Happy New Year & 2010 NYBGH Events

NYBGH wishes all of its supporters, colleagues, collaborators, friends, and family a healthy, successful, and happy 2010!

Highlighting our 2010 series of events is a conference on how health reform will affect New Jersey employers as well as an exclusive Q&A Session with Ken Shachmut, Senior Vice President of Strategic Initiatives, Health Initiatives and Re-Engineering at Safeway, Inc., an industry leader in containing health benefits costs.

The first four scheduled NYBGH events of 2010 are as follows:

Total Health Management: "On the Verge"
Tuesday, January 26, 2010
8:00 am - 10:30 am
NYBGH Members & Non-Members: Complimentary
Union League Club
38 East 37th Street (at Park Avenue)
New York, NY

Healthcare Reform: What's in Store for New Jersey Employers
(Open to HR Professionals and Fund Administrators Only)
Thursday, February 4, 2010
8:00 am - 11:00 am
NYBGH Members: Complimentary
Non-Members: $125
New Jersey Performing Arts Center
One Center Street
Newark, New Jersey

The Safeway Experience: Q&A with Kenneth Shachmut, Senior Vice President of Strategic Initiatives, Health Initiatives & Re-engineering, Safeway, Inc.
Wednesday, February 10, 2010
8:00 am - 10:30 am
NYBGH Employer Members: Complimentary
NYBGH Non-Employer Members: $50
Non-Members: $75
University Club of New York
One West 54th Street
New York, NY

Innovative Engagement Strategies: Driving Shared Responsibility with Your Employees
(Open to HR Professionals and Fund Administrators Only)
Monday, March 22, 2010
9:00 am - 10:30 am
NYBGH Members & Non-Members: Complimentary
Location TBA

To view the full listing of NYBGH events and to register, visit: www.nybgh.org/calendar/index.html

Business Pushes to Modify Health Care Bill

As Congress begins its preliminary work on merging the Senate and House health care reform bills, business organizations continue to urge lawmakers to modify provisions that directly affect employers. Of most concern are new taxes; a lack of overall cost containment and delivery system reform; and a public option that escaped the Senate's modifications to the bill.

For The Wall Street Journal story, click here.

Hormonizing Medicare Payment Policy with the Private Sector

Peter Lee, JD, Executive Director of National Health Policy for the Pacific Business Group on Health, along with Bob Berenson, MD of the Urban Institute and John Tooker, MD, MBA of the American College of Physicians recently published an article in the New England Journal of Medicine describing the importance of harmonizing Medicare payment policies with those in the private sector. While Medicare is the country's largest purchaser of health care, it accounts for only 19% of total health spending. The authors note that in order to achieve a higher-value system overall, Medicare needs to help lead the charge in changing how all public and private payers reimburse for services. To achieve this, four recommendations are made and these, along with the rest of the article, can be found by clicking here.

EBRI/MGA 2009 Consumer Engagement in Health Care Survey

The Employee Benefit Research Institute (EBRI) 2009 Consumer Engagement in Health Care Survey reports that enrollment in CDHPs remains relatively low, but is showing growth and consumers are becoming increasingly more cost conscious. CDHP enrollees are also more likely to be enrolled in employee wellness programs, have higher incomes, and be in better health than enrollees in traditional health insurance plans. Financial incentives, in addition, are shown to be a crucial component in encouraging employees to participate in wellness programs and other consumer engagement initiatives.

For the complete report from EBRI, click here.

Happy Holidays from NYBGH!

New York Business Group on Health wishes all of our followers, readers, supporters, colleagues, collaborators, friends, and family a very happy holiday season and a healthy 2010.

As we take a break from health reform debate and negotiations for a few weeks, check out, in the meantime, Kaiser Health News's article on commonly asked qeustions about health reform and you, an American consumer of health care.

Senate Passes Health Bill

Thursday morning, as expected and as promised by Senate majority leader Harry Reid (D-NV), the Senate approved their version of health reform legislation by a vote of 60-39. The bill now heads to Conference Committee to hash out differing provisions of the two bills. The public option, for instance, is included in the House bill, but was rejected during debate in the Senate. Financing reform is another contentious issue that both chambers will have to resolve.

For additional coverage from major U.S. newspapers, click on the following links:

The Hill
The Wall Street Journal
The New York Times
CQ Politics

Health Bill Set to Pass Out of Senate and Into Conference Committee with House

Senate Democrats are poised to pass historic health care reform legislation out of their chamber and into Conference Committee with the House Thursday morning at 7:00am. The final procedural hurdle was passed Wednesday when a cloture vote of 60-39 ended debate on the underlying bill. All 58 Democrats and two Independents have remained united throughout the week and are expected to do the same on Christmas Eve. Unlike procedural votes aimed at ending filibusters, Thursday's vote requires only a simple majority of 51 yeas. Thursday's roll call will mark the 25th straight day the Senate has been in session, only one day short of matching the record of 26 set in 1917 as Congress, and the country, prepared to enter World War I.

The vote was originally scheduled for 7:00pm Thursday, but was eventually moved to the morning to allow Senators and their staffs time to make it home for the Christmas holiday. On Wednesday, the Senate rejected a number of points of order, one of them questioning the bill's constitutionality, introduced by Republicans and designed to stall the process even further.

To read more, click for articles from The Hill, The Wall Street Journal, and The New York Times.

Obama Approves COBRA Subsidy Extension

On Monday, President Obama signed into law the Fiscal Year 2010 Defense Appropriations Bill (H.R. 3326), which includes provisions affecting the federal COBRA subsidy program. The bill extends the 65 percent subsidy duration period to eligible individuals from nine to 15 months and also extends the COBRA coverage eligibility date from December 31, 2009 to February 28, 2010. Eligible workers - those involuntarily terminated between September 1, 2008 and December 31, 2009 and formerly covered under an employer's group health plan - now include those who are laid off between January 1 and February 28, 2010.

The Wall Street Journal reports that, "the subsidy is provided in the form of a payroll tax credit to employers with 20 or more workers."

For more coverage, clickto visit the Wall Street Journal article or an article from USA Today.

Senate Votes to Adopt Manager's Amendment and Limit Debate on Substitute Amendment - 3 Down, 3 to Go

Early Tuesday, the Senate voted twice, both times along party lines, to move health care reform legislation closer to passage. First, they voted to adopt the manager's amendment introduced by majority leader Harry Reid (D-NV) last Saturday. Second, casting aside another parliamentary delay maneuver, Democrats voted to invoke cloture, or limit debate, on a substitute amendment, thus clearing the way for the final three votes that need to pass if Democrats want to pass health reform legislation by Christmas Eve. The next vote is scheduled for 1:00pm Wednesday, with the final vote slated to occur around 7:00pm Christmas Eve.

To read more, visit a related article from The Hill.

CQ Politics also reports on the votes in this article.

Senate Ends Debate on Manager's Amendment; 1 Down, 5 to Go

Early Monday morning, around 1:00am EST, Senate Democrats voted 60-40 to end debate on the manager's amendment to the health insurance reform bill that was introduced early Saturday morning. This marks the first of six crucial votes that need to occur on the Senate floor for the bill to pass into conference committee with the House health bill that was passed in early November. Majority leader Harry Reid (D-NV) intends on holding the sixth and final vote around 7:00pm Thursday night.

To read the related stories, visit the New York Times or the Wall Street Journal websites.

Senate Democrats Cut a Deal; Reach 60 Votes

Early Saturday morning, Senate majority leader Harry Reid (D-NV) released a 383-page manager's amendment to the Senate health insurance reform proposal, indicating that he has secured the 60 votes needed to pass the legislation by Christmas. Senate Republicans immediately invoked the first of many delay tactics by requiring the Senate Clerk to read the entire bill aloud. Appeasing the last Democratic holdout, Sen. Ben Nelson (D-NE), Mr. Reid modified language that does not require or forbid health insurance plans from covering abortion services, but does include an exemption that allows states to prohibit abortion coverage in the insurance markets or the exchanges, where most plans would be sold. Nebraska will also receive, under the amendment, a substantial increase in federal matching dollars that support the state's Medicaid program - the federal-state entitlement program that provides coverage to the poor.

This version of the Senate bill will cost, according to an analysis by the nonpartisan Congressional Budget Office, $871 billion and reduce the federal deficit by $132 billion over ten years, The Hill reports. Costing $22 billion more than its original version, the bill is predicted to cover an additional 31 million Americans.

The complete manager's amendment can be found on the Senate Democrats' website or by clicking here.

Coming only a day after a public opinion poll released by the Kaiser Family Foundation indicated that public support for reform is weakening, Mr. Reid has scheduled six votes to pass the legislation by Christmas. The first one, the next move in the process, is a 1:00am vote early Monday morning to end debate on the manager's amendment. All six procedural moves can be found at a post to the New York Times Prescriptions Blog or by clicking here.

A New York Times article discussing the changes made to key components of the legislation can be found by clicking here.

COBRA Extension Bill Up for Vote

Around 1:00am Friday morning, the Senate voted to limit debate on the 2010 defense spending bill (H.R. 3326). Buried deep inside the bill are provisions that would extend federal COBRA subsidies to February 28, 2010. A full Senate vote is expected at 7:30am Saturday morning.

Current law provides subsidies only to those who are involuntary terminated and lose health insurance coverage by December 31, 2010. Proposed in the defense spending bill are provisions that would extend the 65% subsidy to 15 months and would be offered to those who become eligible by February 28, 2010. Other provisions of the bill include:

• Clarification that only the date of the qualified event relating to the COBRA coverage (e.g. the involuntary termination of employment) will determine eligibility for the COBRA subsidy - and not the date the individual becomes covered by COBRA

• An opportunity for those individuals who lost eligibility for the subsidy (i.e. when the subsidy expired on November 1, 2009) and then lost COBRA coverage due to non-payment of premiums, to retroactively continue COBRA coverage and the subsidy by paying the premium within the later of 60 days from the date of enactment, or 30 days from notification. This also extends to those individuals who lost eligibility for the subsidy but retained their COBRA coverage by paying the full premium

• New and updated notification requirements, including providing a notification within 60 days of enactment that describes the new subsidy provisions to those individuals who were assistance eligible individuals (AEIs) or became AEIs on or after October 31, 2009. In the case of a qualifying event that occurs after enactment, this notice will be provided as part of the COBRA election notice

• Treating the new requirements as having been included as part of the original language contained in the American Recovery and Reinvestment Act of 2009.

The text of the bill can be read on the House Appropriations Commitee website at http://appropriations.house.gov/.

Source: USI Insurance, Littler Mendelson "Washington DC Employment Law Update"

Communicating Benefits Information via Social Media

Employee Benefit News features an article on using social media to communicate benefits news to employees. Using venues such as Facebook, Twitter, YouTube, Wikis, and blogs, among other things, HR professionals can creatively engage employees to communicate short, quick bits of information.

A recent study by Watson Wyatt, the article describes, found that:

"almost two-thirds of companies plan to increase their use of social media in 2010. Of the 328 companies surveyed from across the globe, 78% have increased their electronic communication in the last 24 months, and 55% have increased face-to-face communication. However, nearly half (48%) have diminished their print communication over the past 24 months."

To read the complete article, click here.

Do Patients Continue to See Physicians Who Are Removed From a PPO Network?

In this article from the American Journal of Managed Care, Rosenthal, Li, and Milstein report on their findings from a study investigating how often patients visit their doctor once he/she is dropped from their network. Using claims data, the researchers found that:

"network narrowing reduced the odds of continuing to see an excluded physician (odds ratio, 0.18; P <.001). Patients who continued to see excluded physicians reduced their office visits by a mean of 0.9 visits per year, 0.8 visits more than comparison patients (P <.001). There were no significant changes in emergency department visits or admissions for patients of excluded physicians compared with a matched cohort.

The complete article can be read by clicking here.

Democrats Drop Medicare Plan

On Monday evening, in a reversal of a highly controversial plan to expand Medicare to those aged 55 and older, Senate Democratic leaders announced that they would be dropping the plan from their proposed bill that is currently being debated on the floor.

The announcement comes only hours before President Obama is scheduled to meet with Senate Democrats Tuesday morning. This comes in response, seemingly, to threats made by two centrists, Sen. Ben Nelson (D-Ne.) and Sen. Joe Lieberman (I-Ct.), to not vote for the bill if it includes the Medicare expansion. Majority leader Harry Reid, along with Mr. Obama, have made it clear that they want a vote on the bill come Christmas and, as evidenced by this latest development, are willing to make all the deals needed.

Read the complete story at The New York Times or the Wall Street Journal.

NYBGH Tribute to Leadership - Dec. 14th

Join NYBGH at our 15th Annual Tribute to Leadership on Monday, December 14th! This year's honorees are Mark Wagar, CEO of Empire Blue Cross Blue Shield along with Pitney Bowes CEO Murray Martin.

More information can be found at nybgh.org.

Medicare Expansion Faces Challenges

As Senate Democrats consider expanding Medicare, the federal health program for the elderly, as part of a public option compromise, myriad political obstacles stand in their way. First, many Republicans oppose the idea, claiming the slippery slope to a government-run, single-payer system it would spark would be worse than the one a public option would have began. Second, three centrists - Sens. Joe Lieberman (I-CT), Ben Nelson (D-NE), and Olympia Snowe (R-ME) have voiced their opposition to the plan that would expand coverage, through a buy-in mechanism, to those between the ages of 55 and 64.

To read more on the issue, click here.

First Wave of COBRA Subsidies Nearing End

Kaiser Health News reports on the soon-to-expire federal COBRA subsidy for workers involuntarily terminated between September, 2008 and December, 2009. As the end of the first wave of subsidies approaches, many workers face the challenge of paying for health insurance coverage, and perhaps forgoing important medical treatment. President Obama has stated that he thinks Congress should make extending the subsidy period a priority, but the issue has not been marked for consideration on the calendars of either chamber. There are, however, two proposed bills waiting to be debated.

Read the complete article by clicking here.

Further coverage, from the New York Times, can be found here.

Mercer Survey Shows Employers May Cut Benefits to Avoid Excise Taxes

A recent survey by Mercer showed that nearly two-thirds of employers would cut health benefits in order to avoid the excise tax proposed by the Senate health bill. The 40% non-deductible tax is expected to apply to about one-fifth of all employers.

The complete story can be read by clicking here.

HealthPass in Crain's New York Business

This week's Crain's New York Business features NYBGH subsidiary HealthPass in its Executive Inbox section. HealthPass is a health insurance exchange with a 10-year track record of providing affordable health insurance and quality customer service to small businesses in NYC, Long Island, Westchester County, Putnam County, Rockland County, and Dutchess County. One legal and structural component central to the success of HealthPass has been New York State's community rating law.

Find the complete article by clicking here.

Senate Begins Debate on Health Bill

Earlier this afternoon in the Capitol, the Senate began debate on and offering amendments to its landmark health reform bill. Among those offering amendments were Senators John McCain (R-AZ), Barbara Mikulski (D-MD), and Bob Casey (D-PA).

Just prior to that, Senate majority leader Harry Reid (D-NV) kicked off the debate with a dose of partisanship and baitsmanship. Asking for unanimous floor requests, Mr. Reid seemingly forced Republicans, specifically Mike Enzi (R-WY), into a trap by accusing them of blocking attempts at government transparency. Find the complete article at the New York Times Prescriptions blog.

This afternoon, just before Mr. Reid opened the debate, Sen. Evan Bayh (D-IN) received a letter from the CBO that discusses how the proposed bill will affect premium costs. They report that individuals who qualify for subsidies (those earning less than 400% FPL), not surprisingly, will experience a premium drop. But, those who don't receive subsidies will pay 10 to 13 percent more. Large employers are estimated to not see marked reductions in the number of employees they cover and premiums are expected to hold steady or drop 3 percent.

Read the complete Kaiser Health News article here.

Health Savings Could Start in the Cafeteria

In the business section of yesterday's Sunday New York Times, columnist Melanie Warner examines how employers' health care costs can potentially be shaved in their cafeteria and in what their employees eat. The article features Safeway, an industry trailblazer in containing corporate health costs, and a Massachusetts start-up, Full Yield, that helps employers cut costs via better food choices.

Read the complete article by clicking here.

Shopping Around for Health Care - New York Times

In today's New York Times, the Patient Money column examines the rising trend of shopping for health care costs, largely in part because of the increasing number of people insured with high deductible health plans.

Find the complete article by clicking here.

The Cost of Dying - CBS's 60 Minutes

Airing on the November 22nd edition of CBS's 60 Minutes, "The Cost of Dying" explores the extraordinary amount of money spent on people at the very end of their lives. Research funded in part by the Robert Wood Johnson Foundation (RWJF) was cited and Dr. Eliot Fisher from the Dartmouth Institute for Health Policy and Clinical Practice explained how many patients end up dying in intensive care units because it is the "path of least resistance" - the easiest way for doctors to manage them.

Find the article by clicking here.

Watch the video by clicking this link.

Senate Health Bill Details

Information on the recently released Senate health reform bill, The Patient Protection and Affordable Care Act, is available on the Senate Democrats' website. The website, run by the Democratic Policy Committee, features PDF files on the full text of the bill, fact sheets related to the sections of the bill, long and short summaries of the bill, and fact sheets on how the bill will help/benefit Americans.

To access the site, click this link.

Senate Moves Health Bill to Floor Debate

This evening, the Senate voted 60-39 - along party lines - for a motion to proceed, thus propelling the recently released Senate health reform bill to the full Senate floor for weeks of debate and amendments. Recent holdouts Joe Lieberman (I-CT), Mary Landrieu (D-LA), Blanche Lincoln (D-AR), and Ben Nelson (D-NE) all voted for the motion to proceed, but indicated clearly that today's vote wasn't a guarantee of their support for the final bill. Mrs. Lincoln, for instance, has said that she won't vote for a final bill that includes a public option.

Of note to employers, the Senate bill contains a provision that would not explicitly require employers to provide coverage, but would penalize employers with 50 or more employee $750 for each full-time worker in the company. The House bill, in contrast, mandates employer coverage and penalizes non-compliant employers (only those with an annual payroll over $500,000) with an 8% wage tax.

The full New York Times article can be found by clicking here.

A Consumers' Guide to Health Reform

Kaiser Health News today answers some of the most commonly asked questions about the proposed health reform bills in their A Consumers Guide to the Health Reform Bills. Among the topics addressed are taxes, mandates, out-of-pocket costs, and the public option.

Find the complete article by clicking here.

Reid Unveils Senate Health Bill

Yesterday evening, Senate majority leader Harry Reid (D-NV) released the Senate's version of a health reform bill, the "Patient Protection and Affordable Care Act". A cost analysis from the Congressional Budget Office (CBO) puts the price tag of the bill at $848 billion over 10 years while expanding coverage to an additional 31 million Americans and is expected to reduce projected federal budget deficits by $130 billion over a decade.

Now, Senator Reid is faced with the task of moving the bill to debate on the full Senate floor through a procedural move called a "motion to proceed", which is expected to happen on Saturday. This motion, along with passage of the bill itself, requires 60 votes. Senators Joseph Lieberman (I-CT) and Bernard Sanders (I-VT) are two Independents who caucus with the Democrats, but have not yet confirmed their support of the bill. If Lieberman and Sanders do not vote for the bill, Democrats will fall short of the required 60 votes by 2.

Full articles on the bill are available by clicking on the following links:

• New York Times
• Wall Street Journal
• The Hill

The full bill text can be found by clicking here. And, a searchable version of the bill, courtesy of the New York Times, is available here.

A talking points look at the Joint Committee on Taxation's revenue analysis can be accesses by clicking here.

The CBO score is available here.

Summary of House Health Bill

Detailed summaries of the House health reform bill (H.R. 3962), broken down into plain English and sectioned off by issue, are available on the House of Representatives and Kaiser websites.

The provisions most affecting employers, as detailed by the House are:

"Employers must provide health insurance to their employees or make a contribution to help fund affordable health insurance [the Health Insurance Exchange Trust Fund]. Employers that choose to offer coverage contribute at least 72.5 percent of premium for workers, 65 percent for families. However, if the coverage is unaffordable for low-wage workers, that worker can choose subsidized coverage in the Exchange and the employer makes a contribution to the Exchange. Employers who do not offer qualified coverage contribute 8 percent of their payroll to help cover expenses of employees who seek coverage through the Exchange. "

Bullet points on these issues can be found on the Kaiser website by clicking here.
Find the House summary by clicking here.

CMS Actuary Releases Cost Analysis of House Health Bill

The health reform bill recently approved by the House will cost $289 billion over the next ten years, according to the chief actuary at the Centers for Medicare and Medicaid Services (CMS). This analysis, however, is not an apple-to-apples comparison of the Congressional Budget Office and Joint Committee on Taxation's cost analyses because CMS doesn't take into account the various tax provisions baked into the legislation.

Additionally, the report claims that the bill falls short of house Democrats' reform goals:

"With the exception of the proposed reduction in Medicare... the provisions of H.R. 3962 would not have a significant impact on future healthcare cost growth rates."

Read the complete story at The Hill by clicking here.

The report from CMS's Chief Actuary can be found by clicking here.

GINA in the New York Times

Today's New York Times features an article about the newly released Genetic Information Non-Discrimination Act (GINA) regulations that will be in effect next weekend.

From the Times article:

"The biggest change resulting from the law is that it will — except in a few circumstances — prohibit employers and health insurers from asking employees to give their family medical histories. The law also bans group health plans from the common practice of rewarding workers, often with lower premiums or one-time payments, if they give their family medical histories when completing health risk questionnaires."

The act takes effect Nov. 21 for all employers with 15 or more employees. It applies to group health insurers whose plan years begin on or after Dec. 7, and it took effect for individual health insurance plans last May. The act does not apply to life insurers.

Read the complete article by clicking here.

Employer Reactions to House Bill

Employee Benefit News's blog writes on three employer and health plan associations' views on the recently passed House health reform bill:

Read the blog here.

EBRI Report on Account-Based Health Plans

In their November edition of EBRI Notes, the Employee Benefit Research Institute reports on the availability, contributions, account balances, and rollovers in account-based health insurance plans from 2006 to 2009. They report that enrollment in consumer-driven health plans (CDHPs) continues to rise; the percentage of individuals with employment-based health insurance eligible for enrollment in a CDHP has increased; and three-quarters of workers with family coverage receive employer contributions of over $1,000.

Find the complete report by clicking here.

House Passes Health Bill

Late Saturday night, the House of Representatives passed their version of health care reform by a slim margin of 220-215, with only one Republican vote, that of Anh "Joseph" Cao from Louisiana.

The full New York Times article can be found by clicking here.
The roll call, as tallied by the New York Times is found by clicking here.
The Wall Street Journal article can be found by clicking here.

Report Indicates that Health Reform May Benefit Small Businesses

A recently released report by the New York State Health Foundation and the Small Business Majority, indicates that inaction on health reform would be a worst-case scenario for small businesses. Using a model developed by MIT economist Jonathan Gruber, a number of scenarios were examined. Among them are:

• Two shared responsibility schemes that would expand public programs, mandate coverage for children, provide tax credits to employers who offer coverage, and require employers who do not offer coverage to pay a fee. These arrangements are similar to those under active consideration by Congress.
• A market reform scenario, which would include tax credits, a pooling of New York's highest-risk individuals, and an easing of State health insurance regulation.
• A single-payer plan in which the government would provide health insurance to everyone-employed or unemployed-and employers and employees share in a 10% payroll tax.

Click here to read the article from the Albany Times Union.

For the complete report, click here.

GOP Releases Health Reform Bill

Today, House Republicans released a 230-page health reform bill that essentially is a substitute for the House Democratic bill released last week. The GOP bill includes principles such as:

• Establishing universal access programs to guarantee access to affordable health care for those with pre-existing conditions
• Ending junk lawsuits
• Prevent insurers from unjustly canceling a policy
• Encourage small business association health plans
• Encourage innovative state-level programs
• Allowing the purchase of insurance across state lines
• Promoting healthier lifestyles
• Enhancing Health Savings Accounts (HSAs)
• Allowing dependents to remain on their parents' policies until age 25

The executive summary of the bill can be found by clicking here.

The full text of bill can be found by clicking here here.

The NPR health blog story is here.

Coverage from the New York Times can be found here.

Rep. Dingell's Manager's Amendments to House Bill

Late Tuesday, House Democrats, led by Rep. John Dingell (D-MI) released a manager's amendment to the recently released House bill, H.R. 3962.

The Wall Street Journal reports:

The appearance of the amendment, which contains an array of minor changes to the bill as it was originally written, means that Democrats have posted all legislative text related to the bill online. In keeping with their pledge to allow 72 hours for citizens and lawmakers to examine the bill, House Democrats could now bring up the measure for a vote later this week.

Included in the amendment is a provision to raise $24 billion by shutting down a biofuels tax credit, which helps fill a revenue hole that will keep the bill budget-neutral over 10 years.

Read the complete WSJ article here.

The text of the manager's amendment can be found here.

The Third School for Controlling Health Costs

In a perspective by Drew Altman, Kaiser Family Foundation President and CEO, a third school of health reformers are discussed. These Systems Reformers believe "that the best way to bend the cost curve is not through external market incentives or regulatory controls, but from the inside out, by creating a smarter health care system with the information base, new delivery models and payment incentives that will improve quality and lower costs." This school of thought is in contrast to the previously two dominant ones, Regulators and Marketeers. Regulators are those who believed that the best way to slow increasing costs was to control the total resources going into the health care system: putting limits on the supply of medical professionals, technology and facilities; setting payment rates; or putting enough purchasing power in the hands of government to drive the right bargain with the health care industry. Marketeers, on the other hand, believed that competing health plans and information-empowered, prudently-purchasing consumers would drive down costs, especially if insurance were restructured to give people the right incentives.

Previously relegated to respected academic journals and conferences, Systems Reformers have gained hold of policymakers' attention and have infiltrated Washington, D.C. and its reform process.

Read the complete article at: http://www.kff.org/pullingittogether/102909_altman.cfm

Financing Health Reform - CBO Style

In a post to the New York Times' Economix blog, Princeton economist Uwe Reinhardt writes on how the Congressional Budget Office (CBO) calculates the cost of financing the various health reform bills floating around Congress.

Find the article at http://economix.blogs.nytimes.com/2009/10/30/the-magic-of-financing-health-care-reform/

J and J's Corporate Wellness Efforts

Kaiser Health News today reports on Johnson and Johnson's corporate wellness efforts.

From KHN,

"Dr. Fikry Isaac, executive director of global health services at Johnson and Johnson, runs the company's wellness program. He spoke recently with KHN's Jenny Gold about Johnson and Johnson's program and how corporate wellness could be incorporated into the current effort to overhaul the nation's health system."

Read the complete story here.

House Democrats Unveil Health Reform Bill

Yesterday, House Democrats released their 1,990-page version of health reform legislation. With the Senate bill set to be released soon, both chambers of Congress are now preparing set for a heated and momentous debate. The non-partisan Congressional Budget Office (CBO) estimates that the House bill will provide coverage to 36 million people, cost $1.05 billion over 10 years, and cut the budget deficit by $104 billion over ten years. Of note, the public option plan, if passed in its current form, will negotiate rates with providers instead of using Medicare reimbursement rates and imposes an income tax surcharge on families making over $1 million.

The Hill reports on more details of the bill here.

The following articles provide more detailed information:

• New York Times
• Wall Street Journal
• The Hill
  

Employers and Wellness Incentives

A recent story by Employee Benefit News reports that the average cash incentive in corporate wellness programs has increased from $204 in 2008 to $329 in 2009. In the study conducted by the National Association of Manufacturers and Health2Resources, a health communications firm, researchers also found that in 2007 only 14% of employers were measuring ROI, but in 2009 73% are monitoring their results. In a separate PricewaterhouseCoopers study, those companies that offered gift cards or cash with less than $50 value in exchange for taking a health risk questionnaire had a 42% participation rate, versus the 49% participation rate for those companies offering between $50 and $299.

Read the complete article by clicking here.

NYS Attorney General Announces New Reimbursement Database and Pricing Website

Yesterday, New York State Attorney General Andrew Cuomo announced the creation of a new consumer reimbursement system for out-of-network charges. The new reimbursement database and website with health care pricing information will be based out of Syracuse University and is called FAIR Health, Inc. The extended research network consists of SUNY Buffalo, SUNY Upstate Medical University, Cornell University, and the University of Rochester.

From the Office of the Attorney General:

Today’s announcement arises from a wide-ranging investigation by Cuomo’s office into how the health insurance industry reimburses consumers for out-of-network health care charges. The investigation uncovered a fraudulent and conflict-of-interest ridden reimbursement system affecting millions of patients and their families and costing Americans hundreds of millions of dollars in unexpected and unjust medical costs.

Read the complete article at: http://www.oag.state.ny.us/media_center/2009/oct/oct27a_09.html

Health Care Reform - House Bill to Reach Floor Soon

House Majority Leader Steny Hoyer (D-Md.) is reportedly set to introduce the health care reform bill that will make it to the full House floor, according to The Hill newspaper. House Democrats want to bring it to the floor so it can be voted on next week. Because they pledged to give 72 hours notice to review the bill, House leaders are expediting their progress. Hill staffers indicate however that a CBO score of the bills need to be released before a bill could formally be introduced.

Read the complete story here: http://thehill.com/homenews/house/64941-house-dems-on-verge-of-bringing-health-bill-to-floor

Health Care Reform - Senate Bill to Include Opt-Out Public Option

In an announcement Monday, Senate Majority Leader Harry Reid (D-Nev.) articulated that the melded Senate Finance and HELP committee health reform bill will include a public option. States, however, under this draft, will be able to opt-out of the public health plan option program. Senate leaders are preparing to submit the legislation to the Congressional Budget Office as soon as Monday to be scored. Details of the new bill haven't been set, but an outline is becoming clearer.

The Wall Street Journal reports on how this legislation would affect employers:

Employers with more than 50 workers wouldn't be required to provide health insurance, but they would face fines of up to $750 per employee if even part of their work force received a government subsidy to buy health insurance, this person said.

Read the complete article at: http://online.wsj.com/article/SB125658273270408669.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsSecond

The New York Times article can be found at: http://prescriptions.blogs.nytimes.com/2009/10/26/reid-to-announce-opt-out-public-plan-today/?hp

Thanks for coming out last night!

Thanks again to all who came out for NYBGH's first-ever social media and health care event! We had a great turnout and two wonderful speakers!

Visit nybgh.org for more information on upcoming events!

Stuart Altman, PhD is speaking about federal health reform at our Annual Meeting on Nov. 18th, 4:00pm - 7:00pm. Check out the details on nybgh.org!

New GINA Rules Impose Restrictions on HRAs

On October 1st, the U.S. Departments of Health and Human Services, Labor, and the Treasury jointly released an advanced copy of the interim final regulations on the Genetic Information Nondiscrimination Act. The interim final regulations were posted to the Federal Register on October 7th and clarify several aspects of GINA as it relates to health risk assessments.

The rules become effective December 7th, 2009. GINA’s provisions for group health plans are effective for plan years beginning on or after May 21, 2009. Thus, the effective date for calendar year plans is Jan. 1, 2010.

Read the rest of this story at: http://ebn.benefitnews.com/news/new-gina-rules-impose-restrictions-on-health-risk-assessments-2682139-1.html

Successfully Implementing an HSA

Employee Benefit News recently released a podcast by OptumHealth's Todd Berkley on successfully incorporating an HSA into a client's health benefit offerings.

Find the podcast by clicking here.

Senate Finance Committe Bill Approval Press Release with Provision Descriptions

In a press release issued by the Senate Finance Committee, a recap of each of the major provisions of the Baucus bill are outlined. Without having to dissect the actual bill and its language, one can get a sense of what each provision is actually proposing.

Find the press release at: http://finance.senate.gov/press/Bpress/2009press/prb101309b.pdf

HealthPass in Wall Street Journal

In the October 14th edition of the Wall Street Journal, NYBGH subsidiary HealthPass gets a nod in a front page story. The article, as part of the Healthy Consumer series, profiles a number of businesses facing changes to their health benefits offerings this year as costs continue to rise and the consequences for their employees.

Find the article at: http://online.wsj.com/article/SB10001424052748703790404574471290259603238.html

Visit HealthPass at: http://www.healthpass.com/

Health Care Reform - Senate Finance Approves Baucus Bill with One GOP Vote

In a 14-9 vote, with Sen. Olympia Snowe (R-ME) as the only Republican voting with the Democrats on the Senate Finance Committee, the landmark Baucus health care reform bill has cleared the panel and is now set to be merged with the Senate HELP committee health reform bill that was approved in July.

For the NYT story, click http://www.nytimes.com/2009/10/14/health/policy/14health.html?hp

For the WSJ story, click http://online.wsj.com/article/SB125543637111982309.html?mod=WSJ_hpp_LEFTTopStories

Open Enrollment Season - Choosing Health Insurance

In Saturday's New York Times Well Blog, journalist Tara Parker-Pope writes about NYT Patient Money columnists Lesley Alderman and Walecia Konrad and their new series on choosing health insurance during this year's open enrollment season. Available with the articles are open discussion forums where benefits managers and administrators can discuss changes they're making this year.

Access the article at: http://well.blogs.nytimes.com/2009/10/09/choosing-health-insurance-during-open-enrollment/

Health Care Reform - Five Key Numbers from CBO Score

A posting on the Wall Street Journal Health blog highlights five key numbers from the CBO scoring of the Senate Finance Committee health bill.

CBO estimates the cost to be $829 billion over 10 years while shaving off over $80 billion from the federal deficit over ten years as well.

Find the article at http://blogs.wsj.com/health/2009/10/07/five-key-numbers-in-cbos-score-of-the-senate-finance-bill/

Health Care Reform - CBO Scores Baucus/Senate Finance Bill

The cost analysis is in! Sen. Max Baucus' Finance Committee bill will cost $829 billion over ten years, up from an initial estimate of $774 billion, according to the Congressional Budget Office. The Finance Committee is now expected to move forward with voting on the bill, which will then get moved to the full Senate floor to be merged with the Senate HELP committee bill that was finalized in July.

The NYT story: http://www.nytimes.com/2009/10/08/health/policy/08health.html?_r=1&hp

The WSJ reports: http://online.wsj.com/article/SB125494356104171425.html

WSJ's Health Blog's take on the five important numbers in the CBO score: http://blogs.wsj.com/health/2009/10/07/five-key-numbers-in-cbos-score-of-the-senate-finance-bill/

Health Care Reform - Senate Finance Rejects Public Plan Option

After a day's worth of debate, members of the Senate Finance Committee voted 15-8 against a public plan option introduced by Senator Jay Rockefeller (D-WV).

Of all the various health reform bills moving through Congress, this is the only one without a provision for a government-run public plan option.

See the NY Times coverage at: http://www.nytimes.com/2009/09/30/health/policy/30health.html?_r=1&hp

Free AARP Workforce Assessment Tool

A big thank you to all who were able to attend today's Aging in the Workforce conference at the Association of the Bar of the City of New York!

If interested, one can access the free, confidential tool at http://www.aarpworkforceassessment.org

Designed to help your organization assess your current and future workforce needs, the AARP Workforce Assessment Tool is a resource for HR managers to:

• Assess how retiring workers will affect their organization
• Address skill shortage challenges due to staff attrition
• Create a work environment that attracts qualified workers of all ages
• Manage a multi-generational workforce
• Build an employer brand that attracts and retains top talent

The tool takes approximately 30 minutes to complete and generates a customized summary report based on your responses.

To register for the next NYBGH event, "Brain Health: How Brain Function Impacts Productivity and Healthcare Costs", please contact Jennifer Cole at jcole@nybgh.org or at 212.252.7440 x223

Two Employers from AARP's 2009 Best Employers for Workers Over 50 List to Speak at NYBGH Aging in the Workplace Conference

Two employers ranking in the 2009 AARP Best Employers for Workers Over 50 list will be speaking at an NYBGH conference next week. The half-day conference, "Aging in the Workplace: Its Impact on Cost, Priorities, and Health" will feature Lynette Chappell-Williams from Cornell University, which ranked #1 on AARP's rankings, as well as Bernadette Kenny from Adecco Group North America, which came in at #20 on this year's list.

Ms. Chappell-Williams is Cornell University's Associate Vice President for the Office of Workforce Diversity and Inclusion. Ms. Kenny is Adecco's Sr. VP of Human Resources & Chief Career Officer.

This event is complimentary for NYBGH employer members.

To RSVP, please contact Jen Cole at jcole@nybgh.org or 212.252.7440 x.223

Health Care Reform - The Costs of Inaction

Business Roundtable recently released a report, presented by Hewitt Associates, a human resources outsourcing and consulting company, on the costs of not reforming the nation's health care system. From the report:

This report makes a case for the potential benefits of health reform if it is done wisely. The United States can reduce upward health care cost trends and expand access for most Americans if:

• Health insurance coverage is expanded to as close to universal levels as we can reasonably get
• Existing sources of employer-based coverage are not disrupted or displaced or saddled with significant additional costs and compliance burdens
• Expanded coverage is accompanied by meaningful delivery system reform led by changes to Medicare; and
• As expected, purchasers in the private sector adopt these reforms.

The report can be found at: http://www.businessroundtable.org/sites/default/files/BRT_Hewitt_HC%20Reform%20Report_Sept2009_FinalONLINE.pdf

HealthPass Celebrates 10th Anniversary

HealthPass, an NYC-based health insurance exchange and a subsidiary of NYBGH, this week celebrates its tenth year in operation. Offering small businesses quality, affordable group health coverage, HealthPass was created 10 years ago through a partnership between NYBGH, the City of New York, and the health insurance industry.

The press release can be found at: http://www.marketwire.com/press-release/Healthpass-1046432.html

Health Care Reform - NewsHour with Jim Lehrer

Last week's health care stories from NewsHour with Jim Lehrer:

One-shot Solution Explored for H1N1 Vaccine

Obama Seizes on Momentum from Wednesday's Health Care Speech

Congress Reacts to President Obama's Speech

Axelrod Optimistic About Health Care Reform Push

Ahead of Obama Speech, Health Reform Debates Renewed in Congress

Kaiser Employee Health Benefits Survey - 2009

Today the Kaiser Family Foundation, along with the Health Research Educational Trust (HRET), released their 2009 Employee Health Benefits Survey that examines insurance premium costs as well as other items within a health benefits package including drug benefits, office visits, wellness benefits, health risk assessments, retiree benefits, and on-site clinics.

Premiums for employer-sponsored health insurance rose to $13,375 annually for family coverage this year, with employees on average paying $3,515 and employers paying $9,860. A number of the study's findings will be published today in a Health Affairs web exclusive.

To access the report, visit the KFF site at: http://ehbs.kff.org/?page=abstract&id=2
For the news release, visit: http://www.kff.org/insurance/ehbs091509nr.cfm

Health Care Reform - Adverse Selection

A new report released by the Rockefeller Institute of Government, the public policy research arm of the State University of New York (SUNY), examines the difficulties states encounter with "adverse selection" in their efforts to broaden coverage. Courtney Burke of the Rockefeller Institute and Katherine Swartz of the Harvard School of Public Health discuss a number of possible strategies, including an individual mandate, creation of an insurance exchange, and a merger of the small group and individual markets.

The report can be found at: http://www.rockinst.org/pdf/health_care/2009-09-HPRC_Managing_Risk.pdf

Health Care Reform - New Coalition Advocates Health Reform Faithful to Free Market

A recent press release from Employee Benefit News tells of a newly formed grassroots coalition made-up of 20 statewide business chambers and employer organizations from across the country. As a group, they oppose an employer mandate.

From Employee Benefit News:

Employers for Quality Health Care is an independent bevy that includes family-owned businesses and Fortune 500 companies, standing alongside national groups such as the U.S. Chamber of Commerce and the National Association of Manufacturers as members. The participants, representing thousands of predominately small to mid-size employers who voluntarily offer coverage to millions of employees and families, delineated their needs and suggestions for health care reform in a letter to President Obama and members of Congress.

As a group they oppose an employer mandate, claiming that most employers who can afford to provide health care coverage already do so in an effort to attract and retain talent. New government-run coverage would shift millions of Americans off their existing private plans, they protest.

The article can be found at: http://ebn.benefitnews.com/news/new-coalition-advocates-health-reform-faithful-to-free-market-2681812-1.html?ET=ebnbenefitnews:e308:2126416a:&st=email

Health Care Reform - NewsHour with Jim Lehrer

Last week's featured stories on health care from PBS's NewsHour with Jim Lehrer:

Seattle Health Cooperative May Offer National Model

Surgeon Gawande Seeks More 'Rational Care' in Medicine

The Case Against the Public Insurance Option

Examining the Public Option in Health Care Reform

Health Care Coverage Tests Perceptions of the Media

Health Care Reform - Congressional Documents Reveal Health Costs

Kaiser Health News has obtained documents prepared by the House Ways and Means Committee that illustrate how the House Tri-Committee Health Reform Bill (America's Affordable Health Choices Act) will affect premium and cost-sharing maximums for low- and moderate-income families and individuals. Under this plan, premiums will be drastically reduced and out-of-pocket limits will decline. The documents only list families whose incomes are up to four times the federal poverty level: $88,200. These are the people who would be eligible for government subsidies.

The documents can be seen at: http://www.kaiserhealthnews.org/Stories/2009/September/04/House-Bill-Premiums.aspx#Families

Retail Medical Clinics

A study published in the September/October issue of Health Affairs and conducted by researchers at the RAND Corporation examines retail medical clinics. The research focused on the types of patients seeking care at these clinics, how patients pay for the services delivered, and the types of ailments treated.

From the press release:

"Retail medical clinics located in pharmacies and other stores typically attract insured and uninsured patients who are seeking help for a small group of easy-to-treat illnesses or preventive care and do not otherwise have a regular health care provider..."

The RAND press release can be found http://www.rand.org/news/press/2008/09/10/

The Health Affairs article abstract is at http://content.healthaffairs.org/cgi/content/abstract/27/5/1272

Minnesota Patients Shop Around for Health Care

Minnesota Governor Tim Pawlenty announced this week the nation's first web-tool that allows consumers to shop around for health care (consumers see insurers' negotiated rates). The site, mnhealthscores.org was developed by MN Community Measurement, which is a "collaborative of state health providers that collected the data from insurance companies", says a Star Tribune article. The article continues, noting that the site provides the average cost for 103 common medical procedures from 110 providers in the state, about 85 percent of primary care in Minnesota. The payment information supplements the quality data that was already on the site, which provides scores on diabetes, vascular disease, depression, and patient experience.

CBO - Effect of Health Insurance on Labor Markets

The Congressional Budget Office (CBO) recently released an issue brief on the effect of changes to the health insurance system on labor markets. The brief reports that:

"Changes to the health insurance system could affect labor markets by changing the cost of insurance offered through the workplace and by providing new options for obtaining coverage outside the workplace. For example:

• Requiring employers to offer health insurance—or pay a fee if they do not—is likely to reduce employment, although the effect would probably be small.
  

• Providing new subsidies for health insurance that decline in value as a person’s income rises could discourage some people from working more hours.
  

• Increasing the availability of health insurance that is not related to employment could lead more people to retire before age 65 or choose not to work at younger ages. But it might also encourage other workers to take jobs that better match their skills, because they would not have to stay in less desirable jobs solely to maintain their health insurance."

The brief can be found at http://www.cbo.gov/ftpdocs/104xx/doc10435/07-13-HealthCareAndLaborMarkets.pdf

Co-Op Only Option For Bi-Partisan Support

Appearing on Sunday morning's Face the Nation with Bob Schieffer on CBS, Senators Chuck Grassley (R-IA) and Kent Conrad (D-ND) - both members of the Finance Committee - agree that creating a health insurance co-op (as the proxy public option) is the only way to pass bi-partisan reform legislation. They also agree that passing legislation via the budgetary reconciliation process (so as to avoid the pay-as-you-go rules that mandate that legislation can only be passed if it is budget neutral) should not be invoked.

See the video at http://www.cbsnews.com/video/watch/?id=5260341n&tag=related;photovideo

The related article is at http://www.cbsnews.com/stories/2009/08/23/ftn/main5260259.shtml?tag=contentBody;featuredPost-PE

Senator Schumer on Meet the Press

On Sunday, Senator Chuck Schumer (D-NY) - a member of the Senate Finance Committee - appeared on NBC's Meet the Press to discuss with host David Gregory the prospects of a public plan option in health reform legislation. Rebutting him was Sen. Orin Hatch (R-UT), a senior member of the Senate Finance Committee.

The video can be found at http://www.msnbc.msn.com/id/21134540/vp/32528251#32528251

Health Care Reform - Splitting the Bill

Rumor has it that Democrats in Congress are beginning to ruminate on the idea of splitting health reform legislation into two parts. One part would include aspects related to budgetary issues and would be the most expensive provisions (e.g. subsidies for low-income individuals to purchase health insurance and an expansion of Medicaid) of the proposed legislation. This would likely pass solely with Democratic votes through a parliamentary budgetary maneuver called reconciliation. This requires only 51 votes - in contrast to the 60 votes usually required to pass legislation in the Senate. The second part of the reform legislation would involve insurance regulation and includes aspects such as mandates and caps on out-of-pocket expenses and would likely require heavy negotiating with Republicans and conservative Democrats.

A Wall Street Journal article about this can be found at: http://online.wsj.com/article/SB125072573848144647.html

Health Reform - EBRI Facts on Benefit Issues

Employee Benefit Research Institute has, on its website, a brief on "Facts on Benefits Issues" to help educate the public about many of the statistics used in the health reform debate.

The topics covered:

• the uninsured,
  
• coverage trends,
  
• factors affecting coverage,
• public opinion: health care costs,
• Medicare, and
  
• tax treatment of health care benefits

Also included is a section on various retirement issues that may be affected by reform legislation.

All answers are derived from studies conducted by EBRI, a nonpartisan research organization that does not lobby and does not take positions on policy issues.

The brief can be found at http://www.ebri.org/campaign/.

WSJ - The Whole Foods Alternative to ObamaCare

Today's Wall Street Journal features an article by John Mackey, CEO of Whole Foods who has been known as an outspoken champion of health savings accounts (HSA) and an advocate of maintaining a functional and free private health insurance market.

The article can be found at http://online.wsj.com/article/SB20001424052970204251404574342170072865070.html#mod=loomia?loomia_si=t0:a16:g4:r1:c0:b0.

Health Care Reform - Public Option in Danger

Appearing on Sunday morning's political talk shows, two of the Obama Administration's leading figures on health care reform have given signals that the "public plan option" will be dropped from the health reform proposals. Facing increased criticism, the Administration has signaled that it is open to compromise and will consider a proposal for a nonprofit health cooperative being developed in the Senate Finance Committee.

Health and Human Services Secretary Kathleen Sebelius said the public option was “not the essential element” for reform and White House Press Secretary Robert Gibbs, appearing on CBS's Face the Nation, said that Mr. Obama, in wanting choice and competition in the insurance market "has, thus far, sided with the notion that can best be done through a public option". However, Mr. Gibbs continued saying that the bottom line is that, "what we have to have is choice and competition in the insurance market", but that it doesn't necessarily have to come from a public option. Many right-leaning health policy experts and pundits believe that the public option will disintegrate the private health insurance market, thus leading to a government-run single payer system.

Articles on the public option's floundering can be found in the following links:
New York Times
Wall Street Journal
Washington Post
Washington Times

Driving Participation in Health Improvement Programs

Recently released by the WellPoint Institute for Health Care Knowledge is a report from Health Management Corporation (HMC), a wholly owned subsidiary of WellPoint, Inc., showing research into what drives health plan members to enroll and engage in programs to improve their health.

An excerpt from the report's abstract:

The 2008 HMC study found that members who face barriers to care are more likely to enroll in health improvement and disease management programs. It also identified monetary incentives and support from health plans and employers as key to participation. After enrollment, successful engagement is tied more to demographic and operational factors than to member characteristics. While members must first express interest in the program, the crux of responsibility falls to the health management program to build on that interest after enrollment.

The full report can be found here: http://www.wellpoint.com/pdf/Helping_People_Help_Themselves.pdf

NYBGH To Host Members of Congress

NYBGH will be hosting two health care reform events in the coming weeks. The August Congressional Recess provides us with a great opportunity to meet with our New York Metro area representatives to discuss health reform. To that end, NYBGH is hosting two forums where NYBGH members can hear about the reform activities set for Congress's fall session as well as pose their own queries.

Our two events are open only to NYBGH members and are as follows:

U.S. Representative Anthony Weiner (D-NY)
Friday, August 14th, 2009
8:30-11:00am
Bar Association of New York City (42 West 44th Street, NY, NY 10036)

&

U.S. Representative Yvette Clarke (D-NY)
Tuesday, August 18th, 2009
8:30-10:00am
University Club of New York City (1 West 54th Street at Fifth Avenue, NY, NY 10019)

WSJ - U.S. Psyche Bedevils Health Effort

Today's Wall Street Journal features an article about how the American mind so desperately yearns health reform, but at the same time grasps onto the status quo so tightly.

"This seems counterintuitive. People know the system is creaking, frustrating and way too expensive. They complain about it all the time. Yet they can't quite let it go.

Why? Like health care itself, the answer is complicated. But there are five big reasons:"

Read the article here.

Health Reform - How Can Employers Help Fix Health Care?

In today's Wall Street Journal, Clayton Christensen and Jason Hwang, co-authors of "The Innovator's Prescription: A Disruptive Solution for Health Care" discuss how they think company CEOs can help change health care. They offer three specific strategies:

We recommend executives make one or more of three innovative changes: 1) encourage employees to use nurse-staffed in-store health clinics for common ailments, 2) partner with integrated health systems like Kaiser Permanente, and 3) set up company-run clinics at corporate offices and plants.

The article can be found here.

Health Care Reform - How to Finance It?

The Kaiser Family Foundation's Health Reform Gateway has released an issue brief on the options available to finance health care reform.

From KFF:

One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period.

This brief explains the likely sources of added costs under reform, the types of financing measures being considered, and some of the key questions likely to be addressed by how a plan is financed. It is part of a series of briefs providing an overview of key issues and concepts related to health reform.

The brief can be found here.

Goodbye to ERISA?

In Monday's Wall Street Journal, an opinion article on the Tri-Committee House health reform bill discusses the possible fate of ERISA pre-emption for employer-based health benefits.

Check out the article here.

Kaiser Poll Finds Majority of Public Support Health Reform

July's Kaiser Health Tracking Poll finds that the majority of the public support reforming America's health care system, although it is softening.

The Kaiser Family Foundation's (KFF) press release reads that:

As has been the case over the past ten months, a majority of the American people (56%) continue to believe that health reform is more important than ever despite the country's economic problems, and the public believes by a two to one margin (51% versus 23%) that the country will be better rather than worse off if Congress and the president enact health reform. More Americans think they and their family will be better off (39%) than worse off (21%) if legislation passes, with roughly a third (32%) believing it will make no difference for them or their family.

The complete poll, with charts and other analyses, can be found on the KFF site.

Consumer Checkbook Releases Report of Patients' Experiences with Doctors

Washington, D.C.-based Consumer Checkbook/Center for the Study of Services, a non-profit consumer organization, today released ratings and reports on hundreds of individual doctors in Memphis, TN; Denver, CO; and Kansas City, MO. Major national health plans Aetna, Cigna, and UnitedHealthcare participated along with regional health plan leaders Blue Cross and Blue Shield of Kansas City as well as BlueCross BlueShield of Tennessee.

The reports on doctors are available free to the public at a CHECKBOOK website (www.checkbook.org/patientcentral) and also through the website of a healthcare coalition in each metro area—the Kansas City Quality Improvement Consortium, the Colorado Business Group on Health, and (in the near future) Healthy Memphis Common Table.

A Public Plan for Connecticut

As reported by the Hartford Courant, yesterday the Democrat-controlled Connecticut state legislature overturned seven vetoes by Connecticut Governor M. Jodi Rell to take the first step in establishing universal health care in the state. Vetoing what she saw as a program too costly (claiming that costs could run as high as $1 billion a year), Gov. Rell did win a smaller victory when the controversial health care "pooling" bill failed to pass in the state Senate. The universal health care program is set to launch in 2012 and details of it will be crafted by a state board.

The story from the Hartford Courant can be found here. And, the story from the WSJ can be found here.

Accredited Office-Based Surgery Practices in New York State

The New York State Department of Health (NYS DOH) has launched a web portal that lists, by county, accredited office-based surgery practices. According to the NYS DOH website:

"Effective July 14, 2009, physician offices that perform surgical or invasive procedures using more than mild sedation must be accredited by one of these agencies:

• Accreditation Association for Ambulatory Health Care (AAAHC)
• American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF)
• The Joint Commission (TJC) "
  

The website can be found here.

Value Based Benefit Design: A Research Agenda

The National Business Coalition on Health (NBCH), NYBGH's national umbrella organization, in partnership with AHRQ recently released a white paper borne out of a value-based benefit design research agenda workshop held in November, 2008. Outlining recommendations from the multi-stakeholder group, it includes and highlights the growing emergence of value-based benefit design (VBBD) as a means of encouraging appropriate health care choices by consumers and providers. Moreover, it presents VBBD's evidence base and a discussion of practical implementation of VBBD as well as consumer perspectives. The white paper can be found here and is in PDF format.

Health Care Reform - Senate Committee Clears Bill

Today, a Senate panel voted, 13-10 and along party line, to approve the Senate Health, Education, Labor, and Pension Committee's health care bill. This comes only days after President Barack Obama urged Congress to quicken their pace with pushing through health reform. Reports can be found at the Wall Street Journal and the New York Times websites.

Health Care Reform - House Democrats Release a Plan

Yesterday, House Democrats released their proposal for sweeping health reform. The bill includes higher taxes on the rich, expands coverage, and penalizes all but the tiniest employers. Main points of the bill include:

• A tax surcharge ranging from 1% to 5.4% for individuals making over $280,000/yr and families making over $350,000/yr

• Employers not providing insurance to workers will have to pay a fee - equal to 8% of wages for an employers with an annual payroll over $400,000/yr - to the government to subsidize coverage. Employers with annual payrolls greater than $250,000 but less than $400,000 will pay a smaller fee.
  

• Has the potential to reduce the rolls of uninsured by 37 million, leaving approximately 17 million still uninsured

A copy of the bill can be found here.

The WSJ article can be found here and the New York Times article can be found here.

Health Care Reform - The Tax Debate

Central to the current health reform debate is the question of how to finance it. One proposal on the table is to tax, for the first time ever, health benefits provided by employers. In the last week, vocal and fierce opposition to this idea has surfaced. To better understand the issue in context, Health Affairs recently released a Health Policy Brief in which the authors describe the arguments for and against this plan. Find the article here.

Two Sides to Every (Health Care Reform) Debate

In this past Sunday's New York Times, the op-ed section focused on health care reform and how there are two sides to each equation. The articles are written by experts in the field and include Jonathan Gruber and Paul Ginsburg, among others. Their writing focuses on three topics: taxing health benefits, defensive medicine, and trimming hospital/health care costs. The article can be found here. The introduction from the Times:

President Obama has pledged to reform health care, but overhauling the system to offer every person in the United States coverage is no easy task. Op-Ed editors asked experts for advice on how to lower health care costs and pay for comprehensive coverage.

CMS Hospital Compare Website Revised

CMS has recently revised its Hospital Compare website to now report readmission and mortality data. The Web site now includes information on how frequently patients return to a hospital after being discharged, a possible indicator of how well the facility did the first time around. The site is www.hospitalcompare.hhs.gov.

WSJ - Support Slips for Tax on Employee Health Benefits

Today's Wall Street Journal reports that Senators on the Finance Committee are cooling on the idea of taxing employee health benefits for the first time ever. The idea is unpopular with many voters, although the idea is not being completely swept off the table. To finance reform, the Committee is now looking at taxing the wealthy - or limiting tax deductions - to help subsidize expanded coverage. The article can be found here.

HR Policy Association Comprehensive Health Care Reform Packet

The HR Policy Association now has a page devoted to comprehensive health reform from an HR professional perspective. This site gives HR professionals up-to-date resources for information on the health reform debate while also showcasing the Association's own efforts in affecting reform. The page includes policy briefs and memoranda; summaries of the Congressional reform proposals; letters to Congress/Administration; HR Policy Association hearing testimony; legislative/regulatory history; press releases; and other useful information.

The page can be found on the HR Policy Association website.

EBRI 2009 Health Confidence Survey

As part of their monthly issue brief series, the Employee Benefit Research Institute (EBRI) released The 2009 Health Confidence Survey: Public Opinion on Health Reform Varies; Strong Support for Insurance Market Reform and Public Plan Option, Mixed Response to Tax Cap.

Find the article here.

Laurel Pickering in the Wall Street Journal

An article in yesterday's Wall Street Journal quotes Laurel Pickering, NYBGH's Executive Director, as she participated last week in a roundtable hosted by the Foundation for Art & Healing. The article showcases how art can help people heal and can be found here. Convening thought leaders from the medical, academic, public health, arts, and business communities, the Arts and the Heart Campaign roundtable was held to explore the relationships between creative expression and healing while also discussing how greater recognition and practice of the concept can happen. Some of the other roundtable participants included Robert Butler, MD, the founder of the International Longevity Center; Steven Safyer, MD, CEO of Montefiore Medical Center; and Edward Hirsch, a poet and the President of the Guggenheim Foundation.

Health Care Reform - Issue Comparisons

As the House and Senate release and mark-up their bills for health reform, one can easily lose track of who's proposing what. The Kaiser Family Foundation and the RAND Corporation have created useful and easy-to-use health reform issue comparison tools and publications on their websites to help sift through the debate.

Kaiser: http://healthreform.kff.org/
RAND: http://www.randcompare.org/

Health Care Reform - Do We Need a Health Care Fed?

The debate surrounding comparative-effectiveness research seems to continually revert back to the question of whether or not the government should be deciding which processes and procedures have the best outcomes. Below are perspectives from both sides.

Jonathan Weiner, a professor of health policy at the Bloomberg School of Public Health at Johns Hopkins University says yes.

Michael Cannon, the Cato Institute's Director of Health Policy Studies says no.

Massachusetts Cuts Health Rolls

To deal with pressing budget cuts, and skyrocketing costs due to increased enrollment of their health insurance coverage mandate, Massachusetts is cutting 12% from the Commonwealth Care budget, the Boston Globe reports.

The article, from the Boston Globe, begins with:

"Overseers of Massachusetts’ trailblazing healthcare program made their first cuts yesterday, trimming $115 million, or 12 percent, from Commonwealth Care, which subsidizes premiums for needy residents and is the centerpiece of the 2006 law.

The board of the Connector Authority made the cuts as officials confronted two side effects of the recession: the state budget crisis and a surge in enrollment by the recently unemployed."

Find the complete article here.

Health Care Reform - Health Wonk Review

The Healthcare Economist blog posted a variety of links to blogs and other websites with commentary on a number of the issues permeating the health reform debate. Check out the posting here.

Health Care Reform - Health Care With a Warranty?

In yesterday's New York Times, Dr. Pauline Chen writes about the concept of health care with a warranty. Bridges to Excellence CEO Francois de Brante, along with colleagues Guy D'Andrea and Harvard economist Meredith Rosenthal, published in the most recent edition of Health Affairs an article that proposes a new health care reimbursement model that comes with a warranty. This model, called Prometheus Payment, first covers all fees for standard and recommended services, treatments, and procedures for specific conditions. However, the fees are "risk-adjusted" for patients who may be old or frail. The warranty, thus, is based on the costs incurred by avoidable complications and half of those costs must be paid for by the provider.

Health Care Reform - Health Co-ops

In the Commonwealth Fund Blog's inaugural post, Commonwealth Fund President Karen Davis writes on the possible impact health insurance cooperatives may have on reform as well as the history of American cooperative health care. The current policy discussion is fraught with variations of how reform will actually take shape and one proposal in play is the one laid out by Senator Kent Conrad (D-ND). The Senate Finance Committee's soon-to-be-released reform bill is considering Conrad's idea for reforming the insurance market by developing and implementing regional- or state-based non-profit health insurance co-ops rather than a public insurance option. Find the article here.

Patient-Centered Medical Home Article

In today's New York Times, Jane Brody writes a thorough and informing article on patient-centered medical homes, their potential to deliver better care, and the attention the concept has been receiving throughout the health reform debate. Check out the article here.

Health Care Reform - House Releases Draft Bill

Early Friday afternoon, the House released a health reform draft bill that consolidates the ideas and discussions from the three committees responsible for health care - Energy & Commerce, Education & Labor, and Ways & Means. If passed, the bill would institute a public health insurance plan, a pay-or-play insurance requirement similar to the Massachusetts model, establish a health insurance commissioner, expand Medicaid eligibility, fill in the Medicare Part D doughnut hole, and would end insurers' practice of denying coverage or charging higher premiums to sick people. Key details of the plan, however, have been left out, such as a CBO cost estimate. An article about the bill can be found in today's New York Times and Wall Street Journal.

Health Care Reform - How to Pay For It?

An article in today's New York Times outlines the numerous proposals to cut costs in the estimated over $1 trillion health care reform bills. Accompanying the article is a detailed and helpful interactive graphic that dissects the key reform proposals, its supporters and dissenters, ways to finance them, and the legislative road map. Find the article here.

A Bipartisan Approach to Health Reform

Today, the Bipartisan Policy Center, along with the Engelberg Center for Health Care Reform at the Brookings Institution, a Washington, D.C.-based think tank, released a report outlining a bipartisan approach to health reform.

The report's blurb from the Brookings site:

"The bipartisan framework, "Crossing Our Lines: Working Together to Reform the U.S. Health Care System," released today by former U.S. Senate Majority Leaders and Bipartisan Policy Center's (BPC) Advisory Board members Howard Baker, Tom Daschle and Bob Dole, provides recommendations for comprehensive health reform to ensure that every American has affordable, quality health coverage. The report is a product of the BPC's Leaders' Project on the State of American Health Care, which was launched last year and is co-directed by health care policy experts Chris Jennings and Mark McClellan."

To access the report, click here.