Tuesday, August 30, 2016

Physicians and health care providers continue to improve quality of care, lower costs

CMS News

August 25, 2016

Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

Physicians and health care providers continue to improve quality of care, lower costs
Affordable Care Act Accountable Care Organization initiatives put patients at the center of their care while generating more than $1.29 billion in total Medicare savings since 2012

The Centers for Medicare & Medicaid Services (CMS) today announced the 2015 performance year results for the Medicare Shared Savings Program and the Pioneer Accountable Care Organization Model that show physicians, hospitals, and health care providers participating in Accountable Care Organizations continue to make significant improvements in the quality of care for Medicare beneficiaries, while achieving cost savings. Collectively, Medicare Accountable Care Organizations have generated more than $1.29 billion in total Medicare savings since 2012.

“The coordinated, physician-led care provided by Accountable Care Organizations resulted in better care for over 7.7 million Medicare beneficiaries while also reducing costs,” said CMS Acting Administrator Andy Slavitt. “I congratulate these leaders and look forward to significant growth in the program in the coming year.”

In 2015, Medicare Accountable Care Organizations had combined total program savings of $466 million, which includes all Accountable Care Organizations’ experiences, for 392 Medicare Shared Savings Program participants and 12 Pioneer Accountable Care Organization Model participants. The results show that more Accountable Care Organizations shared savings in 2015 compared to 2014 and those with more experience tend to perform better over time. 

Today’s results from the Medicare Shared Savings Program and the Pioneer Accountable Care Organization Model show significant improvements in the quality of care providers are offering to an increasing number of Medicare beneficiaries. Accountable Care Organizations are judged on their performance, as well as their improvement, on an array of meaningful metrics that assess the care they deliver. Those metrics include how highly patients rated their doctor, how well clinicians communicated, whether patients are screened for high blood pressure, and their use of Electronic Health Records.

All 12 participants in the Pioneer Accountable Care Organization Model improved their quality scores from 2012 to 2015 by more than 21 percentage points. Overall quality scores for nine out of 12 Pioneer participants were more than 90 percent in 2015.

Accountable Care Organizations in the Medicare Shared Savings Program also continued to show improvement, with Accountable Care Organizations that reported in both 2014 and 2015 improving on 84 percent of the quality measures that were reported in both years. Additionally, comparing 2014 and 2015 results, average quality performance improved by more than 15 percent on key preventive care measures including screening for risk of future falls, depression screening and follow-up, blood pressure screening and follow-up, and providing pneumonia vaccinations.

By meeting quality performance standards and their savings threshold, 125 Accountable Care Organizations qualified for shared savings payments. Since the passage of the Affordable Care Act, more than 470 Medicare Accountable Care Organizations – serving nearly 8.9 million Medicare beneficiaries – have been established through the Medicare Shared Savings Program, the Pioneer Accountable Care Organization Model, the Next Generation Accountable Care Organization Model, and the Comprehensive End-Stage Renal Disease Care Model.

“Accountable Care Organization initiatives in Medicare continue to grow and achieve positive results in providing better care and health outcomes while spending taxpayer dollars more wisely,” said Dr. Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer. “CMS continues to work and partner with providers across the country to improve the way health care is delivered in the United States.”

Accountable Care Organizations were created to change the incentives for how medical care is delivered and paid for in the United States, moving away from a system that rewards the quantity of services to one that rewards the quality of health outcomes. They are groups of doctors, hospitals, and other health care providers who voluntarily come together to develop and execute a plan for a patient’s care and share information, putting the patient at the center of the health care delivery system. In addition, under the proposed Quality Payment Program, health care providers that sufficiently participate in advanced tracks of Medicare Accountable Care Organizations may qualify for exemption from payment adjustments under the Merit-based Incentive Payment System, as well as the additional incentive payments available beginning in 2019 for participation in Advanced Alternative Payment Models.

The Affordable Care Act provides tools, such as Medicare Accountable Care Organizations, to move our health care system toward one  that provides patients with high-quality, cost-effective care. Today’s announcement is part of the Administration’s broader strategy to improve the health care system by paying providers for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality. These efforts support the Administration’s goal to have 50 percent of traditional Medicare payments flowing through alternative payment models by 2018 (already, 30 percent of Medicare payments go through alternative models).

For more detailed information on the quality and financial results, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-08-25.html

For additional information on the Medicare Shared Savings Program, please visit: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html 

For additional information on the Pioneer Accountable Care Organization Model, please visit: https://innovation.cms.gov/initiatives/Pioneer-ACO-Model/ 

Monday, August 29, 2016

Obamacare hits shocking new low as insurers continue pulling out


Bad news continues for the Affordable Care Act as enrollment figures hit less than half of the initial projection, and insurance companies continue to pull out of already sparsely populated markets.

Just 11.1 million people have signed up for health coverage through the federally and state-operated online exchanges as of this year – significantly behind the Congressional Budget Office’s February prediction of 24 million by 2016. With a risk pool of much older, much sicker policyholders than originally expected, major insurance companies have been exiting the exchanges in a hurry, eager to avoid further financial losses.

As a result, every healthcare stakeholder, from provider networks to insurance agents to consumers, is being squeezed by the shrinking marketplace. The Kaiser Family Foundation put out a report this month estimating that more than one in four counties is at risk of having a single insurer on its exchange, and industry experts say that barring a significant shift in policy, the situation is unlikely to change soon.

“In this environment, only carriers with extraordinarily large risk pools can survive,” David Reid, chief executive with broker benefits software group EaseCentral, told Insurance Business America. “The cost of healthcare is going up and provider networks are consolidating. That’s why you’re seeing so many groups looking to consolidate.”

But the US Justice Department has moved to block two of the largest mergers – those between health insurers Aetna and Humana, and Anthem and Cigna – and without the ability to mitigate risk through larger risk pools, health insurance premiums will continue to rise.

That puts pressure on brokers to perform, particularly in the small group health area, Reid said.
“We’re seeing very significant cost increases out there: between 59% and 69% in Texas, and the East Coast is the same,” he said. “When customers face big cost increases, they’re looking to their broker to provide some alternatives beyond deductibles in the $3,500 and $5,000 range. They’re looking for new creative mechanisms designed to help costs.”

Three of the most popular alternatives to traditional group health have proven to be small business exchange-style platforms, the use of telemedicine and the adoption of defined contribution benefit schemes.

This last option is particularly promising. These reimbursement structures, in which employers provide workers with a lump sum to use in purchasing their own insurance, are still gaining traction. Just 2% of employers use defined contributions, according to a recent Arthur J. Gallagher survey, but that’s expected to jump an additional 15% by 2018.

Reid describes this as a “great response to what’s happening” in the market, and was firm on the importance of a trusted advisor in facilitating this and other health insurance alternatives.

“I have no doubt the broker will be involved and have a position in the market,” he said. “As long as you’re bringing efficiency and consultative services that provide companies with an advocate on their side, they will play a high-touch, valuable role in the healthcare system.”

And as to the issue of commission compression, which is driving many of those brokers out of the market?

“The reduction in commission is very real, but those agencies that are using tech-based solutions are able to operate more efficiently and get a greater return on investment,” Reid said. “There are actually new people jumping into the business because of these opportunities.”

CMS proposes new standards to strengthen the Marketplace for 2018

CMS News

August 29, 2016

Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

CMS proposes new standards to strengthen the Marketplace for 2018

The Centers for Medicare & Medicaid Services (CMS) today issued the proposed annual Notice of Benefit and Payment Parameters for 2018, which proposes additional steps to strengthen the Health Insurance Marketplace.  CMS is issuing this rule earlier in the calendar year in order to provide more certainty to the Marketplace as it continues to mature.

"Right now, we are preparing to serve millions of consumers with a new set of innovations during the upcoming Marketplace Open Enrollment. As we do this, we are proposing today a set of critical actions based upon our first 3 years' experience that, if finalized, would improve how consumers and health plans interact with the Marketplace," said Acting Administrator of the Centers for Medicare and Medicaid Services Andy Slavitt. "These proposals help fulfill the promise that affordable, quality health coverage can be provided to everyone who needs it."

Beginning in 2017, the proposed policies will take important steps to strengthen one of the Marketplace’s key tools for protecting consumers’ access to high-quality, affordable coverage options: the risk adjustment program. The rule introduces changes that will make risk adjustment even more effective at pooling risk, allowing issuers to focus on meeting the needs of consumers. First, the rule proposes updates beginning in 2017 to better reflect the risk associated with enrollees who are not enrolled for a full 12 months. Second, beginning in 2018, the rule proposes to use prescription drug utilization data to improve the predictive ability of our risk adjustment models. Third, also beginning in 2018, the rule proposes to establish transfers that will help to better spread the risk of high-cost enrollees, a change that would improve the risk-sharing benefits of the program.  

In addition to these improvements to risk adjustment, this proposed rule contains other provisions to improve the Marketplace consumer experience and strengthen the individual and small group markets as a whole. The proposed rule would give consumers additional tools for assessing the networks of competing plans; broaden availability of this year’s new standardized plan options by accommodating state cost-sharing rules; and create consumer protections for consumers enrolling through the direct enrollment channel. The proposed rule would also create multiple child age bands that address instances in which consumers could face large premium changes after turning age 21; amend the guaranteed renewability regulations to provide additional flexibility for issuers to remain in an insurance market in certain situations; and codify several special enrollment periods that are already available to consumers in order to ensure the rules are clear and to limit abuse. It also seeks information on a number of suggestions offered by issuers, consumers, providers, and others on further improving the risk pool, such as additional changes to special enrollment period policies or outreach; clarifying coordination of benefit rules between Medicare, Medicaid, and the Marketplace; and providing greater certainty on the amount of user fee revenue spent on education and outreach. 

Today’s proposed rule builds on other recent actions to strengthen the Marketplace, including a recent request for information seeking public comment on concerns that some health care providers and provider-affiliated organizations may be steering Medicare or Medicaid enrolled or eligible people into a Marketplace qualified health plan to obtain higher reimbursement rates; the announcement of a new outreach strategy targeting young adults; and the introduction of a pilot project in certain states to display information regarding QHP provider networks to promote greater transparency on HealthCare.gov.

Saturday, August 27, 2016

Between May 2015 and May 2016

the growth in spending on prescription drugs dropped to 5.2%, down from 12.2% in 2014.

Source: "CSHS Health Sector Economic Indicators Briefs: July 2016 Health Sector Economic IndicatorsSM Briefs," Altarum Institute/Center for Sustainable Health Spending, July 2016, http://altarum.org/our-work/cshs-health-sector-economic-indicators-briefs  

According to a survey of large employers by the National Business Group on Health ...

... here are a few of the health plan trends for 2017:

  • 90% of employers will offer telehealth services to employees in states where it is allowed, up from 70% this year
  • 84% will offer a consumer-directed health plan (CDHP), up from 83% this year
  • 35% will only offer CDHPs to employees, up slightly from 33% this year
  • 33% will impose surcharges for spouses who can obtain coverage through their own employer, while a few will exclude spouses who can obtain coverage from an employer

Source: "Large U.S. Employers Project Health Benefit Cost Increases to Hold Steady at 6% in 2017, National Business Group on Health Survey Finds," National Business Group on Health, August 9, 2016, https://www.businessgrouphealth.org/pressroom/pressRelease.cfm?ID=281

According to a recent survey of 600 U.S. employers ...

... total health care costs are expected to increase 5.0% in both 2016 and 2017.  Here are some of the measures employers are using to control costs:

  • 61% of employers have added programs to ensure appropriate use of high-cost drug; 88% indicated that their top priority over the next three years is managing pharmacy spending, especially for high-cost specialty drugs:
  • 28% of employers have already implemented surcharges for spousal coverage when it is available through a spouse’s own employer
  • 19% of employers have differentiated benefit coverage to encourage employees to use centers for excellence for specialty services

Source: "U.S. employers expect health care costs to increase 5.0% in both 2016 and 2017," Willis Towers Watson Press Release, August 8, 2016, https://www.willistowerswatson.com/en/press/2016/08/us-employers-expect-health-care-costs-to-increase-5-percent

3 reasons Congress could approve an ACA change bill

1. Some Democratic lawmakers now represent states with very high individual health insurance prices


2. Some Democratic lawmakers represent states with just one remaining individual health coverage issuer


3.Voting to give states options to change how they implement the ACA might be more politically acceptable than voting to repeal the ACA




Friday, August 26, 2016

4 Actions Needed by Physicians & Health Executives to Accelerate Value-Based Care

1. Seventy-four percent of physicians and health plan executives said that quality measures are too complex, making it difficult for physicians to achieve them


2. About two-thirds (65 percent) of physicians said they do not have all the healthcare information they need about their patients


3. Sixty-four percent of physicians and health plan executives said that physicians do not have the tools needed to succeed in a value-based care system


4. Eighty-five percent of physicians are likely to use a tool that provides on-demand patient-specific data to identify gaps in quality, risk and utilization as well as medical history insight





10 things to know about CMS' new mandatory cardiac bundle

1. The new bundled payment models apply to cardiac care and extend the existing CJR model to include hip and femur fractures

2. The bundle makes hospitals accountable for the cost and quality of care provided during the inpatient stay and for 90 days after discharge

3. Hospitals will be chosen from 98 randomly-selected metropolitan statistical areas for the cardiac bundling program

4. Under the proposed rule, the bundles are set to begin on July 1, 2017

5. Hospitals would receive quality-adjusted target payments for each episode of care

6. At the end of each performance year, hospitals that meet quality standards can earn additional payments based on cost

7. The proposed rule also includes a model to test cardiac rehabilitation services

8. CMS said the cardiac bundle, as well as the CJR bundle, could qualify as Advanced Alternative Payment Models in 2018 under the Medicare Access and CHIP Reauthorization Act

9. Additionally, the proposed rule indicates that CMS plans to build on its Bundled Payments for Care Improvement Initiative

10. CMS is taking feedback on the proposals for 60 days, until September 24





According to a recent survey of community health centers in California, Arizona, Nevada and Hawaii...

... the following are the most common mechanisms for receiving patient feedback:

  • surveys (94% of respondents)
  • advisory councils (69%)
  • suggestion boxes (57%)
  • inviting patients to take part in quality improvement committees (36%)
  • soliciting patient feedback on information materials (33%)
  • involving patients in selecting referral resources (28%)

Source: "REPORTS FROM THE FIELD: Engaging Patients as Partners in Practice Improvement: A Survey of Community Health Centers," Journal of Cliinical Outcomes Management (JCOM), July 2016, http://www.jcomjournal.com/reports-from-the-field-engaging-patients-as-partners-in-practice-improvement-a-survey-of-community-health-centers/

According to a recent report...

... 88% of all ransomware detected in the second quarter of 2016 occurred within the healthcare industry.

Source: "Solutionary SERT Q2 Report: 88 Percent of All Ransomware Is Detected in Healthcare Industry," NTTSecurity Press Release, July 26, 2016, https://www.solutionary.com/company/news-and-events/press-releases/2016/07/solutionary-q2-2016-sert-threat-report/  

Drivers of High Cost

80% of employers ranked specialty pharmacy as one of the top three highest cost drivers, followed by high cost claimants (73%) and specific diseases and conditions (61%).

Source: National Business Group On Health

$241 Billion Spent on Heart Disease in 2012

Kaiser Family Foundation recently released a chart collection on heart disease spending and outcomes in the U.S. Here are some key findings from the report:

·         Heart disease mortality rate has fallen from 590 deaths per 100,000 people in 1983 to 253 in 2013.

·         U.S. disease burden for cardiovascular diseases has decreased 36% in the past 2 decades.

·         Heart disease is the leading cause of death in the U.S., accounting for 23.4% of all deaths in 2014.

·         Circulatory system diseases accounted for 8.6% of medical services spending growth from 2000-2012.

·         13% of adults earning below $35,000 experience heart disease, vs. 10% of adults earning $75,000+.

·         In 2012, spending on heart disease accounted for 13% ($241 billion) of spending on disease treatment.

Source: Peterson-Kaiser Health System Tracker, August 4, 2016

2.3% of Black or Hispanic Children Received Mental Healthcare

The International Journal of Health Services recently published a study on racial disparities in mental healthcare for children. Here are some key findings from the report:

·         11-12% of white and black children needed mental health care, while 7% of Hispanic children did.

·         5.7% of white children and young adults were likely to see a mental health specialist in a given year.

·         Approximately 2.3% of black or Hispanic young people were likely to see a mental health specialist.

·         Black and Hispanic children had 130 fewer visits per thousand subjects than their white counterparts.

·         Black young adults visited a mental health specialist about 280 fewer times per thousand.

·         Hispanics had 244 fewer visits per thousand than white young adults.

Source: International Journal of Health Services, August 12, 2016

Texas Health and Human Services Commission Update

Texas Medicaid has issued a standing order allowing participating pharmacies to provide mosquito repellent to eligible patients in Medicaid and Children’s Health Insurance Plan without a prescription from a patient’s healthcare provider.

Eligible patients enrolled in Healthy Texas Women no longer require a prescription for mosquito repellent to be covered by their insurance. Patients enrolled under this program may now request mosquito repellent directly from a pharmacy.

Pharmacies have been provided with the claims processing information for use of the standing order and for the processing of claims for patients enrolled in Healthy Texas Women.

Patients in Medicaid and CHIP without access to a pharmacy that uses a standing order for the dispensing of mosquito repellent will continue to require a prescription for the repellent. For these patients, prescribers are recommended to use telephone, fax or electronic prescribing to send prescriptions to pharmacies and to avoid requiring an office visit solely to provide a prescription for mosquito repellent.

Please visit www.txvendordrug.com/formulary/zika-virus-prevention.shtml for details related to mosquito repellent as a covered benefit and additional guidance related to prescribing mosquito repellent.

18% of Executives Use Patient-Reported Outcomes

Health Catalyst recently released results from a survey of healthcare executives' use of patient-reported outcomes (PROs). Here are some key findings from the report:

·         18% of executives always use PROs to guide clinical care.

·         Nearly 3 in 4 who said they rarely/never use PROs plan to begin using them in 1-3 years.

·         36% of respondents said "time and/or money" was the most significant barrier to using PROs.

·         1 in 4 said difficulty fitting PROs into clinicians' daily workflow is the greatest barrier.

·         Technology was listed as the most significant barrier to PRO use by 15% of respondents.

·         59% selected "chronic care tracking" when asked to list areas in which they use PROs.

Source: Health Catalyst, August 2, 2016

8 ways retail clinics are shaping healthcare today

1. Retail clinics have been able to adopt information technology and data sharing efficiently to communicate with the healthcare provider’s electronic health record system

2. They are growing beyond urgent care toward chronic disease management and having a larger impact on population health

3. Retail clinics are forming relationships with medical schools and teaching hospitals, including Cleveland Clinic and the University of Chicago Medical Center’s relationships with MinuteClinics

4. Walgreens’ in-store clinics are coordinating care for patients and invested in the Epic EHR for a communications and IT infrastructure

5. The Little Clinic in Kroger stores is going even further to work with preventative services on healthy food choices, dieticians and managing consumer issues such as diabetes or allergies

6. The retail clinics have self check-in kiosks for appointments and provide blood pressure, pulse, weight and BMI through self-serving machines. At Walmart, customers can get a full physical for $40

7. In some retail clinic models, pharmacists are taking on medication therapy management roles for patients

8. Consumers are learning to manage high-deductible health plans, making the lower costs at retail clinics attractive






According to a recent study...

... the percentage of workers covered by health plans, who were enrolled in plans that were self-insured by their employers, increased from 58.2% to 60% from 2013 to 2015.

Source: "Self-Insured Health Plans: Recent Trends by Firm Size,1996‒2015, p.2," Employee Benefti Research Institute Notes, July 2016, https://www.ebri.org/pdf/notespdf/EBRI_Notes_07-no7-July16.Self-Ins.pdf

Thursday, August 25, 2016

CMS examines inappropriate steering of people eligible for Medicare or Medicaid into Marketplace plans

CMS News

August 18, 2016

Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

CMS examines inappropriate steering of people eligible for Medicare or Medicaid into Marketplace plans

Concerns raised about impact of 3rd party premium provider & affiliated organization payments


The Centers for Medicare & Medicaid Services (CMS) today issued a request for information seeking public comment on concerns that some health care providers and provider-affiliated organizations may be steering people eligible for, or receiving, Medicare and/or Medicaid benefits into Affordable Care Act-compliant individual market plans, including Health Insurance Marketplace plans, for the purpose of obtaining higher reimbursement rates. CMS also sent letters to all Medicare-enrolled dialysis facilities and centers informing them of this announcement.

The request for information and letters to providers focus on situations where patients may be steered away from Medicare or Medicaid benefits, which can among other concerns, result in beneficiaries experiencing a disruption in the continuity and coordination of their care as a result of changes to their network of providers. These actions reflect ongoing efforts by the CMS Center for Program Integrity to address possible issues in the Marketplace that could affect the integrity of the programs for both consumers and issuers, and the costs of the individual insurance market, while at the same time help ensure patients are enrolled in the right plan for them.

“Ensuring access to high quality patient care is a top priority for us. We are concerned about reports that some organizations may be engaging in enrollment activities that put their profit margins ahead of their patients’ needs,” said CMS Acting Administrator Andy Slavitt. “These actions can limit benefits for those who need them, potentially result in greater costs to patients, and ultimately increase the cost of Marketplace coverage for everyone.”

“It is improper to influence people away from Medicare or Medicaid coverage for the purpose of financial gain,” said Shantanu Agrawal, M.D., CMS Deputy Administrator and Director of the Center for Program Integrity. “Our goal is to protect patients from being unduly influenced in their decisions about their health insurance options, and to protect the integrity of all the programs we oversee.”

Currently, third-party payment of premiums and cost sharing of qualified health plans in the individual market by health care providers such as physicians, medical facilities or affiliated non-profit organizations are discouraged, but the ultimate decision about accepting those payments are left to health insurance companies. This guidance does not apply to certain federal, state or local government programs, Ryan White HIV/AIDS programs or Indian tribes, tribal organizations and urban Indian organizations, which are expressly permitted to pay insurance premiums for consumers under CMS regulations. Recently, concerns have been raised that certain providers or organizations affiliated with specific providers may steer consumers into individual market plans, including Marketplace health plans, because they would receive higher payment rates under a private plan than under Medicare or Medicaid. 

In addition to asking for more information on instances of problematic steering of consumers to individual market plans, CMS is also considering potential regulatory and operational options to prohibit or limit premium payments and routine waiver of cost-sharing for qualified health plans by health care providers, revisions to Medicare and Medicaid provider enrollment rules, the imposition of civil monetary penalties for individuals that fail to provide correct information about consumers enrolling in a plan, and potential changes that would allow issuers to limit their payment to health care providers to Medicare-based amounts for particular services and items of care. In particular, CMS is looking at authorities to impose civil monetary penalties on health care providers when their actions result in late enrollment penalties for Medicare eligible individuals who are steered to an individual market plan and, as a result, are delayed in enrolling in Medicare.

Like reducing inappropriate use of special enrollment periods and other efforts, today’s steps are a part of the Administration’s ongoing work to strengthen and expand the Health Insurance Marketplace. 

The request for information can be found on the Federal Register website at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-20034.pdf

The letter to all dialysis providers can be found on the CMS website at: https://www.cms.gov/about-cms/components/cpi/downloads/rfi-medicare-dialysis.pdf

Agents and brokers are still having issues with delayed access to the Marketplace Learning Management System (MLMS) ...

... when logging on to complete plan year 2017 registration and training. Make sure that you turn off your computer's pop-up blockers and review the CMS Plan Year 2017 Computer Configuration Requirements Quick Reference Guide to make any additional adjustments to your computer configuration, as needed.


See the quick reference guide for step-by-step instructions to address the following possible issues:

  • Turn off your computer’s pop-up blockers.
  • Download and use the free web browsers that work best with the MLMS: Firefox or Google Chrome.
  • Download the latest version of Adobe Flash to optimize display of animations.
  • Allow cookies.
  • Access the training for registration on a desktop or laptop computer. (The Marketplace training cannot be accessed on a tablet or other hand-held/mobile device.)
  • Check with your network provider for more assistance if you encounter bandwidth and server issues. 

Remember, you must access both the MLMS and CMS-approved vendor training via the CMS Enterprise Portal. For a better user experience, the best days and times to access registration and training are Monday through Friday, between 5:00 PM and 11:00 AM ET and on the weekends.

For more information on plan year 2017 registration and training, visit the Agents and Brokers Resources webpage.

"In a normal political environment ...

...  a landmark piece of legislation [like the Affordable Care Act] would be adjusted over time to improve it. ACA is far overdue for that. Republicans have not wanted to make commonsense adjustments because they have wanted the whole law to collapse. To me a major opportunity is to change the age-rating bands so that a 65-year-old can be charged 5 times what a 21-year-old is charged rather than 3 times. This will enhance the viability of the exchanges and in general make health insurance more popular among younger, healthier people."
— David Williams, co-founder of the Boston consulting firm Health Business Group, told AIS's Health Plan Week.

37 ...

... services delivered by telehealth are covered by Medicare, including emergency department or initial inpatient consultations, office or other outpatient visits, and individual psychotherapy provided in rural areas.

Monday, August 22, 2016

$241 Billion Spent on Heart Disease in 2012

Kaiser Family Foundation recently released a chart collection on heart disease spending and outcomes in the U.S. Here are some key findings from the report:

·         Heart disease mortality rate has fallen from 590 deaths per 100,000 people in 1983 to 253 in 2013.

·         U.S. disease burden for cardiovascular diseases has decreased 36% in the past 2 decades.

·         Heart disease is the leading cause of death in the U.S., accounting for 23.4% of all deaths in 2014.

·         Circulatory system diseases accounted for 8.6% of medical services spending growth from 2000-2012.

·         13% of adults earning below $35,000 experience heart disease, vs. 10% of adults earning $75,000+.

·         In 2012, spending on heart disease accounted for 13% ($241 billion) of spending on disease treatment.

Source: Peterson-Kaiser Health System Tracker, August 4, 2016