Source: iHealthBeat, June 22, 2007
For the first time in more than a decade, the federal government released data on how well the nation’s hospitals care for Medicare beneficiaries with heart problems, but critics say the lack of detailed information prevents consumers from making real choices. CMS said that their quality improvement officials will work with some hospitals to improve care.
Direct to Hospital Compare Database
The database contains:
– Hospital Location Information
– Hospital Quality Information
See Process of Care Measures that show how often hospitals provided recommended treatment for heart attack, heart failure, pneumonia, and surgery. Find information about hospitals’ Death (Mortality) Rates for heart attack and heart failure.
– Hospital Checklist
– Your Rights When You Are in the Hospital
– Hospital Name
– ZIP Code
Source: Peter R. Orszag, Health Care and the Budget: Issues and Challenges for Reform, CBO Testimony, Congressional Budget Office, June 21, 2007
Rising health care costs and their consequences for federal health insurance programs constitute the nation’s central fiscal challenge. Rising costs also represent a critical issue for employers—who sponsor most private health insurance coverage—and for the enrollees and patients who ultimately bear the costs of health insurance and health care. At the same time, substantial concerns exist about the number of individuals who lack health insurance, about the quality of care that is provided both to the uninsured and to the insured, and about trends in health such as the growing prevalence of obesity.
+related presentation: Health Care Issues and Challenges for Reform
+related presentation: Challenges of Health Care Costs
Source: Gulcin Gumus and Tracy L. Regan, Institute for the Study of Labor, IZA DP No. 2866, June 2007
Between the years 1996 and 2003, a series of amendments were made to the Tax Reform Act of 1986 (TRA86) that gradually increased the tax credit for health insurance purchases by the self-employed from 25 to 100 percent. We study how these changes in the tax code have influenced the likelihood that a self-employed person has health insurance coverage as the policy holder of the plan. The Current Population Survey (CPS) is used to construct a data set corresponding to 1995-2005. The empirical analysis is performed for prime-age men and women, and accounts for differences in family structure and potential eligibility. The difference-in-difference estimates suggest that the series of tax credits did not provide sufficient incentives for the self-employed to obtain health insurance coverage. Estimates of the price elasticity of demand confirm the limited response to changes in the after-tax health insurance premium. The effect was largest, however, among the single men and women in our sample, suggesting that a 10 percent decrease in the after-tax price increases the likelihood of coverage by 0.68 and 1.02 percentage points, respectively.
Source: Agency for Healthcare Research and Quality
This Compendium is a searchable directory of health care “report cards” which provide comparative information on the quality of health plans, hospitals, medical groups, individual physicians, nursing homes, and other providers of care.
Designed to be a resource for those interested in creating health care report cards for their organizations, the Compendium includes over 200 examples that demonstrate a wide range of approaches to reporting data. Report card developers can use these examples to explore the scope and types of information they might want to cover as well as various approaches to presenting comparative data.
The Compendium includes a variety of printed and Web-based reports produced since the mid-1990s by a wide range of sponsors. In every case, a primary purpose of the information is to help consumers and patients better understand and choose among their health plan or provider options.
Source: California Health Care Foundation, May 2007
The main source of health insurance for one in six Californians, Medi-Cal is the nation’s largest Medicaid program covering 6.6 million people. Medi-Cal pays for nearly half of all births in the state, two-thirds of nursing home residents, and brings in more than $20 billion in federal funds to California’s health care providers.
The third edition of Medi-Cal Facts and Figures provides the essential elements of this massive program, including new information on enrollment, benefits and cost sharing, program spending and cost drivers. It also features key trends and comparisons with other states, describes the important role that Medi-Cal serves in California’s health care system, and examines several challenges facing the program.
Source: Stuart M. Butler, The Brookings Institution, Hamilton Project Discussion Paper 2007-06, May 2007
For most working-age families, health insurance coverage is directly connected to the workplace. But because of structural weaknesses in this traditional form of coverage, it is steadily eroding, especially for workers in the small business sector. The health insurance system needs to evolve along a different path if it is to adapt to the goals and needs of today’s workforce. Unfortunately, existing laws and insurance arrangements obstruct that evolution. Three key steps are needed to achieve a gradual transformation without disrupting the successful parts of the system.
First, states should establish “insurance exchanges.” Exchanges would offer an array of coverage options, and families could retain their chosen plan from workplace to workplace with the same tax benefits as those available for traditional employer-sponsored plans. Second, most employers should become facilitators, rather than sponsors, of coverage. While many large employers would continue to sponsor coverage, most employers would hand over sponsorship to an insurance exchange and focus on providing administrative support for their employees’ insurance choices. Third, the federal government should reform the tax treatment of health to focus help on lower-income families.
+ Full policy brief
Source: Association of Community Organizations for Reform Now, Inc. (ACORN), March 1, 2007
ACORN’s Healthy Workers, Healthy Families Campaign calls on businesses to provide workers with a fair number of paid sick days a year. We also call on Congress and state legislatures to pass laws guaranteeing that all workers have paid sick days.
Nearly half of American private-sector workers have no guaranteed paid sick days – yet everyone gets sick and everyone needs time to get well. Workers also have families and responsibilities to care for sick children and other relatives who need them.
ACORN called 50 of the largest food service and retail companies operating in America and asked if they provided their hourly workers with paid sick days. Despite the close contact with the public that characterizes jobs in these industries, a near-majority of the companies for which we gathered information were clear that they did not offer paid sick days to hourly employees.
Source: American Hospital Association, May 2007
From press release:
The over-65 population will nearly triple between 1980 and 2030 as a result of the aging Baby Boomers, adding new demands and challenges on an already stressed-out health system, according to a new report released today by First Consulting Group of Long Beach, Calif. With new projections on Boomer health into 2030, the report details how this powerful population will impact health care for decades to come.
The first Boomers will turn 65 in 2011 and, according to today’s report, more than 37 million of them – six out of 10 – will be managing more than one chronic condition by 2030. Also by 2030:
• 14 million Boomers will be living with diabetes – that’s one out of every four Boomers.
• Almost half of the Boomers will live with arthritis and that number peaks to just over 26 million in 2020.
• More than one out of three Boomers – over 21 million – will be considered obese.
Source: Women’s Health Policy Program, Kaiser Family Foundation, June 12, 2007
With maternity care representing one of the most common and costly medical interventions that women experience, Kaiser and the March of Dimes co-hosted a forum to release new studies that analyze the costs of maternity care and assess coverage under consumer-driven health plans (CDHPs). Kaiser released a new study that compares the out-of-pocket costs of maternity care under CDHPs and traditional health insurance plans. The March of Dimes released a new study prepared by Thomson Healthcare that examines the overall costs of having a baby.
+ Executive Summary
+ Full Report
+ Thomson Report: The Healthcare Costs of Having a Baby
+ March of Dimes: Maternity Care Fact Sheet
Source: California Health Care Foundation, June 2007
The report offers a number of key findings including:
– Monthly premiums in the small group market are, on average, 50% higher than in the individual market.
– Insurance covered 83% of a person’s medical bills in the small group market, and 55% of those costs in the individual market.
– A person buying coverage in the individual market earning the median household income ($30,623) would have spent 16% of income for health care and coverage, compared to less than 4% of income in the small group market, where employers are likely to contribute a share of the premium and benefits are more generous.
Further Evidence of Affordability Problems
A companion piece, available as a Health Affairs Web exclusive, provides additional evidence of growing affordability problems in these two markets, albeit in different ways. Jon Gabel and co-authors find that small group premiums in California increased 53% between 2003 and 2006, while premiums for individual coverage rose only 23% between 2002 and 2006.
However, the average actuarial value of individual coverage declined dramatically. In 2003 individual market policies paid 75% of medical costs on average; that figure had dropped to 55% just three years later. In contrast, small group market policies retained their actuarial value, paying for roughly 83% of medical expenses across a similar period.