Reform Update: Hospitals see more paying patients, but there’s a hitch

Insurance expansion under healthcare reform is starting to yield patient volume for hospitals, but the costs of staffing up for more patients are eclipsing the additional revenue.

Earnings reports for not-for-profit systems in the first half of the year show that many providers are seeing rising salary and benefit expenses cut into revenue gains, leading to smaller operating surpluses.

“As the pieces of the Affordable Care Act are coming together, it’s changing the demand for care,” said Jeff Jones, managing director at Huron Consulting Group. “It’s shifting the way that providers are thinking about their labor pools.”

A report from Standard & Poor’s similarly found that in 2013, expenses increased 7%, outpacing revenue growth of 5%. The rating agency attributed the rising costs to preparations that systems were making to prepare for healthcare reform, including staffing needs.

Compensation costs are increasing as more systems move to a physician employment model to drive referrals and prepare for population health management. In addition, healthcare reform is driving demand for specific skill sets such as experience with electronic health-record systems.

“Management is focused on the recruitment and retention of qualified staff in many clinical areas in order to meet the demands of patient activity, particularly as the […]

By |August 21st, 2014|Health Reform|Comments Off

ACA premiums increase 8.2 percent

Premiums for 2015 health insurance plans sold in government-run marketplaces will increase an average of 8.2 percent, according to a new analysis.

The Health Research Institute at PricewaterhouseCoopers found a wide range in premium changes in the 29 states and the District of Columbia where it examined filed rate changes. The average rate increase would raise the average monthly premium—before federal subsidies—to about $385.

Premiums may jump at high as 50 percent in Arkansas and drop by as much as 23 percent in Arizona.

The biggest state average premium increase—among states where all information was available—was slated to occur in Indiana, which reported an average 15.4 percent increase. That increase will bring the average premium among the nine insurers in the state’s marketplace to $514.

Oregon was found to have the lowest average change, -2.5 percent, among 13 insurers. An average premium for the state was unavailable.

The largest states in the report included Florida, 7.4 percent; New York, 6.9 percent; and Ohio, 13 percent. Eleven of the 29 states reported double digit average premium increases, although that included incomplete data from Louisiana. California also has reported incomplete data, but that report included a 4 percent weighted average premium rate increase.

The report noted that […]

By |August 15th, 2014|Health Reform|Comments Off

WellPoint to change name to Anthem

WellPoint, one of the largest investor-owned health insurers in the country, is looking to rebrand itself as Anthem, pending shareholder approval.

Joe Swedish, WellPoint’s CEO, told Modern Healthcare the insurer was making the change to better connect with consumers in a “radically changing” healthcare environment. After surveying 55,000 people about their healthcare preferences, officials said they found brand was at the top of consumers’ list, along with price and provider network.

“We’re dealing with a consumer-oriented industry that now is being put in a position to make healthcare decisions for themselves and their families that is based around more information around access, quality and price,” said Swedish, a former health CEO. “We have to demonstrate a brand that gives each person a value proposition.”

Swedish also said the Anthem name will hopefully eliminate brand confusion among its 48,000 employees and large provider network, in addition to its millions of members. The insurer, which operates Blue Cross and Blue Shield plans, took on the WellPoint name in 2004 when WellPoint Health Networks and Anthem merged. However, most of its plans carry the Anthem name, including in California, Virginia and Connecticut.

“This will help tremendously in aligning our relationships” with all stakeholders, Swedish said.

WellPoint, based […]

By |August 13th, 2014|Industry News|Comments Off


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