Tiptastic Tuesday: 4 Ways To Tackle Healthcare Disparities

Significant care quality disparities due to race, income, gender, and sexual orientation continue to trouble the American healthcare system. For providers, the biggest challenge is pinpointing what to do about it. However, the Affordable Care Act, along with creative solutions at the community level have expanded coverage and care efforts. Experts offer four practices that can help in eliminating these disparities:

  1. Develop health education tools that cater to different segments of the population.
  2. Invest in translation and interpretation services for bilingual patients.
  3. Use electronic health records (EHRs) to track and measure the health outcomes of patients, and use this information to design better treatments.
  4. Partner with the community to foster outreach and care care.

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CMS Report: Healthcare Industry Makes “Clear Progress ” In Triple Aim Measures

According to a new report from CMS, the country’s healthcare system has made “clear progress” in improving its delivery of the “Triply Aim” of improved care, improved health and reduced costs. Of 119 publicly disclosed performance rates for seven quality reporting programs, 5 percent improved between 2006 and 2012. In addition, approximately 35 percent of these measures were classified as high-performing, or had performance rates exceeding 90 percent. The report also found improvements in other areas, including inpatient health failure measures and inpatient hospital surgical process measures. Over the study period, racial and ethnic disparities in care also decreased and improved most among Hispanics, blacks and Asians.

Click here to see the report.

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National Health Expenditures Continued Slow Growth In 2013

According to CMS, health spending continued to grow at a slow rate last year at the Office of the Actuary (OACT). In 2013, health spending grew at 3.6 percent and total national health expenditures in the country reached $2.9 trillion, or $9,255 person. The annual OACT report shows health spending continued a pattern of low growth – between 3.6 percent and 4.1 percent for five consecutive years.

Other findings from the report include:

  •  Medicare spending, which represented 20 percent of national health spending in 2013, grew 3.4 percent to $585.7 billion, a slowdown from growth of 4.0 percent in 2012. This slowdown was primarily caused by a deceleration in Medicare enrollment growth, as well as net impacts from the Affordable Care Act and sequestration. Per-enrollee Medicare spending grew at about the same rate as 2012, increasing just 0.2 percent in 2013.

  • Medicaid spending grew 6.1 percent in 2013 to $449.4 billion, an acceleration from 4.0 percent growth in 2012. Faster Medicaid growth in 2013 was driven in part by increases in provider reimbursement rates and some states’ expanding benefits.

  • Spending for physician and clinical services increased 3.8 percent in 2013 to $586.7 billion, from 4.5 percent growth in 2012. Slower price growth in 2013 was the main cause of the slowdown, as prices grew less than 0.1 percent. Growth in spending from private health insurance and Medicare, the two largest payers of physician and clinical services, experienced slower spending growth in 2013, while Medicaid growth accelerated as a result of temporary increases in payments to primary care physicians.

Click here for more information from CMS.

Health Insurance Marketplace Offering Tools To Help Consumers Review Their Plan Options For 2015

Consumers can visit HealthCare.gov to review detailed information about all the health insurance plans offered in their area before applying ahead of open enrollment on November 15. This year, consumers will find more affordable options for themselves and their families due to more insurers offering coverage through the Health Insurance Marketplace. After answering a few simple questions, consumers will be able to compare plans and get an estimate on how much financial assistance they may qualify for when shopping for coverage without submitting an application.

Open Enrollment for the Health Insurance Marketplace begins Saturday, November 15, 2014 and runs through Sunday, February 15, 2015.

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Increasing Price Transparency In Healthcare

In the U.S., it’s still nearly impossible to compare the price and quality of anything in healthcare. Recently, websites that mine data have been popping up all over the web to fill the void and reveal prices for everything-from an office visit to a cesarean section. In Massachusetts, a new law has forced health insurance companies to increase transparency by making all their prices public in advance. These online tools calculate the patient’s cost based on his or her plan. For instance, in Boston, the prices for an MRI range from $641 to $1,800. Most people don’t have a strong incentive to shop because the co-pay is typically the same no matter where one goes. However, with increasing deductibles, where patients pay the full cost of an office visit or test up to the amount of their deductible, it’s becoming more and more relevant.

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That’s A Wrap! The Affordable Care Act, One Year Later Series Comes To An End

Throughout the month of October, HMS has explored the ins and outs of the Affordable Care Act. Our The Affordable Care Act, One Year Later Series has investigated both the positive and negative aspects of the new health law. It’s been one year since the implementation. Overall, how has the ACA impacted healthcare in America? Our final post in the series will examine if the health law did, in fact, do what it was intended to do-which is reduce the number of Americans without health insurance, make health insurance more affordable, and make Americans healthier.

According to a recent New York Times article, the ACA has indeed reduced the number of Americans without health insurance.  Although a perfect measurement of the number of people affected by the law is still difficult, most private sector surveys and government reports, including a Gallup poll, The Commonwealth Fund, and a CDC survey, reach the same basic estimates. The number of uninsured Americans has been reduced by 25 percent this year-that’s eight to 11 million people. More than half of that appear to be the newly insured who have signed up for Medicaid. Others are enrolled in private health plans through the new state insurance marketplaces. Three to four million people, mostly young adults, also became newly insured through ACA provisions that kicked in. The Congressional Budget Office estimates that by 2017, approximately 26 million more Americans will become insured through the law (lower than previously estimated).

Another question we all have: Is the Affordable Care Act actually affordable? According to the Obama administration, eighty-five percent of those who signed up during enrollment period qualified for federal subsidies to help pay premiums. The subsidies are estimated to have lowered the cost by 76 percent on average. However, the law has also required insurers to provide more benefits to cover people with pre-existing conditions, subsequently causing premiums to rise for some of those who already had insurance. Others plans were canceled or were not eligible for subsidies. On a more positive note, it has also been reported that premiums may actually become lower in the next year due to spurred competition among insurers.

Lastly, has the ACA made us healthier? Most experts believe it’s still too early to know. How will the ACA fare in the long run? Only time will tell!

*You can start shopping for health insurance on Saturday, November 15. If you want coverage to start on January 1, you’ll have to buy it by December 15. If you  miss the December 15 deadline, you can buy coverage, but it will not take effect until February 1 at the earliest.

The Affordable Care Act, One Year Later Series: The Winners Part II

The Affordable Care Act, One Year Later Series: The Winners Part II will continue exploring the ways in which the ACA is working.

  1. Premiums in the marketplaces aren’t rising quickly and more insurers are     joining the marketplaces to compete. Many opponents of the ACA have argued that only older and sicker people are signing up for coverage, and that carriers would increase premiums or abandon marketplaces. However, multiple studies have shown that premiums inside marketplaces are barely rising. In fact, even within states, there is a lot variation. The HHS announced that participation in the marketplaces will actually increase next year.
  2. Employer premiums aren’t rising. Most working-age Americans are insured through their employers. And although critics said employer premiums would skyrocket, this hasn’t been the case. A Kaiser/HRET Survey of Employer-Sponsored Health Benefits found that employer premiums rose by just 3 percent. However, because coverage can still be expensive, employers have asked employees to pay more in out-of-pocket costs.
  3. Overall health costs are rising at historically low rates. When measuring the cost of healthcare, economists mostly care about national health expenditures-what the U.S. spends on medical care through both private and public insurance, as well as through individual out-of-pocket costs. According to the latest projections from CMS, it’s been rising very slowly.
  4. The net effect on the budget has been to reduce the deficit. The ACA calls for new spending since the government now has to underwrite the costs of both the expanded Medicaid program and subsidies for people buying health insurance. With every dollar in new spending, there is also one dollar in either new revenue or new spending cuts. According to the Congressional Budget Office (CBO), the net effect is to reduce the deficit. Additionally, according to the Committee for a Responsible Federal Budget, the total bill for federal healthcare programs is likely to be lower than predicted when the ACA first became law.

Stay tuned to the HMS Affordable Care Act, One Year Later Series to find out who the ACA losers are.

Click here to see our last post.