly snapshot of the coverage companies offer their workers, and highlights from the survey are being published online in Health Affairs, an academic journal. About 150 million people are covered by an employer, a much larger group than the 11 million or so who buy coverage on the exchanges created under the federal health care law. On Tuesday, the Census Bureau reported that the percentage of uninsured Americans fell last year, to 9.1 percent, in part because of the strength of the employer market.