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Tuesday, April 7, 2020

Health Ins. Options During Coronavirus Pandemic

The COVID-19 pandemic has disrupted and changed the health insurance landscape for many people.  Here’s a review of the various options available to people, depending on their specific situation and eligibility:

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Monday, March 30, 2020

CARES Act Impact on Health Insurance

On March 27, 2020,  the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) became law.  The CARES Act amends certain provisions of the Families First Coronavirus Response Act (“FFCRA”).  CARES also temporarily eliminates deductibles for certain services in HSA Qualified High Deductible Health Plans (HDHPs), and temporarily expands the list of qualified expenses reimbursable through HSAs, HRAs, and FSAs.

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Wednesday, March 25, 2020

Families First Coronavirus Response Act

On March 18, 2020 the President signed into law the Families First Coronavirus Response Act (FFCRA), which takes effect April 2, 2020.  The FFCRA includes several provisions that impact employers with less than 500 employees, with allowable exemptions for affected employers with fewer than 50 employees.  This blog post addresses the three (3) main aspects of the FFCRA: 1. Mandated waiver of health insurance related cost sharing for COVID-19 testing; 2. New paid leave entitlements;  and 3. Employer tax credits.  

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Wednesday, March 11, 2020

Coronavirus Health Insurance Benefits

Leaders of the major health insurance companies in the U.S. agreed to expand insurance benefits related to Corornavirus/COVID-19, in a historical meeting held at the White House yesterday (March 10, 2020).  Present at the meeting were executives from: Aetna
Blue Cross Blue Shield (BCBS) Association (representing the 36 BCBS plans throughout the nation, including Anthem)
Cigna
Humana
UnitedHealth Group (aka United Healthcare)

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Thursday, May 9, 2019

Accountable Care…The Savior of U.S. Healthcare?

Since the passage of the Affordable Care Act (ACA) in March of 2010, much has been discussed, debated, written, and deployed relative to healthcare FINANCING reforms (see insurance, Medicare, Medicaid, self-insured employers, fees/taxes, pre-existing conditions, essential health benefits, community rating, minimum loss ratio, etc.).  But very little has been written, or even revealed for that matter, about the ACA’s healthcare DELIVERY reforms and incentives.  This is too bad, since we know that $.80 to $.85 of every dollar of billed health insurance premium is directly related to healthcare delivery.  So it stands to reason that if we could reduce health CARE costs, health insurance PREMIUMS would follow suit.  Enter Accountable Care Organizations (ACO) into the equation.  Let’s examine what ACO’s are…who they are…and why many are looking to them to save America’s healthcare system from imploding.

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Tuesday, April 16, 2019

Prescription Drug Spending Trends

As employers, patients, and other stakeholders continue to struggle with the rising cost of healthcare (and health insurance!), one particular component of overall healthcare spending seems to be occupying the majority of attention – prescription drugs!  In 2019, the U.S. is projected to spend $500 billion on prescription drugs alone, which marks a 12x increase from less than 20 years ago!*  A number of factors are at play in the cost pressures affecting drugs, on both the supply and demand side.   Much is being discussed and debated on the topic of addressing skyrocketing drug prices, including government intervention on a number of fronts.  Needless to say, we are closely monitoring developments in the area of prescription drug trends.  So here is the first of likely several posts addressing some of the more pressing matters affecting prescription drug use and spending. 

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Friday, December 1, 2017

Preventive Healthcare Services and Coverage

An important and often overlooked benefit of the Affordable Care Act (ACA) is full coverage and benefits for preventive care.  Specifically, the ACA established that virtually all private health plans must provide 100% coverage (i.e., no cost share) for a host of preventive healthcare services.  The only exception to this requirement are so called “grandfathered”LEARN MORE

Tuesday, June 2, 2015

Disproportionate Hospital Share (DSH) Payment Change

The Affordable Care Act (ACA) changed the method used to compensate hospitals for disproportionate share, sometimes referred to as DSH. This new method applies to charges “effective on or after fiscal year (FY) 2014. Under the new method, eligible hospitals receive 25% of the former “DSH” amount, and additional funds as follows:

Wednesday, October 15, 2014

Ebola ~ Just the Facts

Readers of this blog (soon to be “resource library”) typically find health INSURANCE, FUNDING, and FINANCING issues addressed here. But occasionally, health CARE issues come to light which I feel compelled to address. With all the media coverage and confusion surrounding the recent outbreak of the Ebola virus, I decided to attempt to clarify some important facts. My primary source of information for this post is the Douglas County Health Department (Douglas County, Nebraska), which under the direction of Dr. Adi Pour, does a fantastic job of data mining and educating, among other things.
The Ebola virus was first discovered in 1976 in the Ebola River…

Wednesday, June 11, 2014

Prescription Drugs – Health Care’s Low Hanging Fruit

There is an often overused metaphor equating things easily obtained with “low hanging fruit”. And in the world of health care and consumer driven health care (CDH), there is perhaps NO lower hanging fruit to be had than prescription drugs. I would further submit that few if any other product category in our entire economy has the sheer number of FREE… DISCOUNTED… REDUCED… SAMPLE offers connected to it, by a variety of constituencies including – manufacturers, distributors, insurers and employers – than do prescription drugs. But do the very people these offers of “low hanging fruit” are directed toward understand the “what”, “why”, or even “where” associated with them?