Healthcare Blog

Posts tagged "healthcare"

The Question Presidential Candidates Must Answer

The Affordable Care Act (ACA) seems to be a topic of discussion for Presidential candidates. Will the ACA still presidential candidatestay intact once the next President is elected into office? What changes will be made to the ACA? The biggest question stated by an article on Bloomberg View is, “How would they (Presidential Candidates) protect people with pre-existing conditions? Left to their own devices, after all, insurers have an incentive to charge higher premiums to potential customers who already have chronic health conditions – or not to offer them coverage at all.”

What the ACA has done well is to ban the refusal of coverage for individuals with pre-existing conditions. To protect the insurance providers the ACA has required ALL individuals and families to obtain coverage. This prevents those that are healthy from only enrolling in healthcare when something goes wrong, then dropping coverage once they are well again. Otherwise premium rates would skyrocket. It’s taking the good with the bad so that everybody is able to obtain coverage.

Several conservative plans offer a different option and still help people with pre-existing conditions as well as provide better options to healthy individuals. The proposal provides tax credits to help those who don’t have employer coverage, requires insurers to offer the same terms for sick and healthy as long as they are continually covered, and creates high-risk pools for anyone else. There are also ideas of rewarding those with continual coverage with protection from premium increases.

Many of the proposed options are trying to remove most of the federal spending and regulation. Bloomberg View states later in the article, “One could expect the need for the high-risk pools and the regulatory protections to diminish. They address problems that in large part result from the way federal and state policies have stunted the growth of the individual market.” All of the proposals on the table focus on allowing a more functional market to emerge. I’m looking forward to seeing the changes and how the ACA will develop with a new POTUS in office!

Read the full article on Bloomberg View HERE

 

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Posted by Lauren Yeager in All Posts, Health Insurance, In The News and tagged , , , , ,

Healthcare Cost Keeps Rising

Healthcare cost continues to rise and the Affordable Care Act (ACA) isn’t exactly affordable at all. The inflation of healthcare is rising faster than the American economies natural inflation rate. What is making healthcare rise faster than everything else? There are many contributing factors and one of the major ones is supply and demand. The demand for healthcare didn’t happen organically, it happened over night. When the ACA was passed the entire United States population had demand, but the supply stayed the same. Sadly the healthcare provider market hasn’t expanded much in response to the demand.

There are some new health insurance carriers that are trying to hedge their way into the market, but the successful ones get bought out by the larger more established companies. The inflation for healthcare is not just attributed to supply and demand though, it is also the result of political decisions and increased regulations as well as the cost of prescriptions, medical devices, and hospital care, according to an article on Forbes. Some of these were already an issue to rising healthcare costs before the ACA was passed, so why did congress put a 2.3% tax on medical devices under the ACA’s law? Doesn’t make much sense when you are trying to keep healthcare cost “affordable.”

Here is a graph that we pulled from Forbes comparing the natural rate of inflation against the healthcare rate of inflation. Will healthcare increases outrun our incomes if more competition doesn’t halt the monopolized lack of supply for the ever increasing demand? What are your thoughts on healthcare costs?

healthcare cost
Read the full Forbes article HERE

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Posted by Lauren Yeager in All Posts, Health Insurance, In The News and tagged , , , ,

What is Zane Benefits?

Zane BenefitsHere at Design Health we partner with a company called Zane Benefits. As we continue to look at and promote small businesses I wanted to introduce you to one that is on the cutting edge of what healthcare is and will be. As group health insurance fades away you will see Zane Benefits name more and more often. What’s so innovative and great about this company and who are they? Let me tell you with their own introduction from their website, “Zane Benefits is the leader in individual health insurance reimbursement for small businesses. Since 2006, Zane Benefits has been on a mission to bring the benefits of individual health insurance to business owners and their employees.”

This company enables companies to save 20 to 60 percent annually compared to traditional employer-provided health insurance. That’s significant as the cost of group health keeps rising. How do they do that? Instead of companies providing a one size fits all plan to their employees and compensating them for all or a portion of the premium employees are now able to find insurance that fits their needs and cost on their own. Once the employee has chosen the plan that is best for them their company works with Zane Benefits to set up monthly healthcare allowances for each employee. The employee then supplies documentation to Zane Benefits to prove the healthcare they purchased is in compliance and once all documentation checks out the employee receives the reimbursement amount set by the company up to the full amount of the employees premium.

This is such a simple concept and one that is being embraced by many employers around the country. As a small business owner do you want your employees to have more choice as well as lessen the weight of rising group health costs on your back? It’s a new way of doing things and it’s better to be on the cutting edge of change rather than straggling in the door behind the curve. We are happy to speak to you about your options as a company. Let us know if you have any questions, and in the meantime check out Zane Benefits HERE

 

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Posted by Lauren Yeager in All Posts, Small Business and tagged , , , ,

Undiagnosed Diabetes?

Did you know that 8.1 million diabetes cases out of the 29.1 million people that have diabetes don’t know it? That’s Diabetes9.3% of the U.S. population that have the disease. The 8.1 million could be harming their body while continuing to leave their blood sugar levels out of control.

Untreated diabetes takes a toll on your heart and blood vessels, eyes, kidneys, nerves, as well as your gums and teeth. Unfortunately the symptoms are so minimal at first that it is hard to detect. With type 2 people often don’t know until there are problems from long term damage already caused by the disease. With type 1 symptoms come on faster and are much more severe. Early symptoms can be slow healing sores or cuts, pain or numbness in feet or legs, unplanned weight loss, as well as nausea and vomiting. Common symptoms for both types are hunger and fatigue, peeing more often and being thirstier, dry mouth and itchy skin, and blurred vision.

There are ways to keep your blood sugar under control and to stay healthy though. Here’s a list from Today.com:

  • Monitor your blood glucose levels
  • Take medication as directed by your doctor
  • Maintain a healthy weight
  • Exercise! Aim for at least 30 minutes of activity most days of the week.
  • Keep a food record
  • Quit Smoking
  • Drink alcohol in moderation (if at all!)

These things along with eating a healthy diet are essential. Often times there are simple things that you can do in your diet that make what you are already eating healthier. Try exchanging croutons on a salad for toasted walnuts or instead of the ranch dressing try a vinaigrette. There are several small changes like these that can effect your blood sugar levels. If you are experiencing any of the symptoms above you should consult a doctor and if you aren’t it’s never a bad time to start eating healthier and adding exercise to your daily routine.

Read the full Today article HERE

 

 

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Posted by Lauren Yeager in All Posts, Wellness and tagged , , , , ,

Medicare Isn’t Sustainable

During a New Hampshire town meeting Jeb Bush was confronted by a senior citizen after a comment about entitlement reform. The women commented by saying, “My Medicare right now is wonderful and I paid into it for all these years. Why are you always attacking seniors?” Where Bush called it the entitlement system the woman rebutted that she had earned it.

I can see where the woman is coming from in the thought that she has paid into the system, and she has, but not nearly enough to contribute to the cost of her medical care. The level of funding is not adequate to support the current and future Medicare participants. It is expected that the Medicare fund will be insolvent by 2026 . According to Grace Marie Turner, “At best, she will have paid for less than half of the expected cost of her lifetime Medicare expenditures and possibly as little as 8%. Medicare is not sustainable as it is currently structured, and reform is indeed vital.” Take a look at this graph on the cost versus what is actually paid.

Medicare
As you can see the benefits received far outweigh what was “paid for” and as a common misconception of those currently receiving Medicare it’s a hard issue to reform. As time goes on with the cost of inflation the difference continues rise. This will be an issue that will have to be looked at in the upcoming Presidential term. Have you previously thought that Medicare is completely covered by what you have paid into over your working years? Do you agree that we need reform to the Medicare system?

Read the full article from Grace Marie Turner HERE

 

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Posted by Lauren Yeager in All Posts, Health Insurance, In The News and tagged , , , ,

Good Decisions For Small Business Healthcare

Under the Affordable Care Act (ACA) a small business above 50 employees is required to provide healthcare for healthcaretheir employees. These companies that have 50 or more full-time employees must provide health insurance to 95% of their employees and dependents up to age 26 or risk paying a tax penalty of $2,000 per full-time employee. An article on Forbes says, “many small businesses still do provide health care for their employees, either out of a sense of responsibility or out of a desire to attract quality candidates (or both).” Although, depending on how those plans are paid for you could run into some trouble.

Kelly Phillips Erb a writer for Forbes goes over ways to make the best choices as a small business to avoid that trouble. She states, “If it doesn’t make good fiscal sense for you to provide health insurance coverage for your employees, or if the coverage you do provide is less than ideal, consider setting up an additional health benefits plan. A Section 105 plan…allows tax-free reimbursements for expenses.”  She also goes on later to recommend using a broker and lists the benefits.

The biggest issue is that companies aren’t informed of their options and there ARE options. It is no longer just the black and white opt in or opt out group plans available to businesses. As a company are you informed of the different options available to you? Is your current situation still affordable? Let me know and in the meantime look at the recommendations from Kelly’s article on Forbes HERE

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Posted by Lauren Yeager in All Posts, Health Insurance, Small Business and tagged , , , ,

The ACA Boasts Fewer Uninsured

The Affordable Care Act (ACA) has boasted an increase in healthcare enrollment, which is to be expected as it’s Uninsuredmandatory. What do those numbers look like on paper though? In Colorado alone the uninsured have been cut by more than half over the past two years. The disheartening news is that the drop is due almost entirely to a surge in Medicaid enrollment, according to Biz Journals.

The Colorado Health Institute (CHI) and The Colorado Trust released its findings from the 2015 Colorado Health Access Survey and the increase in Medicaid enrollment was one of many things the survey revealed. Another is the way that Coloradans are buying health insurance. In a once employer-sponsored dominant healthcare market it showed 42,000 fewer workers receiving health insurance from businesses of 50 or fewer employees. This is a drop of 12% from the previous year. I’m not a betting woman, but I am betting this is due to the rising cost of employer-sponsored insurance and the fact that the ACA does not require companies that employee less than 50 to offer insurance. “That does not mean that fewer small-business employees are insured, however, as many of those workers have moved from group insurance plans to individual plans or to Medicaid, whose eligibility levels were expanded by the state in 2014”, said Michele Lueck, CHI president and CEO.

Ned Calonge, president and CEO of the Colorado Trust said, “The first big intent of the Affordable Care Act was to expand coverage. It’s achieved that. Those next pieces need the coverage piece to happen in order to work on that. We’re exactly where we need to be.” The numbers are there for individuals who are enrolled in healthcare, but now the number of under-insured individual’s needs to be looked at.

All in all the ACA has done well as its first goal was to insure Americans that were uninsured or under insured. What other areas of the ACA do you see that need to be fine-tuned?

Read the full article on Biz Journals HERE.

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Posted by Lauren Yeager in All Posts, Health Insurance, In The News and tagged , , , , , ,

1/3 The Healthcare Providers?

In a recent Washington Post article it was reported that, “Consumers who bought insurance on the health exchanges last year had access to one-third fewer doctors and hospitals, on average, than people with traditional employer-provided coverage” This is not necessarily a negative though as the smaller networks are typically negotiated contracts with the healthcare provider to offer lower costs which results in a lower premium price.

Healthcare Providers
An analysis by Avalere Health said, “Compared with traditional employer coverage, exchange plans had networks with 42 percent fewer cancer and cardiac specialists; 32 percent fewer mental health and primary-care doctors, and 24 percent fewer hospitals.” As stated above the negotiated contracts between healthcare providers and insurance carriers helps control cost. There are plans on the healthcare exchange that provide broader networks, but you are paying for that network in higher premium.

The real issue is not that the network is small, but whether a doctor stays on the network for the entire calendar year. At Design Health we have seen instances where an individual signs up for their health plan in January and their doctor is in network, but by March the doctor has ended their contract and is no longer participating in that network. Unfortunately a consumer is locked into their health plan for the calendar year, unless there is a qualifying event, whereas the healthcare provider can jump ship.

Often times consumers are informed of the network access their health plan provides and understand that there are both in and out of network providers. When the consumer is informed they go to great lengths to make sure their provider is in-network so they do not end up with a full out of pocket payment for services. Although, for those not informed they believe they can go to any doctor because they have insurance. In this instance it doesn’t matter if the network is narrow or broad, if a consumer doesn’t do their research they run the risk of paying much higher prices.

Are you a consumer that understands your healthcare network? When you enrolled in healthcare did you make sure that your doctors were included in the health plan you chose?

Read the full article from the Washington Post HERE

 

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Posted by Lauren Yeager in All Posts, Health Insurance, In The News and tagged , , , ,

How are Health Insurance Subsidies Determined?

Each year during open enrollment individuals are able to see if they are eligible for health insurance subsidies to help supplement their health care costs. The determinations are based on projected adjusted gross income (AGI) for the year compared to the cost of the second lowest silver plan in an individuals state of residence. These two factors along with how many individuals are in the household will determine eligibility to receive assistance.

The only way to receive assistance is to enroll in either your state based exchange or on Healthcare.gov. Documents are required to verify the income that you are claiming is in fact correct. If you qualify for an Advanced Premium Tax Credit (APTC) you may choose how much advance credit to apply to your premiums each month, up to a maximum amount. If you choose to only take a portion of the advanced credit allowed you’ll get the difference as a refundable credit when you file your federal income taxes.

Currently health insurance carriers are submitting their rates for 2016. The rates will either be approved or rejected by the administration and the second lowest silver plan rates will be determined for each geographical area. When receiving a subsidy you have to make sure to report any changes to your circumstance that may change your subsidy eligibility. This will prevent paying a tax penalty at the end of the year. Did you receive a tax subsidy last year? How was your experience with enrollment?

The Kaiser Family Foundation provides a calculator to see if you are eligible for a subsidy, but is currently set with 2015 premium rates until the 2016 second lowest silver plan rates are determined. Remember Open Enrollment Starts November 1st. Check to see if you are eligible to receive assistance HERE

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , , , ,

The Benefit of an HSA and Being Over 65

We covered in previous posts what a Health Savings Account is and how they can be beneficial. One of those benefits is the abilityHSA earnings to pull money out of your HSA account once you reach the age of 65 as tax-free dollars even if you are not using it for healthcare expenses. This enables individuals to use their HSA as a part of a retirement plan. You pay into your HSA account each year and accumulate funds that earn interest. If you build upon that at age 65 that money can be used for expenses other than healthcare, and withdraws are still tax-free.

As of 2015 you can contribute up to $3,350 for an individual and $6,650 for a family annually. If you are over 55 there is a provision allowing an additional 1,000 to be contributed. You must complete contributions for the fiscal year by April 15th of the following year. HSA funds are able to be carried over year after year without any limits.

Take a look at the earning potential that an HSA provides in the graph, and see how beneficial contributions can be. Medical Mutual has a great fact sheet for HSA’s that you can read HERE.

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Posted by Lauren Yeager in All Posts, Did You Know?, Health Insurance and tagged , , ,