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Medica Mobile Rolls Out: Health Insurance Options Brought to Midwest Residents

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Medica Mobile Rolls Out: Health Insurance Options Brought to Midwest Residents MINNETONKA, Minn.--(BUSINESS WIRE)--Medica today announced the launch of the Medica Mobile, a 41-foot RV designed to travel the Midwest to bring information about health insurance to people interested in purchasing coverage. Reported by Business Wire 9 hours ago.

Health Insurance Rates Before and After ObamaCare

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Health Insurance Rates Before and After ObamaCare Reported by ajc.com 7 hours ago.

National Health Care Spending Is Up For A Really Obvious Reason

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WASHINGTON -- President Barack Obama and Democrats in Congress designed the Affordable Care Act to spend a lot of money to give more people health insurance so they could access medical care. The law seems to have succeeded on all three counts, and the results are showing up on America's national health care tab.

The government, businesses and households spent $3 trillion on health care last year, an increase of 5.3 percent from 2013, according to a report published Wednesday by the Office of the Actuary, an independent agency housed within the federal Centers for Medicare and Medicaid Services. That amounted to $9,523 per person, and health care accounted for 17.5 percent of gross domestic product in 2014, up from 17.3 percent the year before.

That's the biggest percentage increase in national health expenditures since 2007, after five consecutive years of unusually slow growth that averaged less than 4 percent annually, and the millions who gained health coverage through Obamacare are the primary reason why. In other words, the auditors found, 8.7 million fewer people were uninsured last year, and the newly covered used their benefits to visit doctors, hospitals and pharmacies.

The other major factor driving higher spending was cutting-edge prescription drugs for diseases like Hepatitis C, cancer and multiple sclerosis, which can cost as much as $1,000 a pill and are increasing expenses for private health insurers and government programs. Between those high charges, price increases for other medicines and more people with health coverage, spending on prescriptions rose 12.2 percent last year, the biggest annual jump in a dozen years.

"The whole point of giving people insurance is so they have better access to health care, so it shouldn't be a surprise that health care spending went up a bit as more people got insured," said Larry Levitt, a senior vice president at the Henry J. Kaiser Family Foundation. "Most of the health care system is growing very slowly, the exception being prescription drugs."What the report doesn't say is whether the health care system is becoming more efficient at the same time that total spending is rising because more people are using it. Health care companies, in part spurred by elements of the Affordable Care Act, are striving to constrain their costs in a way that could reduce future spending growth. Last year, the costs paid for things like hospital care, doctor visits and medicines rose a modest 1.8 percent -- reflecting that increased spending is the result of more people using the health care system, not higher costs.

The latest findings also don't answer the question of whether the recent slowdown in health care expenditures growth represents a hangover from the recession causing Americans to spend less on health care -- as the Office of the Actuary consistently maintained in previous reports -- or whether something bigger is going that is "bending the cost curve" in a permanent way that will mean slower inflation in health care expenditures."It seems hard to believe that we've solved the problem once and for all. I think we've improved it," said Loren Adler, research director at the Center for a Responsible Federal Budget. Trends in the health care marketplace like hospitals and physicians collaborating more closely together or like health insurance with higher deductibles may be altering the health care system itself, but these experiments don't tell us much yet, he said.

"We're in a slightly new world, but that new world is still of health spending growing faster than the economy, just by less so," Adler said. "You're talking about growing at roughly GDP, which is pretty crazy considering the fact that we had a pretty massive coverage expansion going on at the same time."

At some point, the effects of the recession will fade and health care spending will accelerate, as has happened during previous recoveries and periods of faster economic growth, Adler said.

"I can't imagine that we're not going to have a bounce back to more normal levels of spending growth over the next five to 10 years," Adler said. 

The Office of the Actuary published projections in July indicating spending would grow faster than 5 percent a year starting in 2014, still exceeding growth in gross domestic product, but not returning to the much higher inflation in health care expenditures seen in the decades before the recent slowdown.
The Obama administration contended that an initial spike in total spending because of the coverage expansion doesn't portend spiraling growth in the future.

"Aggregate health care spending growth in 2014 had been widely predicted by economists, and it is not surprising given that more people are covered and getting the health care they need. Faster growth in aggregate spending due to rising coverage will be temporary and will fade in the coming years," Richard Frank, assistant secretary for planning and evaluation at the Department of Health and Human Services, said in a press release.

The 5.3 percent increase in 2014 followed a 2.9 percent rise the prior year, which was the lowest recorded since the Office of the Actuary began tracking these numbers in 1960. It also followed a five-year period during which health care spending grew at a historically low 3.7 percent average rate, a stark departure from the 1990s through the mid-2000s, when much faster growth was the norm. In 2009, the year before the Affordable Care Act became law, the actuaries predicted national health care spending would be higher in future years than it turned out to be.

 

The actual spending amounts over the past several years also have been lower than those the actuaries projected from the 2010s at the end of the last decade.

"We've gotten so accustomed to saying health care spending is out of control and unsustainable, and our rhetorical language hasn't quite caught up with reality, because health care spending is not really out of control right now," Levitt said. "It's going up very slowly compared to what it used to be. In the '90s, double-digit increases in health spending were quite common. That's not true anymore."
*Also on HuffPost:*

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 7 hours ago.

National Health Spending Growth Remains on Slow Track

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The nation's health spending continues to grow more slowly than before health reform, figures that the Centers for Medicare & Medicaid Services (CMS) released today show.  Total health spending by governments, private insurers, and individuals grew by 5.3 percent last year, well below the average 6.9 percent increase in the ten years before health reform.Health spending growth in 2014 outpaced 2013's 2.9 percent rate for two major reasons:

· Thanks to health reform, the number of uninsured dropped by nearly 9 million, and the newly insured received health care services previously unavailable to them.  Medicaid spending growth accelerated due to health reform provisions expanding eligibility and boosting payments to primary care providers.  Enrollment in private health insurance also grew, largely due to enrollment in plans offered in the new insurance marketplaces.
· Prescription drug spending grew sharply (by 12.2 percent in 2014, compared to 2.4 percent in 2013), due in part to several costly new drugs, including a treatment for hepatitis C.  This rapid increase highlights the need to do more to rein in drug costs as well as develop new payment methods that encourage the use of cost-effective treatments.  Making prescription drugs more affordable is the public's highest health care priority, according to polling by the Kaiser Family Foundation.

The uptick in health spending growth in 2014, when health reform's major coverage expansions kicked in, isn't news.  For several years analysts have expected an increase in 2014 of roughly the amount reported today.Moreover, the expansion of health coverage slowed the growth in consumers' out-of-pocket health spending, from 2.1 percent in 2013 to 1.3 percent in 2014.  And households' total health spending, including insurance premiums, fell as a share of national health spending.
This post originally appeared on Off the Charts, the Center on Budget and Policy Priorities' blog.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 6 hours ago.

2014 US health spending grew at fastest rate of Obama years

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WASHINGTON (AP) — U.S. health care spending last year grew at the fastest pace since President Barack Obama took office, driven by expanded coverage under his namesake law and by zooming prescription drug costs, the government said Wednesday. The report by nonpartisan experts at the Department of Health and Human Services may signal the end of an unusually long lull in health care inflation that has benefited the Obama administration. "Health care spending growth stayed well below the trend seen prior to the Affordable Care Act," Richard Frank, a top economic adviser, said in a statement. — Prescription drug spending shot up by 12.2 percent in 2014, driven by new medications for hepatitis C infection, as well as treatments for cancer and multiple sclerosis. — Spending on Medicaid, the federal-state health insurance program for low-income people, jumped by 11 percent in 2014, the fastest growth in more than a decade. In some reassuring news for states that face surging Medicaid rolls, the report found that per-person spending declined due to healthier people signing up in the program. Reported by SeattlePI.com 6 hours ago.

2014 Saw Continued Slow Growth in the Cost of Health Care, Even as Coverage Expanded

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Today’s data on national health expenditures show that 2014 was another year of slow health care cost growth, as per-enrollee health care spending growth remained low in both the public and private sectors. The slow growth in the per-enrollee spending seen in recent years is thanks in part to reforms in the Affordable Care Act and is generating major fiscal and economic benefits. Alongside continued slow growth in per-enrollee spending, today’s release corroborates earlier data showing that aggregate health care spending growth increased in 2014, largely because millions of people gaining coverage under the Affordable Care Act began to access care. Faster aggregate spending growth due to expanding coverage is neither a surprise, nor a cause for concern, and will fade as coverage stabilizes at its new, higher level over the coming years. Looking ahead, other data show that slow growth in per-enrollee spending has continued during 2015, alongside further progress in expanding health insurance coverage. But extending this progress into 2016 and beyond will require making full use of the tools provided by the Affordable Care Act to continue building a health care system that provides broad access to efficient, high-quality care.

FIVE KEY POINTS ON TODAY’S NATIONAL HEALTH EXPENDITURE DATA

*1. Per-enrollee health care spending growth remained low in both the public and private sectors during 2014. *Both private insurance and Medicare saw continued slow growth in real per-enrollee spending during 2014*. Although modestly faster than the average rate from 2010 to 2013, the growth rates recorded in 2014 were less than one-third those seen over the preceding decade and below the growth rate of per capita GDP. Prior to 2010, lower annual growth in real per-enrollee spending had been recorded only once for private insurance and just twice for Medicare since these data series began in 1988. Per-enrollee spending trends are a particularly important measure of health care costs trends because the premiums and cost sharing amounts faced by individuals and families depend directly on the per-enrollee cost of care. *
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*2. Growth in per-enrollee spending for services other than drugs was roughly in line with recent experience in 2014, while drug spending accelerated sharply.* For health care services other than drugs, per-enrollee spending growth in 2014 was generally similar to the 2010-2013 period, with growth picking up modestly in Medicare and slowly modestly in private insurance. By contrast, growth in per-enrollee drug spending was sharply higher in both private insurance and Medicare, with real per-enrollee drug spending growth rising into the high single digits in private insurance and reaching double digits in Medicare. Available data indicate that the main factor driving faster drug spending has been the arrival of costly, though often effective, new therapies. While drug spending growth may not persist at its recent rapid pace in the years ahead, trends in this area have raised concerns about access and affordability in both the public and private sectors. 

*3. Aggregate health care spending growth increased in 2014, driven by a historic expansion of insurance coverage. *Today’s release shows that aggregate health care spending grew 3.6 percent in 2014, faster than the historically slow growth over the last few years. The fact that per-enrollee spending growth increased only modestly in 2014 implies that the main driver of this pickup in aggregate spending growth was the historic expansion in insurance coverage under the Affordable Care Act, which increased utilization of health care services by the newly insured. 

Indeed, a pair of recent analyses have estimated that coverage gains due to the Affordable Care Act added at least 1.4 percentage points to growth in aggregate health care spending during 2014. That implies that real aggregate national health expenditures would have grown just 2.2 percent in 2014 absent the coverage expansion, only slightly above the 1.6 percent average annual rate seen from 2010 to 2013. Had real aggregate national health expenditures grown at this rate in 2014, then 2014 growth would have been the fourth lowest on record, after only 2011, 2012, and 2013. 

As we have noted previously, it is neither a surprise, nor a cause for concern to see aggregate health care spending temporarily grow more quickly while coverage is transitioning to its new, higher level. One important goal of expanding coverage is to improve access to care for the newly insured, and faster aggregate spending growth is an important indication that access to care is, in fact, improving. In addition, as noted above, what matters for people who had coverage before is growth in per-enrollee spending, which remains quite low, not growth in aggregate spending.

*4. Out-of-pocket spending reached a historic low as a share of total health care spending in 2014, likely thanks at least in part to expanding coverage. *The share of national health expenditures financed by individuals’ out-of-pocket payments fell to 10.9 percent in 2014, the smallest share since these data began in 1960. The expansion in insurance coverage during 2014 likely played an important role in this decline since the newly insured were previously paying out of pocket for all of their care, but now only pay out of pocket for the portion of their care not covered by their health insurance. 

As also shown in the graph, the share of health care spending borne by consumers in the form of out-of-pocket costs has been falling steadily in recent years. One implication of this fact is that focusing on the steady rise in deductibles in employer coverage since the early 2000s—which suggests that out-of-pocket costs have grown faster than health care spending as a whole—paints a misleading picture of the overall trend in out-of-pocket cost burdens. This is likely the case for a variety of reasons. Even within employer coverage, the trend in deductibles does not appear to be representative of the overall trend in cost sharing, which also depends on other aspects of plan design; for example, the share of individuals with an annual out-of-pocket limit above which no cost-sharing applies has risen sharply in recent years. Focusing solely on employer coverage also misses trends in other types of coverage (or shifts in the composition of coverage), which may also have affected the economy-wide trend in the out-of-pocket share in recent years.

*5. Other data show that per-enrollee health care spending growth has remained low well into 2015. *Data from the Bureau of Labor Statistics’ Employment Cost Index show that employers’ hourly health benefit costs are up just 3.0 percent over the four quarters ending in 2015:Q3, only slightly higher than the 2.6 percent growth recorded over the preceding four quarters. In Medicare, CEA analysis of preliminary data from the Monthly and Daily Treasury Statements implies that nominal Medicare spending per beneficiary in the first ten months of 2015 was roughly 1 percent higher than in the corresponding ten months of 2014, below the 2.4 percent growth rate recorded for 2014. It therefore appears likely that 2015, like 2014, will be another year that pairs slow growth in per-enrollee costs with rapid gains in insurance coverage.  

Jason Furman is the Chairman of the White House Council of Economic Advisers. Matt Fiedler is Chief Economist for the White House Council of Economic Advisers. 

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*Medicaid spending per enrollee, which is not shown, fell in 2014. However, this decline was driven in part by an influx of younger, healthier enrollees as States expanded their Medicaid programs under the Affordable Care Act. It is therefore likely not a reliable guide to underlying cost trends. By contrast, trends in per-enrollee spending in private insurance and Medicare were likely little affected by the coverage expansion. Reported by The White House 5 hours ago.

New York Physical Therapy Association Pushes for Fair Co-Pays

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Stop high co-payments. Meet Assemblyman Tedisco

Scotia, NY (PRWEB) December 03, 2015

MEDIA ADVISORY:

Who:
The New York Physical Therapy Association

What:
Stop high co-payments. Meet Assemblyman Tedisco

When:
Friday, December 4, 2015 at 11:00 AM

Where:
The Scotia Office of Physical Therapy Associates of Schenectady
42 Saratoga Road, Scotia, NY 12302

The New York Physical Therapy Association (NYPTA) is working to end the unfair practice of outrageous “specialty” co-pays, which can cost patients thousands of additional dollars and result in foregone treatment.

NYPTA is asking members of the State Legislature to support A.1063A sponsored by Assemblyman Cahill and the Senate same as bill, S.28A sponsored by Senator DeFrancisco. The bills provide that no health care policy shall impose co-payments in excess of twenty percent of total reimbursement to the provider of care.

Currently, co-pay fees are not limited and equal the amount reimbursed to the physical therapist. For example, some co-pays are as much as $50 per visit for physical therapy treatments that require up to 12 or more sessions per month. The additional co-pays for this patient would be $600 per month. Meanwhile the PT reimbursement might only be $50 per visit, meaning the patient is paying 100% of the per visit costs. The insurer has placed the entire burden of cost on the patient.

“The imposition by managed care companies of ever increasing physical therapy copays is one of the most pressing issues facing the profession at this time.” Said Michael Mattia, PT, DPT, MS, MHA, President, NYPTA, “Health plans continue to progressively defund physical therapy as a covered benefit and shift the cost onto consumers by imposing high specialty copayments for physical therapy visits. The end result is that our patients are shouldering the overwhelming cost of their physical therapy care as they or their employer continues to experience significant increases in health insurance premiums.”

The end result is the consumer is paying more for their coverage and being burdened with higher out of pocket costs when requiring a mandated health care service, which may, and in fact in many cases does result in patients opting not to participate in vital restorative physical therapy care.

For more information: http://faircopays-betterresults.com/

About NYPTA: The New York Physical Therapy Association is a professional, non-profit association of approximately 6500 Physical Therapists (PTs), Physical Therapist Assistants (PTAs) and PT/PTA students. The NYPTA is dedicated to serving the public's health interests, improving the standard of health for people of all ages and advancing the benefits of physical therapy and the interests of physical therapy professionals in state of New York. To learn more about the New York Physical Therapy Association please visit http://www.nypta.org. Reported by PRWeb 21 hours ago.

IRS Mandate Penalizes Small Business For Healthcare Reimbursement Accounts

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New IRS mandate penalizes small businesses for healthcare reimbursement accounts with fees of up-to $36,500 per employee per year.

Los Angeles, CA (PRWEB) December 03, 2015

With minimal fanfare or public outcry, the IRS instituted new changes to the tax code earlier this year that could have a devastating effect on people who are employed by small businesses.

According to IRS Notice 2013-54, companies will be penalized for setting up health reimbursement accounts (HRAs). These accounts allow workers to use pretax money to pay for the cost of their health insurance. Under the new mandate, fines for this type of set up could amount to as much as $100 per day per employee, or $36,500 per employee per year.

Many businesses are not big enough, nor do they have the financial wherewithal to have human resources departments or purchase group health insurance for their employees. Instead they open and fund HRAs for their workers. Now that this practice has become financially challenging, employers concerned about the well-being of their staff will need to pursue other options. Under Notice 2015-17, the IRS is providing transition relief from the excise tax, however this only applies to certain types of employer healthcare arrangements.

Group health insurance, which is purchased by the employer and provides lower premiums than individual policies, has long seemed financially out of reach for many micro-businesses with tight budgets. However, Business Insurance Quotes is changing the way entrepreneurs and their workers view group health insurance.

The majority of working Americans and their families still receive group health insurance as a benefit. With group plans, employers generally pay 50% or more of the health care costs of their workers and their dependents. Some businesses also provide employees with Premium Only Plans (known as POP Plans) that enable them to pay their health care premiums on a pretax basis.

Now that the IRS is taxing HRAs, more entrepreneurs are looking for alternative affordable health insurance options. That’s where Business Insurance Quotes can help. They offer a fast, three-step process for anyone looking for the best and most affordable group health insurance available. Entrepreneurs fill out a short questionnaire with some basic information. Employers then have the opportunity to compare rates from multiple health insurance carriers all in one place. This is a much faster and more efficient option for finding the best plans for any small business owner.

Business Insurance Quotes is happy to assist anyone looking for more information about all types of group health insurance. They can be reached via their website or by telephone. Reported by PRWeb 18 hours ago.

Flex Adds Harken Health to General Agency Portfolio

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ROSEMONT, Ill., Dec. 3, 2015 /PRNewswire/ -- Flexible Benefit Service Corporation (Flex) is excited to announce the addition of Harken Health to our General Agency portfolio for individual health insurance in Illinois. As an independently operated subsidiary of the UnitedHealth... Reported by PR Newswire 17 hours ago.

UMD Study Shows that Affordable Care Act has Reduced Racial/ethnic Health Disparities

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The ACA has significantly improved insurance coverage and use of health care for African Americans and Latinos, according to a new study led by researchers in the University of Maryland School of Public Health.

(PRWEB) December 03, 2015

The Affordable Care Act (ACA) has significantly improved insurance coverage and use of health care for African Americans and Latinos, according to a new study led by researchers in the University of Maryland School of Public Health.

“Since the ACA took effect in 2014, the rates of uninsured African Americans and Latinos were reduced by 7%, as compared to 3% for whites,” explains Dr. Jie Chen, assistant professor in the Department of Health Services Administration at Maryland. “We also found that these groups were more likely to visit a primary care doctor and receive timely health care than before the ACA coverage began.”

In the new report, published in the journal Medical Care, researchers analyzed data from the 2011-2014 National Health Interview Survey, which asked questions about health care access and utilization among various groups of US adults (18-64 years of age), including non-Latino whites, Latinos, African Americans and other racial and ethnic groups. The data suggest that the Affordable Care Act is playing an important role in reducing racial and ethnic health disparities. While all groups benefitted from the health insurance options made available under the ACA, racial and ethnic minorities have historically encountered greater disparities in coverage and access, and therefore have seen greater gains since the ACA went into effect.

African Americans have likely improved more on these measures under the ACA compared with whites because they are more likely to gain insurance coverage through the Health Insurance Marketplace and Medicaid expansion that has occurred under the ACA. Dr. Chen explains the relatively smaller declines in uninsured rates among Latinos by the fact that recent Latino immigrants are more likely to live in states that are not participating in the Medicaid expansion, as well as inadequate outreach to the Latino community regarding ACA eligibility, subsidies and enrollment.

“While Latinos made smaller gains than African Americans in rates of insured, those who were eligible for health coverage were significantly less likely to delay or forgo health care, which is an important factor in improving health outcomes,” says Dr. Chen.

The study findings suggest that the ACA has the potential to continue the trend of reducing disparities in access to health care and health care utilization. Future research could examine changes in health care quality and health outcomes related to the Affordable Care Act to further explore its potential in reducing and eliminating racial and ethnic health disparities.

Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act was written by Jie Chen, PhD, Arturo Vargas-Bustamante, PhD, Karoline Mortensen, PhD, and Alexander N. Ortega, PhD and published in the journal Medical Care. Reported by PRWeb 16 hours ago.

Most Popular Pet Names of the Year Revealed

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"Bella" and "Max" Top Nationwide's Dog and Cat Lists

Brea, California (PRWEB) December 03, 2015

For the first time this decade, “Bella” and “Max” were the most popular pet names in America for both dogs and cats, according to Nationwide, the nation’s first and largest provider of pet health insurance. This year also featured a shift in popularity for pet birds with owners choosing the name “Charlie” more than any other. To determine the most popular pet names of 2015, Nationwide searched through its database of more than 550,000 insured pets. Following are the top 10 most common monikers for dogs, cats and birds:

Dogs
1. Bella
2. Max
3. Bailey
4. Lucy
5. Charlie
6. Molly
7. Daisy
8. Buddy
9. Maggie
10. Sophie

Cats
1. Bella
2. Max
3. Oliver
4. Chloe
5. Lucy
6. Lily
7. Charlie
8. Sophie
9. Tiger
10. Shadow

Birds
1. Charlie
2. Kiwi
3. Baby
4. Coco
5. Mango
6. Buddy
7. Sammy
8. Sunny
9. Ruby
10. Cosmo

Although the top 10 dog and cat names remained similar to last year, there was an emergence of new trends when comparing the names of pets born in 2015 with pets born a decade ago. In dogs, the name “Cooper” is more than three times more common among millennial puppies, and the name “Sadie” doubled in popularity. The canine moniker with the biggest decrease in popularity was “Buddy,” which dropped nearly 20 spots among newborn puppies. For cats, the name “Bella” was only the fifth most common name among kittens. The name “Leo” showed the largest growth and is nearly ten times more common among millennial kittens.

“’Bella’ has been the most popular name since the release of the Twilight franchise 10 years ago, but that title may be coming to an end,” said Curtis Steinhoff, Director of Pet Insurance Communications for Nationwide. “Our data shows that the next generation of pet owners is using different methods and references to determine their favorite moniker for their furry family members. The most popular pet names may begin to shift over the next few years.”

Despite these monikers being the most popular, many pet lovers choose less conventional names for their companions such as “Baron Von Furry Pants” and “Leonardo DiCATprio.” To view some of the more creative monikers selected for Nationwide’s Top 10 Most Unusual Pet Names of 2015, visit wackypetnames.com.

About pet insurance from Nationwide
With more than 550,000 insured pets, Nationwide is the first and largest pet health insurance provider in the United States. Since 1982, Nationwide has helped provide pet owners with peace of mind and is committed to being the trusted choice of America’s pet lovers.

Nationwide plans cover dogs, cats, birds and exotic pets for multiple medical problems and conditions related to accidents, illnesses and injuries. Medical plans are available in all 50 states and the District of Columbia. Additionally, one in three Fortune 500 companies offers pet insurance from Nationwide as an employee benefit.

Insurance plans are offered and administered by Veterinary Pet Insurance Company in California and DVM Insurance Agency in all other states. Underwritten by Veterinary Pet Insurance Company (CA), Brea, CA, an A.M. Best A rated company (2013); National Casualty Company (all other states), Madison, WI, an A.M. Best A+ rated company (2014). Nationwide, the Nationwide N and Eagle, and Nationwide Is On Your Side are service marks of Nationwide Mutual Insurance Company. ©2015 Nationwide. Pet owners can find Nationwide pet insurance on Facebook or follow on Twitter. For more information about Nationwide pet insurance, call 800-USA-PETS (800-872-7387) or visit petinsurance.com. Reported by PRWeb 16 hours ago.

My struggle to get health insurance was more irritating than my full-body rash

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A few weeks ago, with very little warning, my skin burst into a mysterious full-body rash. Also, I quit my job.

My two new conditions — persistent, inexplicable hives and unemployment — did not seem to be related, but they fit together like a hand in glove. What better time to suffer from a mysterious... Reported by L.A. Times 15 hours ago.

Anthem Chief Strategy Officer, Martin Silverstein, M.D., Joins Other Health Industry Leaders at Forbes Healthcare Summit 2015 to Discuss How Consumers Will Change Health Insurance

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Anthem Chief Strategy Officer, Martin Silverstein, M.D., Joins Other Health Industry Leaders at Forbes Healthcare Summit 2015 to Discuss How Consumers Will Change Health Insurance INDIANAPOLIS--(BUSINESS WIRE)--Anthem announces Martin Silverstein, chief strategy officer, will participate in a panel discussion focusing on How Consumers Will Change Health Insurance at the prestigious Forbes Healthcare Summit. Reported by Business Wire 15 hours ago.

Affordable Care Act: Tax penalty for not having health insurance will be higher this year

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Americans who don't sign up for health insurance under the Affordable Care Act this year will have to pay much larger penalties on their 2016 tax returns than during the ACA’s first two enrollment periods. Reported by Christian Science Monitor 14 hours ago.

GOP's New Plan To Repeal Obamacare Is Missing One Obvious Thing

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Senate Republicans would like Americans to believe they’ve come up with a kindlier, gentler way to repeal the Affordable Care Act. They haven’t.

On Wednesday, GOP leaders unveiled and began debating a bill that would eliminate key elements of President Barack Obama’s signature domestic policy achievement -- and wipe out the coverage expansion that has produced a historic decline in the number of uninsured Americans. The bill, which would also defund Planned Parenthood, is moving through the “budget reconciliation” process. That means it is not subject to filibuster and can pass with just 51 votes. As of this writing, the plan is to vote on the bill Thursday, so that the House has time to consider and approve it before adjourning late next week.

For House Republicans, of course, repealing Obamacare is a familiar exercise. They’ve voted to do so more than 50 times since early 2011, when the GOP first wrested control of the chamber away from then-Speaker Nancy Pelosi and the Democrats. But if Senate leaders can hold their caucus together, this will be a first for the Senate -- and that’s important, even though Obama has already said he’d veto the proposal.

While the health care law hasn’t figured prominently in the presidential campaign so far, it’s still on the minds of conservatives -- and still atop the Republican agenda. If the repeal passes the Senate and then the House, it will be a clear signal that Republicans have the votes to make it happen, should one of their own win next year’s presidential election.

Precisely because this is the first time the full Senate is taking up repeal, it’s also the first time Senate Republicans are confronting the trade-offs that such a change would entail. And that includes the political consequences. Hating on Obamacare is a fine talking point, at least in conservative parts of the country. It’s also a great way to raise money from supporters. But millions of people are now getting health insurance through the program, and that includes millions of people in states with Republican senators. (The Huffington Post’s Jeffrey Young recently calculated that 3 million of these people are on Medicaid alone.)

Quite a few of these Republican senators are up for re-election this year. Republicans from ultra-conservative states like Alabama or Utah may not sweat the political repercussions of cutting off Obamacare insurance. But Rob Portman faces a tough re-election fight in Ohio, a state that voted for Obama twice and in which hundreds of thousands of people are getting insurance through the program. Mark Kirk in Illinois, Kelly Ayotte in New Hampshire and several other Republicans face similar situations.GOP leaders have told members not to worry, on the theory that Obama’s inevitable veto makes this something of a consequence-free vote. But, as Politico has reported, Democrats are already planning ads to attack Republicans for voting to take away health insurance. That may help explain a major wrinkle in the Senate’s bill. Instead of cutting off insurance right away, as House repeal measures would have done, the Senate bill would allow key parts of the program’s coverage expansion to remain in place for two years to remain in place for two years. 

Here’s how it’d work, based on initial analysis of the legislation, which didn’t become public until Wednesday evening: For 24 months after enactment, the federal government would continue to finance the law’s expansion of Medicaid, making the government-run insurance program available to all people with incomes below or just above the poverty line, at least in the 30 states (plus the District of Columbia) that have chosen to participate in the program.

During this time, the Affordable Care Act’s insurance exchanges would also remain open for business. People unable get insurance through employers or other government programs could keep buying comprehensive coverage, no matter what their pre-existing conditions, and many would be eligible for the generous tax credits that discount premiums by as much as thousands of dollars a year.

Sen. Shelley Moore Capito (R-W.Va.), who had previously expressed misgivings about yanking insurance from her constituents, explained the logic of the extension. “It’s a two-year transitional period to move to a replacement vehicle so we can come up with a better plan,” she told The Hill. She summed up the feelings of her caucus by saying, “We feel pretty good.”

But there are lots of reasons to question the GOP’s commitment to making sure its constituents can hold onto insurance. One is that the Senate bill would appear to make some changes immediately -- among them, zeroing out the penalties that go with individual mandate. Without those penalties in place, premiums would likely rise, to the point of causing real problems in the exchanges. Another reason is that Republicans have been promising to rally around an alternative scheme pretty much since the Affordable Care Act became law. They haven’t done so yet -- and it’s no great mystery why.
Health care policy can seem complicated but, stripped to the essentials, it’s pretty simple. People who are sick need medical care. That medical care costs money, more than most individuals can pay at any one time. Universal coverage schemes, including Medicare, solve this problem by spreading the financial burden widely -- in effect, transferring money from rich to poor and from healthy to sick. Insurance plans that large corporations offer employees work on similar principles. The Affordable Care Act is an effort to create a similar scheme for the rest of the population.

Conservatives say this is “redistribution.” They are correct. The redistribution from rich to poor is why taxes on the very wealthy went up, and Medicare started paying parts of the health care industry less, when the Affordable Care Act became law. The redistribution from healthy to sick is why some people, mostly young and healthy people whose old coverage didn’t cover as many benefits, must pay more for insurance than they did before the law took effect.

Conservatives boast that repealing the Affordable Care Act would undo these changes -- so that young and healthy people could have access to cheap health insurance again, insurers would be free to sell skimpier policies, and taxes would come back down. Conservative are correct about this, too. 

But these changes would have repercussions. If the young and healthy pay less, then the old and sick will have to pay more -- a fact the young and healthy will learn eventually, once they are the ones who are old and sick. Loosen or eliminate requirements on insurance benefits and the people who need coverage for mental illness, or rehabilitative services, or having a baby may have a hard time finding coverage. Reduce or take away subsidies for the poor and middle class and far fewer will be able to pay for comprehensive coverage.

This is why the reform proposals that circulating among conservatives and Republicans would almost certainly result in some combination of significantly fewer people insured and significantly less protection for people who have insurance.

Republicans haven’t closed ranks behind one of these proposals, perhaps because doing so would mean acknowledging and defending the results. But voting for a repeal bill with no replacement would mean voting to take health insurance away from tens of millions of people, all in one fell swoop. Matt Bevin, the newly elected Republican governor of Kentucky, has already discovered how tricky this could be. As a candidate, he frequently vowed to roll back the state’s Medicaid expansion. But lately he has suggested he’d settle for merely modifying the program, because taking insurance away from so many of his constituents would be so traumatic.

The two-year extension in the Senate bill represents another way of trying to deal with this problem. It’s an attempt to disguise the true impact of repeal. Whether Republicans get away with it depends, in no small part, on whether the voters see through the ruse -- and remember it when they vote in November.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 14 hours ago.

ISMETT Ranks Among Best in Italy for Patient Outcomes, Credits Strong UPMC Partnership

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ISMETT was recently ranked among the top hospitals in Italy based on 30-day morality rates after certain surgeries.

Pittsburgh, Pa. (PRWEB) December 03, 2015

ISMETT, a leading Italian transplant hospital managed by UPMC, was recently ranked among the top hospitals in the country based on 30-day mortality rates following cardiac, thoracic and abdominal surgeries.

The rankings, published in the 2015 edition of the Programma Nazionale Esiti organized by Agenas, the Italian national agency for regional health care services, shows Palermo-based ISMETT as the leader among all regional, public hospitals based on its 2014 results and among the top performers nationally for both public and private hospitals.

Specifically, ISMETT had a 30-day mortality rate of 0 percent after lung, liver and colon cancer surgery, compared with the national averages of 1.3 percent, 2.65 percent and 4.07 percent respectively. ISMETT’s 30-day mortality rate after a heart valve replacement was 0.93 percent vs. the national average of 2.84 percent.

“Thanks to the close collaboration of the doctors, nurses, technicians and other staff working at ISMETT, our patient outcomes are among the very best in the nation and the world,” said Bruno Gridelli, M.D., chief executive officer of ISMETT. “The connection between us and our colleagues at UPMC in Pittsburgh, a leading academic medical center, is a powerful tool for our continuous improvement and ensures that our medical knowledge and competencies remain at the highest levels.”

Added Charles Bogosta, president of UPMC International, “ISMETT’s stellar results show what can be achieved when forward-thinking health care leaders worldwide partner with UPMC to re-think the way that patient care is delivered close to home.” UPMC provides hands-on health care consulting and management services in more than a dozen countries.

The Agenas hospital assessment program, started in 2010, examines efficacy, safety, efficiency and quality of clinical services using 146 indicators, as reported by Italian hospitals. Surgical mortality indicators were added to the report this year.

Formally known as the Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, ISMETT has performed more than 1,600 transplants since it began operations in 1999 and tens of thousands of high specialty procedures, including cardiothoracic and cancer surgeries. An example of innovative and efficient clinical management, ISMETT is a public-private partnership between UPMC and the Region of Sicily, through ARNAS Civico hospital in Palermo. ISMETT is the only hospital in Italy designed and intended exclusively for solid organ transplantation and highly specialized therapies. It treats more than 30,000 patients a year with severe organ disease and was recently accredited for the third time by Joint Commission International (JCI), the organization that certifies the safety and quality of care provided to patients in hospitals around the world.

# # #

About UPMC
A world-renowned health care provider and insurer, Pittsburgh-based UPMC is inventing new models of accountable, cost-effective, patient-centered care. The largest nongovernmental employer in Pennsylvania, UPMC integrates more than 60,000 employees, more than 20 hospitals, more than 500 doctors’ offices and outpatient sites, a more than 2.7-million-member health insurance division, and international and commercial operations. Affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC ranks No. 13 in the prestigious U.S. News & World Report annual Honor Roll of America’s Best Hospitals. For more information, go to UPMC.com.

http://www.upmc.com/media Reported by PRWeb 13 hours ago.

Anthem, Cigna Shareholders Approve Merger As Antitrust Hurdles Await

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Shareholders of Anthem (ANTM) and Cigna (CI) approved by overwhelming margins the merger of the two health plans into the nation’s largest health insurance company. Reported by Forbes.com 12 hours ago.

Antitrust Hurdles Await Anthem, Cigna After Shareholders Approve Merger

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Shareholders of Anthem (ANTM) and Cigna (CI) approved by overwhelming margins the merger of the two health plans into the nation’s largest health insurance company. Anthem’s $54 billion purchase of Cigna still needs approval of federal regulators. Groups representing medical care providers like the American Medical Association and the American Hospital [...] Reported by Forbes.com 12 hours ago.

AmeriHealth Advantage plans provide new options for individuals and businesses in Monmouth and Ocean Counties

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AmeriHealth Advantage plans provide new options for individuals and businesses in Monmouth and Ocean Counties CRANBURY, N.J.--(BUSINESS WIRE)--Residents and businesses in Monmouth and Ocean counties have another choice when shopping for health insurance this year. AmeriHealth New Jersey today announced that its AmeriHealth Advantage plans are available for purchase both on and off the Individual and SHOP Marketplaces during the current Open Enrollment Period. Earlier this year, AmeriHealth New Jersey collaborated with Meridian Health to offer the AmeriHealth Advantage plan to self-funded businesses in Reported by Business Wire 13 hours ago.

The Continued Degradation of Health Insurance Under the ACA

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Even if insured how much can we depend on private health insurance any more? The bottom line--less and less as it continues to degrade after almost six years under the Affordable Care Act (ACA). Its coverage continues to degrade even as its costs become increasingly unaffordable.

Supporters of the ACA tell us that things will work out if we just give it more time, but these inconvenient facts argue otherwise: · The most popular silver plan on the exchanges, with an actuarial value of 70 percent, leaves at least 30 percent of health care costs on the patient, though low-income individuals receive subsidies that have proven to be inadequate. · Regardless of plan, insurers have many ways to shift more costs on the patient, including restricted drug formularies, benefit designs that limit access, denial of services, not covering out-of-network care, and narrow definitions of medical necessity, especially for mental health care. · Premiums are increasing for 2016, averaging 7.5 percent for individual silver benchmark plans, with other examples far higher, such as a 35 percent hike by Blue Cross Blue Shield plans in Raleigh, North Carolina (1); nearly one-half of adults who have visited the ACA's marketplace plans have found their premiums difficult to afford. (2)· The lower the premiums, the higher the annual deductibles, which have become prohibitively unaffordable for many, such as more than5,000 for individuals and more than10,000 for families with bronze plans which have the lowest premiums and 60 percent actuarial value. (3)· Restricted choice through continued narrowing of network plans; for example, almost one-third of physician networks in silver plans in 2014 covered only 10 to 25 percent of physicians in a plan's region. (4)· Lack of price controls under the ACA throughout the system, as indicated in my most recent blog on Big PhRMA, and the ACA's ban on the government's negotiating drug prices. · Continued decline of coverage by employer-sponsored health insurance (ESI); typical American families of four with a PPO plan will pay more than25,000 for health care in 2016 (5), obviously impossible for so many, since the median annual income for American households in 2015 is about53,800.· Despite having insurance, two of five adults with deductibles amounting to 5 percent or more of their annual incomes are not going to the doctor when they get sick, avoid a preventive care test, skip a recommended follow-up test, or get needed specialist care. (6)· According to Pew Research, 55 percent of American households are savings-limited, able only to replace less than one month of their income through liquid savings. (7)· Despite the ACA, our safety net through Medicaid is in tatters, including the 20 states that opted out of Medicaid expansion and others with very restricted eligibility and coverage policies.
 These facts compel us to recognize the inevitable--the industry continues on a death march despite the many ways that the government has subsidized it. Jacob Hacker, Ph.D., professor of political science at Yale University and author of The Great Risk Shift: The Assault on American Jobs, Families Health Care and Retirement, and How You Can Fight Back, saw this coming ten years ago: 

American health insurance is experiencing a steady erosion--a death march--as Americans find it increasingly difficult to afford the ever-rising tab for health insurance and medical services. The epicenter of this transformation is the crumbling of America's employment-based system of health financing, which arose in the mid-twentieth century as a distinctive response to the challenge of health insecurity in the United States. As health care costs have exploded in an increasingly competitive business environment, this old, odd bargain has come undone--and the Great Risk Shift has relentlessly played out. (8)

The private health insurance industry already recognizes this, and is complaining that profits are insufficient to assure its staying in the ACA's marketplace. Stephen Hemsley, CEO of UnitedHealth Group, the nation's largest insurer by revenue, recently announced that it expects to lose $500 million on ObamaCare plans in 2016, and that it may have to exit the individual market in 2017 since "we can't subsidize a marketplace that doesn't appear at the moment to be sustaining itself." (9) (Hemsley's total compensation in 2014 was $66.1 million, more than $254,000 per day). (10) Wayne Deveydt, CFO of Anthem Inc, the nation's largest insurer by membership when it completes its merger with Cigna, has decided to sacrifice market share to keep its plans profitable, acknowledging that "When you have fewer national enrollees and you have price points that we don't believe are sustainable, we've just made a conscious decision we're not going to chase it [market share]." (11) Adding to this point, a current Goldman Sachs analysis of state filings for 30 not-for-profit Blue Cross and Blue Shield insurers projects that they will post aggregate losses for 2015. (12)

We need to recognize that private health insurance has become obsolete. It has only been sustained by subsidies and other industry-friendly provisions of the ACA. Further bailouts will just prolong its death march and worsen the situation for patients, families, and taxpayers. Because of prices and costs of health care continuing out of control, including its enormous costs of bureaucracy and waste, and with no containment on the horizon, it is now beyond the reach of ordinary Americans as well as government payers. The ACA has failed to contain health care costs, make them more affordable, or to assure ongoing adequate access to health care. My soon to-be-released new book, The Human Face of ObamaCare: Promises vs. Reality and What Comes Next, documents all of these points in detail, including more than 50 patient stories that best illustrate these ongoing trends, not reversed under the ACA, while describing the fix--publicly financed national health insurance (NHI), coupled with a more accountable private delivery system. (13) 

Despite persuasive evidence that the private insurance industry has outlived its usefulness and despite solid public support for NHI, including a majority of U. S. physicians, nursing groups and many health care organizations, the political landscape is still a major barrier to NHI. The GOP remains intent on repealing the ACA, replacing it with a non-plan that includes health savings accounts, selling insurance across state lines, and other free market ideas that have already failed. Of the Democratic presidential candidates, only Bernie Sanders recognizes NHI as a workable and affordable solution, while Hillary Clinton continues to think that NHI will cost too much (14) (either unaware of the classic 2013 study by Gerald Friedman, professor of economics at the University of Massachusetts, that showed that we would save some $592 billion a year with NHI while 95 percent of Americans would pay less than they do now for health insurance and get far more (15), or distorting the issue by claiming increased taxes). 
It is clear that deregulated health care markets and the ACA have failed the common good. But there is so much economic and political power in the corporate medical-industrial complex that the obvious solution is still being kept off the table. Can our supposed democracy meet this challenge? 

*References:
*1. Radovski, L, Overberg, P, Armour, S. Price rise challenges appeal of health law. Wall Street Journal, November 19, 2015: A1.3. Collins, SR, Gunja, M, Rasmussen, M et al. Are marketplace plans affordable? Commonwealth Fund, 2015.5. Goodnough, A, Pear, R. Unable to meet the deductible. New York Times, October 17, 2014.7. Andrews, M. Study finds almost half of health law plans offer very limited physician networks. Kaiser Health News, June 26, 2015.9. Milliman. 2015 Milliman Medical Index. May 2015.11. How High Is America's Health Care Cost Burden? Findings from the Commonwealth Fund Health Care Affordability Tracking Survey, July-August 2015. The Commonwealth Fund, November 20, 2015.13. Pew Charitable Trusts. The precarious state of family balance sheets. January 29, 2015.15. Hacker, JS. The Great Risk Shift: The Assault on American Jobs, Families Health Care and Retirement, and How You Can Fight Back, New York. Oxford University Press, 2006, p. 143.17. Mathews, AW, Armour, S. Biggest insurer threatens to abandon health law. Wall Street Journal, November 20, 2015.19. SEC 14A Schedules, Bureau of Labor Statistics, Current Population Survey, 2014.21. Deveydt, W, as quoted by Tracer, Z. Obamacare premiums climb, but insurers struggle for profit. Bloomberg Business, October 30, 2015.23. Ibid # 9.25. Geyman, JP. The Human Face of ObamaCare: Promises vs. Reality and What Comes Next. Friday Harbor, WA. Copernicus Healthcare, 2016 (soon to be released).27. Meckler, L. Clinton and Sanders escalate sniping. Wall Street Journal. November 19, 2015. 29. Friedman, G. Funding H. R. 676: The Expanded and Improved Medicare for All Act. How We Can Afford a National Single-Payer Health Plan. Physicians for a National Health Program. Chicago, IL, July 31, 2013.
Adapted and excerpted, in part, from my soon-to-be released book, The Human Face of ObamaCare: Promises vs. Reality and What Comes Next.
(See advance press release at:  www.johngeymanmd.org)

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 11 hours ago.
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