Today's Datapoint

Nearly 15% of all Medicare beneficiaries (7.2 million of them) are in accountable care organizations, Clif Gaus, CEO of the National Assn. of ACOs, told AIS's ACO Business News.

Quote of the Day

Narrow networks are "becoming a critical part of our retail strategy. With people more directly accountable for paying the premium out of their pocket, they tend to buy the narrow network....On the small-group side of exchange products, those small groups tend to buy broad PPOs almost at the same rate that the consumer on the retail side is buying the narrow network. It is an interesting dynamic; people buy differently than employers do."



— Jerry Bradford, vice president of network management for Blue Cross Blue Shield of Illinois, told AIS's Health Plan Week.

Quote of the Day

"To date, private exchanges only provide access to a more diverse set of the same old (and often unaffordable) group insurance products. New models will provide a compliant model for employees to access the highly-subsidized individual market. The pace of change will be inversely related to the economy. As our bull market begins to soften, more groups will seek truly transformative change to their benefits structure."



— Brian Poger, CEO of Benefitter Insurance Solutions, a California-based technology company, told AIS's Inside Health Insurance Exchanges

Today's Datapoint

$31,317 ... was the average typical cost (without complications) for a total knee replacement in 64 markets where claims data were reviewed by the Blue Cross and Blue Shield Association and Blue Health Initiative for their report "A Study of Cost Variations for Knee and Hip Replacement Surgeries in the U.S." ... but the surgery could cost as little as $11,317 (in Montgomery, Ala.) or as much as $69,654 (in New York City).

Reasons Why Adults Who Tried to Get ACA Coverage Did Not Get Insured

According to a January 2015 Kaiser Family Foundation issue brief:

• 41% - Were deemed ineligible (nonelderly adult population)
• 29% - Coverage too expensive (nonelderly adult population)
• 12% - Application still pending (nonelderly adult population)
• 8% - Didn't finish application (nonelderly adult population)
• 11% - Other/don't know/refused (nonelderly adult population)

Source: Kaiser Family Foundation

Gallup: Obesity and Average Well-Being Index Scores

As Americans become more obese, their well-being declines significantly, as measured by Gallup-Healthways Well-Being Index scores:

• Underweight (WBI mean score of 62.2)
• Normal weight (WBI mean score of 64.5)
• Overweight (WBI mean score of 63.0)
• Obese class I (WBI mean score of 57.5)
• Obese class II (WBI mean score of 54.7)
• Obese class III (WBI mean score of 50.9)

Note: Data from 2014 and Well-Being Index scores are on a scale of 0-100.
Source: Gallup Healthways Well-Being Index

Harris Poll: 1 in 5 Insured Americans Avoid the Doctor Due to Cost Concerns

According to a recent online survey conducted by Harris Poll on behalf of SCIO Health Analytics:

• 1 in 5 (44 million) insured Americans have avoided a doctor visit in the past year due to cost concerns.
• Approximately half of US adults (117 million) have at least one chronic condition.
• 14% (16.4 million) of the chronic population have deferred healthcare in the past year due to cost concerns.

Source: Harris Poll, SCIO Health Analytics