What Happens if There’s No Health Insurance Mandate?

November 30, 2011

Premiums go up, and lots of people remain uninsured — as illustrated in the charts below created by Aaron Carroll using data from Jonathan Gruber.  (Hat tip: Healthbeatblog)


60% of ACOs Are Sponsored by Hospitals, Study Says

November 30, 2011

A tally of 164 accountable care organizations shows that 99 (60%) are sponsored by a hospital or health system, 38 (23%) by an independent practice association, and 27 (17%) by an insurer.  The tally, published by consulting firm Leavitt Partners (Salt Lake City, UT), found that the vast majority of states had at least one ACO.  California had 17, the most of any state.

Summing Up the Berwick Battle

November 30, 2011

From a New York Times editorial following the decision by Don Berwick, M.D., to resign as tempory head of Medicare in the face of fierce Republican opposition to his nomination to the post.   

Through no fault of his own, Dr. Berwick, a respected expert on health care costs and quality, became a lightning-rod for Republican attacks on health care reform and government entitlement programs. Republicans distorted his record and past statements to imply that he would introduce “socialized” medicine and “death panels” and ignored the praise heaped on him by health care professionals and medical organizations.

You Don’t Know Anything About Wellness and Prevention…

November 29, 2011

…until you read about Larry Smarr’s “10-year personal quest to increasingly quantify my body.”  (Hat tip: Infectious Greed).  Smarr, who is founding director of the California Institute for Telecommunications and Information Technology, makes use of a wide variety of consumer tools to track his health and wellness, including Zeo (Myzeo.com), Your Future Health (Yourfuturehealth.com), 23andme.com, Navigenics, Bodymedia.com and Patientslikeme.com:

I started my quantification program by stepping on a bathroom scale every morning and writing down my weight – and ended up having to synthesize more than five dozen blood markers, multiple stool markers, microbial population distributions, and a variety of imaging modalities to try to understand the state of my body’s health and how to improve it. Yet this is precisely what the digital revolution in healthcare is all about.

His findings are eye-opening.  Here’s one interesting observation by Smarr about weight loss:

What gradually became clear to me was that one should think not in terms of weight loss as a goal, but rather think of altering your food intake to better match the biochemical systems of your body. The sub-components of our food (protein, fats, carbohydrates) and their ratios drive not only our digestive system, but much of our complex hormonal system which communicates to all organs of the body.  After changing my nutrition to more of the “Zone” approach, introduced by Barry Sears…., and increasing my exercise, I lost 20 pounds over four years.

And here’s another regarding sleep after using the Zeo sleep monitor:

An even bigger unknown to most people than the minute-to-minute caloric burn of their bodies is the nature of their sleep during the night. I had no idea what mine was like or how important good sleep is to health….Waking up early cuts into my REM in a way I hadn’t realized before. Also, the length of sleep is critical to what Zeo computes as one’s “ZQ” – a score of the quantity and quality of one’s sleep each night.

And here’s one more about what our blood tells us:

I have blood tests four to eight times per year [since insurance only covers certain tests, his out-of-pocket cost for blood tests is $5000 annually] and keep a spreadsheet with all the values….I had no idea that blood samples can reveal whether you need to take vitamin D, if your liver and kidneys are in good shape, if your zinc or molybdenum levels need supplementing, or if you have mercury contamination; today, however, I routinely use food and supplements to “tune my numbers” to more optimal levels. For instance, when blood tests showed that my vitamin D had dropped to 30, I took vitamin D3 supplements till my tests showed it had come back up to 50.

UnitedHealth Shares Rise on ’12 Earnings Outlook

November 28, 2011

UnitedHealth shares are up nearly 4% in morning trading today, reflecting a broader market rally and I’m guessing relief among investors regarding the company’s 2012 profit forecast.  After spooking investors last month with warnings that costs would rise in 2012, United announced today that it projects 2012 earnings per share to be $4.55 to $4.75 per share, compared to $4.52 to 4.57 in 2011.  That’s up to a 4.5% increase (or about 2% at the midpoint), which is below Wall Street expectations.  Still, Scott Fidel of Deutsche Bank notes that United tends to be conservative in its initial guidance for the coming year, adding that investors will view this early outlook positively.

2012 Health Plan Premiums to Rise 7-9% — More or Less

November 23, 2011

It’s always difficult to get a read on health plan premium price increases for the coming year, but our best guess based on interviews with employers and by reading into published surveys is that 2012 premiums will rise 7% to 9% before benefit changes.  That’s pretty much in line with findings from Mercer’s annual survey of employers, which notes that 2012 premiums before benefit changes will rise 8.2% in 2012, down from a 9.8% increase in 2011.  For complete details, you can download our free white paper on the topic.

Are Medical Costs Trends About to Accelerate?

November 23, 2011

Notes Christine Arnold of Cowen, “Key leading indicators metrics suggest medical cost trends may no longer be decelerating, although a dramatic uptick seems unlikely at this point.”  She points to an uptick in physician visit volume and a trough in the S&P non-Medicare healthcare cost index.


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