FACTOID

According to a recent survey of primary practice clinicians, 80.9% of nurse practitioners reported working in a practice with a physician, compared with 41.4% of physicians who reported working with a nurse practitioner.
Source: "Perspectives of Physicians and Nurse Practitioners on Primary Care Practice," The New England Journal of Medicine, abstract only, May 16, 2013, http://www.nejm.org/doi/full/10.1056/NEJMsa1212938

Young Invincibles Offer a Candid Look at Challenge of Finding Insurance, Value

By Steve Davis - May 30, 2013

This week I’m attending the Marketing, Outreach & Distribution on the Health Insurance Exchanges conference in Scottsdale, Ariz. The most intriguing session — maybe the most interesting of any recent conference I’ve attended — was a May 30 panel of 20-something men and women who spoke candidly about the challenges of finding health coverage…and in understanding the value of it.

All eight panelists are employed, though some just part time, and about half have some level of health coverage. Although they understand the risks of not having insurance, they are confused by the myriad choices and frustrated by the jargon used by carriers. They struggle to see value in paying monthly premiums for something they probably won’t use.

Beth, a school teacher who goes without coverage during the summer months, noted that the cost of paying cash for an urgent care visit was equivalent to the copay required for a doctor visit. Tom, a construction worker clad in a t-shirt and baseball cap, is uninsured, but worries about being injured and not being able to afford the medical expenses. He said he had been injured in a car accident and faced a $400 bill for prescription drugs. “I didn’t have $400,” he said.

While they all knew that a significant health law had been enacted, none of them had heard about exchanges or the federal premium assistance that might help to make coverage more affordable to them. They were optimistic about the ability to compare health plans, but they were skeptical that something operated by the government would be any easier to navigate than the existing system.

The panelists agreed that they would be willing to pay between $60 and $100 a month for health coverage. And while they said they would like to buy coverage from an insurer they knew, they place a great deal of value in how plans are rated (by companies such as eHealth, Inc.) and in reviews from current enrollees...particularly their peers.

http://aishealth.com/blog/health-reform/young-invincibles-offer-candid-look-challenge-finding-insurance-value

Montana exchange could offer three carriers

By Allison Bell

May 30, 2013

The Montana Patient Protection and Affordable Care Act (PPACA) exchange could offer consumers a choice of three carriers.

Montana is letting the U.S. Department of Health and Human Services (HHS) provide PPACA exchange services for its residents, but state regulators can still help regulate the plans that will be available through a "federally facilitated exchange" (FFE).

Montana Insurance Commissioner Monica Lindeen reported that Blue Cross Blue Shield of Montana, PacificSource Health Plans and Montana Health CO-OP have filed applications seeking exchange slots.

Insurers will make final commitments about decisions to sell "qualified health plans" (QHPs) through the exchanges in August, Lindeen said.

Montana Blue is trying to set up a "multi-state plan" (MSP) -- a plan regulated by the U.S. Office of Personnel Management (OPM) that could sell coverage through slots in PPACA exchanges in two or more states.

The CO-OP is a new, nonprofit, member-owned health plan.

The drafters of PPACA created the MSP and CO-OP plan systems in an effort to increase the level of competition n states like Montana in which one carrier accounts for more than half of the sales in the individual market. 

http://www.lifehealthpro.com/2013/05/30/montana-exchange-could-offer-three-carriers?goback=%2Egde_3921873_member_245580141

1 in 5 Americans Goes to the ER Each Year: CDC

Report found those on Medicaid were more likely to do so than the uninsured, privately insured

THURSDAY, May 30 (HealthDay News) -- Every year, one in five Americans makes at least one trip to the emergency room, new research shows.

The report, from the U.S. Centers for Disease Control and Prevention, also revealed that children and adults with Medicaid coverage were more likely than uninsured Americans and those with private insurance to make at least one visit to the ER.

One expert said the trend is "consistent" with what he's seen in his hospital's emergency department.

"I believe the increased utilization is in part due to the aging population coupled with increasing medical complexity associated with this population," said Dr. John D'Angelo, senior vice president of emergency services at North Shore - LIJ Health System in Great Neck, NY.

"In addition, emergency departments remain the primary access point for medical care for the uninsured as well as those seeking medical attention after hours and weekends," said D'Angelo, who was not connected to the new study.

Between 2009 and 2010, most adults were in the ER due to injuries (14 percent). Meanwhile, cold symptoms sent most children to the ER during that timeframe (27 percent), the authors noted in a CDC news release.

Also during those two years, about four out of five ER patients (81 percent) were discharged with instructions to receive follow-up care as needed. In another 16 percent of cases, the patient was admitted to the hospital. The researchers noted that in 2 percent of cases, the patient left the ER without being treated and less than 1 percent ended in the patient's death.

In addition, 59 percent of patients in the ER were discharged with at least one drug prescription, according to the CDC's annual, comprehensive report on American's health.

During the decade between 2000 and 2010, 35 percent of emergency room visits required an X-ray. The researchers noted that use of advanced imaging scans, such as CT and MRI, jumped from 5 percent to 17 percent of visits over that time period.

Interestingly, the percentage of uninsured young adult patients in the ER dropped between 2010 and 2011, going from 34 percent to 28 percent among those aged 19 to 25, the CDC researchers found.

More information

The U.S. Centers for Disease Control and Prevention provides more statistics on ER visits.

-- Mary Elizabeth Dallas

SOURCE: John D'Angelo, senior vice president of emergency services, North Shore - LIJ Health System in Great Neck, NY; U.S. Centers for Disease Control and Prevention, news release, May 30, 2013

Probability at Birth of Eventually Dying From Specified Causes of Death

Septicemia - 0.013317
Human Immunodeficiency Virus Disease - 0.003578
Malignant Neoplasms - 0.219744
Diabetes Mellitus - 0.028566
Alzheimer's Disease - 0.023914
Major Cardiovascular Disease - 0.414854
Influenza and Pneumonia - 0.029685
Chronic Lower Respiratory Disease - 0.052608
Chronic Liver Disease and Cirrhosis - 0.008938
Source: Centers for Disease Control and Prevention

Today's Datapoint

$33 … less in real per capita spending was expended by Americans in 2012 on medications, according to a new study by the IMS Institute for Healthcare Informatics.

Quote of the Day

Officials in Massachusetts who launched the Health Connector in 2006 “hoped to have a heck of a lot more plans initially when they started off. What they’re saying now is that they like less plans—still choice, but less plans is easier for consumers.”

— Jim Duffett, executive director of the Illinois advocacy group The Campaign for Better Health Care, told AIS’s Health Reform Week.