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Nearly One in Four Employers Say Private Health Insurance Exchanges Could Provide a Viable Alternative for Full-Time Active Employees in 2016

September 30, 2014 Comments off

Nearly One in Four Employers Say Private Health Insurance Exchanges Could Provide a Viable Alternative for Full-Time Active Employees in 2016
Source: Towers Watson

Results of a July 2014 survey of midsize to large employers by global professional services company Towers Watson (NYSE, NASDAQ: TW) showed that 28% said they had already extensively evaluated the viability of private exchanges. Nearly one in four (24%) said private exchanges could provide a viable alternative for their active full-time employees as soon as 2016.

The results are from the 2014 Towers Watson Health Care Changes Ahead Survey, which was completed by 379 employee benefit professionals from a variety of industries and reflect health care benefit decisions for 2016 – 2017.

The survey also revealed that the top three factors that would cause employers to adopt a private exchange for full-time active employees are:

  • Evidence they can deliver greater value than their current self-managed model (64%)
  • Adoption of private exchanges by other large companies in their industry (34%)
  • An inability to stay below the excise tax ceiling as 2018 approaches (26%)
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Catching Up: Latino Health Coverage Gains and Challenges Under the Affordable Care Act

September 29, 2014 Comments off

Catching Up: Latino Health Coverage Gains and Challenges Under the Affordable Care Act
Source: Commonwealth Fund

For decades, Latinos have had the highest uninsured rates of any racial or ethnic group in the United States. Less than one year after the Affordable Care Act’s health insurance marketplaces opened for enrollment, the overall Latino uninsured rate dropped from 36 percent to 23 percent, according to the Commonwealth Fund Affordable Care Act Tracking Survey, conducted April 9 to June 2, 2014. However, the high uninsured rate among Latinos in states that had not expanded their Medicaid program at the time of the survey—33 percent—remained statistically unchanged. These states are home to about 20 million Latinos, the majority of whom live in Texas and Florida.

New From the GAO

September 29, 2014 Comments off

New GAO Reports
Source: Government Accountability Office

1. Disabled Dual-Eligible Beneficiaries: Integration of Medicare and Medicaid Benefits May Not Lead to Expected Medicare Savings. GAO-14-523, August 29.
http://www.gao.gov/products/GAO-14-523
Highlights –  http://www.gao.gov/assets/670/665492.pdf

2. Patient Protection And Affordable Care Act: Largest Issuers of Health Coverage Participated in Most Exchanges, and Number of Plans Available Varied.
GAO-14-657, August 29.
http://www.gao.gov/products/GAO-14-657
Highlights –  http://www.gao.gov/assets/670/665488.pdf

3. Freight Transportation: Developing National Strategy Would Benefit from Added Focus on Community Congestion Impacts. GAO-14-740, September 19.
http://www.gao.gov/products/GAO-14-740
Highlights – http://www.gao.gov/assets/670/665973.pdf

4. Managing for Results: Agencies’ Trends in the Use of Performance Information to Make Decisions. GAO-14-747, September 26.
http://www.gao.gov/products/GAO-14-747
Highlights – http://www.gao.gov/assets/670/666188.pdf

5. U.S. Currency: Reader Program Should Be Evaluated While Other Accessibility Features for Visually Impaired Persons Are Developed. GAO-14-823, September 26.
http://www.gao.gov/products/GAO-14-823
Highlights – http://www.gao.gov/assets/670/666172.pdf

Entrepreneurship and Public Health Insurance

September 24, 2014 Comments off

Entrepreneurship and Public Health Insurance (PDF)
Source: Brown University

The social safety net provides financial security for millions of Americans, yet few studies have explored its influence on firm formation. This paper tests whether the State Child Health Insurance Program (SCHIP) affected business ownership. I use three identification strategies to isolate this effect: difference-in-differences (DID), regression discontinuity (RD) and a differenced version of RD that incorporates pre-policy data as a falsification check. Monte Carlo analysis suggests this differencing technique significantly reduces bias and Type 1 Error relative to RD and DID, and the procedure can be applied to a wide range of policy evaluations. I show that the local average treatment effect of SCHIP eligibility was a 29% reduction in the number of uninsured children and a 23% increase in self-employment. I also show that SCHIP increased incorporated business ownership by 31% and the share of household income from self-employment by 16%, suggesting these are high-quality ventures. The increase is driven by both a 12% rise in firm birth rates and an 8% increase in survival rates. I also document a large increase in labor supply, equivalent to 8.8 million full-time workers. The central mechanism is a reduction in the riskiness of self-employment rather than a relaxation of credit constraints. I find no evidence that observable characteristics are unbalanced between treatment and control groups. To the extent that entrepreneurs contribute to innovation, job creation or economic growth, these findings strongly suggest that public health insurance programs have spillover benefits on the supply of firms.

The Impact of the Patient Protection and Affordable Care Act on Employment Strategies: Results of the 2014 HR@Moore Survey of Chief HR Officers

September 22, 2014 Comments off

The Impact of the Patient Protection and Affordable Care Act on Employment Strategies: Results of the 2014 HR@Moore Survey of Chief HR Officers (PDF)
Source: University of South Carolina (Darla Moore School of Business)

In order to assess how firms have responded to the Patient Protection and Affordable Care Act (PPACA), as part of the 2014 HR@Moore Survey of Chief HR Officers we asked CHROs how they have experienced different aspects of the health insurance and health care system and how they have changed their employment strategies. The results show that 78% of the respondents indicated that their health insurance costs have risen (by an average of 7.73%) and 37% reported that their labor costs have increased (by an average of 5.6%) as a direct consequence of the PPACA.

Companies have sought to mitigate the increased cost by pushing cost and responsibility to employees, as 73% have moved or will move employees to Consumer Directed Health Plans and 71% have raised or will raise employee contributions toward health insurance. In addition, while not nearly as prevalent, 30% of firms have or will move their pre- 65 retirees to ACA exchanges, have or will cut back coverage eligibility (27%), have or will more rigorously ensure parttime workers work fewer than 30 hours per week (24%), have or will increase the proportion of part-time workers (12%), and have or will limit the number of fulltime hires (10%).

Income, Poverty and Health Insurance Coverage in the United States: 2013

September 19, 2014 Comments off

Income, Poverty and Health Insurance Coverage in the United States: 2013
Source: U.S. Census Bureau

The U.S. Census Bureau announced today that in 2013, the poverty rate declined from the previous year for the first time since 2006, while there was no statistically significant change in either the number of people living in poverty or real median household income. In addition, the poverty rate for children under 18 declined from the previous year for the first time since 2000. The following results for the nation were compiled from information collected in the 2014 Current Population Survey Annual Social and Economic Supplement.

The nation’s official poverty rate in 2013 was 14.5 percent, down from 15.0 percent in 2012. The 45.3 million people living at or below the poverty line in 2013, for the third consecutive year, did not represent a statistically significant change from the previous year’s estimate.

Median household income in the United States in 2013 was $51,939; the change in real terms from the 2012 median of $51,759 was not statistically significant. This is the second consecutive year that the annual change was not statistically significant, following two consecutive annual declines.

The percentage of people without health insurance coverage for the entire 2013 calendar year was 13.4 percent; this amounted to 42.0 million people.

Quality of Health Care After Adopting a Full-Replacement, High-Deductible Health Plan With a Health Savings Account: A Five-Year Study

September 18, 2014 Comments off

Quality of Health Care After Adopting a Full-Replacement, High-Deductible Health Plan With a Health Savings Account: A Five-Year Study
Source: Employee Benefit Research Institute

Executive Summary

  • This study reports use of health care services related to health care quality over five years among over 18,000 individuals from a single large employer in the Midwestern United States that adopted an HSA-eligible health plan for all employees. It represents one of the longest observation periods reported with a full-replacement CDHP, and it is one of the few studies with a matched control group.
  • The introduction of the HSA-eligible health plan had a negative impact on office visits for annual physicals, well-child visits, and preventive visits in the year that the plan was adopted. In the second year, office visits increased for HSA-eligible health plan enrollees, but were mostly unchanged for the comparison group. By the fourth year in the HSA-eligible health plan, office visits for annual physicals, well-child visits, and preventive visits were down slightly relative to the comparison group.
  • Rates of LDL testing for adults with cardiovascular disease were reduced only in the first year of the HSA-eligible health plan. However, the introduction of the HSA-eligible health plan had a negative effect on medication monitoring for adults on select maintenance drugs not only in the first year that the new health plan was introduced, but in the following three years as well. • The HSA-eligible health plan reduced avoidance of both antibiotics for adults with acute bronchitis and imaging services for adults diagnosed with low back pain. Both services are often considered unnecessary.
  • Adoption of the HSA-eligible health plan was associated with a reduction in breast cancer, cervical cancer, and colorectal cancer screening in year one, although screenings for breast cancer and cervical cancer rebounded in year two. By year four, breast cancer screening was higher among enrollees in the HSA-eligible health plan than in the comparison group. In contrast, cervical cancer screening was lower among HSA-eligible health plan enrollees than the comparison group in year four. Throughout all of the study years, colorectal cancer screening was lower among HSA-eligible health plan enrollees than in the comparison group.
  • The HSA-eligible health plan was not associated with a change in the percentage of adults receiving HbA1c testing until the fourth year. LDL testing was lower as a result of the introduction of the HSA-eligible health plan in all years.
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