Category Archives: Health Care

Health Savings Accounts in National Compensation Survey Data

Source: Alan Zilberman, Bureau of Labor Statistics, November 29, 2006

The Bureau of Labor Statistics (BLS) recently reported that 6 percent of private industry workers have access to a health savings account (HSA), a relatively new kind of employer-provided health benefit. These data were published in the summary National Compensation Survey: Employee Benefits in Private Industry in the United States, March 2006. Data on HSAs currently are available for 2005 and 2006. BLS plans to continue to collect HSA data on workers in private nonagricultural industries.

The States Step Up

Source: Marilyn Werber Serafini, National Journal, Vol. 39 no. 11, March 17, 2007
(subscription required)

The ink was barely dry on then-Gov. Mitt Romney’s bold new plan to achieve nearly universal health coverage for Massachusetts residents when Vermont Gov. James H. Douglas signed similar legislation into law last year. “We have a goal of 96 percent coverage within the next three years, and I think we can do that,” Douglas recently boasted to National Journal. “We’re going to be quite aggressive with enrollment.”

Other state officials had been closely watching this pair of Republican governors as they steered away from the safe political path to push plans requiring employers to either offer their employees health insurance or pay a compensating fee to the state. The Massachusetts Legislature went a controversial step further when it decided to require all residents to certify on their state income tax forms that they had health insurance — or face a penalty. Before Massachusetts and Vermont took the plunge, most politicians had spoken only in muffled tones about health care mandates, fearful of a backlash from constituents — voting constituents.

Assessing Nursing Staffing Ratios: Variability in Workload Intensity

Source: Valda V. Upenieks, Jenny Kotlerman, Jaleh Akhavan, Jennifer Esser, Myha J. Ngo, Policy, Politics, & Nursing Practice, Vol. 8 no. 1, February 2007
(subscription required)

In 2004, California became the first state to implement specific nurse-to-patient ratios for all hospitals. These mandated enactments have caused significant controversy among health care professionals as well as nursing unions and professional organizations. Supporters of minimum nurse-to-patient ratios cite patient care quality, safety, and outcomes, whereas critics point to the lack of solid data and the use of a universally standardized acuity tool. Much more remains to be learned about staffing policies before mature links may be made regarding set staffing ratios and patient outcomes—specifically, how nurses spend their time in terms of variability in their daily work. This study examines two comparable telemetry units with a 1:3 staffing ratio within a California hospital system to determine the relative rates of variability in nursing activities. The results demonstrate significant differences in categorical nursing activities (e.g., direct care, indirect care, etc.) between the two telemetry units (X² + 91.2028; p ≤ .0001). No correlation was noted between workload categories with daily staffing ratios and staffing mix between the two units. Although patients were grouped in a similar telemetry classification category and care was mandated at a set ratio, patient needs were variable, creating a significant difference in registered nurse (RN) categorical activities on the two units.

Retiree Health Benefits Examined: Findings from the Kaiser/Hewitt 2006 Survey on Retiree Health Benefits

Source: Hewitt Associates: Frank McArdle, Amy Atchison, and Dale Yamamoto, Kaiser Family Foundation: Michelle Kitchman Strollo and Tricia Neuman, Findings from the Kaiser/Hewitt 2006 Survey on Retiree Health Benefits, December 2006

Employers continue to play an important role in providing health insurance coverage for pre-65 and age 65+ (Medicare-eligible) retirees. Employer-sponsored plans help bridge the gap in coverage for workers and spouses who retire before they turn age 65 and are eligible for Medicare. Today, an estimated 3.8 million early retirees (ages 55 to 64) and dependents receive health coverage from an employer or union. Without these benefits, early retirees often face significant challenges finding affordable coverage in the individual market, leading some to return to the workforce to gain access to health insurance. Employer plans also provide highly-valued supplemental benefits to more than 12 million retirees now on Medicare. For retirees on Medicare, employer plans remain an important source of prescription drug coverage, and provide additional cost-sharing protections, including limits on retirees’ out-of-pocket expenses.

Kaiser/Hewitt Survey Of Large Employers Finds Most Intend To Maintain Drug Coverage For Medicare Retirees In 2007 And 2008

Source: Craig Palosky, Larry Levitt, and Maurissa Kanter, Kaiser Family Foundation, Wednesday, December 13, 2006

Out-of-Pocket Costs for Retirees Continue to Rise for Employer Health Coverage

About One in 10 Firms Eliminate Retiree Health Benefits for Future Retirees

As the new Medicare drug benefit nears its second year, nearly eight in 10 large employers expect to continue to offer drug coverage to their retirees and accept subsidies from the federal government to offset some of those costs, according to a new survey of 302 large private-sector employers conducted by the Kaiser Family Foundation and Hewitt Associates.

Consumer-Directed Plans Cost Women $1,000 More Per Year Than Men

Source: BNA Pension & Benefits Reporter, Vol. 36 no. 16, April 17, 2007
(subscription required)

Consumer-directed health care plans cost working-age women about $1,000 more per year out of pocket than men, and are therefore “discriminatory” against women, according to a report by Harvard Researchers at Cambridge Health Alliance. CDHPs also cost middle-aged adults far more than younger participants, and raise costs substantially for those with even mild chronic conditions, the report says.

The Incredible Future of Home Care and Hospice

Source: Robert Fazzi and Lynn Harlow, Caring, Vol. 26 no. 3, March 2007

If you thought the past of home care and hospice was something, wait until you see the future. Home care and hospice are going to grow in the number of people they serve, and in the scope, clinical, and programmatic sophistication of their services. We will do more, serve more, and play a far bigger role in the future of health care than most people can imagine, and it’s inevitable.

Before you start thinking that these are the dreams of home care and hospice professionals, consider what the United States Department of Labor (2005) says; “The home health care services industry, which provides such in-home services as nursing and physical therapy, has the distinction of becoming the nation’s fastest growing employer by 2014.”

The Health of the Nation: Labor, Business, and Health Care Reform

Source: Marie Gottschlak, New Labor Forum, Vol. 16 no. 1, Winter 2007

Today, health benefits are once again a major arena of labor-management strife. And once again universal calls for universal health care by labor leaders mask important differences between them over health care reform. Some labor leaders are advocating a bottom-up mobilization in support of a single-payer solution that would dismantle the system of job based benefits based on private insurance. Others are staking their health care strategy on wooing key business leaders to become constructive partners in some kind of unspecified comprehensive reform of the health system.

State Government Employee Health Benefits in the United States

Source: Christopher G. Reddick and Jerrell D. Coggburn, Review of Public Personnel Administration, Vol. 27 no. 1, March 2007
(subscription required)

Employer-sponsored health benefits are an important but relatively understudied area in public sector human resource management. This study examines the choices that state governments make in the United States and the views of state human resource directors (HRD) on health benefits. Survey data, gathered from state HRDs in fall 2005, reveal several important findings: In terms of choices, the most common plan offered is the preferred provider organization (PPO); less than one third of states offer health benefits to nontraditional partners; health benefits improve employee satisfaction and the performance of the state government; and cost to the state government is the most important factor that affects choice of plan. There is not a high level of agreement on what strategies state government should pursue to reduce costs of health benefits; however, there is some agreement that premiums will be increasing in the near future.

Paying for Promises

Source: Jonathan Walters, Governing, Vol. 20 no. 5, February 2007

Call it the six stages of GASB 45: anger, denial, sorrow, acceptance, study and action. That’s been the general response to a new set of governmental accounting rules that ask state and local governments to spell out the costs of their promises to provide retired employees with health care as well as other post-employment benefits.