... civil money penalty settlements related to individuals who were excluded from federal health programs were entered into by the HHS Office of Inspector General during the last four months of 2015, according to the agency.
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
Tuesday, February 23, 2016
21 ...
... civil money penalty settlements related to individuals who were excluded from federal health programs were entered into by the HHS Office of Inspector General during the last four months of 2015, according to the agency.
"Insurers are telling us they want one common ...
...
e-commerce
platform that works across all commercial lines of business — group and
individual — and that eventually can include retirees on Medicare. They are
looking for creative ways to retain and grow their membership while cultivating
member-for-life relationships. A top priority for insurers will be to match each
consumer with the health and voluntary products that best meet their needs at
the particular time of their life, regardless of line of business."
— Jonathan Rickert, CEO of Seattle-based Array Health, a developer of private exchanges for health plans, told AIS's Inside Health Insurance Exchanges.
— Jonathan Rickert, CEO of Seattle-based Array Health, a developer of private exchanges for health plans, told AIS's Inside Health Insurance Exchanges.
Consumers who enrolled in Federally-facilitated Marketplace (FFM) plans in plan year 2015 ...
... will receive forms that provide information about their health coverage
for 2015. Some consumers may not know what to do with these forms and may
contact you for guidance.
The Internal Revenue Service has prepared questions
and answers about health care information forms to help consumers
understand these forms, including who should expect to receive them and how to
use the information in them when preparing their federal income tax returns.
The information on this webpage will be useful to you in helping consumers.
You can also direct consumers to resources CMS has provided on health
coverage and federal income taxes at Marketplace.CMS.gov.
Remember: While you may provide information to consumers about the advance
payments of the premium tax credit reconciliation process and the tax forms
that they will receive from the FFM, it is important that you not provide any
tax filing advice or answer any tax filing questions.
Please refer consumers seeking answers to their questions or advice
regarding their personal situations to a tax professional for assistance. For
more information on the tax assistance options available, direct consumers to: IRS.gov/freefile
or IRS.gov/VITA.
Geography Influences Government Grading of Medicare Advantage Plans
Geographic location is an important predictor of the quality grades assigned to Medicare Advantage insurance plans, and the federal government should consider accounting for geographic differences to allow for fairer comparisons among plans, School of Public Health researchers say in a new study.
The study in the journal PLOS ONE found that lower “star ratings” were assigned to plans in the Southeastern region of the US, and that many states’ ratings would rise or fall if these governmental measures adjusted for geographic differences nationally.
The rating system was instituted by the federal Centers for Medicare and Medicaid Services (CMS) as a way to make sure Medicare beneficiaries in different plans were getting high-quality care. CMS has tied financial incentives to the ratings; plans that earn at least four (out of five) stars receive a boost in reimbursement, have the option to expand as a business, and are eligible for bonuses.
Indicators used in the ratings include health outcomes, access to care, patient ratings of satisfaction and other measures of quality—but not location of the plan.
“These findings suggest that the effect of geography on the plans’ ratings is not trivial, and should be considered in future comparison of plans,” says the study, led by Lewis Kazis, professor of health policy and management. Because different regions of the country have different community health characteristics and access to hospitals and providers, accounting for geography would help to “level the playing field” when comparing plans, the authors say.
Kazis and colleagues analyzed 409 Medicare Advantage contracts nationally, covering about 10.6 million beneficiaries, or about 86 percent of the total Medicare Advantage population. They found that geography alone explained 59.5 percent of the variation in the plan’s ratings, while demographic differences (age, race, education, poverty level, and median household income) explained 31.2 percent of the variation.
When the rating system was adjusted for geography, 20 percent of states rose in the rankings, while 24 percent fell. For example, Michigan, which was ranked 26th in the country, rose to the 4th highest ranking. The opposite occurred with Hawaii, which fell from 4th to 26th place after the adjustment.
“The Affordable Care Act focuses on changing the system to increase access to health services, improve quality of care and decrease costs,” said Kazis. “Our results suggest a rationale for a geographical focus that reflects factors that are largely local, rooted in the environmental, social, economic, and behavioral determinants of health.”
Co-authors on the study include: Howard Cabral, professor of biostatistics; Rene Soria-Saucedo, research fellow; Peng Xu, a former SPH student; and Jack Newsom of CenseoHealth of Dallas.
—Lisa Chedekel
http://www.bu.edu/sph/2016/01/12/geography-influences-government-grading-of-medicare-advantage-plans/
The study in the journal PLOS ONE found that lower “star ratings” were assigned to plans in the Southeastern region of the US, and that many states’ ratings would rise or fall if these governmental measures adjusted for geographic differences nationally.
The rating system was instituted by the federal Centers for Medicare and Medicaid Services (CMS) as a way to make sure Medicare beneficiaries in different plans were getting high-quality care. CMS has tied financial incentives to the ratings; plans that earn at least four (out of five) stars receive a boost in reimbursement, have the option to expand as a business, and are eligible for bonuses.
Indicators used in the ratings include health outcomes, access to care, patient ratings of satisfaction and other measures of quality—but not location of the plan.
“These findings suggest that the effect of geography on the plans’ ratings is not trivial, and should be considered in future comparison of plans,” says the study, led by Lewis Kazis, professor of health policy and management. Because different regions of the country have different community health characteristics and access to hospitals and providers, accounting for geography would help to “level the playing field” when comparing plans, the authors say.
Kazis and colleagues analyzed 409 Medicare Advantage contracts nationally, covering about 10.6 million beneficiaries, or about 86 percent of the total Medicare Advantage population. They found that geography alone explained 59.5 percent of the variation in the plan’s ratings, while demographic differences (age, race, education, poverty level, and median household income) explained 31.2 percent of the variation.
When the rating system was adjusted for geography, 20 percent of states rose in the rankings, while 24 percent fell. For example, Michigan, which was ranked 26th in the country, rose to the 4th highest ranking. The opposite occurred with Hawaii, which fell from 4th to 26th place after the adjustment.
“The Affordable Care Act focuses on changing the system to increase access to health services, improve quality of care and decrease costs,” said Kazis. “Our results suggest a rationale for a geographical focus that reflects factors that are largely local, rooted in the environmental, social, economic, and behavioral determinants of health.”
Co-authors on the study include: Howard Cabral, professor of biostatistics; Rene Soria-Saucedo, research fellow; Peng Xu, a former SPH student; and Jack Newsom of CenseoHealth of Dallas.
—Lisa Chedekel
http://www.bu.edu/sph/2016/01/12/geography-influences-government-grading-of-medicare-advantage-plans/
47% of Firms With 3-9 Workers Offered Health Coverage in 2015
The Kaiser Family Foundation recently conducted a study on health insurance coverage offerings in large and small businesses. Here are some key findings from the report:
·
Small firms employ 30%
of workers who receive health insurance through their own job.
·
Of firms with 3-199
employees, 56% offer health insurance to some of their employees.
·
98% of firms with 200
or more employees offer health insurance to some employees.
·
Of firms with 3-9
workers, 47% offered coverage in 2015.
·
41% of small firms not
offering coverage indicated cost as the primary reason.
·
Small firms(18%) are
less likely to offer health benefits to part-time workers than are large
firms(35%).
Source: Kaiser Family Foundation, February 5, 2016
According to a recent report, 18% of U.S. adults visited ...
... an
emergency room at least once in 2014, giving the following reasons for their
most recent ER visit:
- 77%
- seriousness of the medical problem
- 12%
- their doctor's office was not open
- 7%
- lack of access to other providers
- 4%
- no reason given
Source: "Reasons for Emergency Room Use Among U.S.
Adults Aged 18–64: National Health Interview Survey, 2013 and 2014,"
National Health statistics Reports Number 90, Centers for Disease Control and
Prevention, February 18, 2016, http://www.cdc.gov/nchs/data/nhsr/nhsr090.pdf
Monday, February 22, 2016
According to the most recent Kaiser Health Tracking Poll,
83%
of Americans support allowing Medicare to negotiate the price of prescription
drugs (93% of Democrats and 74% of Republicans).
Source: "Searching for Savings in Medicare Drug Price Negotiations," The Henry J. Kaiser Family Foundation, February 9, 2016, http://kff.org/medicare/issue-brief/searching-for-savings-in-medicare-drug-price-negotiations/
Source: "Searching for Savings in Medicare Drug Price Negotiations," The Henry J. Kaiser Family Foundation, February 9, 2016, http://kff.org/medicare/issue-brief/searching-for-savings-in-medicare-drug-price-negotiations/
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