A statistical brief from AHRQ looked at trends in health expenditures for the over-65 population for 2001, 2006 and 2011, in constant dollars. $414.3 billion was spent on health care for this population in 2011, $100 billion higher than in 2001. Average per person expense was $9863 compared to $8815 in 2001. The percent of people with an ER visit, inpatient stay or hospital outpatient visit declined from 2001 to 2011 and outpatient care and drugs accounted for more expense in 2011 than in 2001. Average costs for all types of services were higher in 2011. Medicare paid for 62.4% of the elderly's health expense in 2011 compared to 54.7% in 2001.
An AHRQ statistical brief based on survey data for 2012 finds that about 55.4 million employees were enrolled in their company's health plan (including dependents, the total number covered is much higher). Eighty percent were in a plan with a deductible. Single deductibles averaged $881 at larger employers and over $1500 at smaller ones, family deductibles averaged $3300 for small firms and $1800 at larger ones. About 66% of enrollees had copays, with more small companies than large ones including them in the benefit design. The average copay was $23.77. Around 27% of plans had coinsurance, with the average being about 19% of cost.
In a statistical brief that helps explain why so few younger Americans are signing up for coverage under the exchanges, AHRQ survey data for 2011 finds that 13.4% of adults aged 18 to 64 think they are two healthy to need insurance and 26% said health insurance isn't worth the cost, relatively stable with the same responses in 2010. But a smaller percent agreed with the statement in both years, indicating that attitudes can shift in both directions. Interestingly, wealthier and higher education people are more likely to say they need insurance and it is worth the cost.
Mercom Capital Group released a report of VC funding for HIT in 2013, finding that $2.2 billion was raised, up substantially from $1.2 billion in 2012. There were 571 deals and 466 investors. There were two HIT IPOs in the year, and 165 M& A transactions in the sector.
A brief report from Mark Farrah Associates indicates that Blue Cross/Blue Shield plans currently enroll about 98.7 million Americans, 31% of the total population and 40% of the commercially insured group. There are 36 BCBS companies, several are large multi-state organizations such as WellPoint, with plans in 14 states and HCSC, with plans in 5 states, including Texas and Illinois. Blues plans received over $186 billion in premiums in 2012 and are the largest plans in 45 states.
According to Mark Farrah Associates as of December 1, 2013, there were 15,146,000 people in Medicare Advantage plans, about a 9% increase over the same time last year. UnitedHealth Group has about 21% of the market, followed by Humana with 16% and Kaiser with 8%. Around 17% of MA enrollment comes from employer retiree group plans. 2014 open enrollment ended on December 7, so the early indications are that there was strong growth.
Millenium Laboratories, which helps personalize drug therapies, has acquired RxAnte, which provides analytics and decision support for medication adherence.
HHS has announced that it will begin releasing physician level utilization data on a case-by-case basis. This is a huge development that will allow the identification of physician practice patterns and an understanding of which doctors may be engaging in inappropriate overuse.
The Employee Benefits Research Institute issued a short brief detailing reasons for wellness program participation. A survey found that the desire to improve health was the main reason for participating and that a belief that the person could make changes on their own or lack of time were the main reasons for not participating. Cash incentives and premium discounts would motivate more participation.
United Recovery Systems, which provides receivables management across several industries, has acquired Financial Health Strategies, which provides revenue cycle management services to hospitals and health systems. United Recovery is backed by Audax Private Equity.
CareCore National, which began as an imaging benefits manager and has expanded to managing utilization and cost of other specialty care, has received a "significant" investment from Great Atlantic, a private equity firm, which probably means a majority recap transaction.
RestorixHealth, a wound care clinic company, received an investment from Sverica International to fund its merger with Candescent Healing, which is in the same business.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.