Viewing entries tagged with 'Admin'
FACT CHECK: What is Driving Premium Increases
Posted by The Campaign on June 22, 2010 at 11:19 AM
Fact Check: What Is Driving Premium Increases
“Insurance is still going to be expensive because healthcare is expensive.”
-- Gary Claxton, VP, Kaiser Family Foundation
(Reuters, 06/21/2010)
Underlying Medical Costs Drive Premium Increases
· Federal government data confirms that rising health care costs are driven by increased spending on hospital care, physician services, and prescription drugs. The government data[i] show:
o “Hospital spending growth is projected to have accelerated from 4.5 percent in 2008 to 5.9 percent in 2009, as spending reached $760.6 billion.”
o “Spending growth for physician and clinical services is expected to have accelerated to 6.3 percent in 2009, up from 5.0 percent in 2008, with expenditures having reached $527.6 billion.”
o “Prescription drug spending is expected to have grown 5.2 percent in 2009, an acceleration of 2.0 percentage points from 2008, and to have reached $246.3 billion.”
· Between 2000-2008, the growth in premiums tracked directly with the growth in benefits.
|
|
2000 |
2008 |
2000-2008 Growth |
|
PHI* Premiums |
454,784 |
783,157 |
72% |
|
PHI* Benefits |
402,802 |
691,179 |
72% |
Source: http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf
(see table 12)
Note: PHI = Private Health Insurance as defined by CMS
http://www.cms.hhs.gov/NationalHealthExpendData/downloads/quickref.pdf
*****
Health Plan Administrative Costs are Not the Cause of Premium Increases
· Health plan administrative costs increased at a slower rate than spending on prescription drugs, physicians and clinical services, hospitals, and total national health expenditures from 2000-2009.
· In 2009, the percentage of premiums that went towards administrative costs and profits declined for the sixth year in a row.
· The average yearly increase in health plan administrative costs from 2000-2009 was lower than the increase in spending on hospitals, physicians and clinical services, prescription drugs, and total national health expenditures.
Health Plan Profits Average Between 3-5 percent
“Insurance company profits in the large picture have very little to do with the overall rising cost of health care.”
-- Henry Aaron, Brookings Institution
(ABC News, 11/10/09)
· According to Yahoo! Finance’s latest analysis of quarterly financial data, the net profit margin for the entire health care sector is 15.48%. Using the same index, health plans have a 4.7% net profit margin.
o This ranks the health insurance plan industry 12th out of the 16 industries that make up Yahoo! Finance’s health care sector.
· Analyzing 13 health insurance plan companies on the Fortune 500 list, the profit margin for these 13 companies averaged 3.19 percent for 2009 -- for 2008 it was 2.3 percent for these same 13 companies.
o Six of the 13 companies actually saw a decline in their profit margin - averaging a decline of 48.7% in profit margin from 2008 to 2009.
· What experts say about health insurance plan profits:
o According to Kaiser Health News, “With the nation’s health care spending estimated at $2.5 trillion this year, even the elimination of insurers’ profits and executive compensation would lower health care spending by just 0.5 percent.”
o According to Ezra Klein of The Washington Post “The insurance industry is not a particularly profitable industry…That’s not to pretend that 3.3 percent is nothing, but it’s hard to see how that’s a primary driver of health-care spending, much less the growth in health-care spending.”
o Alwyn Cassil, Center for Studying Health System Change: “‘…this idea that (taking) this $12 billion that they have in profits … would fix our health-care spending problems is just a pipe dream.’”
For a printable version click here.
[i] Truffer, et al, Health Affairs, “Health Spending Projections Through 2019: The Recession’s Impact Continues”, Published online February 4, 2010.)
BREAKING NEWS: White House Releases Outline of New Health Care Reform Proposal
Posted by The Campaign on February 22, 2010 at 6:05 AM
This morning the White House released its health care reform proposal.
Click here to read the outline of the proposal.
BREAKING NEWS: Health plans collaborate to streamline health insurance paperwork in New Jersey
Posted by The Campaign on February 11, 2010 at 4:50 AM
The New York Times today reports on the announcement by health plans in New Jersey to launch a pilot program to “offer doctors and hospitals the ability to use a single Web portal to check a patient’s coverage and track claims”. A few excerpts are below:
• “As part of the discussion last year over how best to overhaul the nation’s health care system, the insurance industry promised to do its part by tackling the burdensome paperwork involved in paying medical claims. Despite the health care legislation’s impasse in Congress, the insurers say they still plan to make good on their promise.”
• “The effort is aimed at one of the most vexing problems in the nation’s insurance system: hospitals and doctors spend enormous amounts of time and money trying to determine whether a patient has coverage or why a claim was denied. Tens of billions of dollars each year are said to be wasted because of such administrative inefficiency.”
• “’The pilots are a great example of the industry’s commitment to voluntarily make progress eliminating the administrative hassles that physicians face,’ said Ronald Williams, the chief executive of Aetna.”
• “The promise to produce significant savings through streamlining paperwork was made as part of the industry’s discussions in June with the White House. But the pilot project effort has taken place parallel to the general discussions over the health care legislation, said Karen Ignagni, the president of America’s Health Insurance Plans. The move by the insurers to develop standards and systems to make it easier for doctors to determine a patient’s coverage and get paid will continue regardless of the status of any federal legislation, she said.”
• “’We wanted to make sure we were taking a leap,’ said Ms. Ignagni, who said the two state projects were a way for the insurers to test different Web systems and see what technology worked best for the hospitals and doctors before eventually beginning other efforts.”
For the full article, click here.
FACT CHECK: PricewaterhouseCoopers' Study on Benefits and Administrative Costs
Posted by The Campaign on November 02, 2009 at 6:11 PM
According to the U.S. Government, Underlying Medical Costs and Premiums Track Directly Together
According to government data, health insurance premiums track directly with the underlying cost of medical care. As the cost of providing medical care increases, premiums rise accordingly. Some employers and families have chosen plans with lower premiums and higher cost-sharing (deductibles, co-pays, and coinsurance) to offset the increase in premiums.
Source: PricewaterhouseCoopers, A Shared Responsibility: Advancing Toward a More Accessible, Safe, and Affordable Health Care System for America, p.7
PwC Report Is Entirely In Line With Government Data
- In 2008, PwC released "The Factors Fueling Rising Health Care Costs 2008" which analyzed 2007 National Health Expenditure (NHE) data. The findings of this report relative to administrative costs and medical benefits paid are entirely consistent with the NHE data.
- PwC reported "About 87 percent of the costs of health insurance are benefits paid out. Administrative costs and profits account for the other 13 percent."
- According to NHE data taken from Table 12 of the National Health Expenditure data the net cost of private health insurance was 12.2 percent. (NOTE: CMS defines the net cost of private health insurance as "the difference between benefits and premiums. This difference includes administrative costs, and in some cases, additions to reserves, rate credits and dividends, premium taxes, and profits or losses and, is estimated separately for various types of insurers."
ICYMI: Youngstown Business Journal Daily -- Health Plans Collaborate to Cut Costs
Posted by The Campaign on October 07, 2009 at 7:37 PM
Health Plans Collaborate to Cut Costs
Oct. 6, 2009 5:56 a.m.
COLUMBUS, Ohio -- Eight major health plans have launched a collaborative initiative intended to simplify information flow between health plans and doctors’ offices, and later between health plans and hospitals, officials said.
For the full story click here.
ICYMI: Making It Easier for Doctors To Spend More Time with Patients
Posted by The Campaign on October 05, 2009 at 8:16 PM
Making It Easier for Doctors to Spend More Time With Patients
“Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, said the new system will provide ‘transparency and clarity and the physician and practice staff will have more time with patients.’” Full story here.
-- Cleveland Plain Dealer, Eight Ohio insurance companies plan to simplify billing for doctors, consumers, 10/05/09
*******
“‘We applaud the efforts of health plans and providers to continue to work together to reduce administrative expenses in an effective manner, slowing the growth of health-care costs, which could ultimate make health-care coverage more affordable for Ohioans,’ [Ohio Insurance Department Director Mary Jo] Hudson said in a release.” Full story here.
-- Columbus Business First, Web site in works to save docs, insurers time, money, 10/05/09
********
“‘Initiatives that streamline health care administration, such as this effort, have great potential to slow the growth of the cost of care and contribute to savings nationally,’ said Karen Ignagni, president and CEO of America's Health Insurance Plans.” Full story here.
-- Associated Press, Paperwork angst drives Ohio doctor, insurer effort, 10/05/09
********
“The program, which allows access to such information on 91 percent of the state’s residents with insurance coverage, is a model for a national system that once implemented would help ‘bend the curve’ in growing health care spending, said Karen Ignagni, president of America’s Health Insurance Plans.” Full story here.
-- CQ, Insurers See ‘Curve-Bending’ Savings From Paperwork Changes, 10/05/09
********
“‘This landmark initiative in Ohio demonstrates the commitment of health plans to simplify healthcare and the potential that exists to achieve savings through efficiencies in what we used to call “paperwork,”’ said AHIP President and CEO Karen Ignagni in a written statement.”
-- ModernHealthCare, Insurers announce initiative to ease paperwork, 10/05/09
FACT CHECK: Health Plan Profits and Administrative Costs
Posted by The Campaign on September 29, 2009 at 11:25 AM
Today's Senate Finance Committee markup focused on health plan profits and administrative costs. Here are the facts about these two issues:
For every dollar our nation spends on health care, less than one penny goes towards health plan profits. A sincere cost-containment discussion would focus on the other 99 cents. Check out this document which sets-the-record-straight about health plan profits. Also, check out Fortune Magazine's recent industry profitability rankings. In 2008, health plans had a profit margin of 2.2% and are 35th on the list.
As part of the Fortune 500 list, Fortune magazine looks at industry profit margin. Fortune reports that the "Health Care: Insurance and Managed Care" sector had a profit margin of 2.2% in 2008. To see where this puts the health plan industry on the list, click here.
The Heritage Foundation released a research paper comparing administrative costs between Medicare and private health plans.
Two important facts to consider: *****
THE WHITE HOUSE: President Obama to Host Press Conference Wednesday Night
Posted by The Campaign on July 20, 2009 at 10:42 AM
On Wednesday night, President Barack Obama will hold a nationally-televised news conference at 9:00PM.
You can view the press conference live on the White House website by clicking here.
MUST READ: Ezra Klein Examines Administrative Costs
Posted by The Campaign on July 07, 2009 at 8:48 PM
The Washington Post's Ezra Klein examines several recent articles in various publications comparing administrative costs between Medicare and private health plans.
To read the full article click here.
To learn more about the value of health plans download this report.
FACT CHECK: Medicare's True Administrative Costs
Posted by The Campaign on June 26, 2009 at 1:55 PM
The Heritage Foundation released a research paper comparing administrative costs between Medicare and private health plans.
Two important facts to consider:
- "...on a per-person basis Medicare's administrative costs are actually higher than those of private insurance--this despite the fact that private insurance companies do incur several categories of costs that do not apply to Medicare."
*****
- "In the years from 2000 to 2005, Medicare's administrative costs per beneficiary were consistently higher than that for private insurance, ranging from 5 to 48 percent higher, depending on the year."
This graphic illustrates the point very clearly:
