A volunteer team of 20 individuals that included residents, a nurse, and paramedics from Mount Sinai St. Luke’s and Mount Sinai Roosevelt’s emergency departments was on hand at the New York City Marathon’s Finish Line Medical Tent, Sunday, November 2, to treat runners who required medical attention. “We saw a number of runners with exercise-associated collapse, and we also treated patients with chest pain, head injuries, muscle injuries and cramps, scrapes, and bruises,” says Michael Redlener, MD, Medical Director for Prehospital Care and Medical Captain for the team. “Thanks to a strong team, the runners we treated all received excellent care.” The hospitals have been providing clinical care to New York City Marathon runners since 1993.
The New York Times article noted “At least that’s one of the curious connections to emerge from a health care analysis project at the insurance division of the University of Pittsburgh Medical Center.”
“It is at the forefront of an emerging field called predictive health analytics, intended to improve patients’ health care outcomes and contain costs. But patients themselves are often unaware of the kinds of intimate details about their households that insurers and hospitals may use to try to sway their treatment decisions.”
The Hill reported: “Almost 7 million people can sign up for health plans under ObamaCare even before the new enrollment period begins in November, according to an advocacy group.”
“Enroll America, an ObamaCare enrollment group with close ties to the White House, said Wednesday that millions of adults are eligible to sign up for insurance before Nov. 15 because they have moved, gotten married, had children, lost insurance or become American citizens.”
“Even though millions of Americans got covered before open enrollment closed earlier this year, we’re not resting on our laurels since seven million consumers might have the opportunity to get covered even now through a special enrollment period,” said Anne Filipic, president of Enroll America.
The Wall Street Journal article noted “The Obama administration plans to automatically renew for next year the health plans and premium subsidies that consumers obtained through the Affordable Care Act’s federal insurance exchange.”
“The move, which will apply to most of the five million people who selected insurance through HealthCare.gov for 2014, will make it easier for consumers to stay in their plans and retain tax credits lowering the cost of coverage. It also will relieve pressure on the federal exchange, which was crippled during parts of its first enrollment period.”
The Wall Street Journal article noted “Most U.S. employers will continue to sponsor health benefits for their employees over the next few years, but the way that benefits are provided may begin to shift for many workers, according to a report.”
“These private exchanges, modeled around the Affordable Care Act’s state exchanges, allow employees to ‘shop around’ for different plans and insurance companies, depending on how much their employer is willing to subsidize healthcare…”
The Kaiser Health News article noted “…Employers are inquiring about it and brokers and consultants are advocating for it.”
“Health spending is driven largely by patients with chronic illness such as diabetes or who undergo expensive procedures such as organ transplants. Since most big corporations are self-insured, shifting even one high-cost member out of the company plan could save the employer hundreds of thousands of dollars a year — while increasing the cost of claims absorbed by the marketplace policy by a similar amount.”
The Health Affairs article reported on Consumer Directed Health Plans, noting:“Consumer-directed health plans (CDHPs), which feature a high deductible and a personal health savings account, can reduce medical spending by employers and consumers.”
“Patients enrolled in CDHPs had fewer episodes of care over the same time period than patients enrolled in traditional plans. Furthermore, these patients were found to have fewer visits to specialists, fewer hospitalizations, and lower use of brand-name drugs — all of which lowered their costs.”
The Wall Street Journal article noted “The federal government … announced … that it would require people who wanted to buy a particular type of insurance called ‘fixed indemnity plans’ to demonstrate first that they also had traditional health-insurance coverage.”
“Fixed indemnity plans typically pay a limited cash benefit, with no deductible, to people who are hospitalized or encounter other medical costs. But the federal government said it was concerned that people might confuse those plans with standard health-insurance plans, and that the fixed indemnity plans alone couldn’t be considered to be coverage under the law’s requirement for most people to have insurance or pay a penalty.”
Just when you thought that maybe you sort of understood the cost of an Obamacare health care insurance policy, a Kaiser Health News article noted: “This could be the next shoe to drop, as people don’t realize that if they’re buying a bronze plan, they may have to pay $5,000 out of pocket before it contributes a penny…”
“Experts worry that some enrollees will be discouraged from seeing doctors if they have to pay the full charge, rather than simply a copayment.”
We all “demand” tests and prescriptions from out doctors and it is often easier for them to comply than argue. Now there may be a price to pay.
The Reuters article reported on “value-based” insurance with this vignette:
“When Tanner Martin, 17, developed excruciating back pain last year, he was sure he needed an X-ray to find out what was wrong. So was his mother, who worried that the pain might indicate a serious injury that could cause permanent disability.”