Professional Documents
Culture Documents
National Edition
In this Issue
1. News
Consumerism
3. Vitals
Data Snapshots from MCOL
4. California
Language Possible Enrollment Barrier Briefs - DMHC Orders Kaiser To Cover Physical And Related Therapies, Greater Newport, MemorialCare Enter Into Affiliation
5. Midwest
For Diabetes, Meds May Be Cheaper A Closer Look At The Safety Net Briefs - Minneapolis Named Nations Healthiest City, Cap On Insurance Benefits Lifted For Millions Of Americans
6. WebinarsWhitePapers
Recent and Upcoming Events Healthcare and Campaign Finance in California Midwest Non-Profit CEO Compensation
3. To what degree are the successes of health care consumerism initiatives dependent upon provisions of the Affordable Care Act? Key findings: When asked to rank price and quality transparency, account based plans, wellness incentive programs, web based patient health records for consumers and retail offerings of health plans/healthcare as 1 through 5, price and quality transparency had the highest average weighted rank at 1.84. A majority (56.5%) of respondents ranked price and quality transparency as having the highest value from their perspective. This trend continued when broken down by respondent organization category with 55.8% of purchasers, 51.4% of providers and 64.3% of vendor or others ranking this component of having the highest value.
Price & Quality Transparency 56.5% 21.3% 8.3% 9.3% 4.6% 1.84 Account Based Plans 18.5% 18.5% 30.6% 16.7% 15.7% 2.92 Wellness Incentive Programs 11.1% 24.1% 36.1% 17.6% 11.1% 2.93 Web Based Health Records 4.6% 22.2% 10.2% 32.4% 30.6% 3.62 Retail Offerings 9.3% 13.1% 15.0% 24.3% 38.3% 3.69
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2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved
MARKETPLACE/EMPLOYMENT NEWS
Value of Typical
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Percentage of Respondents Who Selected a Ranked Value for This Component of Consumerism
Perceived
When ranking account based plans respondents did not rank them with as high a value as the previous component though it did have the second highest average weighted rank at 2.93. A plurality of respondents (30.6%) gave this component a rank of 3. Those who categorized themselves as purchasers or vendor/other were more likely to rank account based plans with a higher value than providers. Over 70% of both purchasers and vendor/others ranked account based plans as 3 or higher while only 56.8% of providers did so. The average weighted rank of wellness incentive programs was only .01 higher than account based plans at 2.94. As with the previous component a plurality (36.1%) of respondents ranked wellness programs as 3. A low amount of respondents (11.1% for each) ranked this component as either high (1) or low (5). When broken down by respondent category there was variation on the value placed on this component. Almost 20% of providers but less than 5% of purchasers ranked this component as having the highest value. Over 40% of both purchasers and providers ranked this component as a 3 while less than 20% of vendor/others did. Respondents did not place a very high value on web based health records, 63% of respondents rated it as either a 4 or 5. The weighted average rank for this component was 3.62. There was not significant variation when broken down by respondent category, with trends staying constant across the three categories. Retail offerings of health plans/healthcare had the lowest weighted average rank at 3.69. This component had the most variation among respondent categories. Almost 50% of purchasers gave this component the lowest valued rank while just over 25% of vendor/others did the same. Less than 5% of purchasers and 13.5% of providers ranked this component as a 3 while over 33% of vendor/others did.
Respondents did not feel strongly about whether the success of health care consumerism initiatives depended on provisions of the Affordable Care Act (ACA). Just under a majority (47.3%) of respondents thought that consumerism initiatives success somewhat depended on the ACA. The amount of respondents who thought that initiatives were highly dependent or not very dependent on the ACA were close with 27.3% thinking they were highly dependent and 25.5% thinking they were not very dependent, less than a 2% difference. Dependence of the Success of Health Care Consumerism Initiatives On Provisions of the ACA
Highly dependent Somewhat dependent Not very dependent Purchaser 28.6% 45.2% 26.2% Provider 26.2% 57.1% 16.7% Vendor/ Other 26.9% 34.6% 38.5% Total 27.3% 47.3% 25.5%
When broken down by respondent category there was no significant variation among those who thought initiatives were highly dependent on the ACA with just over a quarter of respondents in each categorizing answering as such. There was variation by category for those who saw initiative as being somewhat or not very dependent on the ACA. Over 57% of providers thought that consumerism initiatives were somewhat dependent while only 35% of vendor/others did. 38% of vendor/others thought that consumerism initiatives were not very dependent on the ACA while only 17% of providers though so. N=111
Dependence of the Success of Health Care Consumerism Initiatives On Provisions of the Affordable Care Act
2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved
MARKETPLACE/EMPLOYMENT VITALS
LISTS from
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1. Cost of Tests/Reimbursement 77.5% 2. Lack of Familiarity with Tests 49.0% 3. Questions About the Validity of Tests 30.7% 4. Lack of Evidence of Test Effectiveness 39.1% 5. Less or Not Relevant to Practice 3.6% 6. Questions About Patient Ability to Understand
Results 29.6%
Source: UnitedHealth, Center for Health Reform & Modernization, Working Paper 7, March 2012 http://www.unitedhealthgroup.com/hrm/UNH_WorkingPaper7.pdf
Employers Taking More Aggressive Steps to Manage Their Rising Costs and Improve Employee Health
According to an annual survey by Towers Watson and the National Business Group on Health found that total health care costs per employee are expected to rise 5.9% this year, as compared to 5.4% in 2011. Health care costs per employee averaged $10,982 last year, and is expected to rise to $11,664 in 2012. Employees share of costs increased 9.3% during this period, to $2,764. This amount represents a 40% increase in costs from just five years ago, as compared to a 34% increase for employers over the same time period. For 2012, retirees not yet eligible for Medicare can expect to pay an average of $4,226 per year for single-only coverage and $10,500 for family coverage.
Source: Towers Watson, March 8, 2012 http://www.towerswatson.com/press/6558
Sources: Alzheimers Association, 2012 Alzheimers Disease Facts and Figures, Alzheimers & Dementia, Volume 8, Issue 2, http://www.alz.org/downloads/Facts_Figures_2012.pdf
2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved
MARKETPLACE/EMPLOYMENT CALIFORNIA
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In Brief
DMHC Orders Kaiser To Cover Physical And Related Therapies
The Department of Managed Health Care has ordered Kaiser Foundation Health Plan to cease and desist from denying enrollees access to physical, occupational and speech therapy. According to the DMHC, it has received more than 100 complaints from Kaiser enrollees who had been denied such services. Kaiser had claimed the enrollees did not have a physical condition linked to surgery, trauma or a congenital condition. However, California law regarding health maintenance organizations considers such services to be medically necessary. Kaiser Health Plans policy to deny physical, occupational, and speech therapy services for nonphysical conditions is not permitted under the Knox-Keene Act, said Anthony Manzanetti, DMHCs chief of enforcement.
The Payers & Providers California Edition is published every Thursday with six pages of hard-hitting healthcare business and policy news and insights
2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved
MARKETPLACE/EMPLOYMENT MIDWEST
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In Brief
Minneapolis Named Nations Healthiest City
The metropolitan area surrounding Minneapolis recently ranked as the healthiest in the nation on Forbes magazines annual ranking of fit cities. The rankings are based on the American College of Sports Medicines Fitness Index. The report grades 50 metro areas across the country and creates a composite score based on factors including preventive health behaviors, prevalence of chronic diseases, access to care, policies supporting physical activity and crime levels. Minneapolis ranked first because of its benefits like low poverty and unemployment levels, low prevalence of chronic conditions like cardiovascular disease, asthma and diabetes. They also have abundant parkland and playgrounds, farmers markets and public transportation. The residents tend to be physically active, have lower smoking rates and are apt to bike or walk to work. Other Midwestern metro areas ranking in the top 50 include: Denver at 5, Cincinnati, 14; Milwaukee, 21; Kansas City, Kan., 22; St. Louis, 26; Chicago, 28; and Indianapolis, 45.
2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved
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A new Payers & Providers white paper, Follow The Money: Healthcare and Campaign Finance in California, discusses and analyzes the influence of the sectors money on politics and policy. It traces the biggest healthcare industry contributors to candidates and political action committees, how much theyre giving, and where that money is going. Follow the Money is available for $149. In addition to this concise and in-depth investigation, two databases in an easyto-read Excel spreadsheet format are also available for purchase for $129, or with the white paper for $199. They include: All healthcare-related organizations and the itemized contributions they made to candidates and PACs for the 2009-2010 campaign season. Details on more than 90 organizations and big individual contributors are included. A database of the largest donations made by individual employees of Californias hospitals, insurance plans and other healthcare organizations. Details on more than 200 entities are included. Both databases are available in an easy-to-read Excel spreadsheet format.
Given the ramifications of the landmark U.S. Supreme Court Citizens United case, you and your organization simply cannot lack a roadmap to where the political money flows from the healthcare industry in California. To order, call 209.577.4888 or go to www.healthexecstore.com
Payers & Providers popular non-profit hospital CEO salary survey is now available the Midwest edition. This voluminous survey will examine the compensation of more than 700 hospital CEOs in 10 states throughout the Midwest. The salary survey is available in two distinct components: The salary survey white paper analyzes the compensation data from the 30,000-foot view. Authored by Payers & Providers Midwest edition editor Duncan Moore, it includes interviews with hospital officials and compensation experts and includes key compensation statistics. This white paper is $149. The raw salary compensation data itself is available in an Excel spreadsheet format. It includes base salary, additional compensation and other key indicators. The data is taken from the 990 tax returns each hospital submits to the Internal Revenue Service. This data may be purchased on its own for $249, purchased in combination with the white paper for $349, or by state for $99 apiece.
The hospital CEO compensation survey is Payers & Providers single most popular product. Its useful for quickly gauging what your colleagues earn and whether your own compensation is in line. To order, call 209.577.4888 or go to www.healthexecstore.com
2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved
MARKETPLACE/EMPLOYMENT MARKETPLACE
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Employment
The following employment opportunities are listed in the Payers & Providers MCOL Employment Marketplace online at www.mcol.com/emp.htm Chief Financial Officer - Wellesley, MA Market Expansion Professional - Southern CA Regional Vice President for Payer Relations and Contracting - Oklahoma City, OK Executive Positions, Managed Care Organizations Throughout US The Payers & Providers MCOL Employment Marketplace provides three solutions for employers and recruitment firms to promote employment opportunities to the MCOL and Payers & Providers audience: 1. Payers & Providers Display Ads - that prominently feature your opportunity in the California, Midwest and or National Editions of Payers & Providers. 2. Payers & Providers Marketplace Ads - economically provide readers detailed information on your opportunity in any editions of Payers & Providers. 3. Online Advertising - with a package including web site listings of your opportunity in mcol.com and PayersandProviders.com, plus inclusion of your listing in the monthly edition of MCOL's @Career enewsletter, and eligibility to post the announcement in MCOL's member LinkedIn group. All Payers & Providers Display Advertising, plus qualifying Payers & Providers Marketplace ads receive the online advertising package at no additional cost. Call 209.577.4888 or go to www.mcol.com/aboutcls.htm to request an Employment Advertising Kit, post an employment opportunity or obtain additional information.
Volume 2, Issue 3
Payors & Providers Natinal Edition is published monthly by Payers & Providers Publishing, LLC. Inquiries may be directed to: Phone: (877) 248-2360 e-mail: info@payersandproviders.com Postal: 818 N. Hollywood Way, Suite B, Burbank CA 91505 Web: www.payersandproviders.com Facebook: http://www.facebook.com/Payers-Providers Twitter: www.twitter.com/payersproviders Editorial Board Members: California Edition: Steven T. Valentine, President, The Camden Group; Ross Goldberg, Immediate Past President, Los Robles Hospital and Medical Center; Mark Finucone, Managing Director, Alvarez & Marsol; Henry Loubet, Chief Strategy Officer, Keenan; Anthony Wright, Executive Director, Health Access California Midwest Edition: William M. Dwyer, Healthcare Strategist, Jay Warden, Senior Vice President, , The Camden Group, Ross A. Slotten, M.D., Klein Slotten & French, Michael L. Millenson, President, Health Quality Advisors LLC, Publisher /Editor: Ron Shinkman publisher@payersandproviders.com
Advertising Opportunities
Payers & Providers, publishes the weekly California and Midwest Editions in electronic format and the monthly National Edition in print and electronic format, and serves as the superior source for healthcare business and policy news and insights. Available advertising solutions through these publications include: Dedicated e-blasts to applicable Payer&Providers distribution lists Sponsor messages in each cover email of any Edition Display Advertising inside each Edition Inquire about Sponsored white paper and webinar opportunities To request a 2012 Payers & Providers Media Kit or other detailed Advertising information, please call 209.577.4888.
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