By Jordan Rau
Despite the government’s push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices, according to a poll released Tuesday.
Prices for the health care industry have historically been concealed and convoluted, unlike those for most other businesses. The 2010 health law aimed to make such information more transparent.
Only one in five people say they had seen specific cost or quality information about a hospital, insurer or doctor.
The federal government also publishes more than 100 quality ratings about hospitals, as do some large private insurers.
Private groups such as Consumer Reports and U.S. News & World Report also rate providers, and Internet forums such as Yelp are now littered with easily accessible opinions.
The poll from the Kaiser Family Foundation found that about two of three people say it is still difficult to know how much specific doctors or hospitals charge for medical treatments or procedures. (KHN is an independent program of the foundation.)
Only about one in five people said they had seen specific cost or quality information about a hospital, insurer or doctor.
The poll found that this information rarely makes a difference. About 6 percent of people ever used quality information in making a decision regarding an insurer, hospital or doctor. And fewer than 9 percent used information about prices, most commonly in relation to health plans. Only 3 percent said they used price information about physicians, the poll found. Continue reading
With Medicare and Medicaid turning 50 this year, the Kaiser Family Foundation produced an updated video that provides a brief history of both programs, including an examination of the health care, social and political landscapes that gave rise to them, the significant ways each program has evolved over five decades and the important roles they play in the U.S. health care system today.
The video includes archival footage, as well as commentary and perspective from policymakers, government officials and experts.
To learn more about Medicare go to the Kaiser Family Foundation Medicare webpage.
Fifty-one percent of U.S. adults say that while the Affordable Care Act may still require small changes, “we should see how it works,” according to a new Bloomberg Politics poll.
Twelve percent said President Barack Obama’s signature legislative accomplishment should be left alone, 35 percent said it should be repealed, and two percent said they weren’t sure.
By Michelle AndrewS
Business groups praised a proposed new rule from the Equal Employment Opportunity Commission clarifying how employers can construct wellness programs, but consumers advocates said the new policy could harm workers.
The EEOC published the long-awaited rule Thursday.
“This is a big step forward, primarily because the EEOC has defined what it means for a wellness program to be voluntary,” says Steve Wojcik, vice president for public policy at the National Business Group on Health, which represents large employers.
The Americans With Disabilities Act prohibits employers from discriminating against workers based on their health. But they can ask workers for details about their health and conduct medical exams as part of a voluntary wellness program.
Before this proposal was unveiled, employers and consumer advocates alike had been uncertain how the commission defined voluntary. Continue reading
By Michael Ollove
Fifteen states are betting they can convince more doctors to accept the growing number of patients covered by Medicaid with a simple incentive: more money.
The Affordable Care Act gave states federal dollars to raise Medicaid reimbursement rates for primary care services—but only temporarily. The federal spigot ran dry on Jan. 1.
Fearing that lowering the rates would exacerbate the shortage of primary care doctors willing to accept patients on Medicaid, the 15 states are dipping into their own coffers to continue to pay the doctors more.
It seems to be working. Continue reading
The Tax Deadline and Your Coverage
April 15 is the deadline to file your taxes. There is only 1 day left!
If you owe a fee on your taxes for not having health coverage in 2014 and don’t yet have health coverage for 2015, you may still be able to get covered for 2015. The Health Insurance Marketplace is providing individuals and families who need to pay the fee when they file their 2014 taxes with one last chance to get covered for 2015.
This is too important to put off. If you don’t have coverage for the remainder of 2015 you’ll risk having to pay the fee again next year. The fee for people who don’t have coverage increases in 2015 to $325 per person or 2% of your household income – whichever is greater.
We hope you take advantage of this extended opportunity to get quality coverage this year.
The HealthCare.gov Team
If you’re uninsured, you may have questions about possible penalties for not having coverage. The fine may be bigger than you expect. Here are the details:
Is everyone required to have health insurance or pay a fine?
Most people who can afford to buy health insurance but don’t do so will face a penalty, sometimes called a “shared responsibility payment.”
The requirement to have health insurance, which began in 2014, applies to adults and children alike, but there are exceptions for certain groups of people and those who are experiencing financial hardship.
What kind of insurance satisfies the requirement to have coverage?
Most plans that provide comprehensive coverage count as “minimum essential coverage.” That includes job-based insurance and plans purchased on the individual market, either on or off the exchange.
Most Medicaid plans and Medicare Part A, which covers hospital benefits, count as well, as do most types of Tricare military coverage and some Veterans Affairs coverage. Continue reading
Underlining a change across the nation, nearly 9 out of 10 adults now say they have health insurance, according to an extensive survey released Monday.As recently as 2013, slightly more than 8 out of 10 had coverage.
By Lisa Gillespie
As consumers increasingly are being asked to pay a larger share of their health bills, a coalition of insurers, pharmaceutical companies, and provider and consumer advocacy groups launched Thursday a new push for greater transparency regarding the actual costs of services.
The group includes AARP, Novo Nordisk, the National Consumers League, the Ambulatory Surgery Center Association, the National Council for Behavioral Health and Aetna.
Transparency means all consumers have the information they need to estimate cost and quality of health services.
The initiative, “Clear Choices,” will add to private and government efforts already underway to get more such information to patients, including Medicare’s Physician Compare, and the Health Care Cost Institute’s ‘Guroo,’ which culls data from private insurers to provide average prices regionally.
The group’s first priority is advancing the Medicare doctor payment legislationp ending in the Senate because it includes a provision requiring Medicare to release for broader use a substantial amount of data on claims at the provider level.
The group’s other objectives include:
- Improving quality measures for doctors and hospitals so that patients will be armed with more comparative information.
- Requiring hospitals to be clearer regarding what may or may not be included in their cost estimates for care.
- Creating better tools for consumers to make medical decisions based on price, quality and safety of medical services.
By Jenny Gold
A federal law that passed in 2008 was supposed to ensure that when patients had insurance benefits for mental health and addiction treatment, the coverage was on par with what they received for medical and surgical care.
But until now, the government had only spelled out how the law applied to commercial plans.
That changed Monday, when federal officials released a long-awaited rule proposing how the parity law should also protect low-income Americans insured through the government’s Medicaid managed care and the Children’s Health Insurance Program (CHIP) plans. The proposed regulation is similar to one released in November 2013 for private insurers.
“Whether private insurance, Medicaid, or CHIP, all Americans deserve access to quality mental health services and substance use disorder services,” said Vikki Wachino, acting director at the Center for Medicaid and CHIP Services.
Medicaid and CHIP programs are funded jointly by the federal and state governments.
Even if the state has carved out some benefits under a separate behavioral health plan, patients would be protected under the rule. Medicare patients are generally not affected by the regulation, nor are those in Medicaid fee-for-service plans .
But the rule does affect the majority of the 70 million people on Medicaid who are in managed care plans, and the 8 million children covered by CHIP plans.
Insurers, advocates and the general public will have a chance to comment on the proposed rule. The government will then release a final version.
Photo courtesy of Sanja Gjenero
By Michael Ollove
More than a half-million adults who said they wanted help with their serious mental conditions last year couldn’t get it because they lacked the resources and weren’t eligible for Medicaid to pay for treatment, a new study finds.
Those people — an estimated 568,886 adults ages 18 through 64 diagnosed with a serious mental illness, serious psychological stress or substance use disorder at the start of last year — lived in 24 states that didn’t expand Medicaid eligibility under the Affordable Care Act in 2014, according to a study published this week from the American Mental Health Counselors Association (AMHCA).
More than a half-million adults who said they wanted help with their serious mental conditions last year couldn’t get it.
The upshot, said Joel Miller, AMHCA’s executive director, is “the health of hundreds of thousands of people would be improved” if all states provided Medicaid coverage as they were given the option to under the Affordable Care Act (ACA).
Photo: Willi Heidelbach
By Jenny Gold
By law, many U.S. insurance providers that offer mental health care are required to cover it just as they would cancer or diabetes treatment.
But advocates say achieving this mental health parity can be a challenge.
Jenny Gold of Kaiser Health News spoke with NPR’s Arun Rath over the weekend about the issue.
Rath noted that many patients have trouble getting their mental health care covered, and she outlined some of the issues confronting both patients and the insurance industry. Here is an edited transcript of her comments.
Where does parity stand?
It’s been a mixed bag so far. Insurance companies often used to have a separate deductible or a higher copay for mental health and substance abuse visits. Right now, that usually isn’t the case. In that way, insurers really have complied. Continue reading
From Kaiser Health news:
Are you still getting your taxes done ahead of the April 15 deadline? Don’t forget that your 2014 tax bill could be affected by your health insurance.
The federal health law requires that most people have health coverage. If you were insured through work, bought a plan on the new insurance marketplaces or enrolled in Medicare Part A, Medicaid or Tricare you likely met the requirement and can simply check that box off on your tax form.
If you didn’t have coverage or had it for only part of the year, you need to fill out Form 8965. That lets you claim an exemption or calculate your penalty. That penalty is $95 or 1 percent of your family’s income, whichever is greater. Continue reading