Healthcare plans

Almost everyone in Massachusetts has health insurance under a state mandate, but many doctors do not accept the subsidized insurance programs available to low-income residents, a new study shows.

Large health insurers expect an increase in deals in the industry after last year's U.S. healthcare overhaul made it tougher for smaller companies to compete.

U.S. hospitals that improve medical care for elderly patients and reduce deadly errors will get millions of dollars under an incentive program launched on Friday that aims to cut overall Medicare costs.

A corporate health care exchange run by Aon Hewitt is “open and ready for business,” according to Ken Sperling, global health & benefits practice leader for the human resource consulting firm. Aon Hewitt Announced last week that it is launching the exchange for employer groups of 1,000 or more full-time employees beginning as early as January 2012. While the infrastructure — based on Aon Hewitt’s existing retiree benefit exchange model with 2.4 million participants — is built, the timing depends on securing a viable number of both employer and insurance company participants.

Many of us remember when employers provided an opt-out credit to employees who did not enroll in their medical coverage. Over time, as health care costs continued to rise, the opt-out credit was the first to go in most organizations. Then some employers, in an effort to control costs, began to replace the opt-out credit with a spousal surcharge. But is the opt-out credit poised for a return?

There is a dramatic difference in how employers tackle health cost trends. Some are doing "everything possible to control costs and improve workers' health, while others have not been willing or able to do it as aggressively," Helen Darling, president and CEO of the National Business Group on Health told attendees at the Health Benefits 9-1-1: Heightened Urgency to Control Cost and Improve Health conference.

A sluggish economy hasn't slowed the nation's health care consumerism movement, according to a recent analysis by the Employee Benefit Research Institute.

You may remember the two extremes depicted in the 2008 presidential election regarding health care. We heard health care proclaimed as an inalienable "right" of sorts. Politicians would ask their constituents polarizing questions like, "Is health care a right for all Americans?" or, "Is it a privilege to which only the wealthy minority are entitled?," as if these two extremes were the only positions that a health care stakeholder (consumer, provider or carrier) might have on such a complex topic.

Amid the nationwide noise of budget debates and court battles over the constitutionality of health care reform, Vermont has gone largely unnoticed as its legislature uses the Patient Protection and Affordable Care Act's state exchange requirement to set the stage for an eventual switch to a single-payer health care system. Bob Gaydos, president of the Benefits Group of New England, spoke with EBA about his efforts to slow down the fast-paced bill that, as of press time, had already passed in the House and was a week or two away from passing in the Senate. "There's no doubt it'll pass at this point," says Gaydos. "You've got to applaud the governor on a well-played political hand."

It's like taking gourmet cooking lessons, but continuing to eat at drive-throughs. It's like buying a highly praised book and leaving it on the shelf. In a similar fashion, your clients' wellness programs might not reach their potential if they are unable to engage employees and change behavior.

The New Year began with a wince for many employers around the country as they saw their health insurance premium costs increase once again, some by double-digit percentages. The recession, medical cost inflation, and uncertainty over health care reform dealt a punishing blow to employer-sponsored health care programs, forcing the majority of organizations to pass some of the cost increases on to their employees. Still, despite the trying times, some employers were able to hold their rates steady.

Last September, Carter Express, a logistic, freight and transport firm based in Anderson, Ind., accomplished something that every self-insured employer wants to do. It saved 23% on an employee's surgery for prostate cancer. Plus, not only did the company spend nearly $12,000 less, but the employee was happy with his surgical experience.

Built-up demand for health savings accounts helped to account for a solid 2010 for J.P. Morgan’s HSA business, according to David Josephs, managing director with the company.

Have HR and benefit professionals who work for midsize employers lost their hunger for cafeteria plans in austere times? It seems that the answer depends on semantics and plan design nuances.

Helping employers get more bang for their health care buck is the focus of a new online tool from the Center for Health Value Innovation.

The Leapfrog Group, an employer coalition advocating increased health care quality and safety, joined many other organizations in applauding the Obama administration's new $1 billion Partnership for Patients safety program.

Employers nationwide - big and small, retail and high-tech - are watching and waiting keenly to see whether the public state exchanges created under health care reform will succeed when they open for business in 2014. Small employers and those with low-paid or part-time employees are especially interested in finding out whether funneling their employees into, or finding coverage for them through, an exchange would be beneficial.

Having spent about 30 years in health care benefits consulting, health plan management and health services delivery, I've witnessed many products, services, strategies and platforms introduced to the employer market, climb to the top of the solutions menu and eventually fade away as more effective alternatives emerge. One very popular solution today is the onsite health clinic.

Some employers are investing more time and resources to find out whether workers are tobacco-free and in the process are rewarding those who pass muster with lower health premiums or financial rewards.

It’s no surprise that unhealthy employees cost employers big bucks. But a new workforce wellness index shows that the unhealthy behaviors of the U.S. workforce cost employers an average of $670 per employee annually.