Millions of people could qualify for federal subsidies that will pay the entire monthly cost of some health care plans being offered in the online marketplaces set up under President Obama's health care law, a surprising figure that has not garnered much attention, in part because the zero-premium plans come with serious trade-offs. Three independent estimates by Wall Street analysts and a consulting firm say up to seven million people could qualify for the plans, but federal officials and insurers are reluctant to push them too hard because they are concerned about encouraging people to sign up for something that might ultimately not fit their needs.
In Washington, most of the 290,000 people covered by insurance plans they purchased on the individual market received letters this fall telling them that their plans are going away. That's because under the Affordable Care Act, insurance plans must meet new requirements, including limits on how much money patients spend in out-of-pocket medical expenses, and they must cover 10 so-called essential benefits such as preventive care, prescription drugs and maternity care. So all 90,181 people with insurance coverage from Regence BlueShield have learned their plans will be canceled, as did all 60,000 people covered by Group Health Cooperative.
Open-enrollment packets have reminded local employees in recent weeks that the U.S. health-care system is the most-expensive in the world. Employee-benefits consultant Aon Hewitt is forecasting a 6.9?percent increase in overall annual premium costs in the Columbus area next year, with the average total premium cost per local employee reaching $10,777. That includes both the employer's and employee's share. It's the largest local increase in seven years, up from the 3.9 percent increase this year and 4.9?percent increase last year, according to the annual survey.
A sedated woman lay in an Emory University Hospital intensive care bed, surrounded by machines and monitors — including a ventilator, feeding tube and six intravenous solution pumps. Each machine poured out data on treatment and vital signs. It was a lot to keep track of — perhaps too much. Nurses and doctors caring for multiple patients struggle to keep up with every beep and alarm, let alone stop and think about how all the readings may add up. "If you were to ask me, 'What's been going on with this patient for the last minute? The last five minutes? The last 30 minutes?' I couldn't tell you. There's so much data going by," said Dr. Tim Buchman, director of the Emory Center for Critical Care.
Consumers shopping for coverage on the new health insurance exchanges have been focused on the lowest-cost options. But some shoppers are trying to determine which plans offer the widest array of doctors and hospitals — and are finding that can be trickier than it sounds. John Batteiger applied for insurance coverage on the New York state exchange. But after he'd selected a plan, he had second thoughts: He'd forgotten to check if the plan he picked included a hospital near him. Batteiger is 54 and healthy. But all things being equal, he figures, why not make sure his neighborhood hospitals are considered "in-network" with his insurance plans?
With health care companies scrambling to keep costs in check, data is more important than ever. And Charlotte-based Premier Inc. plays a key role in providing health systems with information that leads to better care and outcomes with lower expenses, president and CEO Susan DeVore says. The solutions company shares clinical and operational data and strategies culled from its membership, which includes 2,900 community hospitals, and nearly 100,000 providers, from nursing facilities to pharmacies. Now, Premier's reach can potentially grow broader because of the company's initial public offering last month.