S&S Benefits.....Opinion,
Hearsay & News Review
We have been harping on the
subject of the false savings estimates
given by insurance carriers to compete against each other and other PPOs. In the
meantime, we have found an excellent paper which discusses in detail the tricks
used by various companies to inflate their savings estimates. The paper has been
posted to our website under the Truth tab at http://ssbenefits.net/Med%20Cost%20WhitePaper.pdf
(White Paper-The Truth About PPO Discount Comparisons). It is very
worthwhile reading, especially for those who wonder how the Milliman Blues
discounts are calculated.
Latest trend survey result
from Aon: HMO-10.8%, PPO-10.9%, POS-10.5%, CDH-10.3%- all slightly less when
combined with Rx (except CDH). Dental is at 7% and DHMO at 4.2%. Stand alone Rx
is 9.2% and Specialty Pharmacy trend is 12.2%.
The Presidential candidates
have been chosen and now the Vice Presidential candidates are too. We can be
sure that health costs will be widely debated by those who understand little
about the costs. It should be annoying. Some new figures- While native born
Americans comprise 34.1M of the uninsured, the uninsured immigrant population
has increased from 6.9M to 12.3M people from 1994 until 2006. The 80% increase
compared to a 15% increase in the same time period for native born Americans
(4.4M people).
Researchers from the
University
of
Minnesota
have discovered that 26 brand name drugs have had price increases ranging from
100% to 1000% recently. Many are older products that treat fairly rare, but
serious and possibly life-threatening illnesses. Express Scripts said that
prices rose on average by 7.4% for 1,344 brand name drugs in the last year.
Research covering nearly
75,000 companies shows that there is about a 60% non-compliance
rate on 5500 form filing. Non-compliance fees could be as much as $1,100 per
day. With the DOL stepping up random audits, it is important for employers to
maintain compliance.
CareFirst in
Maryland
is among the Blues Plans facing renewed scrutiny for holding generous surpluses
in view of their non-profit status. Other states recently battling with the
Blues over similar issues are
Michigan
,
Washington
,
New Jersey
and
Pennsylvania
.
BCBS of IL will in 2010 no
longer administer claims to 445,000 employees of Wal-Mart. They are losing the
business to Blue Cross of Arkansas and now will be part of the Blue Card program
for the
Arkansas
program which will reduce the number of members covered by their networks by
about 245,000.
Spencer’s reports that the
Dept. of Health and Human Services says that medical errors cost employers
nearly $1.5 billion dollars per year. The study also found that one in ten
patients who died within 90 days of surgery did so because of a preventable
error. The study was based on 161,000 patients age 18 to 64 covered by employer
sponsored health plans.
Illinois
has passed a law saying that young adults can stay on their parent’s health
insurance until age 26, and if they are in the military they can be covered
until age 30. The law is set to take place on January 1st. The law is
expected to receive legal challenges due not only to the expansion of coverage,
but also due to the way the law was passed.
People uninsured for any part
of 2008 are expected to spend about $30B out of pocket and receive approximately
$56B in uncompensated care while uninsured. If all uninsured people were fully
covered, their medical spending would be expected to increase by $122.6 Billion
according to a recent study published in Health Affairs. The government pays
about 75%, or $42.9 billion of the amount that uninsured patients can’t pay.
A study by ComPsych reveals
that more than half of people in their 60s have healthy diets compared to 17.7%
of employees in their 30s. Employees in their 50s and 60s also compared
favorably to those in their 30s in the areas of exercise, positive outlooks and
stress.
