A study by CVS Caremark (NYSE: CVS), published this week in the American Journal of Pharmacy Benefits, finds that insurance benefit designs that reduce the cost of medications for plan participants result in patients being more likely to start and stay on their medication therapy. The study compared more than 20, 000 plan participants in value-based insurance design (VBID) plans to more than 190, 000 participants of similar age and gender breakdowns in standard three-tier plans. The study concluded initiation and adherence rates for both insulin and oral diabetes medicines among participants in value-based plans were significantly higher. "There have been discussions around the impact of price and affordability on patients' ability and willingness to start and stay on their medications and this research adds to that body of knowledge. We took a look at one disease state diabetes and showed how cost impacts a patient's prescription initiation and adherence rates, " said Troyen A. Brennan, M.
The Columbus Dispatch reports that a health-insurance co-operative founded by Tom Rose, a retired businessman from Marietta, Ohio, "hopes to give people who feel alone in the health-care market that power-in-numbers feeling. ... Benefits Unlimited Inc. started in 2007 and started accepting dues-paying members across the nation last month. ... Annual dues range from $25 for an individual or household to $1, 500 for employers or associations with 500 or more people. Rose hopes to sign up 35, 000 people nationally within a year, which would generate the money needed for the business to become a health-insurance company in Ohio" (Hoholik, 2/15). The Associated Press/Boston Globe : "Rhode Island Lt. Gov. Elizabeth Roberts will testify before the Health Insurance Advisory Council in opposition to proposed rate hikes for large and small group employer health plans. The Council will be taking public comment at the hearing Tuesday at the Department of Labor and Training in Cranston" (2/15).
Anthem Blue Cross is agreeing to postpone until May a planned 39 percent rate hike for insurance policies that would have taken effect March 1. Democrats have decried the proposed increase, saying it exemplifies issues being raised in the health care overhaul debate, The New York Times reports. "With health care negotiations stalled in Washington, the Obama administration is seizing on the seething fury felt by ... nearly 700, 000 other Anthem customers in California who have received notices of increases that average 25 percent. About a quarter of them are seeing leaps of 35 percent to 39 percent, the company said, at least four times the rate of medical inflation." The Times reports that the "the confrontation has also reinforced an emerging shift of focus in Washington from the need for universal coverage to the need for serious cost control. And it brought into clear relief the deep rift between the administration and the insurance industry concerning a central question: whether such unsustainable pricing is driven by the bloodless economics of risk or a corporate culture of greed" (Sack, 2/15).
The IRS is helping more than 40, 000 residents of Michigan buy health insurance "after they lost their jobs to foreign competition or had their pension plans terminated, " The Detroit News reports. "The unlimited assistance will put thousands of dollars in the pockets of workers struggling to cope with the burden of paying for their own health care coverage after their jobs were eliminated or their pensions and retirement benefits cut, and will allow others to buy coverage to replace their lost benefits. ... The IRS is expanding efforts to publicize the little-known Health Coverage Tax Credit, which refunds 80 percent of health care premiums and can arrange to pay the bulk of those premiums each month going forward. The credit covers anyone whose job loss is certified under the Trade Adjustment Assistance Act, as well as anyone 55 and over whose pension plan has been taken over by the pension board." In some cases, the tax credit covers more than $15, 000 a year in premiums (O'Connor, 2/15).
Proponents of state-based health reform are saying that the federal stall over a health overhaul is giving states a perfect opportunity to showcase what they can do to solve the health care cost and coverage crisis, The Washington Post reports. "Advocates of a state-by-state approach are invoking welfare reform, which originated in the states, and education, an area in which the federal government goads states to improve but lets them choose their own approaches. Imposing national health-care reform, they argue, ignores local variations in health-care markets and politics." The advocates come from states like Texas, Missouri and many in the South and West. "Supporters of a national approach counter that relying on states would mean accepting the status quo for years to come. A state-by-state approach makes it harder to rein in health costs with systemwide reforms. And cash-strapped states are in no position to launch new initiatives." In California, for instance, a bill to provide universal coverage for that state's residents is being met with a veto promise by Gov.
Newly Unemployed In March Face COBRA Assistance Cut-off Unless U.S. Senate Follows House Lead To Restore Subsidy
Workers who lose their jobs after February 28 are likely to find that the cost of continued health coverage is unaffordable because they will not qualify for help under a special federal assistance program, which pays 65 percent of health coverage premiums under COBRA for laid-off workers, unless Congress acts to extend the eligibility deadline. In response to that looming deadline, Families USA sent a letter today to Senators urging them to follow the lead of the House of Representatives and extend the subsidy. The Senate is scheduled to act on a jobs bill that could include an extension of the subsidy. The COBRA subsidy was adopted last year as part of the federal stimulus bill, the American Recovery and Reinvestment Act of 2009. Although COBRA allows workers to retain health insurance from their previous employer, it requires workers to pay the full cost of that coverage without any contribution from that former employer. A Families USA report released in December 2009 shows that, without the subsidy, COBRA premiums for family coverage consume, on average, 83.
The Minneapolis Star Tribune : "Gov. Tim Pawlenty's proposal to cut a net of $347 million from programs for sick, aged, disabled and jobless people is akin to the advice an ailing George Washington got from his doctors 210 years ago, one critic said Monday: Bleed him, in hope of a cure. Pawlenty would eliminate the General Assistance program in which about 20, 000 disabled and very-low-income people receive an average of $175 a month. He also would remove about 21, 500 childless adults earning between $8, 100 and $27, 000 from MinnesotaCare, the health insurance program for lower-income working people" (Wolfe, 2/15). The Oklahoman, on the effects of at least $17 million in cuts to the state Mental Health and Substance Abuse Services Department: "Already almost half of the 400 available beds have been cut. More cuts are on the way. ... Hospitals and their emergency rooms will be asked to pick up the slack for now-missing services. The Oklahoma Hospital Association ran information on mental health and substance abuse center closure issues in a recent newsletter, Executive Director Rick Snyder said.
The Los Angeles Times offers advice to consumers on how to understand and correct medical bills. "People with health insurance who get a medical bill this early in the new year may also get some sticker shock. Few will have satisfied their plan's annual deductible this soon, meaning they'll be responsible for a hefty portion of the bill, if not all of it." Before paying those charges, it is important to understand them. Tips include paying attention to details, learning the terminology, reading the remarks, using customer service, considering a billing advocate and dealing with the doctor's office (Kritz, 2/15). In a separate article, the LA Times details some of the avenues available to correct billing problems. "Check first with your provider or insurer to see if the problem can be resolved. If it can't, a wide range of groups -- state agencies, nonprofits, consumer advocates -- can help explain your policy or help you file a complaint" (Worth, 2/15). This information was reprinted from kaiserhealthnews.
News outlets report on several of the pending policy issues of a health care overhaul. "An agreement to tax high-cost, employer-sponsored health insurance plans, announced with fanfare by the White House and labor unions last month, is losing support from labor leaders, who say the proposal is too high a price to pay for the limited health care package they expect to emerge from Congress, " The New York Times reports. "With support for the tax eroding, Congressional leaders are searching for alternative sources of revenue." Many House Democrats also "continue to criticize the tax as bad policy, " and say "the tax is bad politics because it would set the middle class against the poor - people struggling to keep health insurance against people struggling to get it" (Pear, 2/15). Meanwhile, the individual mandate, which would require most Americans to carry health insurance, is now "one of the most abhorrent provisions of the Democrats' health overhaul bills" to Republicans, NPR reports, quoting Sen.
"Federal healthcare benefits are going unclaimed by an estimated 17, 000 Californians whose jobs were moved overseas or retirees whose pensions are being paid by the government after their former employers terminated their retirement plans, " the Los Angeles Times reports." "So far, less than a third of those in the state who could be eligible are getting the money that can pay as much as 80% of their healthcare costs." The federal government has launched a major effort "to find people who are eligible. The Internal Revenue Service, which is in charge of finding eligible recipients, will hold a series of meetings in states with low participation, including California, Georgia and New York." In the past, however, efforts to promote the program "have had little success. ... Across the U.S., about 23, 000 out of an estimated 100, 000 potentially eligible people are receiving the credit, said Shannon Norman, an IRS spokeswoman" (Olivarez-Giles, 2/12). This information was reprinted from kaiserhealthnews.