Report: Premium hikes for top Medicare drug plans

WASHINGTON — Seniors enrolled in seven of the 10 most popular Medicare prescription drug plans will be hit with double-digit premium hikes next year if they don't shop for a better deal, says a private firm that analyzes the highly competitive market.

FILE - In this Feb. 20, 2008, file photo, a shopper walks toward the pharmacy at a Little Rock, Ark., Wal-Mart store. A study says seniors in seven of the 10 most popular Medicare prescription drug plans will be hit with double-digit premium hikes next year if they don�t shop for a better deal. The report by Avalere Health is a reality check against the Obama�s administration�s upbeat pronouncements. Back in August 2012, officials had announced that the average premium for basic prescription drug coverage would stay the same in 2013, at $30 a month.

Why care under the Affordable Care Act will be unaffordable

Posted Sept. 25, 2012, at 1:56 p.m.
Several recent articles should dispel any remaining notion that care provided under the so-called Affordable Care Act will in fact be affordable.
Just the opposite is true.
The Wall Street Journal reported that when physicians sell their practice to hospitals and become hospital employees, services they provide to patients become significantly more expensive. The reason for this, simply put, is that overhead is much higher, and third parties reimburse at a higher rate for exactly the same service.
Another way to say this is that hospitals are less efficient than a private office. And, as I have pointed out, physicians are considerably less productive when working for a salary, as opposed to fee-for-service. This was an entirely predictable outcome.
Yet, health planners behind the Affordable Care Act pinned their hopes for cost containment on exactly this consolidation occurring. The act promotes Accountable Care Organizations; groups of “providers” and administrators who will assume financial risk for caring for patients assigned to them, by accepting a lump-sum payment to cover all their medical needs.
Accountable Care Organizations are the latest version of managed care, and will have similar problems. They will have a strong financial incentive to cherry pick healthy patients; those with serious problems will end up in emergency rooms and hospitals, where care is much more costly.
This brings us to the most recent article from the New York Times, which shows that when hospital emergency rooms and physician practices adopt electronic health records, reimbursements for physician services go way up.
Wait a second. Isn’t the EHR the magic wand that is somehow going to result in huge efficiencies and cost savings? Well, not exactly. It seems doctors and hospitals are able to use the EHR to “enhance” documentation of patient encounters and services provided, which entitles them to “up-code” and receive higher reimbursement from third party payers.

Feds: Health reform law helps Mainers save $13 million

Posted Sept. 24, 2012, at 1:33 p.m.
Federal officials say Maine seniors and people with disabilities have saved $13.1 million on prescription drugs since President Obama’s health reform law was enacted in 2010.
The health care law has allowed Mainers in the Medicare prescription drug coverage gap known as the “doughnut hole” to save an average of $522 during the first eight months of this year, according to the U.S. Department of Health and Human Services.
The health reform law, fiercely opposed by Republicans, calls for the doughnut hole to be closed by 2020. The law began phasing out the coverage gap in 2010, giving Medicare beneficiaries who hit the doughnut hole a $250 rebate. Last year, beneficiaries received discounts on generic drugs and some brand name medications.
The Affordable Care Act improves Medicare coverage for prescription drugs and provides seniors with preventive care at no cost. U.S. HHS touted a new report this week that found the law will save the average person with traditional Medicare coverage $5,000 from 2010 to 2022. People on Medicare who have high prescription medication costs will save more, around $18,000, over that period.
“I am pleased that the health care law is helping so many seniors save money on their prescription drug costs,” U.S. HHS Secretary Kathleen Sebelius stated in a recent press release. “A $5,000 savings will go a long way for many beneficiaries on fixed incomes and tight budgets.”
Nationally, more than 5.5 million people have saved nearly $4.5 billion on prescription drugs since the law was enacted, according to U.S. HHS.
The reform law also made a number of preventive health services, such as yearly wellness checks and colorectal cancer screenings, free to seniors without co-pays or deductibles. U.S. HHS said in February that the law provided more than 400,000 Maine residents with preventive care last year.
The Affordable Care Act has been vehemently opposed by Republicans, becoming a centerpiece issue in this year’s presidential campaign. Republican presidential nominee Mitt Romney has vowed to repeal the law while keeping of its more popular provisions, saying the law harms businesses and represents a government takeover of health care.