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Expanding coverage: How primary care physicians are accommodating the newly insured

May 21, 2015 Comments off

Expanding coverage: How primary care physicians are accommodating the newly insured
Source: Deloitte

Are there enough physicians in the US to accommodate the millions of newly insured patients? If not, how will the health care system manage its growing (and aging) patient population?

The Deloitte Center for Health Solutions 2014 Survey of US Physicians shows that 44 percent of physicians are treating more newly insured patients – an important finding for health care stakeholders and decision makers. More primary care physicians (PCPs) (56 percent) experienced an increase in the number of newly insured patients than did surgical specialists (40 percent), non-surgical specialists (38 percent), and other physicians (33 percent). Survey respondents report that this is causing longer appointment wait times and driving PCPs to work longer hours. To cope, some PCPs are adding new physicians and hiring clinical staff to help with care coordination.

Job Lock and Employer-Provided Health Insurance: Evidence from the Literature

May 20, 2015 Comments off

Job Lock and Employer-Provided Health Insurance: Evidence from the Literature
Source: AARP Public Policy Institute

This report, written by Dean Baker at the Center for Economic and Policy Research, reviews the research literature on health insurance-related “job lock”—a labor market pattern that occurs when workers are reluctant to leave a job that offers health insurance because they cannot otherwise obtain affordable insurance. Based on the research, the author concludes that the Affordable Care Act’s insurance market reforms should have substantial, positive labor market effects.

The report reviews the research on three types of job lock:

  • Workers remaining in jobs in which they are not satisfied because of the fear of not being able to get health insurance at a new job (or not being able to buy or afford it in the individual market);
  • Workers being reluctant to start a business because they do not want to lose employer-provided health insurance; and
  • Workers staying employed (or employed full time) in order to obtain employer-sponsored insurance, when they would otherwise prefer to retire or work part time.

All three types of job lock are likely to be reduced by the Affordable Care Act, resulting in important gains for workers, families, and the economy.

Non-Group Health Insurance: Many Insured Americans with High Out-of-Pocket Costs Forgo Needed Health Care

May 15, 2015 Comments off

Non-Group Health Insurance: Many Insured Americans with High Out-of-Pocket Costs Forgo Needed Health Care
Source: Families USA

The Affordable Care Act has increased access to health insurance and financial assistance for millions of Americans. But even with the new assistance that helps consumers pay their premiums and out-of-pocket health care costs, one-quarter of consumers who buy insurance on their own still have problems being able to afford needed care.

This report looks at the portion of adults who went without needed medical care because they could not afford it, as well as the possible causes of those affordability issues. We also discuss actions that health insurers and state and federal governments can take to make out-of-pocket health care costs more affordable.

Vital Signs: Hispanic Health

May 14, 2015 Comments off

Vital Signs: Hispanic Health
Source: CDC

Hispanics or Latinos are the largest racial/ethnic minority population in the US. Heart disease and cancer in Hispanics are the two leading causes of death, accounting for about 2 of 5 deaths, which is about the same for whites. Hispanics have lower deaths than whites from most of the 10 leading causes of death with three exceptions—more deaths from diabetes and chronic liver disease, and similar numbers of deaths from kidney diseases. Health risk can vary by Hispanic subgroup—for example, 66% more Puerto Ricans smoke than Mexicans. Health risk also depends partly on whether you were born in the US or another country. Hispanics are almost 3 times as likely to be uninsured as whites. Hispanics in the US are on average nearly 15 years younger than whites, so steps Hispanics take now to prevent disease can go a long way.

CRS — An Introduction to Health Insurance: What Should a Consumer Know? (April 30, 2015)

May 14, 2015 Comments off

An Introduction to Health Insurance: What Should a Consumer Know? (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

Congress has seen a renewed interest in the market for private health insurance since the passage of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). This report provides an overview of private-sector (as opposed to government-provided) health insurance.It serves as an introduction to health insurance from the point of view of many consumers under the age of 65. No background in health insurance is assumed, and all terms are defined in the body of the report.

Federal and State Standards for “Essential Community Providers” under the ACA and Implications for Women’s Health

May 13, 2015 Comments off

Federal and State Standards for “Essential Community Providers” under the ACA and Implications for Women’s Health
Source: Kaiser Family Foundation

Millions of previously uninsured Americans have gained access to health coverage through the Affordable Care Act (ACA) Marketplace plans. The provider networks of the Marketplace plans determine where enrollees can seek medical care. Many of these individuals have received their care for years from safety-net providers, such as community health centers and family planning clinics. Recognizing the important role these providers play in promoting continuity of care as people transition from being uninsured and relying on safety net clinics to private insurance, and to meet the increased demand for medical care in underserved communities, Congress established general requirements to assure that these providers have the opportunity to participate in the health plans that are offered through the Marketplaces. These safety net clinics and hospitals are referred to as Essential Community Providers (ECPs), and the ACA specifically requires that Qualified Health Plans available through the federal or state insurance Marketplaces have a “sufficient number and geographic distribution of ECPs, where available, to ensure reasonable and timely access to a broad range of such providers for low-income, medically underserved individuals in the plan’s service area.”1 Because both the Center for Medicare and Medicaid Services (CMS) and state regulators can have the authority to decide how to implement the broad ECP standard, there is considerable variation across the country in both the categories of providers included as ECPs as well as the standards required for inclusion in plan networks. This brief reviews the definition of ECP, examines the federal and state rules that govern the extent to which plans must include these providers in their networks, identifies the variation from state to state, and discusses the particular importance of these rules and providers for women’s access to care.

Health-Care Coverage for Youth in Foster Care—and After

May 13, 2015 Comments off

Health-Care Coverage for Youth in Foster Care—and After
Source: Child Welfare Information Gateway

This issue brief reviews the eligibility pathways for children and youth in foster care to receive Medicaid or other health-care coverage and looks at some of the newer benefits now mandated through the Patient Protection and Affordable Care Act (ACA), especially those for older youth in or formerly in foster care.

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