A new system designed to improve health care quality has insurers like Humana and UnitedHealth Group trying to seek a 4-star or better rating (on a scale of 1-5) as a way to earn a larger share of the estimated $2.5 billion in yearly bonuses being offered. Designed to offset the 10-year scheduled cut in U.S. payments for the plans,  Nathan Goldstein, svp of strategic development with Gorman Health Group, calls it “Health-care Darwinism.” The good news is it will significantly offset the planned cuts to Medicare Advantage, helping it to remain a viable option for retirees.

Read the full article on BusinessWeek.com here.

The Pew Center on the States published an eye-opening report earlier this year. “The Trillion Dollar Gap,” examines the gap that exists between the $2.3 trillion participating localities have set aside to pay for employees’ retirement benefits and the $3.3 trillion price tag of those promises. Read the rest of this entry »

By Allison Tomek

Despite the doubt and confusion surrounding the state of health care reform in Washington D.C, President Barack Obama is reportedly aiming to step up the fight against identity thieves who attempt health care identity theft, medical identity theft, and identity fraud in the upcoming FY 2011 Budget. Read the rest of this entry »

The executive director of the Massachusetts Health Connector, in an article published in the American Journal of Medicine, makes a strong case for the advantages of health insurance exchanges. One of the important advantages he notes is something we’ve been saying too: the exchange model provides greater choice and that’s good for insurance consumers:

“There is then another step in an exchange’s sales process: approved plans compete with one another for individual customers. This “retail sale” differs from the process for most group insurance, whereby an employer picks one health plan, partly on the basis of ease of administration, and the employee has one choice — take it or leave it. Offering just one plan averts the need for annual enrollment fairs, dealing retroactively with employees’ dissatisfaction over their choice of plan, the administrative hassles of working with multiple carriers, and the need to worry about and police risk selection. The one-plan model favors health plans with the largest provider networks. So that no employee (or spouse or child) has to switch doctors, employers prefer to offer a health plan that permits access to virtually every doctor and hospital, rather than health plans offering limited networks of physicians integrated into prepaid systems of care. Therein lies the root of frustration on the part of many managed-competition enthusiasts, who yearn for a radical restructuring of health plans into competing delivery systems.”

To read the full article, click here.

Thanks to the new health care legislation, many HR departments are now trying to make sense of their obligations to employees with respect to all the changes that will go into effect soon. This webinar by SHRM will take a more detailed look at specific actions HR professionals need to take in the areas of plan design and administration, the financial aspects of complying with the new law, and clear, correct and timely communication with your workforce.

It’s a 90-minute on-line session and costs only $99 for SHRM members, $119 for non-members. If you can’t attend, you can still sign up and get the on-demand version. You can register by clicking here.

Some Medicare recipients are unclear how health care reform will impact their prescription drug coverage. In particular, there’s been a lot of talk around the ‘donut hole’ – a coverage gap in prescription coverage. With an estimated 7M people reaching the coverage gap each year, the new health care bill plans to eliminate the donut hole over the next 10 years. To learn more about how drug costs will be affected by reform, check out this article over at RetireNet.com.

Extend Health is now providing articles to RetireNet.com as the resident expert on Medicare for their 103,000+ members. Our published articles will help Medicare recipients understand some of the changes brought about by the health care reform law. We’ve agreed to provide regular content to the RetireNet community around this important and sometimes confusing topic.

The media has made many seniors quite fearful of Medicare cuts in the new health care bill. For example, some press coverage has suggested potential hikes in premiums, loss of certain benefits, and even the complete loss of Medicare – making recipients very worried about their futures.

This article over at RetireNet.com separates fact from fiction, providing a clear summary of how things may change. It even offers up the top 5 ways seniors will benefit from the reform. They are:

  1. Provide a $250 rebate on prescription drug spending this year.
  2. Close the donut hole.
  3. Make preventive care and annual checkups FREE.
  4. Reduce fraud and abuse.
  5. Invest in quality, patient safety, and innovation.

Read this comprehensive outline to gain a full understanding of how health care reform will actually be good for Medicare recipients.

Extend Health is now providing articles to RetireNet.com as the resident expert on Medicare for their 103,000+ members. Our published articles will help Medicare recipients understand some of the changes brought about by the health care reform law. We’ve agreed to provide regular content to the RetireNet community around this important and sometimes confusing topic.

Our President & CEO, Bryce Williams, was recently quoted on AOL’s money and finance website, DailyFinance. The article touches upon the potential competition amongst state-run exchanges and private insurers. Bryce goes on to say:

“You see incredible plan competition among carriers. If the exchanges can work for seniors, who are the most sensitive consumers and the hardest to satisfy, they should work beautifully for active employees or for the self-employed.”

The article can be read in full here.

Affordable health insurance is one of the thorniest issues facing early retirees, but the health care reform legislation creates a program, being launched today, that will make it easier for businesses to help out with coverage. Here are links to a couple of resources for more information. The first is by CBS MoneyWatch writer Steve Vernon, author of the Money for Life blog, who gives you an overview of the program.

The second is an upcoming “live chat”  on May 5 with HHS Secretary Kathleen Sibelius and Commerce Secretary Gary Locke, who will explain the program and take questions from individuals and businesses. You can send your questions to healthreform@hhs.gov in advance of the webcast, or send them live during the event via Twitter using the handle @HHSGOV. If you miss the web event you’ll find it posted later at the healthreform.gov website.

By Bryce Williams, President & CEO of Extend Health

We’ve been taking a wait-and-see attitude toward the upcoming reductions in subsidies to Medicare Advantage plans. Plenty of stories have predicted big cuts in availability or benefits, but we think any changes will be gradual and the insurance carriers will react in a calm and rational manner.

There’s still a big opportunity here for carriers that want to go after it, and the bottom line for our employer clients and their retirees is the Medicare Advantage market will continue to offer a wide variety of choices. This article appeared recently in Bloomberg Business Week and supports our take on the matter. It’s an interesting read; Steven Helmsley, CEO of UnitedHealth, says

“We have said for some time now that our Medicare Advantage business must ultimately be able to perform better than fee-for-service Medicare on a comparable-benefits basis and with care quality considered. We believe we can achieve and sustain that standard in the majority of our local markets.”

You can read the article in full here.