Large employers say the cost of health-care plans will grow 5 percent next year, to an average cost of more than $14,000 per employee. The increases, reported in a new survey of 148 large companies, were attributed largely to expensive specialty drugs and individuals with high medical costs.

The average 5 percent hike is modest in comparison to thedouble-digit premium increasesthat insurers that sell plans in the Affordable Care Act marketplaces have been requesting, citingthe financial challenges of the marketplace and threats by the White House to discontinue federal subsidies.

"Its the fifth year in a row that employers are saying their costs will rise 5 percent. Its not great, because it's still multiples ofwage increases and general inflation ... but its not the volatility youre seeing in the public exchanges," said Brian Marcotte, president of the National Business Group on Health, a nonprofit organization whose members are large employers, including 73 Fortune 100 companies.

According to the survey, employers will shoulder approximately 70 percent of those health costs, leaving employees on the hook for an average of $4,400, through premiums, out-of-pocket costs and contributions to health savings accounts.

The survey found that an ongoing shift toward high-deductible plans will continue, with 40 percent of employers offering one as the only plan option next year -- an increase from last year. Nearly all employers -- 90 percent -- will offer at least one high-deductible plan in 2018.

The average deductible in such a plan was $1,500 for an individual and $3,250 for a family, although the employer often makes a contribution to a health savings account that significantly reduces the cost to individuals.

Marcotte said that much of the current debate over health care has been about the question of access: whether people have health insurance.

In the employer-sponsored health plan world, where there is greater stability, the focus islargely on containing costs. Companies areincreasing their use of cheaper telemedicine consults, with nearly all employers offering plans that allow phone and videoconferencing with doctors if it is allowed in their state. More employers are opening on-site health centers. There's also a growing push toward health plansthat reward employees for activities that result in more efficient care, such as reduced premiums when they actively manage chronic diseases.

Not all cost-containment efforts may succeed. A study by the Rand Corp.found that,instead of replacing visits that would have otherwise taken place in person, most telemedicine consults were new utilization -- made up of complaints that would never have triggered a visit to the doctor. The ease of picking up the phone could thus increase the use of health-care resources; the researchers found that yearly spending on acute respiratory illness increased by $45 per user.

An emerging concern for employers is the cost of specialty drugs, expensive medications that can cost thousands or tens of thousands of dollars a month. A quarter of employers cited specialty drugcosts as the biggest driver of spending in 2017, and 80 percent ranked it in the top three contributors to rising costs. In contrast, three years ago only 6 percent of employers cited it as the major contributor to high spending.

Original post:

Large employers say health plans will cost more than $14000 for an employee in 2018 - Washington Post

Durham, N.C. Blue Cross Blue Shield of North Carolina on Tuesday named a top official in the federal Centers of Medicare and Medicaid Services as the company's next president and chief executive.

Dr. Patrick Conway will start at Blue Cross on Oct. 1, succeeding Brad Wilson, who announced in February he would retire late this year after seven years in charge of North Carolina's largest health insurer.

Conway is deputy administrator for innovation and quality at CMS the most senior non-political executive at the agency and director of the Center for Medicare and Medicaid Innovation. He is one of the driving forces behind the national movement to value-based care, with health care payments tied to quality and innovation.

"Dr. Conway is a national and international leader in health system transformation, quality and innovation," Frank Holding Jr., chairman of Blue Cross' Board of Trustees, said in a statement. "His unique experiences as a health care provider and as a leader of the worlds largest health care payer will help Blue Cross NC fulfill its mission to improve the health and well-being of our customers and communities."

A practicing pediatric hospitalist, Conway joined CMS in 2011 as chief medical officer. He previously oversaw clinical operations and research at Cincinnati Childrens Hospital Medical Center. He was elected to the National Academy of Medicine Institute of Medicine in 2014 and has received the Presidents Distinguished Senior Executive Rank and HHS Secretarys Distinguished Service awards.

He earned a bachelor's degree from Texas A&M University, graduated from Baylor College of Medicine and completed a pediatrics residency at Harvard Medical School's Children's Hospital Boston.

"Blue Cross NCs role in transforming the health care system in North Carolina is a model that other plans aspire to and that I want to work with the Blue Cross NC team to further improve," Conway said in a statement. "I look forward to collaborating with Blue Cross NC employees, health care providers and employers to deliver the best health outcomes and best service experience at the lowest cost for our customers."

Read more here:

Blue Cross names top federal health care official as CEO - WRAL.com

What happened

After reporting second-quarter earnings and offering up guidance for 2017, shares ofTenet Healthcare(NYSE:THC) have fallen 14.6% as of 2:30 p.m. EDT on Tuesday.

Tenet Healthcare's year-over-year same-hospital patient revenue improved 0.4% as a 1.9% increase in revenue per adjusted admission was largely offset by a 1.4% drop in adjusted admissions. Tenet Healthcare also reported that bad-debt expense increased over the period as more uninsured patients sought out care.

IMAGE SOURCE: GETTY IMAGES.

Overall, the company's net revenue declined 1.4% in the quarter, to $4.8 billion, and its net loss expanded 19.6%, to 55 million, or $0.55 per share. On an adjusted basis, the net loss per share was $0.17. The company's top and bottom line was shy of what industry watchers were expecting.

In terms of uncompensated care expenses, those costs increased 13.6% year over year, to $1.375 billion.

The poor quarterly performance led management to adjust its full-year forecast lower. It now expects full-year revenue of between $19.1 billion to $19.4 billion and a net loss of between $90 million to $115 million. On an adjusted basis, the company is forecasting earnings per share (EPS) of between $0.69 to $0.99, a wide range that reflects a lot of uncertainty in the marketplace. Previously, Tenet was guiding for revenue of at least $19.7 billion and adjusted EPS of at least $1.05.

The lower expectations do little to add confidence to investors that Tenet Healthcare is turning a corner, and that's particularly a problem because decisions in Washington, D.C. could result in more people canceling their health insurance. Until Tenet Healthcare demonstrates that it's right-sized itself, and uncertainty surrounding health insurance markets is resolved, there are probably better investments to make.

Todd Campbell has no position in any stocks mentioned. His clients may have positions in the companies mentioned.The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.

Originally posted here:

Why Tenet Healthcare Shares Dropped 14.4% Today - Motley Fool

MSNBC

Trump's health care antics carry consequences for consumers MSNBC The pattern is familiar: the public learns of discouraging news about the health care system; the right seizes on the news as evidence against the Affordable Care Act; and a closer look at the news shows the developments are less about Obamacare and ... Report: Healthcare failure costs Senate Republicans $2M in donationsThe Hill How to Compromise on Health CareBloomberg GOP donors withhold $2 million amid Senate failure on health plan, sources sayCNN International ABC News all 156 news articles »

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Trump's health care antics carry consequences for consumers - MSNBC

For decades, officials who work with veterans have sympathized with rural residents like Graham, but have had little to offer. Now, by testing new ideas through pilot programs like the van rides provided by Volunteers of America North Louisiana, the VA is developing models and spreading them across the country to get more rural veterans the health care they need.

VA expansion

Just 20 miles from where the dirt road to Grahams driveway begins, in Texarkana, theres a VA outpatient clinic. But the clinic doesnt provide chemotherapy. It, like many local clinics for veterans, provides basic physical and mental health care, but not emergency care or some specialized services.

While there is a general lack of doctors and hospitals in rural areas, the situation is even worse for veterans who rely on the VA, said John Hoellwarth, a spokesperson for American Veterans, the nations largest veterans organization. In recent years, the VA has set up more community-based clinics, and the Obama administration created a program, called Choice, that allows non-VA clinicians to serve rural veterans and receive reimbursement from the VA. But the problem persists.

Many rural veterans rely on a combination of VA health insurance and other forms of insurance, such as private insurance, Medicaid (the joint federal-state health insurance program for the poor and disabled), or Medicare (federal health program for the elderly), according to census data. The number ofveterans enrolled in Medicaidincreased by about 340,000 under the Affordable Care Act, according to an analysis by Families USA, a nonprofit that advocates for high-quality, affordable health care.

For veterans in rural areas, Medicaid could mean the difference between them getting care, and them not getting care, said Andrea Callow, Families USA associate director of Medicaid initiatives.

To improve care for rural veterans, the VA needs to expand both the services it provides and the services it pays others to provide, said Margaret Puccinelli, chairwoman of the Veterans Rural Health Advisory Committee, which makes recommendations to Secretary of Veterans Affairs David Shulkin.

Because of the geographic isolation for many vets that are eligible, you have to approach it as creatively as possible, Puccinelli said.

The U.S. House of Representatives last weekvoted to fund the Choice programfor another six months, which would allow lawmakers more time to agree on changes to the program. The bill now goes to the Senate. The program, which is open to veterans who live more than 40 miles from a VA clinic or hospital or who face long wait times, has been plagued with problems from the start, including difficulty for veterans trying to make appointments, and long wait times for reimbursement.

Medicaid could mean the difference between them getting care, and them not getting care

New approaches

The Volunteers of America North Louisiana program was one of five to receive $2 million from 2014 to 2016 from the VA Office of Rural Health, which develops models for care that can be replicated nationwide.

The idea of shuttling veterans to and from their appointments is not new. The VA has had a transportation program for decades, under which Disabled American Veterans donates vans to the VA that volunteers use to take veterans to medical appointments.

But the Volunteers of America North Louisiana program was different: It used paid drivers, picked rural veterans up at their homes, and transported veterans in wheelchairs, which the other program does not do.

Graham tried using the Disabled American Veterans program in his area. But the pickup location is in Texarkana, and Graham said rides werent available at the times he needed them.

Volunteers of America North Louisiana knew there was a need, but it was overwhelmed by the response, said Gary Jaynes, the organizations director of veteran services. In the two years the program was running, it provided 2,229 rides to veterans, logging nearly 300,000 miles and saving veterans nearly $400,000 in travel expenditures, Jaynes said.

Most of the Office of Rural Healths $250 million budget for programs goes to rolling out promising models in local VA clinics. A few approaches that have stuck include using home-based rehabilitation for veterans who have heart attacks, and using telehealth for patients with HIV or multiple sclerosis.

Like Volunteers of America North Louisiana, the Nebraska Association of Local Health Directors received a $2 million grant. The Nebraska nonprofit used its money to place 10 coordinators in local health departments to spread the word about services available to veterans and teach health workers how to find veterans in need of help. The Nebraska program ended up referring about 600 veterans to services in and out of the VA, and created a statewide network of people working toward the same purpose, said Teri Clark, the projects director.

We didnt reach just a couple veterans, Clark said. Instead, we changed the system.

Telehealth expansion

On the way to the VA, just before crossing into Louisiana, Graham gets the hiccups. His cancer exhausts him, and makes it hard for him to digest food. He rubs his chest, recalling a time he had to drive himself home from chemotherapy.

I got the cold sweats, he said, as Texas ranches flew by outside the car window. I got sick as soon as I pulled up in the yard.

The VA knows that providing telehealth to rural veterans makes many long trips unnecessary.Telehealth makes veterans healthier, reducing hospital admissions by 35 percent, and saves them money about $2,000 per patient each year, according to a 2014 VA study.

In addition to driving veterans to appointments, the Volunteers of America bought a telehealth van equipped with communications equipment and broadband internet, which is used to see patients across state lines.

Graham now feels too sick and tired to work, but he used to be a chef. He cooked at the convention center and a cafe in Shreveport. Then he was kitchen manager at a seafood restaurant in Texarkana. He laughs remembering all the energy he had at opening day in 2013, as he ran around trying to feed a hundred guests at once, with food orders stuffed in his shirt pocket.

A couple years later, he was raking leaves and he got dizzy. When he got to the hospital, they found his cancer. He quit his job, sold his truck and signed up for Medicaid.

On his rides with Volunteers of America North Louisiana, Graham bonded with his drivers and fellow riders. Veterans appreciated the program so much that they started calling their representatives in Congress. Now, clinic officials plan to meet with Jaynes and congressmen to discuss ways to keep the services in operation.

Thomas Klobucar, acting director of the Office of Rural Health, said his office is still evaluating the results of the Volunteers of America North Louisiana program, and will report to Congress by October on its findings.

Continued here:

Rural veterans face long paths to health care - PBS NewsHour

With Republicans unable to advance a health care bill in Congress, President Donald Trump's administration may find itself in an awkward role as caretaker of the Affordable Care Act, which he still promises to repeal and replace.

The Constitution says presidents "shall take care that the laws be faithfully executed." So as long as former President Barack Obama's law is on the books, that doesn't seem to leave much choice for Trump, even if he considers "Obamacare" to be "a disaster."

"It's either caretaker or undertaker," quipped economist Joe Antos of the business-oriented American Enterprise Institute. "I think in the end it's going to be 'caretaker' because they'll finally realize nobody is going to blame Obama. Having the thing blow up is going to be considered in the public eye to be Trump's fault."

Every move by Trump's health chief will be scrutinized by Democrats for evidence of "sabotage," a charge they're already making. Meanwhile, the administration will try to use its rule-making power to bend Obama's law toward Republican priorities.

The Trump administration's first sign-up season, for 2018 coverage, starts in about three months, on Nov. 1.

Some things to watch for:

INTENSE SCRUTINY

Consumer organizations, state officials, Democrats, insurers, and groups representing various health care interests will keep close tabs on the actions of Health and Human Services Secretary Tom Price and his deputy, Seema Verma, who runs the federal agency that administers health insurance programs.

"We are going to hold HHS accountable to fully implement the law," said lawyer Mara Youdelman, who heads the Washington office of the National Health Law Program, an advocacy group. "The Affordable Care Act is the law of the land, and everyone who is working for the administration should be committed to upholding the law of the land."

Former Obama administration officials intimately familiar with the program will be looking over the shoulders of the Trump team Twitter accounts at the ready.

Price so far has sent mixed signals. His department recently canceled contracts for community groups to provide sign-up assistance in 18 cities. His official rhetoric about the law has been harsh, maximizing its faults without recognizing the health benefits of 20 million more people with insurance.

But the department did work with Alaska on a waiver that's been praised for helping to stabilize that state's insurance market. And early on, the agency issued a regulation that made several changes insurers had requested to help things run more smoothly.

About 10 million people are signed up for private insurance in subsidized markets, and 11 million more have coverage through expanded Medicaid.

DON'T OVERLOOK THAT COMPUTER SYSTEM

Few things were as damaging to Obama's aura of cool competence as the failure of the HealthCare.gov computer system when it went live in the fall of 2013. Few people managed to sign up that first day, and it took weeks for a technological rescue team to sort through layers of problems, restoring acceptable functionality.

After that chastening experience, Obama administration officials constantly kept tinkering with the website, trying to improve its technical capacity and usability for consumers.

It's unclear what the Trump administration has been doing since he took office in January. No media preview of 2018 open enrollment has been announced.

The administration may have made its own job harder by cutting in half the sign-up season for next year. This time, open enrollment will run from Nov. 1-Dec. 15. Previously, it ran through Jan. 31.

In earlier years, Dec. 15 was a big day for the computer system because it was the last opportunity to sign up for coverage effective Jan. 1. This year the Dec. 15 crunch could be even more overwhelming, because it's also the last chance for most people to sign up for the coming year.

The day falls on a Friday a sort of "Black Friday" for health insurance sign-ups.

"The system has to be ready at the start, and they have to be prepared to detect problems, especially when they hit the end," said Antos.

UNCERTAINTY OVER SUBSIDIES

The clearest signal Trump could send of his administration's good faith would be to remove the uncertainty around billions of dollars in payments to insurers. That money reimburses the insurers for reducing copayments and deductibles for people with modest incomes.

The "cost-sharing" subsidies are called for in the health law, but they are under a legal cloud because of a lawsuit brought earlier by House Republicans, questioning whether the law included a specific instruction for the government to pay the money. The case is on hold before a federal appeals court; the administration has continued making monthly payments.

After the Senate's GOP health bill failed, the president sent out a series of tweets in which he seemed to threaten to stop the payments.

"If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies...will end very soon!" said one of Trump's Twitter messages.

Experts say the money is not a bailout, but a government obligation. GOP leaders in Congress want the payments continued.

Without a subsidy guarantee from Trump, some insurers have been seeking double-digit premium increases, on top of raises that reflect underlying medical costs.

"This month-to-month uncertainty is just corrosive," said former HHS Secretary Kathleen Sebelius, who served in the Obama administration.

LOSING GROUND?

Obama's law reduced the U.S. uninsured rate to a historic low of about 9 percent.

That was widely seen as an indicator of progress under the health overhaul, and one of the main problems for the recent Republican bills is that they would have significantly increased the number of uninsured people.

Amid confusion about the future of the ACA, there are signs that coverage is already beginning to erode.

A major survey called the Gallup-Sharecare Well-Being Index recently estimated that the number of adults without health insurance grew by about 2 million this year.

What happens next is in the hands of the Trump administration.

Online: http://www.HealthCare.gov

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Caretaker for Obamacare? Trump's health care role may shift - ABC News

Sen. Orrin HatchOrrin HatchFive tough decisions for the GOP on healthcare GOP debates deep cut to corporate tax rate Overnight Healthcare: GOP states move to cut Medicaid | Senate passes key FDA funding bill MORE (R-Utah) raised some eyebrows when he used a colorful phrase to argue that it was time for Republicans to move from the healthcare debate to tax reform.

Were not going back to healthcare. Were in tax now," Hatch told Politicoon Wednesday in a story published Monday.

"As far as Im concerned, they shot their wad on healthcare and thats the way it is. Im sick of it.

"As few of you were alive during the Civil War, here's a valuable jargon lesson on 'wads' and the shooting of them," Hatch tweeted.

As few of you were alive during the Civil War, here's a valuable jargon lesson on "wads" and the shooting of them. https://t.co/dOYvcfgImO pic.twitter.com/wk9aaNb3s2

Hatch's office linked to an online version of the Oxford dictionary.

While the phrase Hatch used has taken on a sexual connotation, it also has meanings that are far from blue comedian material.

The Oxford dictionary's definition for the phrase is that it means someone has spent all of their money.

Hatch's Civil War reference is a nod to the definition of "wad" described by Merriam-Webster as "a soft plug used to retain a powder charge or to avoid windage especially in a muzzle-loading gun."

The comments come after the GOP plan to repeal and replace ObamaCare collapsed last month.

Some lawmakers are pushing forRepublicans tocontinue their healthcare push in an effortto fulfill their longtime campaign promise to repeal and replace former President Obama's signature domestic achievement.

Others are arguing that Republicans should move on to otheragenda items, such as tax reform.

Senate Majority Leader Mitch McConnellMitch McConnellFive tough decisions for the GOP on healthcare McConnell on healthcare failure: 'Feel better, Hillary Clinton could be president' George Will warns grotesque is becoming normal for GOP MORE (R-Ky.)said this past weekend he doesn't like to "dwell on situations where we come up a little bit short."

Even on the night when we came up one vote short of our dream to repeal and replace ObamaCare, heres the first thing I thought about: feel better, Hillary Clinton could be president," he said during an appearance at a Republican event in Kentucky.

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Hatch on GOP's ObamaCare repeal push: 'They shot their wad on healthcare' - The Hill

DENVER Colorado has some of the best health care in the country, according to a new report from WalletHub.

The Centennial State landed in 13th place on WalletHubs list of the best states for health care.

What does that mean, exactly?

In its effort to rank each state (and Washington, DC), WalletHub looked at a range of factors, including cost, access and health outcomes. That means states were graded on things like out-of-pocket medical spending, hospital beds per capita, doctors and clinics per capita, the share of insured adults and children, life expectancy and rates of diseases like diabetes, cancer and heart disease.

In essence, the report aims to measure not just availability of health services, but also their value and efficacy, in order to give a more comprehensive picture of health care in each state.

Colorado ranked especially well in certain health issue-related measures, with the fourth-lowest cancer rate in the country and the third-lowest rate of heart disease, according to WalletHub.

Hawaii came in at the top of the list, while Louisiana landed at the bottom.

Here are the top 15 states overall, according to WalletHub:

1. Hawaii 2. Iowa 3. Minnesota 4. New Hampshire 5. District of Columbia 6. Connecticut 7. South Dakota 8. Vermont 9. Massachusetts 10. Rhode Island 11. Maryland 12. Kansas 13. Colorado 14. Maine 15. Utah

To read the full report, log on to wallethub.com.

Go here to read the rest:

Report: Colorado among states with best health care - The Denver Channel

Ahead of Septembers Healthcare Security Forum, Healthcare IT News will be hosting a Twitter chat on Aug. 24 to explore the current healthcare cybersecurity landscape. The discussion will be moderated by Healthcare IT News Associate Editor Jessica Davis (@JessieFDavis).

Kicking off at 3 p.m., the event will feature two security experts:

Last year was a wakeup call for the healthcare sector, with more than 27 million healthcare records stolen in 2016 across 450 reported data breaches. And 26.8 percent of these were caused by ransomware, hacking or malware, according to the 2016 Protenus 2016 healthcare data report.

And this year isnt fairing much better: The latest Protenus reporting found at the current rate 2017 will exceed last year with more than one health data breach per day.

Combined with the U.S. Department of Health and Human Services Health Care Industry Cybersecurity Task Force report that found three out of four healthcare organizations operate without a designated security person, now is the time for healthcare to rapidly improve its cybersecurity posture.

The chat will highlight these challenges and some of the major cybersecurity questions facing the healthcare sector:

RSVP for the event by adding the Twitter chat to your calendar.

Have some pre-chat thoughts and insights of your own? Share on Twitter using #HITSECURITY before the event on Aug. 24.

Twitter:@JessieFDavis Email the writer: jessica.davis@himssmedia.com

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#HITSECURITY Twitter chat to zero-in on state of healthcare cybersecurity - Healthcare IT News

Colorado Governor John Hickenlooper and Ohio Governor John Kasich say the next step toward changing the Affordable Care Act -- after lawmakers failed to follow through on health care reform-- should now include a bipartisan effort.

"Let's get a bipartisan group of people together, and include some governors, who are the guys who have to- the people who have to implement these plans, and look at how do we stabilize private markets, how do we, you know, deal with these high-cost pools, and what's the best way," Democratic Gov. Hickenlooper said on CBS News' "Face the Nation" on Sunday.

"There are some basic remedial steps that can improve our health care system without having to throw everything out the window," he added.

Hickenlooper noted that Americans will be "surprised" at the number of senators willing to "roll up our sleeves, and work on a bipartisan basis, and see how far we can go."

Kasich, who has been collaborating with Hickenlooper in recent weeks, echoed Hickenlooper's comments, saying that once lawmakers realize the system is "melting down," he's hopeful Congress can put aside their philosophical differences and provide a bipartisan solution.

"I think there is a hunger in the Congress at least in the Senate to try to do what they went to do, which is to solve problems. And you can't solve immense, difficult problems without both sides," Kasich said on Sunday.

When asked what compromises both parties would likely be making in such a bipartisan effort, Kasich said Democrats may have to be willing to allow more choices in the insurance marketplace to help drive costs down, while Republicans will have to admit that "there's going to be a group of people out there who are going to need help."

When asked for specific ways in which a revised policy could include a bipartisan solution on the issue of individual mandates, Hickenlooper said, "The key here is to recognize that when you let healthy people not be part of the pool, you're going to concentrate people with serious health issues, so much more expensive insurance risks, into the market. And that's of course going to raise the cost for everyone."

He added, "whether it's a mandate or a reinsurance type pool, that's where we can sit down."

Kasich said that while differences may persist in Washington, putting aside which party "wins" in the end could help ensure a successful outcome.

"If you don't worry about which party gets the credit or which politician gets the credit, it can work," he said. "Now, I can't guarantee you that Hickenlooper and I are going to agree on this, but I'm hopeful."

2017 CBS Interactive Inc. All Rights Reserved.

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Govs. Hickenlooper, Kasich urge bipartisan effort to move forward on health care - CBS News

Quora Questions are part of a partnership between NewsweekandQuora, through which we'll be posting relevant and interesting answers from Quora contributors throughout the week. Read more about the partnershiphere.

Answer from Michael Lee, Public Policy Analyst:

Health care policy involves a lot of political challenges. Leaving aside the policy questions for the momentlets just talk politicsthe challenges include:

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With a stunning late-night vote, Republican Senators John McCain, Lisa Murkowski, and Susan Collins crossed party lines voting against the GOP's "skinny repeal" version of Obamacare reform. Zach Gibson/Getty

So when talking about the Republican health care proposal this year, even leaving aside the policy issues, we have a new government entitlement in the form of ACAs insurance subsidies that now has a constituency (both via the insurance industry and the covered individuals) that doesnt want things to change! But reversing field (even if Republicans were interested in building on ACA) isnt too workable either, because it would require new tax revenue to cover more people.

Remember, Democrats in 2010 passed ACA even though it had a lot of problems and didnt really reflect their policy priorities. And they did it because it moved the ball in their direction and they were convinced that theyd be rewarded by the voters for providing a new benefit. That hasnt happened quite yet, but voters still agitated against the Republican proposal because it would have reduced health insurance coverage compared to current law.

It remains to be seen where we go from here.

Why is the health care bill considered such a hard problem? originally appeared on Quora - the place to gain and share knowledge, empowering people to learn from others and better understand the world. You can follow Quora on Twitter, Facebook, and Google+. More questions:

Read the original here:

Quora: Why Is Health Care So Difficult to Solve? - Newsweek

For what its worth, most hospitals and health systems have realized the value in investing in big data. Theyre eagerly raking in a plethora of data, focusing solely on the collection aspect.

But thats insufficient, Gray Matter Analytics president and CEO Sheila Talton proposed during an event last week at Chicago-based startup incubator MATTER.

The real story is: How do you have data thats accessible that can actually become information? Because data is not information, she said.

Most healthcare organizations have gotten the data gathering process down pat, and theyve become experts at utilizing data to report what happened. However, the industry needs to keep moving forward so that data can be used to get descriptive insights, predictive insights and prescriptive recommendations.

Systems are clearly impeded from making good use of the data they have. Part of the problem is the fact that much of the data is siloed.

For other organizations, its simply a budget issue. The majority of health systems can hardly obtain the financial resources to maintain their existing tools, let alone implement new processes and programs.

When a hospital does hop on the bandwagon and begin to manage data, its often pulled into believing in a one-size-fits-all model. Every tool and solution that a certain hospital utilizes will work for me, the hospital thinks.

Yet thats not the case, Talton stressed. Each hospital has a different patient population and budget, meaning it requires its own unique solution.

The need for better data integration is especially applicable in this day and age as the healthcare sector pushes for value-based care.

Value-based care is here to stay, Talton said. That continuum is continuing.

Since the industry is moving toward shared risk models, figuring out how to use data is more important than ever. Health system leaders need to ask, How do we manipulate and manage our data? How can we use it to make the lives of our clinicians easier?

On top of asking these questions, everyone from payers to providers needs to be finding ways to share data with each other. Only by doing so can the healthcare field glean meaningful insights and information.

In closing, Talton shared her belief of what a health systems number one focus should be: Becoming a data-centric entity. But it also boils down to planning for the long term. Instead of focusing solely on installing one-off solutions and collecting data, systems must consider their ultimate goals.

Photo: from2015, Getty Images

Excerpt from:

In healthcare, big data alone isn't enough - MedCity News

When Nicole Thurman first noticed the health issues that CHG Healthcare was treating its own employees at its Salt Lake City clinic anxiety, substance abuse and post-traumatic stress disorder, among others it became apparent that the medical staffing firm needed to hire a mental health counselor.

We have a young population, so we have an opportunity to help with mental health issues before they turn into substance abuse issues or physical health issues, says the senior director of talent management. I look at this as preventative care.

The staffing firm, which temporarily places physicians in hospitals and clinics, is still in its first year offering mental health counselors to its employees but this benefit has earned $1.73 on every dollar it spends on its Salt Lake City on-site clinic. The ROI was based on claims where high costs claims that cost more than $25,000 were not factored, according to CHG Healthcare.

The mental health counselors are solely available for about 1,300 CHG healthcare employees in the Salt Lake City location. CHG Healthcare plans to roll out the service to 600 employees in the Fort Lauderdale office this January, and is still thinking about its approach for bringing mental health services to locations with fewer than 100 employees. The company started out in Salt Lake City to find doctors and medical professionals for the rural west but it now has four subsidiary companies that all operate under CHG Healthcare. So far, only the Utah-based CHG Healthcare offers this service to its employees.

CHG Healthcare added three counselors to its on-site clinics in November 2016 and said about a third of the 75 visits each month are related to mental health.

We have a really high stress, high intensity workplace because most of our people are recruiters. They need to make their numbers, Thurman says. [The counselors] see a lot of people with anxiety, home and work-life balance problems, depression, marital issues, substance abuse, financial wellness. If we didnt have our clinic here, [our employees] would go elsewhere.

See also: This app tells you when youre depressed. Who else does it tell?

The clinic offers services such as primary care, health coaching, orthopedic injury treatment, pediatric services and womens health, among a myriad of other services, so its impossible for the company to know if an employee is seeking mental health services or treatment for a bad back, Thurman says.

Thurman declined to reveal the cost of the mental health services out of concern that it would deter other employers from offering similar services. However, she says the service is easily scalable.

Originally, the mental health services started out as a referral system, where CHG healthcare leaders could direct their employees. From there, CHG Healthcare has expanded its advertising to fliers, benefit brochures, online communications and physician assistant-led lunch-and-learn sessions, Thurman says.

There is an undercurrent that happens here, she says. Its all word of mouth. Someone will have a good experience and tell someone else. Its exciting to me because that stigma is broken down.

Thurman admits that the company has a good culture built upon trust, which makes a service like mental health counseling more widely used by employees.

Its convenient, its no cost and its high quality, Thurman says of the benefit that is not charged to the employees. Thats why it works.

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Mental health services increase ROI for CHG Healthcare - Employee Benefit News

Sen. Ron Johnson, R-Wis., said it is probably time for legislators to focus on areas of work like taxes and the economy while continuing to negotiate on a healthcare bill in the background.

Johnson was asked by CNN's Jake Tapper about a tweet from President Trump aimed specifically at Congress' upper chamber, stating, "Unless the Republican Senators are total quitters, Repeal & Replace is not dead! Demand another vote before voting on any other bill!"

"I really do think we probably ought to turn our attention to the debt ceiling and funding the government and tax cuts until we can really get all the parties together," Johnson said. "From my standpoint that really is getting the governors, House members, senators [and] the White House on the same page in terms of healthcare."

Tapper noted that Trump has also been critical of the Senate for leaving town with numerous campaign pledges by Republicans and the president himself still unfulfilled or languishing, such as funding and construction of a border wall, tax cuts, and plan to repeal and replace of Obamacare.

"My preference would have been to stay in session, to grapple with those issues I was talking about," Johnson said. "At the same time, getting back to the state, talking to constituents -- on Friday I traveled with Agriculture Secretary Sonny Perdue and had some really informative discussions with farmers and agriculture interests in the state. We are not on vacation. We really are working. I continue discussions on healthcare as well as taxes with my colleagues even though we're not in Washington, D.C.

Johnson went on to note that Obamacare markets are still unstable, and that the issues around healthcare "aren't going away."

With regards to the ongoing Russia investigations, a bipartisan Senate bill was introduced that would protect special counsel Robert Mueller from being fired by President Trump.

"I don't see that Bob Mueller is going to be fired," Johnson said. "But at the same time I was pretty vocal, saying I would have preferred the congressional committees, the House and Senate Intel Committees finish their work, issue their report before we begin thinking about special counsel. Let's face it, the history of special counsel, special prosecutors, sometimes they go off the rails, they start going on witch hunts. And we have enormous challenges facing this nation. We don't really need that kind of distraction."

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Sen. Ron Johnson: Put healthcare reform on back burner and focus on other legislative issues - Washington Examiner

A proposal to stabilize the Obamacare exchanges would allow people who live in counties with no insurer to buy coverage from the same place members of Congress get theirs: Through the small business exchange in Washington, D.C., created under the law.

Just like members of Congress and their staff members who live in other states, people from these "empty" counties would be able to buy coverage through the D.C. small business exchange, called SHOP. But because they don't receive contributions from an employer to pay for coverage, the federal government would contribute toward the cost of premiums if they meet a certain income threshold.

The idea, called the Health Care Options for All Act, from Sen. Claire McCaskill, D-Mo., is somewhat similar to an often-cited proposal by Republicans, which would enable people to buy their coverage across state lines, but it's not clear whether it would receive bipartisan support. Outside experts caution that some hurdles would need to be worked out.

For instance, the way that SHOP and the individual exchange work financially is different. Under SHOP, people receive contributions from their jobs to help them pay for coverage. Under the individual exchange, which often covers people who are self-employed, customers can receive federal subsidies to help pay for premiums and out-of-pocket medical costs. SHOP is not set up to calculate these federal subsidies, but would need to be under the McCaskill proposal.

"I think it's creative, but there are problems," Timothy Jost, emeritus professor at the Washington and Lee University School of Law, said of the proposal. "How do you figure out what the premium tax credit is, and how do you administer that? My impression is that it isn't something they could do, or not something they could do without a tremendous amount of reworking the system."

Also, insurers would go from covering a predictable customer base to adding customers who may have more costly medical needs, and having to do so on short notice because final contracts must be signed Sept. 27.

"From an actuarial point of view, you need to have a good idea of what your population is going to be like in order to set your rates," said David Anderson, research associate of the Health Policy Evidence Hub at Duke University's Margolis Center for Health Policy. "A national insurer can make a wild guess as to what that might look like, but they can't make a guess if they don't have enough time to figure out who might not be covered."

McCaskill has been meeting with Democrats and Republicans on various healthcare solutions, according to her office. The bill is drafted so that different agencies would work together to address out the details of the proposal, her office explained, and though she requested the bill pass by unanimous consent, the request was objected to.

Not all states have shared details about how their exchanges are shaping up for next year, but 20 counties across the country, where 12,123 people live, are facing the prospect of having no insurer to buy tax-subsidized coverage from next year, according to data compiled by the Kaiser Family Foundation.

In contrast, the D.C. exchange for small businesses has four insurers to choose from, and at 60,000 customers, it has the largest enrollment of any small business exchange in the country. Because the insurers are national brands, people can use the coverage to see doctors and go to hospitals outside of D.C.

The individual exchanges in states, which are separate from SHOP and allow people to buy tax-subsidized coverage, have struggled while Republicans worked in recent months to repeal and replace portions of Obamacare. Insurers are not obligated to sell plans on the exchanges, and some have announced they would not be participating in the program next year, while others said they were proposing double-digit rate hikes on premiums. The companies have blamed various factors for the decisions, including uncertainty over whether the Trump administration would fund insurer payments under Obamacare as well as massive losses.

The exchanges faced a similar trend last year, and how to address the issue has become the center of fierce debate. Democrats have blamed Republicans for sabotaging the law, and Republicans have pointed to the outcomes to support their assertion that the law is failing under its own weight.

Senators left Washington Thursday for their August recess, vowing that when return they will change course on healthcare and work in a bipartisan way to stabilize the Obamacare exchanges. Divisions already are emerging on what the best way will be to do that, but Democrats have detailed their priorities, which would include a discussion on the McCaskill proposal.

"We should look at Claire McCaskill's proposal for bare counties that offer real opportunities for health insurance for counties the relatively small number of counties all, most all rural, that are not covered," Senate Minority Leader Chuck Schumer said on the Senate floor hours after Republicans failed to advance a healthcare bill.

Even without legislation, the number of empty counties has fluctuated as state officials have worked with insurers to fill them. In McCaskill's home state of Missouri, for instance, health insurer Centene moved to fill empty counties, saying that the exchanges have been profitable.

"This announcement is great news for many Missourians who'll now have more choices for health insurance," McCaskill said in a statement at the time. "But Centene's news continues to underscore the uncertainty in our insurance markets, something that's just unacceptable for folks in my state. And something that my legislation, which would let Missourians who don't have access to a local provider get the same plans that Congress gets, would go a long way to address."

Many of the counties are unattractive to insurers because they are largely rural, but they could still be coaxed into participating by a state because they would have a monopoly on the market and could charge higher rates. In Iowa, for instance, Medica said that it would continue to sell plans in the state as the sole provider on the exchange, but requested an increase of 43.5 percent for the cost of premiums. The federal government kicks in more money toward premiums when rates increase, so most people who buy coverage through the exchanges don't personally feel the increase. But those who make more than $48,000 a year for an individual, the cutoff under the law, will for the most part pay significantly more for premiums, and many of them will have to change plans and likely doctors and hospitals after they switch insurers.

Anderson said that if the counties don't get insurers, another solution would be for the Department of Health and Human Services to temporarily enact Medicaid there, a move that has been used before for public health emergencies, such as the water crisis in Flint, Michigan.

"It could be viable for 2019, but I'm not sure how it works for 2018," Anderson said of the McCaskill proposal.

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Claire McCaskill turns to Congress' healthcare as a solution for counties without Obamacare insurers - Washington Examiner

Obamacare or the ACA has been a success, though as it exists, it is flawed in many ways and needs many changes to really work. It's been a success in that it brought millions of Americans into the health care system and woke people up to the necessity of health care being a fundamental right for all Americans. It did nothing to rein in the total cost of health care, which at 1/6 of the U.S. GDP is an obscene example of the so-called free market run amok. Health care for Americans will never be affordable without breaking the back of this so-called free market, where everybody gets "a piece of the action."

Unfortunately, the dialog about health care lacks any semblance of honesty. The system as it exists was crafted to protect corporate profits the insurance industry. The entire "fee for service" billing and collection structure is a millstone around our necks. It has produced a vast bureaucracy that serves no purpose except self-perpetuation. Worse yet, the insurance industry is a "cost plus" business. This has enabled the wild and absurd inflation of health care costs.

Rather than looking at the problem with honesty, I see our reps and people in general squabbling over nonsense. "Why should the young and healthy pay for the old and sick?" for example. Guess what? You will one day be old and sick! Pay now and benefit when you are in need. There is no free lunch here. It's time to take responsibility and craft a system that works for future generations.

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Health care critical to all - Billings Gazette

After Senate Republicans failure to repeal Obamacare, Mr. Alexander has set out on what he sees as a rescue mission to stabilize the insurance program by guaranteeing the consumer subsidies to insurance companies that President Trump has threatened to cut off, while granting states more flexibility to offer different insurance options.

He and Senator Patty Murray of Washington, the top Democrat on the panel who has been a productive negotiating partner with Mr. Alexander in the past, have agreed to convene hearings when the Senate returns in September and to try to push some minimalist legislation through Congress by the end of the month.

Even a small bill would be a feat in a Congress that has delivered so few results. But Mr. Alexander, a durable believer in the legislative process, sees it as a possibility, with the alternative being a failure that is certain to rock already reeling individual insurance markets.

It has to be simple if we are to get bipartisan agreement by mid-September on an issue that has divided the parties so much, he said. Stabilizing the markets for a year, he said, would provide breathing room to tackle bigger issues on health care.

Mr. Alexanders political and policy challenges are formidable. First, he would have to get a consensus on his own committee, which ranges from Senator Rand Paul, Republican of Kentucky, on the right, to Senator Bernie Sanders, independent of Vermont, on the left, with a bit of everything else in between. Then he would have to get it through the full Senate, where nothing to do with health care has been able to attract a majority. Then the measure would go to the House, where resistance is even stronger to anything that resembles an effort to prop up the health care law.

Finally, there is the White House, where President Trump has suggested he might unilaterally terminate the funding Mr. Alexander wants to preserve and let the current health program collapse an idea the senator thinks is a bad one. His opposition could put him in the line of fire from a president he barely knows.

But Mr. Alexander is the rare senator who has strong relationships with Senator Mitch McConnell, the Kentucky Republican and majority leader, as well as Senator Chuck Schumer of New York, the Democratic leader. Those ties could prove useful. But he is already under attack from conservatives framing his effort as a bailout for insurers a critique meant to resonate with voters still angry about the 2008 bank bailout.

The Senates inability to produce 51 votes for a piece of legislation that delivers on a seven-year campaign promise to repeal and replace Obamacare is not license for a bipartisan bailout of a failing law, Michael Needham, head of Heritage Action, a conservative advocacy group affiliated with the Heritage Foundation, said. Obamacare is becoming a zombie law, and throwing more taxpayer money at Zombiecare is unacceptable.

Mr. Alexander, who has run for president twice, served as education secretary and was a two-term governor and a university president before joining the Senate in 2003, realizes he is going to come under fire for doing anything seen as sustaining the health care law. He is undeterred.

What would he tell an upset voter? You are not going to think very much of me if I come up here and all I do is argue and never get a result, he said.

In the end, he said, the job is to get a result that can last and people respect that when we do.

If he can be successful in this push, Mr. Alexander hopes it could provide needed momentum for the Senate, one that is admittedly finding it hard to produce because of intense partisanship.

After Senator John McCain, the Arizona Republican, last week called on the Senate to return to the more traditional approach of working together on national problems, Mr. McCain said he had great faith that Mr. Alexander and others could pull off a bipartisan feat. Mr. Alexander said he had embraced that praise as motivation.

We have got a fractured country, he said. This is the most important institution for creating a consensus on tough issues like health care, like civil rights, like elementary and secondary education.

I think most of us understand that, Mr. Alexander said of his colleagues, comparing them to an underachieving football program. It is like a team of All-Americans that is not winning many games. We need to play better.

Back in 2011, Mr. Alexander took the unusual step of surrendering his party leadership post in pursuit of more freedom to work across the aisle rather than hew to the partisan line required of Senate leaders. Even absent the title, he is going to need a large following if he is to bridge the seemingly intractable division over health care.

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A version of this article appears in print on August 5, 2017, on Page A12 of the New York edition with the headline: On a Mission to Rescue the Health Law.

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Republican Senator Is on a Mission to Rescue the Health Care Law - New York Times

Americas health care

Mass confusion!

One hears people wanting Obamacare to stay in place, while others want Obamacare to be repealed and replaced. Republicans railed against Obamacare for seven years to develop a new and improved health care plan but were too busy complaining to do any real work on a new health care plan!

First, the House of Representatives had fits trying to get a health care bill passed by the Republicans. However, in a last-ditch effort they finally did pass a health care bill and sent it to the Senate.

Then you had Senate Majority Leader Mitch McConnell just wanting to pass anything in the Senate as his big burning desire was to get rid of Obamacare. Reason: Sen. McConnell hated President Obama for all eight years of his presidency!

Then you have President Trump that bragged he had a great health care bill that would reduce insurance premiums for all Americans all ready to go. Perhaps he misplaced his great health care plan.

Honestly, President Trump does not care whether an American health care plan is good or bad for the citizens of America. President Trump only wants credit for getting a new health care plan bill passed and Obamacare repealed.

Our country just might have health care problems resolved if Sen. McConnell would have worked with all senators instead ofm only allowing Republicans to issue a new health care plan.

Charley Rasp

Enid

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Letter: America's health care - Enid News & Eagle

WOODSTOCK Woodstock officials are exploring accessible health care options in the wake of Centegras announcement to overhaul operations at its Woodstock hospital.

Centegra on Friday announced intent to submit its plans to the Illinois Health Facilities and Services Review Board in mid-August. This follows a June announcement from the health system saying it would suspend most inpatient services as well as discontinue surgical and intensive care services in Woodstock. The changes are set to take effect Aug. 14.

Inpatient behavioral health services will remain at Woodstock hospital, and outpatient behavioral health and inpatient physical rehabilitation services will move to that location as well.

Only certain changes, such as relocating inpatient beds, need state approval. If the changes arent approved, the hospital will have to reverse anything put in place, Centegra spokeswoman Michelle Green said.

The first application filed with the board will be to discontinue the 22-bed comprehensive physical rehabilitation unit at Centegra Hospital McHenry, Green said. An application will also be filed to move those services to Woodstock, she said.

A final application will be to discontinue the medical-surgical and intensive care categories of service at Woodstock, which will result in a loss of 72 beds at that hospital, Green said.

Services previously at Woodstock will be relocated to Centegras other hospitals in McHenry and Huntley.

A public hearing on the changes isnt required unless someone requests one. If a public hearing is requested, it must be held within 30 days of the request.

Woodstock Mayor Brian Sager said its likely the city will request a hearing.

At this point, barring any change in what I understand is the direction in which Centegra is going, it would be in the citys best interest to request a hearing, he said.

He added he has held numerous meetings with Centegra representatives and other health care providers in the area.

The fact is Centegra does have interest in continuing to provide quality health care that is easy and accessible for people of Woodstock and larger region, he said. The city is strongly interested in ensuring residents have access, regardless of the provider, and we will continue the dialogue to ensure that occurs.

Centegra Health System officials projected their financial losses could reach $40 million by the June 30 end of its fiscal year, according to a May 3 filing with Fitch Ratings. Centegras leaders attributed the results in large part to the cost of opening the Huntley hospital and a rise in uncompensated care.

The changes could save the health system $15 million annually, Centegra officials have said. Executives also are working on other strategies to save money. Losses topped $30 million through the first three quarters of its fiscal year.

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Woodstock exploring healthcare options after Centegra announcement to suspend services - Northwest Herald

By CHRISTOPHER THOMPSON August 05. 2017 7:12PM Unless you've completely disconnected from every source of news over the last several months, you can't avoid all of the chatter about health care in the United States. It seems like one of those topics that just carries on and continues with constant debate and no progress. The issues Congress is dealing with are deep and complex, but there's more to this health care debacle.

We've heard the horror stories about certain parts of the country where consumers have only one insurance carrier option, or scenarios where their deductible is so high, they can't afford to get the care they need, or the premiums have increased so much, they simply can't afford it.

Take New Hampshire as an example. In the individual market, one carrier is proposing raising premiums more than 40 percent. It's simply not sustainable for most businesses and consumers.

The majority of Americans have health insurance that is sponsored through their employer. Employer-sponsored plans vary in type, but most companies pay for a large portion of the employee's plan. For most small- and medium-sized businesses, health insurance for employees is often the second or third largest expense, aside from payroll.

As we know, insurance premiums aren't likely going down, and businesses need to find ways to control and minimize the major increases that occur each year.

There are a lot of ways this can be accomplished that you unfortunately don't hear much about.

I recently had lunch with Tom Harte, the CEO of Landmark Benefits (www.landmarkbenefits.com) and talked a lot about how health insurance costs are impacting New Hampshire businesses. Tom explained that the biggest way companies can control their health care costs is by educating their employees on the choices they have when it comes to where they receive medical services.

When a medical situation arises, you do what is necessary to get treatment, and oftentimes, you aren't thinking about the financial side of it. If it's an emergency, you go to the closest hospital or doctor and get taken care of. But what about all of the other medical services that aren't urgent? It's possible to shop around for the best option, and when you do, you'll be blown away by what you find.

There is an app (and website) called MyMedicalShopper that allows you to compare prices for certain procedures across numerous hospitals and medical facilities. This is an example of how businesses can control their health care premium costs by shopping for routine procedures and doing a little bit of research.

Take a MRI as an eye-opening example. According to MyMedicalShopper, Derry Imaging Center in Derry will charge $776 for a MRI. But if you happen to limp into Wentworth Douglass Hospital in Dover for that same procedure, you'll be paying $3,058. How's that for a difference?

Emergency room visits are another example of ways employees can be smarter about their medical care. Let's say you sprained your ankle and went to the emergency room. You can expect to pay substantially more for that visit versus going to an urgent-care clinic like ConvenientMD, which happens to have nine facilities in New Hampshire.

According to the New England Health Institute, 56 percent of emergency room visits were avoidable and many could have been handled in urgent care. According to Aetna, an in-network urgent-care visit can cost as little as 20 percent of the cost of a visit to the ER.

And we can't forget about wellness. Companies that implement wellness programs and incentives for their employees can also reap the benefits of controlling rising costs and having a healthier and more productive workforce. Not everyone will participate, but it's certainly worth the time and resources to create these types of programs.

Health insurance costs for employees is a major part of every company's budget, and it's important to understand how employees can help control and manage those costs. Education on this topic is most important, and most people don't think about the costs of medical services before they get them.

Everyone in the company is accountable and influences the premiums their group will be charged. Reducing costs is a win for both the company and its employees, and more time needs to be spent working on this very serious issue.

Christopher Thompson (chris.thompson@talientaction.com) is vice president of business development at Talient Action Group in Manchester and writes Closing the Deal weekly for the Sunday News.

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Christopher Thompson's Closing the Deal: We can all help reduce health care expenses - The Union Leader