Save the date for Safety Net Clinic Week 2014! SNCW 2014 will be celebrated August 18th through the 22nd. It is a week dedicated to raising awareness of all the various types of clinics with a commitment to serving patients who might otherwise have difficulty getting medical care.
Why is it important to celebrate Safety Net Clinic Week? Because while safety net clinics have some similarities, they also look very different from one another, and it is important to know where, why and how healthcare is currently being delivered. When it comes time for the federal, state, or even local government to make decisions regarding provider reimbursements, tobacco tax funds, Medicare or Medicaid payments, public coverage program eligibility, electronic health records (EHR) incentives, or other important policy choices, the people making those decisions need to understand how they affect safety net clinics like yours.
Therefore, the Colorado Rural Health Center and ClinicNET encourage you to celebrate Safety Net Clinic Week August 18th through the 22nd. Look for more information from CRHC and ClinicNET soon!
Wednesday, May 14, 2014
What Will Happen As Networks Continue to Narrow?
In the midst of all the turmoil in healthcare these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.
These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans. While the sizes of the networks vary considerably, many plans now exclude at least some large hospitals or doctors’ groups. Smaller networks are also becoming more common in healthcare coverage offered by employers and in private Medicare Advantage plans.
Insurers, ranging from national behemoths like WellPoint, UnitedHealth and Aetna to much smaller local carriers, are fully embracing the idea, saying narrower networks are essential to controlling costs and managing care. Major players contend they can avoid the uproar that crippled a similar push in the 1990s. Read the article in the New York Times here.
These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans. While the sizes of the networks vary considerably, many plans now exclude at least some large hospitals or doctors’ groups. Smaller networks are also becoming more common in healthcare coverage offered by employers and in private Medicare Advantage plans.
Insurers, ranging from national behemoths like WellPoint, UnitedHealth and Aetna to much smaller local carriers, are fully embracing the idea, saying narrower networks are essential to controlling costs and managing care. Major players contend they can avoid the uproar that crippled a similar push in the 1990s. Read the article in the New York Times here.
Division of Insurance to Seek Shift on Geographic Rating Areas for 2015
Press Release from Colorado Division of Insurance (May 9, 2014)
###
The Colorado Division of Insurance regulates the insurance industry and assists consumers and other stakeholders with insurance issues. DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado.
The Colorado Division of Insurance (DOI) today announced it will ask the federal government for approval to change Colorado’s geographic rating areas for health insurance for 2015.
Geographic rating areas are geographical units made up of metropolitan statistical areas (MSAs), counties or three-digit zip codes, which are used by insurance carriers to price premiums.
The DOI seeks to reduce the number of rating areas from 11 to nine, combining four rural areas into two larger rating areas, while retaining the seven urban (or metropolitan statistical areas, or MSAs). Such a change will require approval from the U.S. Department of Health and Human Services.
“Consolidating the higher health cost regions into larger rating areas will spread the risks and the costs of providing health care more equitably over a larger population,” said Marguerite Salazar, Commissioner of Insurance. “We understand that people across the state are concerned about high health care costs and the impact on health insurance premiums. This is the fairest way of addressing the issue and working toward stable premiums in all regions of the state.”
Geographic rating areas are geographical units made up of metropolitan statistical areas (MSAs), counties or three-digit zip codes, which are used by insurance carriers to price premiums.
The DOI seeks to reduce the number of rating areas from 11 to nine, combining four rural areas into two larger rating areas, while retaining the seven urban (or metropolitan statistical areas, or MSAs). Such a change will require approval from the U.S. Department of Health and Human Services.
“Consolidating the higher health cost regions into larger rating areas will spread the risks and the costs of providing health care more equitably over a larger population,” said Marguerite Salazar, Commissioner of Insurance. “We understand that people across the state are concerned about high health care costs and the impact on health insurance premiums. This is the fairest way of addressing the issue and working toward stable premiums in all regions of the state.”
The announcement comes after a meeting last week of the Health Care Cost Study Group. At that meeting, the DOI put forth three options for rating areas following presentation of an actuarial analysis commissioned by the DOI for the study group. The DOI invited comments through Wednesday, May 7.
The DOI received 306 comments of which 138 addressed the rating area options. Of those, 117 were supportive of the nine rating areas structure.
As part of this change, on Friday, May 9, DOI will formally request approval from the Department of Health and Human Services to change Colorado’s rating area structure. Due to this change, the DOI also will extend its deadline for insurance carriers to provide plans and rates for 2015 from May 15 to June 6, providing time for insurance carriers to adjust to the new areas.
###
The Colorado Division of Insurance regulates the insurance industry and assists consumers and other stakeholders with insurance issues. DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado.
Survey Says - Healthcare Executives Don't Trust Payers
A survey designed to measure the level of trust that hospital executives have in health insurance companies finds several factors that contribute to low scores, including the length of time it takes for claims to be paid, and the rates hospitals and physicians are paid.
Payers scored poorly on all three of the new trust questions in the annual National Payor Surveyconducted by ReviveHealth, a Nashville, TN based strategic communications firm and Catalyst Healthcare Research. The results from the final question, which asked providers whether a particular payer "balances its interests with ours and doesn't routinely take advantage of us," were particularly dire. Read the article in HealthLeaders Media here.
New Telemedicine Policy Draws Opposition
New guidelines issued by the Federation of State Medical Boards (FSMB) could have a chilling effect on the growth of telemedicine – especially in rural areas and among low-income patients, say some patient advocates, healthcare providers and healthcare companies. But the Federation says the updated guidance will safeguard patients’ privacy and ensure high-quality care in the current fast-changing healthcare delivery environment.
As part of a wide-reaching April 26 policy statement, FSMB changed the definition of telemedicine to care that “typically involves the application of secure videoconferencing… to provide or support healthcare delivery by replicating the interaction of a traditional encounter in person between provider and a patient.” It is not, according to the Federation, “an audio-only, telephone conversation, e-mail/instant messaging conversation or fax.”
The statement, which is not a legal document but is intended to help state medical boards’ develop professional policies and standards for their members, triggered a backlash from some stakeholders. Read the rest of the article in Kaiser Health News here.
Wednesday, May 7, 2014
Telemedicine Still Facing Barriers In Most States
With more than 7 million people signing up for coverage under federal healthcare reform and millions more gaining coverage under Medicaid Expansion, providers now need to reach more rural patients than ever before. But providers and payers in many states are still struggling with outdated laws and other obstacles in their effort to reach patients in remote areas.
But experts say those barriers to care are slowly disappearing as more states pass laws to allow Medicaid to reimburse providers. That effort is also being helped by pilot programs launched by providers and insurers in an effort to improve care and generate savings by allowing rural residents to address health problems before they get worse. Read the article in Health Leaders Media.
But experts say those barriers to care are slowly disappearing as more states pass laws to allow Medicaid to reimburse providers. That effort is also being helped by pilot programs launched by providers and insurers in an effort to improve care and generate savings by allowing rural residents to address health problems before they get worse. Read the article in Health Leaders Media.
Insurance Extension Decision Could Impact Many Coloradans
Insurance Commissioner Marguerite Salazar announced Friday that state residents who extended plans that do not meet minimum benefits required under federal healthcare reform before the end of last year may extend them again through the end of 2015 if their insurers continue to sell the plans.
It is unknown how many of the roughly 100,000 people currently covered by such plans in Colorado will have the opportunity to re-up and will choose to do so. But the people in such plans are viewed by many health analysts to be healthier than those who recently have purchased insurance for the first time. And keeping them out of the larger risk pool could cause prices for insurance policies to rise across the board.
Read more about how the extension decision could impact Coloradans in the Denver Business Journal or read about a national study on the impact of the canceled plans in Politico.
It is unknown how many of the roughly 100,000 people currently covered by such plans in Colorado will have the opportunity to re-up and will choose to do so. But the people in such plans are viewed by many health analysts to be healthier than those who recently have purchased insurance for the first time. And keeping them out of the larger risk pool could cause prices for insurance policies to rise across the board.
Read more about how the extension decision could impact Coloradans in the Denver Business Journal or read about a national study on the impact of the canceled plans in Politico.
Is Rate Relief Coming to Colorado's Ski Towns?
Last Friday, Colorado Insurance Commissioner Marguerite Salazar said she wants to redraw the geographic rating boundaries which previously lumped together Garfield, Pitkin, Eagle and Summit Counties and created the most expensive insurance market in the U.S. Commissioner Salazar announced that by redrawing the boundaries, those counties will now be part of a 22 county region.
Read more about the change in boundaries in Kaiser Health News or in Health News Colorado.
Study Says When Hospitals Buy Physician Practices, Costs Go Up
A new study gives ammunition to what health economists and health insurers have argued for years: When hospitals buy physician practices, the result is usually higher hospital prices and increased spending by privately insured patients.
The study, published Monday in the journal Health Affairs, was based on an analysis of 2.1 million hospital claims from workers of self-insured employers between 2001 and 2007. The analysis by Stanford University researchers found prices were most likely to increase when hospitals bought physician practices, as opposed to hospitals forming looser contractual relationships with physicians.
The study, published Monday in the journal Health Affairs, was based on an analysis of 2.1 million hospital claims from workers of self-insured employers between 2001 and 2007. The analysis by Stanford University researchers found prices were most likely to increase when hospitals bought physician practices, as opposed to hospitals forming looser contractual relationships with physicians.
Read the article in Kaiser Health News.
Subscribe to:
Posts (Atom)