With just a couple Health Wonk Review publication dates between now and the election, we decided to jump into this with both feet. Which is decidedly different from anything we’re hearing from the Presidential candidates, and pretty much everyone running for elective office.
Not that a little silence wouldn’t be welcome right about now, especially in those hotly-contested toss-up states (we’re talking about FL OH PA NC AZ NV…)
First up is a fact-filled briefing on why insurers are leaving the Exchanges from the keyboard of Louise Norris. Louise notes that, despite losses in the individual market/Exchanges, insurers are doing fine. That’s because only 6 percent of Americans get their insurance via individual plans in 2014.
InsureBlog’s got a view on the Exchanges, courtesy of Mike Feehan. Mike opines: “The collapse of most Obamacare exchanges has captured the attention of the media in recent months” While I’d encourage Mike to not get his shovel ready just yet, in his view private exchanges may – emphasize may – work, but it’s too early to tell.
(HWR Hero Hank Stern is participating in the Strides Against Breast Cancer event next week; you can help him out here.)
healthinsurance.org is wondering if the GOP would get behind a Medicare expansion that focused on Medicare Advantage plans offered by commercial insurers, these plans are favorites of the Republican establishment.
All you need to know on “Clinton & Trump on workplace issues“, a service provided by the talented and ever-entertaining Julie Ferguson. Parental leave? Health reform? Drug pricing? Zika? It’s all there!
Brad Wright offers a trenchant piece on the actual results of ACA to date; Brad notes that most of the folks who gained coverage got it via Medicaid, with significant increases even in non-Medicaid expansion states. About a third of the growth in coverage came from private insurance bought on the Exchanges. Not only did Brad report on the data, he got additional insights from one of the study’s principal authors…
Peggy Salvatore is peering into the future of health insurance, and what she sees is pretty darn intriguing. Peggy’s review of the “demonetization” of health insurance and potential use of real-time data capture and analysis by “health insurers” makes for compelling reading. Lest you think it too far-fetched, a decade ago you couldn’t read this on your phone…
A BIG issue this election has been pharma costs, with the EpiPen the proverbial poster child. David Williams thinks that there’s been a bit too much grandstanding and hyperbole here; check out his perspective at Health Business Blog here.
Acronym soup! My contribution is a primer on physician reimbursement changes from CMS. MACRA. MIPS, APM, RBRVS, SGR, along with a discussion of implications for workers’ comp is ready for viewing.
Our good friends at Health Affairs provide welcome insight into maternity care, and why less is more; less care = better outcomes for moms and babies. That being the case, why is “more” so common? Some thoughts on that, too.
Meanwhile on the hospital front, things aren’t as rosy – unless rosy describes the color of the ink on the financial reports.
http://blogs.hospitalmedicine.org/Blog/assumptions-about-your-hospital-remaining-in-the-black-are-wrong-and-you-better-listen-to-who-is-saying-so/
Insight into how private equity’s involvement can end up in a heads-they-win, tails-you-lose result comes from Roy Poses MD. The most persistent and insightful “investigative blogger” I know, Roy’s decade-long focus on the often ugly intersection of capitalism and health care makes for disturbingly necessary reading. Today he takes on Cerberus’ involvement with Steward Health. His reporting will NOT make you feel good about our “system”.
There’s a new blog in the blog-o-sphere; GoodNewsWorkComp is up and running, It’s the place for industry folk to meet, greet, and share their stories. Read Ronnie’s Story for a perspective you won’t get from the “work comp is evil” set.
Meanwhile, Jaan Sidorov is pondering why Apple and insurance companies are working to put Apple watches on members’ wrists. Hint – it’s kinda-sorta big brother, but there’s a win in it for you!
Thanks for reading this far, clicking thru, and sharing with friends, family, and frenemies.
To Dr Poses…Other examples of private equity investment at the expense of both patient care and the pension funds underwriting the investments in post acute care deserve your investigative attention. Nursing homes are almost never a happy story and the addition of private equity in the past ten years has added nothing to the care of some of the most vulnerable and the treatment of staff.