Category Archives: Health Care

Differences in Health Insurance Coverage between Part-Time and Full-Time Private-Sector Workers, 2005 and 2015

Source: William A. Carroll and G. Edward Miller, Agency for Healthcare Research and Quality, Statistical Brief #511, April 2018

Highlights:
– In 2015, among non-elderly private-sector workers, those working full time were more than 4 times as likely as part-time workers to be policyholders of employer-sponsored insurance provided through their current main job (66.9 vs. 15.1 percent).
– In 2015, part-time workers were more than 2 times as likely as full-time workers to have other ESI coverage (38.9 vs. 14.5 percent) which accounted for nearly three-quarters (72.0 percent) of all ESI coverage held by part-time workers.
– From 2005 to 2015, the percentage of part-time workers covered by ESI from any source decreased by 10.1 percentage points, from 64.1 to 54.0 percent.
– From 2005 to 2015, the increase in public coverage was larger for part-time workers than for full-time workers (11.3 vs. 2.2 percentage points).
– Both groups of workers had a significant decline in the percentage uninsured from 2005 to 2015, with the uninsurance rate for full-time workers dropping 3.0 percentage points (from 12.6 to 9.6 percent) and the rate for part-time workers dropping 6.6 percentage points (from 19.3 to 12.7 percent).

RAND Hospital Data Web-Based Tool

Source: RAND, 2018

From the summary:
Medicare-certified hospitals and other institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor. Cost reports contain provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data. The Centers for Medicare & Medicaid Services (CMS) maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS). The RAND Hospital Data tool is an effort to enhance CMS HCRIS data to make them more accessible and useful to a broad audience of academics, analysts, and hospital executives and their consultants. The tool provides users with data sets that are conveniently packaged and documented and that include value-added fields derived from HCRIS data, such as measures of occupancy and profitability. The goal of the tool is to make analytic tasks easier for those who work regularly with the data and to broaden the set of users.

Even Libertarians Admit Medicare for All Would Save Billions

Source: Matt Bruenig, Jacobin, July 30, 2018

A new study from a libertarian think tank admits that Medicare for All would save a whopping $300 billion. …. The report’s methods are pretty straightforward. Blahous starts with current projections about how much the country will spend on health care between 2022 and 2031. From there, he adds the costs associated with higher utilization of medical services and then subtracts the savings from lower administrative costs, lower reimbursements for medical services, and lower drug prices. After this bit of arithmetic, Blahous finds that health expenditures would be lower for every year during the first decade of implementation. The net change across the whole ten-year period is a savings of $303 billion. ….

Related:
The Costs of a National Single-Payer Healthcare System
Source: Charles Blahous, George Mason University, Mercatus Working Paper, 2018

The leading current bill to establish single-payer health insurance, the Medicare for All Act (M4A), would, under conservative estimates, increase federal budget commitments by approximately $32.6 trillion during its first 10 years of full implementation (2022–2031), assuming enactment in 2018. This projected increase in federal healthcare commitments would equal approximately 10.7 percent of GDP in 2022, rising to early 12.7 percent of GDP in 2031 and further thereafter. Doubling all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan. It is likely that the actual cost of M4A would be substantially greater than these estimates, which assume significant administrative and drug cost savings under the plan, and also assume that healthcare providers operating under M4A will be reimbursed at rates more than 40 percent lower than those currently paid by private health insurance.

Health Insurers Are Vacuuming Up Details About You — And It Could Raise Your Rates

Source: Marshall Allen, ProPublica, July 17, 2018

Without any public scrutiny, insurers and data brokers are predicting your health costs based on data about things like race, marital status, how much TV you watch, whether you pay your bills on time or even buy plus-size clothing. ….

…. This year, ProPublica and NPR are investigating the various tactics the health insurance industry uses to maximize its profits. Understanding these strategies is important because patients — through taxes, cash payments and insurance premiums — are the ones funding the entire health care system. Yet the industry’s bewildering web of strategies and inside deals often have little to do with patients’ needs. As the series’ first story showed, contrary to popular belief, lower bills aren’t health insurers’ top priority. ….

Work perks and benefits: what employees and candidates want

Source: Randstad, Workforce Insights June 19, 2018

From the press release:
….The takeaway? Almost all employees (94%) want their employers to ensure the benefits offered have a meaningful impact on their quality of life, like paying off student loan debt and offering more flexible work arrangements. But before employers attempt a benefits overhaul, they should perhaps focus on better education and communication about their existing benefits. Just under half (48%) of employees report knowing all the perks their employers offer, and only 40 percent say their employers help them understand the benefits that are available…..

Benefits can be an even stronger incentive than salary when considering a job offer, and an unattractive benefits package may drive candidates away.

– Sixty-six percent of workers agree that a strong benefits and perks package is the largest determining factor when considering job offers, and 61 percent would be willing to accept a lower salary if a company offered a great benefits package.
– Forty-two percent of employees say they are considering leaving their current jobs because their benefits packages are inadequate.
– Fifty-five percent have left jobs in the past because they found better benefits or perks elsewhere.

Both benefits and perks matter

When evaluating benefits, quality health insurance reigns supreme. But when it comes to perks, the survey findings indicate that workers want to maximize their time spent at work and appreciate conveniences that help them get the most out of their days.

– When considering a potential employers’ benefits (defined in the study as “standard forms of compensation paid by employers to employees over and above salary”), workers prioritize health insurance (75%), followed by retirement funds and/or pensions (21%).
– Highly rated perks (defined in the study as “workplace-related extras”), that workers want to see more of in the workplace are:
– early Friday releases (33%)
– flexibility and remote working (26%)
– onsite lifestyle amenities, like gyms and dry cleaning (23%)
– unlimited vacation time (22%)
– in-office meal options, like communal snacks or food courts (18%)
– onsite childcare (15%)

When it comes to benefits and perks, one size does not fit all

Age, income level and gender all play a role in the benefits that employees prioritize:

– Forty-one percent of respondents aged 18 to 24 said their current employers do not offer student loan repayment benefits, but wish they did.
– Workers aged 50+ named health insurance as the top benefit they wish their employers offered.
– Nearly a third (28%) of respondents who earn more than $150,000 annually say bonuses are one of the most important perks when considering new employment.
– More women than men want better parental leave policies (women: 22% vs. men: 14%) and onsite childcare (women: 15% vs. men: 6%).
– More men than women would like to see their employers offer life insurance (women: 15% vs. men: 23%).

State and Local Government Workforce: 2018 Data and 10 Year Trends

Source: Gerald Young, Center for State and Local Government Excellence, International Public Management Association for Human Resources, and the National Association of State Personnel Executives, May 2018

From the summary:
Since 2009, the Center for State and Local Government Excellence has partnered with the International Public Management Association for Human Resources and the National Association of State Personnel Executives to conduct a study on state and local workforce issues. This year’s report contains both 2018 data on emerging issues like the gig economy and flexible work practices and longitudinal data on recruiting challenges, retirement plan or health benefit changes, hiring, and separations from service.

The Case for Single-Price Health Care

Source: Paul S. Hewitt and Phillip Longman, Washington Monthly, Vol. 50 no. 4/5/6, April/May/June 2018

We could largely solve the cost crisis simply by making Medicare prices universal.

Related:

Their Own Medicine
Source: Fran Quigley, Washington Monthly, Vol. 50 no. 4/5/6, April/May/June 2018

Patient activists were once at the forefront of lowering the cost of life-saving medication. To solve today’s prescription drug crisis, they’ll have to find their voice again.

Assessing The Value Of 40 Years Of Local Public Expenditures On Health

Source: Jonathon P. Leider, Natalia Alfonso, Beth Resnick, Eoghan Brady, J. Mac McCullough, and David Bishai, Health Affairs, Vol. 37 no. 4, 2018
(subscription required)

From the abstract:
The US public and private sectors now spend more than $3 trillion on health each year. While critical studies have examined the relationship between public spending on health and health outcomes, relatively little is known about the impact of broader public-sector spending on health. Using county-level public finance data for the period 1972–2012, we estimated the impact of local public hospital spending and nonhospital health spending on all-cause mortality in the county. Overall, a 10 percent increase in nonhospital health spending was associated with a 0.006 percent decrease in all-cause mortality one year after the initial spending. This effect was larger and significant in counties with greater proportions of racial/ethnic minorities. Our results indicate that county nonhospital health spending has health benefits that can help reduce costs and improve health outcomes in localities across the nation, though greater focus on population-oriented services may be warranted.

Affordable Care Act’s Cadillac Tax Could Affect One-Fourth Of Workers With Employer Health Coverage By 2025

Source: Mark J. Warshawsky and Michael Leahy, Health Affairs, Vol. 37 no. 4, April 2018
(subscription required)

From the abstract:
The excise tax on high-cost health insurance plans (known as the Cadillac tax) under the Affordable Care Act (ACA) is an important part of the law’s attempt to control rising health care costs. Analysts using different data sources have come to divergent estimates of how many people would be affected by this tax. We used the National Compensation Survey from the Bureau of Labor Statistics, which is better suited to this analysis because of its law-relevant details on employer-provided health benefits. Our research clarifies an important area of empirical uncertainty, thereby informing the debate about the ACA and its proposed replacements. Our base estimate of impact, 12 percent of workers participating in employer-provided health plans in 2020, lies in the middle of other estimates, but it is considerably more comprehensive, accurate, and delineated by worker characteristics (region, number of employees at the firm, industry, occupation, and so on) than others. Workers affected at the highest rate include those in education occupations and high-income workers, while those in industries involving manual labor and public safety are affected at some of the lowest rates.