Today's Datapoint

52% … of Medicare Advantage enrollees are in plans earning four stars or more in 2014, up from 38% in 2013, according to CMS.

Quote of the Day

“By the end of November, HealthCare.gov will work smoothly for the vast majority of users….The HealthCare.gov site is fixable. It will take a lot of work. A lot of problems need to be addressed. But let me be clear: HealthCare.gov is fixable.” — Jeffrey D. Zients, President Obama’s troubleshooter on the project to fix HealthCare.gov, told The New York Times for an article on Oct. 26.

Senior's Misconceptions About Medicare and Exchanges

According to a national survey from Express Scripts, of those age 65 and older, one-in-five seniors mistakenly thinks they can enroll in a medical and prescription drug plan through a health insurance exchange, even though the eligibility age ends at 65. Another 17 percent believe health exchanges could replace their Medicare plan altogether. Eighty-six percent of survey respondents reported confusion about how healthcare reform will affect their Medicare prescription drug coverage. Among the notable misconceptions: -Nearly one-third of seniors (29 percent) believe the ACA raises the Medicare eligibility age, with 68 being the average age cited; -52 percent falsely believe they're paying more for their prescription drugs in the Coverage Gap under healthcare reform; and -65 percent do not know that Medicare enrollment begins in October. Source: Express Scripts

Employer Healthcare Coverage and Healthcare Costs

Based on early responses from a survey conducted annually by Mercer, employers expect health benefit cost per employee will rise by 4.8% on average in 2014. Cost growth slowed to 4.1% in 2012, a 15-year low. The projected increase for 2014, while still relatively low, represents a slight uptick in the rate of growth. Some employers will minimize the number of newly eligible employees by cutting back on hours for at least a portion of their workforce - 11% of all large employers say they will do so. Few large employers - just 5% - say it's likely they will terminate their health plans within the next five years, even though public insurance exchanges will provide another source of health coverage. About a fifth of employers with fewer than 200 employees say it's likely they will terminate their plans; employers of this size are much less likely to offer coverage to begin with. Source: Mercer

3.3 Million Expected to Spend $7,202 in Out-of-Pocket Medical Costs in 2016 Under the ACA

According to a RAND Corporation study, Out-of-pocket medical expenses will decline for most consumers who become newly insured or change their source of health insurance under the federal Affordable Care Act. The largest reduction in out-of-pocket spending will be for the 11.5 million consumers who become newly insured under an expanded Medicaid program, with the analysis predicting their annual out-of-pocket medical costs will fall from $1,463 to $34. The largest increase in overall health costs is expected to be among people who become newly insured on the individual market and have incomes more than four times the federal poverty level. An estimated 3.3 million consumers are expected to spend $7,202 in 2016 under the Affordable Care Act, compared to $5,368 if the law was not in place. Some low-income people in states that do not expand Medicaid could see higher health spending compared what would happen if Medicaid was expanded. For example, a Texas resident with an income below the federal poverty level who does not qualify for Medicaid will face costs of $1,831 per year, compared to $28 if they were covered by Medicaid. Nationally, the 11.5 million people who become newly insured by Medicaid will see their risk of spending at least 10 percent of their income on medical costs drop from 45 percent to 5 percent. Source: RAND Corporation http://www.rand.org/news/press/2013/10/01.html

Savings Needed for Medigap Premiums, Medicare Part B Premiums, Medicare Part D Premiums and Out-of-Pocket Drug Expenses for Retirement at Age 65 in 2011-2013

By Percent Chance of Having Enough Savings with Median Prescription Drug Expenses Throughout Retirement Men 2011 2012 2013 50% $71,000 $70,00 $65,000 75% 107,000 105,000 96,000 90% 136,000 135,000 122,000 Women 50% 95,000 93,000 86,000 75% 124,000 122,000 111,000 90% 156,000 154,000 139,000 Married Couple 50% 166,000 163,000 151,000 75% 231,000 227,000 207,000 90% 287,000 283,000 255,000 Source: Employee Benefit Research Institute

Emergency Department Visits by Persons Aged 65 and Over

In 2009-2010, a total of 19.6 million emergency department (ED) visits in the United States were made by persons aged 65 and over. The visit rate for this age group was 511 per 1,000 persons and increased with age. The percentage of ED visits made by nursing home residents, patients arriving by ambulance, and patients admitted to the hospital increased with age. Twenty-nine percent of ED visits by persons aged 65 and over were related to injury, and the percentage was higher among those aged 85 and over than among those aged 65-74 or 75-84. The percentage of ED visits caused by falls increased with age. Source: CDC/National Center for Health Statistics