Category Archives: Health Care

Performance in an Era of Uncertainty: Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care

Source: Towers Watson, 2012

From the abstract:
The 17th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care tracks employers’ strategies and practices, and the results of their efforts to provide and manage health benefits for their workforce. This report identifies the actions of high-performing companies, as well as current trends in the health care benefit programs of U.S. employers with at least 1,000 employees. Respondents were also asked about specific implications for their health care benefit programs attributed to the health care reform Patient Protection and Affordable Care Act (PPACA).

The survey was completed by 512 employers between December 2011 and January 2012, and reflects respondents’ 2011 and 2012 health program decisions and strategies and, in some cases, their 2013 plans. Respondents collectively employ 9.2 million full-time employees have 8.0 million employees enrolled in their health care programs and operate in all major industry sectors. In 2011, respondents spent, on average, $10,982 per employee on health care, which equates to a collective $87 billion in total health care expenditures.

How Would Eliminating the Individual Mandate Affect Health Coverage and Premium Costs?

Source: Christine Eibner, Carter C. Price, RAND Corporation, Research Brief, RB-9646-CMF, 2012

From the abstract:
An analysis of the effects of implementing the Affordable Care Act without an individual mandate found that over 12 million people who would have otherwise signed up for coverage will be uninsured and premium prices will increase by 2.4 percent.

Employer and Worker Contributions to Health Savings Accounts and Health Reimbursement Arrangements, 2006-2011

Source: Paul Fronstin, Employee Benefit Research Institute, EBRI Notes, Vol. 33, No. 2, February 2012

From the summary:
This report presents findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey, as well as earlier surveys, examining the availability of health reimbursement arrangement (HRA) and health savings account (HSA)-eligible plans (consumer-driven health plans, or CDHPs). It also looks at employer and individual contribution behavior.

Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond

Source: John Schmitt, Center for Economic and Policy Research, February 2012

From the abstract:
This paper uses data from the Current Population Surveys for 1980 through 2011 to review trends in health-insurance coverage rates for low-wage workers (defined as workers in the bottom fifth of the wage distribution in each survey year). In 2010, over 38 percent of low-wage workers lacked health insurance from any source, up from 16 percent in 1979. The biggest reason for the decline in coverage is the erosion of employer-provided health insurance, either through a worker’s own employer or as a dependent on another family member’s employer-provided policy. Over the last three decades, the role of public insurance in providing coverage for low-wage workers has increased, though not nearly enough to offset the declines in private insurance. In 2010, about 10 percent of low-wage workers had coverage through Medicaid, double the share in 1979. While a great deal of uncertainty still surrounds the Affordable Care Act (ACA) and its likely impact on employers and workers, reasonable estimates based on consensus projections suggest that the ACA will have a substantial positive effect on health-insurance coverage rates for low-wage workers. Even so, the ACA will likely leave an important share of low-wage workers, especially low-wage Latino, African American, and Asian workers, as well as many immigrant workers, without coverage. At the same time, if the ACA is blocked – in the courts or in Congress – there is every indication that coverage rates for low-wage workers will continue their long, steady decline.

Employer and Worker Contributions to Health Savings Accounts and Health Reimbursement Arrangements, 2006-2011

Source: Paul Fronstin, Employee Benefit Research Institute, EBRI Notes, Vol. 33, No. 2, February 2012

Enrollment in health savings accounts (HSAs) and heath reimbursement arrangements (HRAs) continues to grow, but contribution patterns to these account-based health plans are changing, according to a new report from EBRI. Annual contributions from employer have fallen since 2008, while contributions from individuals have gone up.
See also:

The Income Divide in Health Care: How the Affordable Care Act Will Help Restore Fairness to the U.S. Health System

Source: Sara R. Collins, Ruth Robertson, Tracy Garber, and Michelle M. Doty, Commonwealth Fund, Issue Brief, February 2012

The new Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults finds nearly three of five adults in families earning less than 133 percent of the federal poverty level were uninsured for a time in 2011; two of five were uninsured for one or more years. Low- and moderate-income adults who were uninsured during the year were much less likely to have a regular source of health care than people in the same income range who were insured all year. In addition, uninsured lower-income adults were more likely than insured adults in the same income group to cite factors other than medical emergencies as reasons for going to the emergency room. These included needing a prescription drug, not having a regular doctor, or saying that other places cost too much. The Affordable Care Act will substantially narrow these inequities through an extensive set of affordable coverage options starting in 2014.
See also:
Chartpack (PDF)
Chartpack (PPT)
News Release (PDF)

Benefits Design and Delivery – A New Era

Source: Don Heilman, IPMA-HR News, Vol. 78 no. 1, January 2012
(subscription required)(scroll down)

Governmental employers are faced with many challenges in managing benefits in today’s environment. Among those challenges: static/decreasing revenues, increasing costs, future/unfunded liabilities, workforce planning and health care reform–not to mention increasing public scrutiny….[T]he benefits configuration creating many of the challenges is most valued by the baby boomers that are both contributing to the costs and who are entering their retirement phase. These employees in turn will be replaced with an employee population with a different level of expectations and values elated to benefits, and for that matter, total compensation.

Viewpoint: Lessons learned while adjusting retiree health benefits

Source: Lynna Soller and Steve Burrows, American City and County, Vol. 127 no. 1, January 2012

For many years, Tempe, Ariz., provided active and retired employees — about 2,450 individuals — with a generous health plan at little or no cost. But recently, the city faced up to a hard reality: that plan simply was not sustainable.

Tempe officials had to figure out how to make good on retiree medical benefit promises in a sluggish economy marked by staggering deficits, relentless health care inflation and growing numbers of retirees. It was a huge challenge to design a plan that would stem the fiscal bleeding, be fair to all parties and that could be communicated in a clear, concise way. We had our ups and downs along the way. In the end, however, by working with retirees and unions, we achieved a consensus and achieved a long-term solution.

Here are seven lessons we learned that may be instructive to other cities and counties contemplating reform of their retiree benefits plans:

A Fatter Butt Equals a Skinnier Wallet: Why Workplace Wellness Programs Discriminate Against the Obese and Violate Federal Employment Law

Source: Steven C. Sizemore, Wyoming Law Review, 2011
(subscription required)

This comment examines the complicated nature of obesity in America to ascertain whether workplace wellness programs requiring the disclosure of legally protected genetic information discriminate against the obese and violate federal employment law. To accomplish this, the background section discusses the facts behind America’s alleged obesity epidemic in an attempt to address some of the societal issues underpinning America’s growing concern with obesity and the workplace wellness program solution. Following a discussion of the relevant sections of the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA), this comment analyzes whether the ADA and GINA permit employers to provide discounts to the non-obese which results in charging the obese more for the same insurance benefits. This comment concludes Patient Protection and Affordable Care Act’s (PPACA) sanction of workplace wellness programs discriminates against the obese and violates the ADA and GINA by unequally allocating health insurance benefits among employees and requiring the disclosure of statutorily protected genetic information.

While workplace wellness programs provide a multitude of benefits for employers and their employees, ultimately such programs discriminate against the obese through the unequal distribution of health insurance premiums and violate federal employment law by compelling the disclosure of legally protected information. As a result, PPACA’s endorsement of workplace wellness through awarding grants to implement workplace wellness programs discriminates against the obese and violates federal employment law.