The Continuing Saga of Long Term Care

My masters thesis was on solving how long-term care is financed in this country. All these years later the financing issue is still unresolved. One option, LTC insurance, is only held by 10% of seniors. Medicaid still funds the majority of LTC costs. This column from Kaiser Health News is a good summary of the issue:.

http://www.kaiserhealthnews.org/Columns/2010/December/122310pollack.aspx

Docs in MA Looking to Improve Patient Experience

In Massachusetts, where patient experience survey results are publicly reported, the majority of physician groups have undertaken initiatives to improve office visits for their patients, such as changing office workflow, training staff, and investing in electronic health records, according to a new Commonwealth Fund–supported study published online by the Journal of General Internal Medicine. There has been less focus, however, on efforts to enhance clinicians' interpersonal skills, which play a central role in patients' care experiences.

Isn't it amazing how things that are publicly reported actually are paid attention to by those who are effected by the results?

Why No Outrage Over Deaths Caused by Medical Errors?

Mistakes that occur in a hospital setting are the real death panels out there. Yet these unnecessary deaths garner little attention:

Just before Thanksgiving, the Times did place on the front page a New England Journal of Medicine study concluding that the death rate from medical injury had not declined since 1999. Worth noting was were the vague explanations by health care leaders as to why progress has been so slow. Additionally, the story did not even mention the HHS report, which was based on a seemingly better methodology and more recent data. Perhaps the medical editors don't read the business pages.

Completely ignored by all was a careful study released in August by the Society of Actuaries that used claims data from private insurers. Even in this younger and presumably healthier population, errors in 2008 caused more than 2,500 avoidable deaths -- not to mention more than "10 million lost days of work." (I presume this figure refers to the effect of injured workers, not dead ones.)

Looks Like 10% or More is the Definition of "Unreasonable"

From Kaiser Health News:

Health insurers seeking a rate increase of 10 percent or more in 2011 must publicly detail why the increase is needed, under proposed rules released by the Obama administration Tuesday.

In following years, the Department of Health and Human Services will adjust the specific percentage threshold for each individual state. Thresholds would vary partly because medical costs vary by state.

The proposed rules, which would affect insurance policies sold to individuals and small businesses but not large employers, result from the new health care law. Administration officials repeatedly criticized insurers for raising rates excessively during and after the long debate leading up to passage of the law in March.

http://www.kaiserhealthnews.org/Stories/2010/December/21/ratesdec21.aspx

McKinnsey Model Results on Impact of Individual Mandate

This is surprising:

McKinsey and Co., an international consulting company, estimates the number of people residually uninsured will be as high as 40 million in 2016. Dr. Robert Kocher, director of the firm's Center for U.S. Health System Reform and a former special assistant to President Barack Obama on health care, recently spoke with Kaiser Health News' Amita Parashar about the center's estimates and who might not get insured as the health law takes effect.

Massachusetts though also implemented a mandate and saw its uninsured rate drop to around 3 percent. What Lessons can be learned from the Bay State?

Massachusetts did a nice job on public education. By having the Boston Red Sox help publicize, by using a lot of different channels, they've reached much of the population that perhaps has less awareness about health care insurance and also did a great job of getting young people in. Overall they had a relatively better risk pool and better pricing than you get if they weren't as effective in that area. The plans on the exchange are also well-represented and easy to "shop" for – enrollment is quite fast and easy. I enrolled in a plan on the exchange as an experiment and was impressed at how easy and effective it was to make a choice. It narrowed the choices based on your ZIP code and various factors you put in, which made shopping simple.

Uninsured Number Almost 60 Million

According to the National Health Interview Survey as of March 2010 over 59M people did not have HI the previous 12 months. This works out to 19% of the population.

Regulators Aim to Make Comparing Policies Easier

I have personally seen how many people do not have a clue when it comes to understanding their health insurance benefits. So for regulators to develop a template that insurers will have to follow to make it easier to compare policies is a great idea:

http://www.kaiserhealthnews.org/Stories/2010/December/15/State-Insurance-Officials-Vote-Rules-Health-Policies.aspx