Exchange Rates Are Lower than Expected

July 29, 2013

From a report by HHS’ Office of the Assistant Secretary for Planning and Evaluation:

In the eleven states for which data are available, the lowest cost silver plan in the individual market in 2014 is, on average, 18% less expensive than ASPE’s estimate of 2014 individual market premiums derived from CBO publications….Although the ASPE-derived CBO estimate of 2014 premiums is higher than the actual 2014 premium costs seen to date, the ASPE-derived CBO estimate was still much closer to actual 2014 premiums than those of many other analysts. For example, in a 2009 report, Oliver Wyman estimated that the average premium for an individual purchasing coverage in the individual market would be $4,561(or $380 per month) in 2009 dollars due to the Affordable Care Act reforms, and that this would represent a 54% premium increase over the status quo….The Oliver Wyman predictions are clearly far above the reality of 2014 premiums. In the eleven states with available data 2014 premiums average $321 per month for the lowest cost silver plan, and $352 per month for the second lowest cost issuer.

ASPE Exchange Rates
Source: HHS



NY Individual Health Insurance Premiums to Fall 53%

July 17, 2013

Health insurance exchange rates in New York will be 53% lower than existing individual premium rates, the state announced.  The figure doesn’t include subsidies, the state notes, which will lower effective rates for New Yorkers even more.

It was generally expected that rates would fall in New York’s dysfunctional individual health insurance market with the advent of exchanges.  That’s because New York had guaranteed issue and community rating without an individual mandate–a formula for adverse selection.  The amount of the decline, however, is eye-popping.

Seventeen health plans will offer insurance through the exchange, including companies like Aetna, Capital District PHP, Excellus, HIP, United and WellPoint.  You can see all the rates here.

Living Longer, Sinking Faster

July 15, 2013

Americans are living longer, but we’re not keeping pace with health and well-being advancements in other wealthy nations.  Those are the main results of a study by Christopher Murray, M.D., of the University of Washington.

From 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and HALE [healthy life expectancy] increased, all-cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable. However, morbidity and chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations….The United States spends the most per capita on health care across all countries, lacks universal health coverage, and lags behind other high-income countries for life expectancy and many other health outcome measures. High costs with mediocre population health outcomes at the national level are compounded by marked disparities across communities, socioeconomic groups, and race and ethnicity groups.

Here’s the money chart comparing the U.S. to other wealthy nations.


Medicaid Utilization Still Lower for Publicly Traded Health Plans

July 10, 2013

We’ve written this story before.

Publicly traded Medicaid plans are typically more profitable than privately held plans.  One reason why may be that utilization of medical services at publicly traded plans is lower, according to data compiled by CRG in Managed Medicaid 2013.  For example, physician visits per 1000 members were 27% lower than for private plans.  Bed days per 1000 were 15% lower.  Medical cost ratio was 420 basis points lower.  Click here to obtain a copy of the report.


Provider-Controlled Medicare Plans Have Higher Premiums, Quality, Study Says

July 2, 2013

From a study coauthored by Austin Frakt of The Incidental Economist:

Controlling for quality, Medicare Advantage (MA) plans that are fully integrated with providers (owned or controlled by the same entity) charge higher premiums, relative to plans that are not integrated in this way. We also found that such plans have higher star quality ratings, which is why it was important to control for them. Lastly, we found no evidence that integration is associated with more generous benefits.

An abstract of the report adds:

Current policy encourages plan–provider integration, although potential effects on health insurance products and markets are uncertain. Policy makers and regulators may want to closely monitor changes in premiums and quality after integration and consider whether quality improvement (if any) justifies premium increases (if they occur).

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