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One Long-Term or Two Short-Term Plans?

For those who qualify, short-term health plans can be a great alternative to ACA compliant individual plans, especially now that the individual mandate penalty has been reduced to zero. True, short-term plans do not cover preventive care or pre-existing conditions, and they are not guarantee issue like individual plans are, but they do offer much lower monthly premiums than individual plans.

And now that the administration has increased the maximum length of a “short-term” plan to twelve months, with the ability to renew for up to three years in many states, individuals who use utilize health care less, do not have chronic conditions, and have a tight budget may have the opportunity to save on their health insurance one year at a time.

Preventive Care Isn’t Really Preventive

Let’s be honest—most preventive care visits don’t really prevent illnesses. When we go to the doctor to get poked and prodded during our annual physical, most of the tests are intended to determine if we already have or are susceptible to something that, without treatment, could become more serious.

Don’t get us wrong, these tests are critically important, but we think they’re also misnamed. The goal of a preventive visit is to catch things early and intervene before they get worse. Think of it like pulling a weed as soon as you see it, before it grows, multiplies, and takes over your entire yard. But treating your yard so that those weeds never appear in the first place—that’s preventive care.

Upcoming Executive Order on Price Transparency

In a recent AHCP blog post, we explained that a hospital price transparency law that went into effect January 1 of this year really does very little to help consumers better understand the cost of medical care. Instead, it simply requires hospitals to post their chargemaster data in a machine-readable format on its website. We finished the post by saying that “only time will tell how impactful this particular rule will be, but the movement towards transparency is a step in the right direction.”

Well, we’re happy to report that the government might be taking another—and this time much bigger—step. On May 29, Amy Goldstein and Josh Dawsey with the Washington Post wrote about an executive order President Trump is preparing to issue in an effort “to foster greater price transparency across a broad swath of the health-care industry.”

Adverse Selection vs. Moral Hazard

If you think back to the days when you were studying for your insurance license, you may remember learning a couple terms that are related but have different meanings. In this post, we’ll discuss Adverse Selection and Moral Hazard and explain why both of these terms are relevant in today’s health insurance environment.

Do Something with Your Time

As we enter the second quarter, this is officially the slow time of the year. The phone has stopped ringing off the wall, and you’ve settled back into your normal insurance routine. So we have a question:

What are you doing with all your free time?

If you’re not being productive, the truth is that you’re just wasting time, and we know you don’t want to do that. To make sure you’re making the most of your time, here are a few ideas about what you can do with the extra hours in the day.

Five Percent of People Have Huge Medical Bills

A recent article from Health Leaders Media summarizes the results of a global study from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. Here are a few of the findings:

  • “The United States exceeds every other nation in total healthcare costs.”
  • The average cost of an outpatient visit in the United States is nearly $500.
  • The average inpatient stay in the United States costs more than $22,000.
  • Higher utilization is observed among females during reproductive years.
  • “[G]lobally, visits per person and admissions per person increase with age, beginning around age 25 for visits, and age 50 for admissions.”
Why Medicare Advantage?

The Annual Election Period (AEP) for Medicare Advantage and Medicare Part D prescription drug plans runs from October 15 to December 7. During this time of the year, Medicare recipients can join an Advantage plan, switch from one Advantage plan to another, or leave their Advantage plan and return to Original Medicare.

If you work with Medicare clients, they may be asking you what the advantages are of joining an Advantage plan. There are several, but here are three that you might want to point out.

New Hospital Transparency Rule

A new rule intended to increase price transparency went into effect January 1st of this year. The rule, issued by the Centers for Medicare and Medicaid Services (CMS) on August 2, 2018, requires “hospitals to make publicly available a list of their standard charges or their policies for allowing the public to view this list upon request…on the Internet in a machine-readable format.”

Drug Makers Increase Prices for 2019

In 2019, some of the nation’s largest pharmaceutical companies, after holding prices steady for much of 2018, announced they are raising the cost on hundreds of drugs. You probably saw some of the headlines.

New Rule Could Increase Premiums and Out-of-Pockets

The Wall Street Journal recently reported on proposed changes by the Trump Administration “that could raise health insurance costs for millions of Americans who get coverage on the job or receive subsidies under the Affordable Care Act.” As they explain, the two sides continue to bicker about the Affordable Care Act: “Republicans say subsidies for consumers are inflated; Democrats see another effort to sabotage the health law.”

The proposed changes they are referring to are found in the Notice of Benefit and Payment Parameters for 2020. This is an annual notice released by the Centers for Medicare and Medicaid Services (CMS) that sets the standards for issuers and exchanges for the coming year.

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