Professional Documents
Culture Documents
Midwest Edition
Calendar
November 15-16
S09101!H$1B4#07!?11$"40#4$9!?99607! <$93&9#4$9*!>8&'0#$9!!3&'7095!/0'E@!?! 30'4&#.!$=!B$74".!095!D$#430#4$907! 1B&0E&'1!L477!541"611!#8&!"8077&9:&1! =0"49:!8$1B4#071!49!S09101@!OP,QOP+P@ <74"E!H&'&!=$'!A$'&!I9=$'D0#4$9
December 4-5
;4=&>"4&9"&!?77&.!099607!"$9=&'&9"&@! A499&0B$741!<$93&9#4$9!<&9#&'@!?9! &C0D490#4$9!$=!#8&!E&'.!5'43&'1!49!74=&! 1"4&9"&!095!8&07#8"0'&@!<$1#!FG?@ <74"E!H&'&!=$'!A$'&!I9=$'D0#4$9
December 13
<8077&9:&1!49!#8&!J$'75!$=!H$1B4#07! A&':&'1*!?K?!H&07#8!;0L!>&"#4$9! M41#09"&!;&0'949:!<$DD4##&&@!J&%490'! 095!N&7&"$9=&'&9"&*!<84"0:$*!O((PQO(RP@ <74"E!H&'&!=$'!A$'&!I9=$'D0#4$9
WEBINAR
E-Mail info@payersandproviders.com with the details of your event, or call (877) 248-2360, ext. 3. It will be published in the Calendar section, space permitting.
Noon, CDT
!"#$%&'!()*!+,(+!-!+,(+!%.!/0.&'1!2!/'$345&'1!/6%741849:*!;;<
NEWS
Vouchers (Continued from Page One)
they remained in traditional Medicare. The study found people in Los Angeles would have paid $260 more and people in Miami would have paid $492 more, for instance. In other regions where Medicare costs were lowsuch as Alaska, Delaware, Hawaii, Wyoming and Washington, D.C. people in traditional Medicare would not pay more, but people in many private Medicare Advantage plans would face higher premiums if they didnt want to change to traditional Medicare. People in Portland, Ore., for instance, would have paid $211 more a month and people in Honolulu would have paid $254 a month to stay in their preferred private plan. About one in every four Medicare beneciaries are now enrolled in these private plans, some of which are preferred provider organizations while others are HMOs. Overall, premiums would increase 27% nationwide. Although many Midwest states would see lower premiums increases, the study projects a 43% rise for Michigan and a 41% boost for enrollees in Illinois. Although the ght over premium support often has been characterized as a battle between defenders of traditional Medicare and proponents of private health plans, the study found that it could have a substantial impact on people who enrolled in Medicare Advantage plans. Nationwide, 88% of those beneciaries would have paid more to stay in their plans, averaging $87 more per month, if it had been in place in 2010. Of course, getting many beneciaries to switch to less expensive plans is how the architects of premium support envision saving money. They say it will bring pressure on insurers, doctors and hospitals to offer lower prices. The study noted, however, that such shifts might mean signicant changes in the type and quality of care for beneciaries. In some regions, the low cost plans might be HMOs, which have tightly controlled networks of doctors and hospitals. If
Page 2
Advertise Here
(877) 248-2360, ext. 2
In Brief
Hospital Employees Cost More To Treat Than Other Workers
A study by an Ann Arbor, Mich.based research firm concluded that healthcare spending is much higher on hospital employees than the general population. The study examined healthcare data for 740,000 hospital workers nationwide during 2010, and compared them to data for workers in other professions. According to the study by Truven Health Analytics, formerly a part of Thomson Reuters, healthcare spending is 9% higher on hospital employees than the general population. They are at higher risk for chronic conditions such as depression and diabetes, and are 5% more likely to be hospitalized than the population at large. Moreover, the average community hospital expends 4% of its operating revenue on healthcare benefits. Those benefits also consume about 68% of all operating profit for those institutions. Hospitals and health systems have a compelling opportunity to improve the health of their workforce, said Michael Taylor, M.D., vice president and national business medical leader for Truven Health Analytics and co-author of the study. In doing so, they will strengthen their business performance and set the standard for the broader community.
beneciaries switched from traditional Medicare to HMOs,! they might not be able to keep seeing their regular doctors or go to their preferred hospital. In other areas, beneciaries perhaps people in private plans that coordinate care might not like shifting into less costly traditional Medicare. "Beneciaries' preferences and plan choices are not purely driven by premiums, and some beneciaries may not view the lowcost plan, whether a private plan or traditional Medicare, as optimal for meeting their individual needs and circumstances," wrote the authors, led by analyst Gretchen Jacobson. Other studies have found that only a small portion of Medicare beneciaries switch their Part D prescription drug or Medicare Advantage plans each year, even when doing so could save them money. "There are tradeoffs involved in making changes and we know from Part D and Medicare Advantage that people dont really change very often," said Tricia Neuman, who oversees the foundations Medicare analyses. In addition, the new study noted that some low-cost plans might not be able to handle an inux of new beneciaries. A particularly glaring example is in Los Angeles County, where fewer than 10,000 beneciaries are enrolled in one of the two lowest-cost plans, while more than 900,000 beneciaries are enrolled in traditional Medicare or other plans. The study did not estimate how much money the plan would have saved Medicare. In a statement, the Romney campaign said: "As the authors stress, this is not a study of the Romney-Ryan plan. Our plan would always provide future beneciaries guaranteed coverage options with no increase in out-ofpocket costs from today's Medicare." The
Continued on Next Page
Continued on Page 3
!"#$%&'!()*!+,(+!-!+,(+!%.!/0.&'1!2!/'$345&'1!/6%741849:*!;;<
NEWS
Vouchers (Continued from Page One)
Obama campaign trumpeted the study, saying it "demonstrates how hollow" is Romneys claim that the elderly would retain the option of enrolling in traditional Medicare under their plan. Joe Antos, a healthcare expert at the American Enterprise Institute, said that the study is "the best technical study so far of this sort," although he expected a premium support market would be much more competitive than the current Medicare Advantage market is, since the latter is guaranteed a certain payment by the federal government. "The competition would be even more
Page 3
Advertise Here
(877) 248-2360, ext. 2
*For our ads, not your hospital
In Brief
Chicago-based Meridian Health Plan is entering the dual-eligible market in Illinois, covering individuals enrolled in both the Medicare and Medicaid programs. Meridian will offer coverage for dual-eligibles in Knox, McHenry, Mercer and Warren Counties. The State of Illinois is committed to making people healthier. We are honored to be an integral part of reaching this goal, said Vijay Kotte , President of Medicare Operations for Meridian Health Plan. Given the tremendous growth in the Medicare eld, this is an exciting opportunity for Meridian. I'm thrilled to be able to contribute to this growth. Meridian covers about 300,000 Medicaid enrollees in Illinois.
intense," he said, especially since most Medicare beneciaries would not be able to afford anything more expensive than the benchmark plan, and thus insurers would compete to meet those prices.! "You just can't have high costs if people cant pay it," he said. JORDAN RAU, Kaiser Health News Kaiser Health News!is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprot, nonpartisan health policy research and communication organization not afliated with Kaiser Permanente.
To learn more about our products and services, visit our website at www.contexomedia.com
Contexo Media is an independent provider of revenue-enhancing solutions for medical practices to maximize their coding, reimbursement and compliance efforts. Thousands of health care professionals rely on Contexo Medias coding books, software, eLearning and educational workshops to stay on top of critical updates across the fast-changing medical landscape.
19144
!"#$%&'!()*!+,(+!-!+,(+!%.!/0.&'1!2!/'$345&'1!/6%741849:*!;;<
OPINION
Page 4
=$76>&!+*!?116&!@A
/0.&'1!2!/'$345&'1!41! B6%7418&5!&3&'.!C6&150.!%.! /0.&'1!2!/'$345&'1!/6%741849:*! ;;<D!E9!099607!4954345607! 16%1"'4B#4$9!41!FAA!0!.&0'! GF(HA!49!%67I!6B!#$!(,! 16%1"'4%&'1JD!?#!41!5&743&'&5!%.! &K>047!01!0!/LM!0##0"8>&9#*! $'!01!09!&7&"#'$94"!9&N17&##&'D
E77!053&'#4149:*!16%1"'4%&'!095! &54#$'407!49O64'4&1P
GQRRJ!+HQK+@), 49S$TB0.&'1095B'$345&'1D"$>
U04749:!055'&11P
Q(Q!VD!W$77.N$$5!X0.*!Y64#&!Z Z6'%09I*!<E!A([,[
X&%14#&
NNNDB0.&'1095B'$345&'1D"$>
M0"&%$$I
NNNDS0"&%$$ID"$>\B0.&'1B'$345&'1
CN4##&'
NNND#N4##&'D"$>\B0.&'1B'$345&'1
]54#$'407!Z$0'5
X47740>!UD!LN.&' W&07#8"0'&!Y#'0#&:41# ^09101!<4#.*!U$D _0.!X0'5&9 Y&94$'!=4"&!/'&145&9# C8&!<0>5&9!`'$6B a$11!ED!Y7$##&9*!UDLD ^7&49!Y7$##&9!2!M'&9"8 <84"0:$ U4"80&7!;D!U477&91$9 /'&145&9# W&07#8!b6074#.!E5341$'1!;;< W4:87095!/0'I*!?77D
/6%7418&'
B6%7418&'TB0.&'1095B'$345&'1D"$>
a$9!Y849I>09
E11$"40#&!]54#$'
#0>>.DN$'#8T1%":7$%07D9&# ?S!.$6!5$!9$#!'&"&43&!.$6'!4116&!$S! /0.&'1!2!/'$345&'1!%.!(!/DUD!$9! C6&150.*!B7&01&!"077!GQRRJ+HQK+@),D
C0>>.!X$'#8
!"#$%&'!()*!+,(+!-!+,(+!%.!/0.&'1!2!/'$345&'1!/6%741849:*!;;<
MARKETPLACE/EMPLOYMENT
Page 5
CAN HELP.
We publish advertisements for those seeking new career opportunities for just $1.25 a word. If you prefer discretion, well handle all responses to your ad. Call (877) 248-2360, ext. 2, or e-mail advertise@payersandproviders.com.
!"#$%&'!()*!+,(+!-!+,(+!%.!/0.&'1!2!/'$345&'1!/6%741849:*!;;<