2010 Potpourri XXXV

Aon, soon to be merged with Hewitt, released its survey results on cost increase expectations for employer-based health insurance.  Unlike many other benefit firms’ surveys, Aon’s is based on information from health insurers.  It expects 2011 costs to employers to rise between 10.5-11%, depending on plan design.  Interestingly, the highest increase is for high-deductible plans, although the absolute level of premium for that design remains significantly lower than for others.   (AON Release)

We miss Massachusetts, but fear not, another study is always just around the corner, and wait, here’s one.  Research in the Journal of General Internal Medicine found that while reform in the state reduced the numbers of the uninsured, it did not improve access to physicians or in self-reported health status.  It also did not reduce disparities across groups in access to care.   (Journal Article)

Pay-for-performance programs have many issues.  One is the extent to which differing characteristics of one physician’s patient population versus another’s may affect the ability to render high-quality care.  Research published in the Journal of the American Medical Association reveals that indeed, patient panel characteristics can have a strong influence on quality performance, with poorer, less educated and higher-minority panels being correlated to lower quality rankings.  It is apparent that patient panel characteristics need to be taken into account in formulating quality measurements.   (JAMA Study)

Another piece of research validates the need to be sure patients with terminal illnesses fully understand the hospice alternative.  A study reported in the Journal of Clinical Oncology found that cancer patients who died in the hospital had much worse quality of life than those who chose a hospice option.  In addition, the caregivers of these patients who died in the hospital were more likely to suffer a pyschiatric disturbance in the six months following the patient’s death than were caregivers of a patient who died under hospice care.   (Hospice Study)

More news of insurers ripping off consumers and companies with outrageous and unjustified premium increases!  Insurers in Connecticut have filed for rate hikes of as much as  20%, citing both rising general medical costs and costs associated with specific  provisions of the federal health law.  Predictably, insurers said people were being unrealistic if they didn’t think reform would drive up costs and regulators said the increases were completely unjustified.  Actuaries will have the final word and we suspect they will find that there are significant cost increases that have to be passed on or the insurers will go bust.   (Connecticut Story)

Towers Watson also issued results from a survey of what employers are expecting in the way of insurance costs next year.  The firm says that employers expect costs to rise an average of 8.2%.  That apparently is just the companies’ share, after cost shifting to employees.  The survey also noted that employers expect in future years to continue increasing the use of high-deductible plans, continue moving premium share to employees and shift incentives in regard to wellness programs from rewards for participating to rewards for making measurable biometric changes.   (Towers Release)