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FOR IMMEDIATE RELEASE January 4, 2017 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries
Biweekly
Enrollment Snapshot
WEEKS 8 AND 9, DEC 18 – DEC 31, 2016 8.8 million Americans have signed up for coverage through HealthCare.gov since Open Enrollment began on November 1st. This compares to about 8.6 million plan selections last year at this time, demonstrating Americans’ strong and growing demand for affordable, quality coverage. Total plan selections as of December 31st, which include auto reenrollments, consist of 2.2 million new consumers and 6.6 million returning consumers. Among returning consumers, two thirds, or 4.4 million, actively selected a plan, an increase from last year’s already high levels of consumer engagement. “With 8.8 million Americans signed up for coverage through HealthCare.gov, more than last year at this time, it is clear that Americans want and need this vital coverage,” said U.S. Department of Health and Human Services Secretary Sylvia M. Burwell. “As we enter the New Year, Americans who are still uninsured should sign up by January 15th to have coverage starting February 1.” Today’s report covers the period from December 18 through December 31, 2016. This snapshot does not include plan selections from the 12 State-Based Marketplaces that use their own enrollment platforms. Those numbers will be included in the upcoming Mid-Open Enrollment report. As in past years, enrollment weeks are measured Sunday through Saturday. Since this year Open Enrollment began on a Tuesday, the totals reported in this snapshot reflect two fewer days than last year’s Week 9 snapshot, yet still enrollment exceeds last year’s total. Every two weeks during Open Enrollment, the Centers for Medicare and Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Marketplaces and State Partnership Marketplaces, as well as some State-based Marketplaces. These snapshots provide point-in-time estimates of biweekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov. The final number of plan selections associated with enrollment activity during a reporting period may change as plan modifications or cancellations occur, such as due to life changes like starting a new job or getting married. In addition, as in previous years, the biweekly snapshot does not report the number of consumers who have paid premiums to effectuate their enrollment. Definitions and details on the data are included in the glossary. Federal Marketplace Snapshot
HealthCare.gov State-by-State Snapshot
Consumers across the country continued to explore their health insurance
options by reaching out to a call center representative at 1-800-318-2596,
attending enrollment events in their local communities, or visiting HealthCare.gov or CuidadoDeSalud.gov.
Individual plan selections for the states using the HealthCare.gov platform
include:
The Week 9 snapshot includes a look at plan selection by top Designated Market Areas (DMAs) which are local media markets. This data provides another level of detail to better understand total plan selections within local communities. Some DMAs include one or more counties in a state that is not using the HealthCare.gov platform for 2017. Plan selections for those DMAs only include data for the portion of the DMA that is using the HealthCare.gov platform, so the amounts reported in the snapshot do not represent plan selections for the entire DMA. However, in cases where a DMA includes portions of multiple states but all of those states use the HealthCare.gov platform, the reported amounts reflect the whole DMA. Because not all DMAs are listed in the table, the amounts reported for local markets will not sum to the national total. Later in the Open Enrollment period we will be reporting enrollments for all DMAs.
Plan Selections: The cumulative metric represents the total number of people who have submitted an application and selected a plan, net of any cancellations from a consumer or cancellations from an insurer that have occurred to date. The biweekly metric represents the net change in the number of non-cancelled plan sections over the two-week period covered by the report. To have their coverage effectuated, consumers generally need to pay their first month’s health plan premium. This release does not report the number of effectuated enrollments. New Consumers: A consumer is considered to be a new consumer if they did not have Marketplace coverage at the start of Open Enrollment on November 1st, 2016. Renewing Consumers: A consumer is considered to be a renewing consumer if they had 2016 Marketplace coverage on November 1st, 2016 at the start of Open Enrollment and either actively selected the same plan or a new plan for 2017, were automatically re-enrolled into their plan, or were signed up for January 1 coverage through a suggested alternate plan. Marketplace: Generally, references to the Health Insurance Marketplace in this report refer to 39 states that use the HealthCare.gov platform. The states using the HealthCare.gov platform are Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming. HealthCare.gov States: The 39 states with Marketplaces that use the HealthCare.gov platform for the 2017 benefit year, including those with Federally-facilitated Marketplaces, State Partnership Marketplaces, and State-based Marketplaces. Consumers on Applications Submitted: This includes consumers who are requesting coverage on a completed and submitted application, including an application that is created through the automatic re-enrollment process, which occurs at the end of December, in a state that is using the HealthCare.gov platform. If determined eligible for Marketplace coverage, a new consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to get covered (i.e., effectuated enrollment). Because families can submit a single application, this figure tallies the total number of people requesting coverage on a submitted application (rather than the total number of submitted applications). Call Center Volume: The total number of calls received by the call center for the 39 states that use the HealthCare.gov platform over the course of the weeks covered by the snapshot or from the start of Open Enrollment. Calls with Spanish speaking representatives are not included. Calls with Spanish Speaking Representative: The total number of calls received by the Federally-facilitated Marketplace call center where consumers chose to speak with a Spanish-speaking representative. These calls are not included within the Call Center Volume metric. HealthCare.gov or CuidadodeSalud.gov Users: These user metrics total how many unique users viewed or interacted with HealthCare.gov or CuidadodeSalud.gov, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once. Window Shopping HealthCare.gov Users or CuidadoDeSalud.gov Users: These user metrics total how many unique users interacted with the window-shopping tool at HealthCare.gov or CuidadoDeSalud.gov, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once. Users who window-shopped are also included in the total HealthCare.gov or CuidadoDeSalud.gov user total.
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CMS news at cms.gov/newsroom, sign up for CMS news via email
and follow CMS on Twitter @CMSgovPress
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At Medicare is Simple, we look to educate and enable you to choose among Medicare plans to help find the policy that may best fit your needs. Get free quotes using our advanced quoting technology. HealthCare Reform is also a hot topic of interest to people of all ages, and we look to keep you updated on the issues relevant to learning more. Medicare Is Simple 800-442-4915
Wednesday, January 4, 2017
Biweekly Enrollment Snapshot
20 conditions top U.S. health care spending
Jan 03, 2017 | By Marlene Y. Satter
Looking for where the most dollars go in health care spending?
Check out diabetes ($101 billion), ischemic heart disease ($88.1 billion)
and low back and neck pain ($87.6 billion)
These three categories topped the list in spending in 2013, and along
with hypertension and injuries from falls, made up 18 percent of all personal
health spending and totaled $437 billion in 2013.
The figures, along with plenty of other data, are contained in a
comprehensive financial analysis titled “US Spending on Personal Health Care
and Public Health, 1996–2013,” published in JAMA on Dec. 27, 2016.
Latest research from Harbor Health Systems quantifies impact of
comorbidities like obesity, diabetes and hypertension on workers’ comp claims.
The study tracks a total of $30.1 trillion in personal health care spending
over 18 years.
“While it is well known that the
U.S. spends more than any other nation on health care, very little is known
about what diseases drive that spending,” Dr. Joseph Dieleman, lead author of
the paper and assistant professor at the Institute for Health Metrics and
Evaluation (IHME) at the University of Washington, said in a statement.
Dieleman added, “IHME is trying to fill the information gap so that
decisionmakers in the public and private sectors can understand the spending
landscape, and plan and allocate health resources more effectively.”
The majority of personal health care spending was associated with
noncommunicable diseases, but when it came to infectious diseases, respiratory
infections such as bronchitis and pneumonia topped the list.
Well care, on the other hand, accounts for just 6 percent of personal
health care spending, with nearly a third devoted to pregnancy and postpartum
care (the 10th largest category of spending, at $55.6 billion).
The study examines spending by diseases and injuries and distinguishes
spending on public health programs from personal health spending, including
both individual out-of-pocket costs and spending by private and government
insurance programs.
It covers 155 conditions.
For employers looking to get a handle on health care expenses, it can be
useful to know which conditions eat up the most dollars.
Dieleman estimated that, in addition to the $2.1 trillion spent on the 155
conditions examined in the study, approximately $300 billion in costs, such as
those of over-the-counter medications and privately funded home health care,
remain unaccounted for, indicating total personal health care costs in the U.S.
reached $2.4 trillion in 2013.
http://www.benefitspro.com/2017/01/03/20-conditions-top-us-health-care-spending?kw=20%20conditions%20top%20U.S.%20health%20care%20spending&et=editorial&bu=BenefitsPRO&cn=20170104&src=EMC-Email_editorial&pt=Benefits%20Broker%20PRO
Tuesday, January 3, 2017
4 in 10 Medicare Advantage Plans Rated 4 Stars or Higher in 2017
January
3, 2017
4 in 10 Medicare Advantage Plans Rated 4 Stars or Higher in
2017
Kaiser
Family Foundation recently released an analysis of Medicare Advantage (MA)
plans in 2017. Here are some key findings from the report:
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1 in 3 Medicare beneficiaries
enrolled in Medicare Advantage plans in 2016.
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The average beneficiary will be able
to choose from 19 MA plans in 2017.
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1 in 4 beneficiaries will have a
choice of plans from 3 or fewer firms in 2017.
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The average beneficiary will be able
to choose from plans offered by six firms.
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Limits on out-of-pocket costs for
Part A and B have increased 25% since 2011.
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4 in 10 (41%) Medicare Advantage
plans are rated as 4 stars or higher in 2017.
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Source:
Kaiser Family Foundation, December 21, 2016
October 2016 Medicaid and CHIP Application, Eligibility Determination, and Enrollment Report
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December 30,
2016 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries
October 2016 Medicaid and
CHIP Application, Eligibility Determination, and Enrollment Report
Today, the
Centers for Medicare & Medicaid Services (CMS) released a monthly report
on state Medicaid and Children’s Health Insurance Program (CHIP) data
representing state Medicaid and CHIP agencies’ eligibility activity for the
calendar month of October 2016. This report measures eligibility and
enrollment activity for the entire Medicaid and CHIP programs in all states ,
reflecting activity for all populations receiving comprehensive Medicaid and
CHIP benefits in all states, including states that have not yet chosen to
adopt the new low-income adult group established by the Affordable Care Act.Enrollment in Medicaid and CHIP has grown by nearly 17 million individuals, comparing October 2016 to July-September 2013 (the period before the start of the first Marketplace open enrollment period in October 2013). Among the 51 states (including the District of Columbia) that reported enrollment data for September and October 2016, enrollment increased by 45,279 from September to October 2016. Also, for the first time, the report includes separate Medicaid-only and CHIP-only enrollment figures in addition to the combined Medicaid and CHIP number. Among the 51 states reporting October 2016 Medicaid and CHIP enrollment data, 68,858,877 individuals were enrolled in Medicaid and 5,511,011 individuals were enrolled in CHIP. Among the 48 states reporting both total Medicaid and CHIP enrollment and child enrollment data for the current period, total enrollment is comprised of:
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Patients Treated by Female Physicians Had Lower 30-day Mortality
JAMA
recently published results from a study on mortality and readmissions rates for
patients treated by female physicians compared to patients treated by male
physicians. Here are some key findings from the report:
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Female physicians account for
one-third of the US physician workforce.
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Half of all US medical school
graduates are women.
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Patients treated by females had lower
30-day mortality (11.07% vs 11.49%).
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Readmissions were 15.02% for patients
treated by females vs 15.57% for males.
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Patients of female physicians had
lower mortality for sepsis (23.05% vs 25.09%).
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An estimated 32,000 fewer patients
would die annually if male physicians achieved the same outcomes as female
physicians.
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Source:
United Health Foundation, December 12, 2016
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