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Member News: Intermountain Healthcare CEO Marc Harrison discussed a range of issues in a Q&A with Axios. Harrison said Intermountain is committed to the community it serves and the exchanges. He also expressed concern that many people could be left uninsured if ACA subsidies end.
Patients who qualify for subsidies are not buying ACA plans
Nearly half of all patients who are eligible for financial assistance on the ACA exchanges are buying off-exchange plans not eligible for subsidies, according to a study published in Health Affairs. About 41 percent of the 6.3 million people who bought off-exchange plans in 2015 would have qualified for federal tax credits had they bought on the exchanges. Consumers may buy off-exchange plans because they want a broader provider network or find it simpler to buy directly from a broker, but experts also say people are unaware of financial assistance available on the exchanges.
Health care costs rising for employers
Large employers say the cost of health care for their employees will jump five percent next year, averaging more than $14,000 per worker. The increase has been attributed to high medical costs for some individuals and the price of specialty drugs. This is the fifth consecutive year that prices are rising five percent for employers.
Despite the price increases, large employers remain committed to offering coverage for workers, according to two new surveys. Companies are looking to control costs rather than shrink or drop benefits. The approach is a change from several years ago when many large employers considered ending employee health benefits and shifting workers to ACA plans.
More companies are turning to self-insurance to control costs
Since the ACA passed in 2010, there has been a jump in the number of self-insured small and midsize companies. Organizations are increasingly turning to self-insurance as a way to control costs. Many self-insured companies are able to use discount programs provided by PBMs, national stop-loss carriers, and health management programs to control expenses. Companies also believe self-insuring provides more flexibility in developing ACA-compliant coverage that best fits employee needs.
Corporate wellness program increases worker productivity
A new study found healthy employees are more productive. Researchers studied a small sample of workers at commercial laundry plants, finding those who participated in employer-sponsored health programs increased their productivity by four percent on average the following year. The study’s authors attribute productivity gains to better nutrition, more exercise and less stress.
California partners with food nonprofits to promote health
Medi-Cal, California’s version of Medicaid, is launching a three year pilot program that pays six food nonprofits across the state to provide food assistance for sick Californians. The organizations will prepare meals that patients can take home after a doctor visit and provide food delivery to patients identified under the program. State officials hopes the program will provide an entry point for discussions about health and nutrition with heavy Medi-Cal users and plan to measure the program’s success by monitoring participating patients’ hospital readmission rates, stays at long-term care facilities and emergency room use.
AHIP challenges Upshot’s critique of Medicare Advantage
AHIP is pushing back on an analysis written by The Upshot’s Austin Frakt that questions why there are high cost differences between Medicare and Medicare Advantage (MA). In comments to Axios, AHIP points out that Frakt’s analysis relies on data collected before the ACA was passed and lower MA payments were implemented. The organization notes that a report from the Medicare Payment Advisory Commission finds payments between the two programs are now in line. AHIP also argues the savings accrued from lower medical costs under MA are being rolled into wider benefit packages, accounting for cost differences.