health change bulletin
Health Change Bulletin                                                                      October 2020
  
 
Quote 
  “Some insurers think the pandemic will have a downward effect on their costs next year, while others think it will increase their costs. If there is pent-up demand for forgone health services and widespread uptake of a vaccine, especially if the vaccine requires multiple doses, that could drive up costs.”  
-Cynthia Cox, Vice President, Kaiser Family Foundation
 
Factoid
 
Percentage of adults aged 18–64 who identified with selected reasons for being currently uninsured: United States, 2019



Note: A sample adult can provide more than one reason for being currently uninsured

Source: CDC: Reasons for Being Uninsured Among Adults Aged 18–64 in the United States, 2019
 
   
Healthsprocket List 
 
  WalletHub: 10 States With The Lowest Uninsured Rates in 2019

1. Massachusetts: 1.52% Children's, 3.39% Adults'
2. Rhode Island: 1.90% Children's, 4.68% Adults'
3. Hawaii: 2.80% Children's, 4.57% Adults'
4. Vermont: 2.09% Children's, 5.09% Adults'
5. Minnesota: 3.08% Children's, 5.48% Adults'
6. Iowa: 2.92% Children's, 5.70% Adults'
7. New York: 2.36% Children's, 6.06% Adults'
8. Wisconsin: 3.77% Children's, 6.31% Adults'
9. Pennsylvania: 4.56% Children's, 6.11% Adults'
10.Michigan: 3.42% Children's, 6.49% Adults'

Source: WalletHub 
 
 
HealthshareTV video
 

 
Health Systems Must Integrate and Rationalize
 
  Health Systems Must Integrate and Rationalize

Redundancy, duplication, and waste are pervasive in today’s healthcare delivery system, driving up both operating and capital costs. To achieve economic sustainability and market essentiality, health systems must integrate and rationalize to enhance clinical care, optimize operations, and lower costs, ultimately focusing on the improvement of every aspect of patient care operations.

    

 
Check out HealthshareTV, the home for health care videos    
 
Insights
  Refuge in the Storm? ACA’s Role as Safety Net Is Tested by COVID Recession
The Affordable Care Act, facing its first test during a deep recession, is providing a refuge for some — but by no means all — people who have lost health coverage as the economy has been battered by the coronavirus pandemic.
Kaiser Health News, October 7, 2020

Investing In Safety-Net Innovation To Address The Impacts Of COVID-19
The health care safety net—the patchwork of hospitals, clinics, and health systems that provide care to significant numbers of uninsured, underinsured, and publicly insured patients—provides a disproportionate amount of care to low-income communities of color, that are suffering the most from COVID-19.
Health Affairs Blog, October 5, 2020

Health services deals insights: Midyear 2020
As expected, health services deal activity slowed in the first half of 2020. Deal volumes edged below 500 for the first time since 2015, but two sub-sectors grew year over year: Labs, MRI & Dialysis and Other Services (which includes medical office buildings). Long-Term Care was, again, the largest sub-sector by volume.
PwC, October 2020

Guidehouse: Hospital Executives Predict Significant Shifts in Payer Mix
Approximately 70% of hospital and health system leaders are preparing for an increase in post-COVID-19 self-pay consumers and Medicaid beneficiaries, and a decrease in commercial reimbursement, according to a Guidehouse Center for Health Insights analysis of an executive survey conducted by Healthcare Financial Management Association (HFMA).
Guidehouse, September 30, 2020

Effects of the ACA Medicaid Expansion on Racial Disparities in Health Care
This issue brief builds on a previous literature review that broadly investigated the effects of Medicaid expansion by examining how the expansion has affected racial disparities in health coverage, access to care, health outcomes, and economic outcomes. It is based on KFF’s review of 65 studies which examined the impacts of Medicaid expansion by race/ethnicity and were published beginning in January 2014 (when the coverage provisions of the ACA went into effect) through July 2020.
KFF, September 30, 2020

Reasons for Being Uninsured Among Adults Aged 18–64 in the United States
Previously published data from the National Health Interview Survey (NHIS) reported that the percentage of uninsured adults aged 18–64 significantly decreased from 20.4% in 2013 to 13.3% in 2018. Lack of health insurance has been associated with not receiving preventive services or screenings and may, in turn, lead to delays in disease diagnosis and poorer health outcomes.
CDC National Center for Health Statistics, September 2020

What drives health spending in the U.S. compared to other countries
The United States spends significantly more on healthcare than comparable countries, and yet has worse health outcomes. Much of the national conversation has focused on spending on prescription drugs and administrative costs as the primary drivers of health spending in the U.S.
Peterson-KFF, September 25, 2020
   
 
    
News 
  Health care rates for 2021 stable, but 2022 may bring challenges
A drop in health care costs is projected to keep insurance rates low in 2021, but long-term worries about the COVID-19 pandemic are raising concerns about potential spikes in future years.
Roll Call, October 8, 2020

KFF: Average Family Premiums Rose 4% to $21,342 in 2020
Annual family premiums for employer-sponsored health insurance rose 4% to average $21,342 this year, according to the 2020 benchmark KFF Employer Health Benefits Survey. On average, workers this year are contributing $5,588 toward the cost of family coverage, with employers paying the rest.
KFF, October 8, 2020
 
Rates of key tests drop with fewer doctor visits, more telemedicine
The number of in-office visits to primary care physicians in the United States were 50% lower in the spring compared with the same periods in 2018 and 2019, a study published Friday by JAMA Network Open found. At the same time, more than 35 million telemedicine consultations -- in which patients communicate with their doctors by phone or online -- were held in April, May and June, a 30-fold increase over previous years, the data showed.
UPI, October 2, 2020
 
UnitedHealth, Cigna to expand Medicare Advantage footprints
Major payers are expanding their Medicare Advantage footprints next year, and focusing on telehealth benefits and reduced cost-sharing — both trends accelerated by the COVID-19 pandemic. The increased competition puts more plans in the market with low or no premiums as bullish payers have reported massive profits from deferred care over the past several months. Companies will also benefit from the elimination of the Health Insurance Tax starting in 2021.
HealthcareDive, October 2, 2020
 
4 million more Americans turn to Medicaid as coronavirus roils the economy
Just over 4 million more Americans turned to Medicaid last spring as the coronavirus pandemic upended the nation's economy, new federal data released Wednesday shows.
CNN, September 30, 2020
 
Modifiable health risks add $730B to U.S. healthcare spending
Modifiable health risks such as smoking, obesity and high blood pressure have been associated with more than $730 billion in U.S. healthcare spending, according to a study published Wednesday in The Lancet Public Health.
HealthLeaders, September 30, 2020
 
Even before pandemic struck, more US adults were uninsured
About 2.5 million more working-age Americans were uninsured last year, even before the coronavirus pandemic struck, according to a government report issued Wednesday. The study from the Centers for Disease Control and Prevention found that 14.5% of adults ages 18 to 64 were uninsured in 2019, a statistically significant increase from 2018, when 13.3% lacked coverage.
Associated Press, September 29, 2020
 
UnitedHealthcare teams with St. Luke to create new narrow network plan
UnitedHealthcare partnered with St. Luke’s Health System and Children’s Mercy in Kansas City to create a new narrow network commercial plan intended to offer a cheaper option. The plan would only provide care at the St. Luke system that includes 18 hospitals and 130 physician offices and the children’s hospital.
FierceHealthcare, September 29, 2020
 
US hospital admissions for non-COVID-19 have only partially rebounded
While declines in U.S. hospital admissions during the onset of COVID-19 has been well-documented, little is known about how admissions during the rebound varied by age, insurance coverage and socioeconomic groups. The decline in non-COVID-19 admissions was similar across all demographic subgroups but the partial rebound that followed shows that non-COVID-19 admissions for residents from Hispanic neighborhoods was significantly lower than for other groups.
Dartmouth College News Release, September 25, 2020
  
 
 
 
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