Tag Archives: PPACA

On Demand Doctor Apps are Here

New smartphone apps can deliver doctors to your doorstep.

Heal is a smartphone app similar to the on-demand car service Uber, but instead of a car, a doctor shows up at your door. Users download the app and then type in a few details such as address and the reason for the visit. After adding a credit card and a request for a family doctor or a pediatrician, the physician arrives in 20 to 60 minutes for a flat fee of $99. Heal began in Los Angeles in February, recently expanded to San Francisco and is set to roll out in another 15 major cities this year. Heal doctors are on call from 8 a.m. to 8 p.m., seven days a week, said Dr. Renee Dua, a founder and the chief medical officer of Heal.

Heal doctors arrive with a medical assistant and a kit stocked with the latest high-tech health gadgets, including tools needed to take your vitals or shoot high-definition video of your eardrum. Heal has a roster of doctors who have affiliations with respected hospitals and programs such as the University of California, Los Angeles; Columbia; and Stanford.

“We’re bringing back old-school techniques with new-school technology,” Dr. Dua said.

Obviously, Heal doctors can offer only limited services on a house call. Among other things, they can diagnose and treat moderate ailments like bronchitis, give flu shots, stitch up a nasty cut or write a prescription (they will even pick the prescription up for an extra $19). But you will have to file the insurance paperwork.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Data Released to The Public on Medicare Prescription Spending

The heartburn drug Nexium — whose advertisements have long been ubiquitous on television — was prescribed to 1.5 million Medicare patients in 2013, for a total cost of more than $2.5 billion, the largest amount spent on any drug prescribed through the government program, according to data released by Medicare officials on Thursday.

The data was the most detailed breakdown ever provided by government officials about the prescription claims of Medicare beneficiaries. It included information about 36 million patients, one million prescribers and $103 billion in spending on drugs under the program’s Part D in the year 2013, the most recent year available. The data did not take into account rebates that the drug manufacturers pay to the insurers that operate the Medicare beneficiaries’ drug plans.

Although the government has previously released similar data to outside entities — including ProPublica, the nonprofit news group — officials said they decided to make the information available on a public website to encourage experts to weigh in, potentially leading to new solutions for policy challenges, like how to contain costs.

“We know that there are many, many smart minds in this country,” Sean Cavanaugh, a deputy administrator at the Centers for Medicare and Medicaid Services, said in a conference call with reporters on Thursday. “We are excited to unleash those minds and see what they can find in our data.”

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Tylenol May Not Be As Effective As You Think

Acetaminophen (Tylenol) is widely recommended for the relief of back pain and the pain of knee and hip arthritis. But a systematic review of randomized trials has found that it works no better than a placebo.

Australian researchers reviewed three randomized trials that compared acetaminophen with a placebo for the relief of spinal pain, and 10 trials that compared their use for easing the pain of osteoarthritis. All together, the analysis included 5,366 patients. Acetaminophen was given orally in doses between 3,000 and 4,000 milligrams a day, except for one study in which a dose of 1,000 milligrams was administered intravenously.

The review, published online in BMJ, found high quality evidence that Tylenol is ineffective in treating low back pain or disability. It also found evidence that the drug quadruples the risk of an abnormal liver function test, but the clinical significance of that finding is unclear.

The studies of pain from knee and hip arthritis found a small but clinically insignificant short-term pain-relief effect for acetaminophen compared with a placebo.

Clinical guidelines from medical groups typically recommend acetaminophen for pain relief, but “the American guidelines were published in 2007, when the evidence was weaker,” said the senior author, Manuela L. Ferreira, an associate professor at the George Institute for Global Health in Sydney. “This new evidence — the highest quality evidence from papers all over the world — shows that it is time to review the recommendations on acetaminophen.”

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Truths and Myths of Obamacare

The Obamacare debate has always been rife with myths, from the infamous “death panels” to the armed IRS agents that would arrest those who don’t buy insurance (really, this was an actual myth).

But as the Affordable Care Act turns five, it appears one myth reigns above them all: the idea that the health-care law has gotten increasingly expensive over time.

A Vox poll conducted by communications firm PerryUndem shows that 42 percent of Americans think Obamacare has cost “more than expected.” Only 5 percent got the right answer: that the Affordable Care Act has actually come in under budget, costing “less than what was estimated.”

Yes, it’s really true: Obamacare has come in under budget. Twice in the past year, the Congressional Budget Office has revised downward projected spending on the Affordable Care Act. In fact, the federal government is expected to spend less on health care now than it predicted in early 2010 — and those predictions didn’t include any spending from Obamacare!

That isn’t just about Obamacare — projections on what we’ll spend on Medicare and Medicaid, the two other big federal health-care programs, went down, too. But it is pretty remarkable that health-care spending is now expected to be lower than projections made before Congress passed a massive health insurance expansion.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Affordable Care Act: Where Are We On Its Fifth Anniversary?

When Democrats passed the Affordable Care Act in 2010, they knew it wasn’t popular — poll after poll showed pluralities, if not majorities, opposed to the legislation after the bruising national fight that led to its passage. But Democrats had a theory about the law: as time went on, and Americans started to gain coverage, the law’s favorability would rise.

“As that bill is enacted, it’s going to become more and more popular,” Sen. Charles Schumer (D-NY) predicted on Meet the Press in March 2010.

“I think that [the law] over time is going to become more popular,” David Axelrod, then a senior adviser to President Obama, declared in September.

Five years later, it’s fair to declare that prediction dead wrong: 83 percent of Americans still hold the same opinions they did in 2010. And of those who have changed their minds, 58 percent of them have become more negative toward the law, a new Vox poll conducted by PerryUndem shows.

If there’s any area of consensus, it’s in misperceptions of the law: 82 percent of Americans either say the price tag has gone up, or aren’t sure (the law’s price has actually decreased as compared with initial estimates), and only 13 percent know the law met its first-year enrollment goals.

Taken overall, the poll paints a frustrating picture for Democrats: most Americans aren’t changing their opinion; those who are have mostly become more negative; and some widely held beliefs about the Affordable Care Act are far from accurate.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Mental Health Benefits In ACA Plans Are Disappointing

Insurance coverage for mental and physical illness remains unequal despite promises that Obamacare would help level the playing field, mental health advocates and researchers say.

A new study by the Johns Hopkins Bloomberg School of Public Health found that consumer information on a quarter of the Obamacare plans that researchers examined appeared to go against a federal “parity” law designed to stop discrimination in coverage for people with mental health or addiction problems.

This makes it nearly impossible for consumers to find the best plan to cover their mental health needs, the research suggests.

“It’s critical to monitor whether these regulations are being implemented in a way that fulfills the promise of parity,” says associate professor Colleen Barry, who led the study published in the current online issue of the journal Psychiatric Services. “Clearly, better monitoring is needed.”

Barry and her colleagues examined benefit brochures offered during the first Affordable Care Act enrollment period in 2013-14 in two state-run exchanges, hoping to replicate a consumer’s shopping experience. Although she won’t name the states, Barry says one was large and the other small, and adds that the results can be extrapolated to plans offered in other states and on the federal exchange.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

You Have Extra Time to Sign Up for Obamacare Plans

Americans who couldn’t enroll in federal Obamacare insurance plans over the weekend because of computer glitches or long waits will now have until next Sunday to sign up, federal officials announced early Monday.

“We are pleased that the vast majority of consumers were able to apply and pick a plan through HealthCare.gov or its call center without a problem,” said Aaron Albright, spokesman for the U.S. Centers for Medicare and Medicaid Services.

“For those consumers who were unable to complete their enrollment because of longer than normal wait times at the call center in the last three days or because of a technical issue such as being unable to submit an application because their income could not be verified, we will provide them with a time-limited special enrollment period for March 1 coverage.”

The special enrollment period begins Monday and ends Feb. 22.

The extension was prompted by the Saturday outage of an Internal Revenue Service function for Obamacare enrollment, which could have prevented about 500,000 people from enrolling. The glitch prevented some people from getting their income verified so they could enroll on HealthCare.gov and at least some state exchanges by the Sunday deadline.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

How PPACA has Changed Health Care

People with individual health coverage used more health care in the third quarter of 2014, and people with group coverage used less.

Katherine Hempstead, an analyst at the Robert Wood Johnson Foundation, is reporting that finding in an analysis of insurer data from the National Association of Insurance Commissioners (NAIC). Hempstead compared care utilization data for the individual market and the group market for 2013 and 2014.

The Patient Protection and Affordable Care Act (PPACA) has set up the public exchange system and exchange plan premium subsidies. Other parts of the law have all but eliminated medical underwriting in the individual health insurance market.

Even in the third quarter of 2014, many patients still had coverage written under the rules in effect before Jan. 1, 2014, when exchange plan coverage came to life and the major PPACA underwriting rules took effect. But, by July 1, 2014, PPACA World might have started to gel. Health care providers and insurers may have gotten past the stage of doing whatever they could, however they could, just to keep the health care system going.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

2015: The Year of Voluntary Benefits

Sales of voluntary products across the board will likely see a nice bump in 2015, as employers finalize their health care decisions and the War on Talent begins to heat back up.

“Employers have had time to recover from the recession, and they’ve analyzed how the [Patient Protection and Affordable Care Act] is going to impact them, so now they’re more willing to look at their overall benefit package,” says Bonnie Brazzell, vice president of Eastbridge Consulting Group Inc. in Avon, Connecticut.

Indeed, according to a recent Eastbridge survey, 14 percent of respondents said they were thinking about adding a new voluntary benefit. Moreover, 17 percent said they were thinking about moving some existing benefits to voluntary, and 12 percent said they were thinking of adding new partially employer-funded benefits.

“That’s exciting for brokers, as the doors are opening a little bit,” Brazzell says.

LIMRA experts “cautiously” see a lot of opportunity in the voluntary benefits marketplace, says Ron Neyer, assistant research director at LIMRA in Windsor, Connecticut. Approximately 15 percent of employers in a recent LIMRA study said they are either “very” or “extremely likely” to add a new voluntary benefit over next couple of years, and about 25 percent are “somewhat likely.” The percentage of employers who plan to replace an employer-paid or contributory benefit with a voluntary arrangement is lower — approximately 5 percent were “very” or “extremely likely” to, compared to 12 percent in 2010.

“We see that as a good thing, as employers seem a little less focused on cost-shifting than they did several years ago,” Neyer says. “As the job market becomes more competitive, employers become more mindful about how voluntary benefits can improve their ability to attract and retain employees and boost worker morale and job satisfaction.”

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary