Studies Gauge Health Law’s Impact On Consumer Savings, Rx Drug Coverage


Topics: Supreme Court, Insurance, Marketplace, Health Reform, States

Dec 05, 2012

The Commonwealth Fund concluded that consumers saved $1.5 billion in 2011 as a result of a provision that limits how much insurers can spend on expenses not related to medical care. Meanwhile, Avalere Health found that drug coverage plans offered on health exchanges will vary by state.

Los Angeles Times: ‘Obamacare’ Saves Consumers Nearly $1.5 Billion
Consumers saved nearly $1.5 billion in 2011 as a result of rules in President Obama’s healthcare law that limit what insurance companies can spend on expenses unrelated to medical care, including profit, a new analysis shows. Much of those savings — an estimated $1.1 billion — came in rebates to consumers required because insurers had exceeded the required limits. The study by the New York-based Commonwealth Fund also suggests that the Affordable Care Act forced insurers to become more efficient by limiting their administrative expenses, a key goal of the 2010 law (Levey, 12/5).

Modern Healthcare: Reform Law Aiding Insurance Consumers: Report
A new report estimated insurance consumers benefited from $1.5 billion in either rebates or reduced costs last year, due to requirements of the healthcare overhaul. But insurers warned that money could have funded anti-fraud and quality-improvement programs. Research supported by the Commonwealth Fund, which backed the Patient Protection and Affordable Care Act, concluded that the law’s medical loss-ratio requirements implemented in 2011 provided big savings—mainly in the individual insurance market. Individual market policyholders had “substantially reduced premiums” due to the law’s requirement that insurers spend at least 80% of premium dollars on direct healthcare or quality-improvement activities, or else pay a rebate to their customers, according to the report (Daly, 12/5).

The Associated Press/Washington Post: Study: Prescription Drug Coverage Under Obama Health Care Law Could Vary Markedly By State
A new study says basic prescription drug coverage could vary dramatically from state to state under President Barack Obama’s health care overhaul. That’s because states get to set benefits for private health plans that will be offered starting in 2014 through new insurance exchanges (12/4).

The Hill: Analysis Finds Big State-By-State Swings In Prescription Coverage
President Obama’s signature healthcare law requires insurance plans to cover a range of prescription drugs, but the number of drugs covered will vary widely from state to state, according to a new analysis from Avalere Health. The Affordable Care Act requires plans to cover a set of “essential health benefits,” including prescription drugs. To prevent benefit mandates from driving up premiums, the Health and Human Services Department has said it will let states fill in most of the details about their essential-benefits packages (Baker, 12/4).

In other coverage related to the health overhaul –

MPR: Federal Health Care Law
The federal health care overhaul is here to stay after surviving an epic legal battle at the United States Supreme Court and the contentious 2012 elections. But that does not mean the massive law will remain intact, as enacted. Congress may be tempted to raid some of the Affordable Care Act’s funding as part of a deal to avert the collection of automatic tax hikes and spending cuts known as the “fiscal cliff.” The court battles are hardly over; legal challenges involving issues the Supreme Court did not address when it upheld the law in June, 2012, are already underway. But for the most part, key provisions, such as the individual mandate requiring most Americans to obtain health insurance, will take effect January 1, 2014 (Stawicki, 12/4).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

English: President Barack Obama's signature on...

English: President Barack Obama’s signature on the health insurance reform bill at the White House, March 23, 2010. The President signed the bill with 22 different pens. (Photo credit: Wikipedia)

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U.S. Behind France, Germany, U.K. In Stopping Preventable Deaths


US Navy 031223-D-9880W-120 Dr. William Winkenw...

US Navy 031223-D-9880W-120 Dr. William Winkenwerder, Jr., assistant secretary of defense for health affairs, holds a press conference at the Pentagon (Photo credit: Wikipedia)

Former Assistant Secretary of Defense (Health ...

Former Assistant Secretary of Defense (Health Affairs) (Photo credit: Wikipedia)

Dr. Nils Daulaire, U.S. Representative to the ...

Dr. Nils Daulaire, U.S. Representative to the WHO Executive Board and Director of the Office of Global Health Affairs (Photo credit: Wikipedia)

Topics: Delivery of Care, Health Costs, Insurance, Quality, Public Health

Aug 30, 2012

The study, published in Health Affairs, pointed the finger at the lack of health insurance — as well as conditions such as hypertension and medical errors — in the U.S. as part of the problem.

The Hill: Study: U.S. Tops France, Germany, UK In ‘Potentially Preventable’ Deaths
Americans younger than 65 are more likely to die from a lack of timely health care than their peers in France, Germany or the United Kingdom, according to a new study. Research published in Health Affairs looked at the rate of “potentially preventable” deaths — deaths before age 75 that could be avoided with timely and effective health care — and found that the United States lags behind its U.K. and European peers. The United States was also less effective than France, Germany and the United Kingdom in remedying the problem between 1999 and 2007, study authors wrote (Viebeck, 8/29).

WBUR: Report: U.S. Lags When It Comes To Preventable Deaths
More bad news for the U.S. health care system. According to a new report by the Commonwealth Fund, America is worst among three other industrialized nations when it comes to preventing avoidable deaths through timely, effective medical care. The problem, once again, is the lack of health insurance, the report suggests. (Things were worse for folks under 65; presumably those over that age qualify for Medicare.) (Zimmerman, 8/29).

Politico Pro: Study: U.S. Could Prevent More Deaths
America’s health care system doesn’t do as good a job of preventing avoidable deaths as health systems in other countries, a new study shows. A report posted online by Health Affairs on Wednesday compared the rates of “amenable mortality” — deaths that could have been prevented by better health care — in France, Germany, the United Kingdom (all countries that have universal health care) and the United States between 1999 and 2007. The research pointed to circulatory conditions like hypertension, as well as mortality rates due to surgical conditions and medical errors, as part of the problem with U.S. amenable deaths (Smith, 8/29).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

For Hospitals, The Rush Is Not On To Become An ACO


Topics: Delivery of Care, Health Costs, Hospitals, Marketplace, Quality, Health Reform

Aug 17, 2012

According to a Commonwealth Fund report, only about 13 percent of hospitals surveyed are participating or planning to participate in an accountable care organizations.

Kaiser Health News: Capsules: Survey: Few ACOs Ready For Financial Risk
Few hospitals interested in becoming accountable care organizations are ready to take on financial risk, according to a survey released Friday from The Commonwealth Fund (Gold, 8/16).

Politico Pro: Study: Few Hospitals Sign On To ACOs So Far
Most U.S. hospitals are not rushing into becoming an ACO. Three-fourths of hospitals aren’t even thinking of participating in an ACO, while 13 percent are currently participating or planning to be part of one in the following year, according to a new Commonwealth Fund report on findings from the 2011 National Survey of Hospital Readiness to Participate in an Accountable Care Organization. “Results show we are at the beginning of the ACO adoption curve,” the report’s authors wrote (Smith, 8/17).

Modern Healthcare: Doctors Play Key Role In ACO Leadership: Commonwealth Fund
Not many hospitals were participating or planning to participate in an accountable care organization last year, but among those that were, physicians were front and center in governance of the ACO, according to a new issue brief from the Commonwealth Fund. The Commonwealth Fund reported that only about 13% of hospitals surveyed were participating or planning to participate in an ACO; 12% were unsure; and 75% said they were not exploring the model at all (Robeznieks, 8/17).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Deputy Administrator and Director for the Cent...

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations (Photo credit: Christiana Care)