Pay Attention To Health Insurance Non-Benefit Costs!
The McKinsey Global Institute reported in 2007 and 2008 that the United States spends twice as much for health care as for food. According to Census and Department of Agriculture data that pattern continues. Yet millions remain outside the protection of health insurance and many nominally within its bounds are seriously underinsured. Millions of individuals and thousands of businesses stagger under the cost of health care, many state and local communities find them unmanageable and some businesses find them a handicap or unaffordable. Alas, health insurance premiums continue to rise â on average another 9 percent in 2011. Medical care costs can change direction if policy makers stop whistling past a significant contributor â non-benefit costs.
These very substantial outlays include: payments by providers and insurers to prepare and process about a billion non-Medicare bills a year; pay to health provider personnel preparing records of services rendered as a prelude to billing; fees providers pay contractors to assemble their bills; fees that large employers pay contractors to administer their plans; provider payments to bill collection companies, largely in vain, to squeeze past due payments from patients, many already wrung dry by the costs of illness and income lost by family caregivers; lost time and pay for dickering with insurers seeking to minimize reimbursements; efforts by insurers and self-insurers to shift the duty to pay to other insurers and entities; and expenses for seeking reimbursement from other plans (a zero-sum endeavor which adds to costs without any overall savings).
Non-benefit costs also include fees, usually not counted in the total cost of care but nonetheless real, that employers pay consultants and the time executives expend in selecting plans; insurer Wall-Street-style executive pay and bonuses; commissions to sales agents, with repeat payments on renewal; advertising and other promotional activities like payments to physicians for speeches and âconsulting;â reinsurance fees to hedge against large âlosses;â investment expenses; and, not least, insurer profits. Donât omit provider and insurer outlays to promote and protect tax breaks and other arrangements favorable to private plans.
Medicaid Health Insurance Eligibility - News
Specifically, the law vastly broadens the minimum eligibility requirements for Medicaid, which provides health insurance to the poor and disabled with a combination of federal and state dollars. Under the old rules, in exchange for federal grants that
The state also would pay slightly more for children under the expanded Medicaid program than it does under the child health insurance program shared with the federal government. Altogether, the effects of the federal health care overhaul could add
About 865000 low-income residents who receive medical treatment through Medicaid, mostly children, will be steered to a new program called BAYOU Health. It will be a largely insurance-based model when fully phased in by mid-2012.
Low-income Utahns on Medicaid and the Children's Health Insurance Program (CHIP) would be added, too, until they take steps to opt out. The bill sets up a double standard when it comes to patient privacy. Currently, privately-insured patients must
Medicare and Medicaid both provide government-sponsored health insurance. However, they differ in many ways, including eligibility criteria, enrollment procedures and the types of services that are covered. It is important for dual-eligibles to
Senate Approves Legislation to ... - Health Industry Washington Watch
H.R. 674 , which would repeal a requirement that the government withhold 3% of certain payments made to private contractors – including Medicare providers -- as a credit against the contractor’s income tax. This requirement currently is scheduled to take effect on January 1, 2013. The House of Representatives had approved its version of the repeal bill in October. Before passage, the Senate added language from another House-approved bill (H.R. 2576) to modify the ACA’s definition of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. The Congressional Budget Office has estimated that this change would save $13 billion over ten years, primarily by tightening Medicaid eligibility standards. Specifically, the legislation would provide that modified adjusted gross income includes both taxable and non-taxable Social Security benefits to align the definition with other federal subsidy programs. Beginning in 2014, this income definition would be used to determine financial eligibility for Medicaid and the State Children’s Health Insurance Program, and for premium tax credits and cost-sharing reductions available through Affordable Insurance Exchanges. The Senate also amended H.R. 674 to add tax credits for hiring unemployed veterans. The Senate-approved bill is expected to be considered by the House later this month.