“Revenue at not-for-profit hospitals grew at an all-time low of 3.9% last year with sluggish gains in both inpatient and outpatient activity, according to a report on 2013 medians from Moody’s Investors Service.
In comparison, hospital revenue increased 5.1% in 2012 and historically has grown about 7% per year.
Moody’s pegged the increased popularity of high-deductible health plans for leading people to postpone care or seek out lower cost retail clinics. “Patients have more skin in the game,” said Jennifer Ewing, an analyst at Moody’s.
The volume decline also is coming amid a number of Medicare reimbursement cuts, including the ones known as sequestration triggered by the 2012 Budget Control Act and reductions in disproportionate-share hospital payments under the Patient Protection and Affordable Care Act. In addition, Medicare’s two-midnight rule has made it harder for hospitals to bill short stays as inpatient care, and commercial payers have offered lower payment rate increases.”
“As more Americans gain insurance under the federal health law, hospitals are rethinking their charity programs, with some scaling back help for those who could have signed up for coverage but didn’t.
The move is prompted by concerns that offering free or discounted care to low-income, uninsured patients might dissuade them from getting government-subsidized coverage. It also reflects hospitals’ strong financial interest in having more patients covered by insurance as the federal government makes big cuts in funding for uncompensated care.
If a patient is eligible to purchase subsidized coverage through the law’s online marketplaces but doesn’t sign up, should hospitals “provide charity care on the same level of generosity as they were previously?” asks Peter Cunningham, a health policy expert at Virginia Commonwealth University.
Most hospitals are still wrestling with that question, but a few have changed their programs, Cunningham says.”
“Listing to a panel discussion sponsored by the Greensboro Chamber of Commerce Tuesday morning, I heard reference to a metaphor for the Affordable Care Act that I’ve heard a number of time before — the three-legged stool.
Describing the different core components of the health care reform law, three primary tenets offer their support to the law, with, each complementing and reliant upon the others, and the stool falling over if one of the legs falters.
They are: guaranteed issue and community rating (meaning an insurer can’t deny coverage or charge astronomical rates coverage because of pre-existing conditions), the individual mandate (everyone must have coverage or face a fine) and subsidies (financial assistance from the federal government to help low-income consumers can pay for coverage).
I’ve sat in on numerous, similar discussions, and had heard the metaphor before. But it wasn’t until comments from panelist Mark Hall, a professor at Wake Forest University School of Law and a leading health care policy scholar specializing in health care reform, that I realized I was missing a key part of that image.
Those are the three legs — what’s the seat represent?
As Hall noted, if you go by what the law is called, the “Affordable Care” Act, you’d be mistaken.
“One thing it doesn’t do is it doesn’t make care more affordable,” Hall said said during the discussion, which was organized by Pilot Benefits. “Mistake number one was to call it that. It doesn’t change in any significant way how doctors and hospitals are paid.”
As Hall noted, while many opponents might criticize the bill for not reducing health care spending, “the main point is it does not affect how health care is delivered or paid for. … That point is lost on about half of the population.'”
“From Halbig to Sovaldi, this summer was a busy one for health policy and politics. We’ve made it easy to catch up, collecting all of the top stories you clicked on over the past few months. Together, they tell a story about the state of healthcare in the U.S., and offer clues as to where things may be headed when Congress returns in the fall.
Among them: The political battle over Obmacare has become more complicated for Republicans since the government cleaned up the Healthcare.gov mess, and with midterm elections around the corner, the focus will be on how much either party continues to attack or ignore the law. There are policy, legal and business matters to be settled as well – the employer mandate is under attack from the left and the right, the courts have been a wildcard for the health law to this point and could continue to be so, and employers and employees are finding themselves wading through the on-the-ground impacts of the law. That doesn’t even get to our top three storylines of the summer, so be sure to click through to find out what tops the list.”
“Supporters of President Obama’s health care law have been touting proposed insurance rates for 2015 — arguing that they aren’t as high as some of the dire warnings of the law’s critics.
But it’s worth considering some additional context.
Data compiled by the Health Research Institute of PricewaterhouseCoopers from about 29 states plus the District of Columbia show that the average premium increase for insurance starting next year is currently 8.2 percent. But within that average, there’s a wide range.
In Arizona, for instance, the average premium increase submitted was 11.2 percent, but rates ranged from a decrease of 23 percent to a spike of 27 percent. In Arkansas, where the average increase was 11.2 percent, some consumers could see their premiums soar by 50 percent.
Defenders of Obamacare argue that rates typically went up annually before the law went into effect.
However, it’s important to keep in mind that it was Obama himself who repeatedly promised that premiums would go down by an average of $2,500 per family.”
“A clinic in Minneapolis that provides medical care to thousands of uninsured and underinsured people is closing its doors next week, in large part because more people are obtaining health insurance through the Affordable Care Act and seeking care elsewhere.
When the Neighborhood Involvement Program shuts down Aug. 29, the 3,000 patients that visit its Uptown clinic will be without a medical provider. But its dental and mental health clinics, as well as its senior and youth programs, will continue operating in Uptown.
But managers of the NIP Community Medical Clinic say many people still need the low-cost care and customer service they provide. Medical bills at the clinic on Hennepin Avenue are as easy to understand as a restaurant check, with a price list like a menu: $10 for a strep test, for example, and $80 for a basic doctor visit. If a patient’s monthly income is less than $1,900 dollars, those fees drop considerably.”
“Thanks a lot, Obama.
Add the Affordable Care Act – or, specifically, the big-business Cubs’ response to it – to the causes behind Tuesday night’s tarp fiasco and rare successful protest by the San Francisco Giants.
The staffing issues that hamstrung the grounds crew Tuesday during a mad dash with the tarp under a sudden rainstorm were created in part by a wide-ranging reorganization last winter of game-day personnel, job descriptions and work limits designed to keep the seasonal workers – including much of the grounds crew – under 130 hours per month, according to numerous sources with direct knowledge.
That’s the full-time worker definition under “Obamacare,” which requires employer-provided healthcare benefits for “big businesses” such as a major league team.
Cheap,” said one of three high-ranking officials from other organizations the Sun-Times contacted Thursday – all of whom fall below the Cubs on Forbes’ annual revenues list.”
NOTE: This story is behind a pay wall.
“Most of the political class seems to have decided that ObamaCare is working well enough, the opposition is fading, and the subsidies and regulation are settling in as the latest wing of the entitlement state. This flight from reality can’t last forever, especially as the evidence continues to pile up that the law is harming the labor market.
On Thursday the Federal Reserve Bank of Philadelphia reported the results of a special business survey on the Affordable Care Act and its influence on employment, compensation and benefits. Liberals claim ObamaCare is of little consequence to jobs, but the Philly Fed went to the source and asked employers qualitative questions about how they are responding in practice.
The bank reports that 78.8% of businesses in the district have made no change to the number of workers they employ as the specific result of ObamaCare and 3% are hiring more. More troubling, 18.2% are cutting jobs and employees. Some 18% shifted the composition of their workforce to a higher proportion of part-time labor. And 88.2% of the roughly half of businesses that modified their health plans as a result of ObamaCare passed along the costs through increasing the employee contribution to premiums, an effective cut in wages.
Those results are consistent with a New York Fed survey, also out this week, that asked “How, if at all, are you changing (or have you changed) any of the following because of the effects that the ACA is having on your business?” For “number of workers you employ,” 21% of Empire State manufacturers and 16.9% of service firms answered “reducing.””
“The Affordable Care Act (ACA) presents employers and potential employees with a variety of new rewards and penalties. These are, in part, exactly what the law intended: by penalizing potential employees for not purchasing health insurance, and employers for not providing it, the law aims to increase the fraction of the population with health insurance.
Yet these same rewards and penalties have additional effects, including on the incentive to work; Mulligan
(2014), for example, suggests that the ACA may reduce employment by 3 percent on average and have a range of
positive and negative effects on average hours worked.
In the work summarized here, I quantify the number of people who will have essentially no short-term financial reward from working more than 29 hours, since this would either render them ineligible for the ACA’s assistance or increase
the penalties that may be owed by their employer.
This is the first paper to show that the ACA will put millions of workers in the economically extreme situation of having
zero short-term financial reward (or less) to working full-time rather than part-time.”
“Obamacare puts employers in a bind, two New York Federal Reserve surveys show. Employers’ health care costs continue to rise, and the health care law is driving them to hire more part-time labor, CNBC reports:
The median respondent to the N.Y. Fed surveys expects health coverage costs to jump by 10 percent next year, after seeing a similar percentage increase last year.
Not all firms surveyed said the Affordable Care Act (ACA) is to blame for those cost increases to date. But a majority did, and the percentage of businesses that predicted the ACA will hike such costs next year is even higher than those that said it did this year.
Obamacare’s higher costs will cascade down to consumers. The surveys found that “36 percent of manufacturers and 25 percent of service firms said they were hiking prices in response” to Obamacare’s effects.
The Empire State Manufacturing Survey polls New York State manufacturers, and the Business Leaders Survey polls service firms in the New York Federal Reserve District.
A June Gallup poll found that four in ten Americans are spending more on health care in 2014 than in 2013.”