Health insurance deductibles up 40 percent since 2010

People with work-based health insurance are paying much bigger deductibles than they used to.

Those with single coverage are paying an average deductible this year of $1,318, up some 40 percent since 2010, when the total was $917, according to national data released Tuesday.

Patients will continue to pay more out of pocket for healthcare over the next several years. Even Medicare will cover fewer services and pass more expense to the patient.

It is time for healthcare to embrace being UpFront with patients about costs, so patients can make informed decisions and healthcare organizations to work through payment options prior to the surprise medical bill.

To read more about this article, click here:

http://www.startribune.com/kaiser-study-average-deductibles-up-40-percent-in-past-five-years/328664941/

Collecting from patients is not a new issue! Says MGMA

The April 2010 issue of MGMA Connextion describes some of the major problems facing healthcare organizations today, but which are even getting worse. Here are some of the highlights:

• Providers collect 25% of their revenues from patients directly.
• 60% of the providers reported that it was extremely difficult collecting from patients after the services were provided.
• Providers send out 3.3 billing statements before they are paid.
• They recover only $15.77 for every $100 owed.

Providers are often reluctant to address past due payments because of long term relationships and belief it is unprofessional.

The article provides 17 recommendations from “peer healthcare providers”. These include:

• Provide payment options including credit cards.
• Set up on line billing payments.
• Encourage patients to pay current balances and charges at the time when services are provided.
• Send out invoices as soon as possible after the services or procedures are provided
• Train staff to firmly but gently communicate about payments due.
• Be willing to refuse service to patients who will not abide by the financial policies.
• Replace collection letters with personal collection phone calls.

Of course you need Enablemyhealth to automate all these recommendations in one easy to use solutions. Enablemyhealth will enhance your cash flow and improve patient satisfaction. 

Read more of the article:

http://www.mgma.com/Libraries/Assets/Practice%20Resources/Publications/MGMA%20Connexion/2010/Perspective-on-patient-payments-MGMA-Connexion-April-2010.pdf

More in Minnesota have health coverage but still can't afford to be sick

In the past year, Minnesota’s main hospital and clinic groups filed nearly 9,000 lawsuits against people with large or long-standing medical debts — a sharp increase since 2005, according to a Star Tribune analysis of court records.

Once a leading cause of personal bankruptcy in the United States, medical debt was widely expected to decline as more Americans got health insurance following federal health reform. Instead, shifts in the insurance market are pushing more people toward high-deductible policies that can require them to pay as much as $7,500 before any insurance benefits kick in.

To ensure strong patient satisfaction and prevent these lawsuits, hospitals and groups need to provide estimates to patients prior to their medical visit, procedures and tests. Patients will contine to take on more of the financial risk of healthcare.

http://www.startribune.com/more-minnesotans-have-health-coverage-but-still-can-t-afford-to-get-sick/318545021/

Out-of-network medical bills a costly shock in N.J.

They were moments of crisis for each family. A newborn who wasn’t breathing was rushed to intensive care. A 15-year-old skier who wiped out on a slope in the Catskills needed surgery to reconstruct his shoulder. A 65-year-old insurance agent who survived a heart attack needed urgent bypass surgery to clear his arteries.

The stress didn’t stop once these medical crises passed, however. Within a few weeks, each family received an unexpected medical bill.

They had been savvy enough to follow their insurers’ rules and choose in-network hospitals to maximize their coverage and minimize their out-of-pocket costs. But one or more of the physicians who took care of them — and over whom they had no choice — did not participate in their insurance network.

Enablemyhealth allows surgeries, tests and all treatment to be managed Upfront. Know what providers are in network for insurance plans. Know what the cost is before you receive that surprise medical. Hospitals and groups need to solve this problem equally as much as successfully treating patients! 

Here is the complete article:

http://www.northjersey.com/news/out-of-network-medical-bills-a-costly-shock-in-n-j-1.1345737

NY's New "Surprise" Medical Bill Law

Health care consumers in New York had a great deal to celebrate when, on the last day of the Affordable Care Act’s first open enrollment period, the state legislature passed new consumer protections from “surprise bills"—medical bills to consumers that result from the unexpected use of out-of-network medical providers, or bills which impose far higher costs on consumers than they have reason to expect. The “Emergency Medical Services and Surprise Bills” law, together with associated changes in a number of other statutes, is a response to years of advocacy and reflects the considerable efforts of the State Department of Financial Services to bridge the different perspectives of consumers, the health insurance industry, and New York’s medical societies. Prior to the new law—which is effective April 1, 2015—insured individuals often complained about receiving inadequate reimbursement (or none at all) from their insurers for medical services that they received outside of a provider network. In many cases the patients were unaware that the medical services they were receiving were, in fact, out of network and thus more expensive. Many patients were not financially prepared to handle these additional costs. The problem was so common that these types of consumer complaints outnumbered all other complaints handled by the state’s health consumer assistance agencies, insurance regulators, and the state Attorney General’s Health Care Bureau. - See more at: http://familiesusa.org/blog/2014/04/new-york%E2%80%99s-new-surprise-bill-law-rolls-out-new-health-insurance-protections-consumers#sthash.SRn51QAY.dpuf

Read the complete article:

http://familiesusa.org/blog/2014/04/new-york%E2%80%99s-new-surprise-bill-law-rolls-out-new-health-insurance-protections-consumers

Massachusetts Hospitals violate price transparency law

Hospitals and groups in Massachusetts have been ignoring the Massachusetts law requiring patients be give estimates 2 days prior to a procedure or test. This is why Enablemyhealth is so important: read more -

https://www.bostonglobe.com/metro/2015/06/23/despite-law-hospitals-flummoxed-requests-for-price-information-survey-finds/4gfgPrC4J2NCWDcJpZhXZO/story.html

High Deductible Plans and other patient out of pocket expenses here to stay ...

HEALTH PLANS WITH high deductibles are the fastest growing type of health insurance in the United States. More than a quarter of employers provide this kind of plan for their employees, and, last year, they made up 85 percent of all plans sold on the Affordable Care Act’s health insurance exchanges. These plans often save insurers and employers money — and not only by shifting more costs onto consumers. They actually result in less medical care used and, in total, cost less than more generous plans.

From a pure cost-containment standpoint, this is a victory. Generous health insurance insulates consumers from the true price of their care, encouraging overuse and driving up costs without meaningful benefit to health. That adds up — US health care spending reached $2.9 trillion in 2013, the highest in the world per capita. Unnecessary medical services cost everyone.

Enablemyhealth works to solve these surprise medical bills and help patients and healthcare organizations work together to solve these payment issues ... Upfront!

Check out more about this article ....

http://www.bostonglobe.com/ideas/2015/06/25/how-health-plans-with-high-deductibles-became-new-normal/06TD5uBm2oUXK2d4MMEbbM/story.html

Hospitals keeping close eye on revenue cycle vendors

As Value-based pricing, ACOs and increases in patient responsibility evolve, hospitals, imaging centers, and groups face new complex challenges ahead. This article in HealthcareITnews discusses some of this change:

http://www.healthcareitnews.com/news/hospitals-keeping-close-eye-revenue-cycle-vendors?mkt_tok=3RkMMJWWfF9wsRogsqzPZKXonjHpfsX56egrWqG0lMI%2F0ER3fOvrPUfGjI4GSMNkI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D

Solutions like Enablemyhealth lead this transformation with shared patient insurances, coordination of estimates and codes, and team based communications.

Bad Debt Increasing in Minnesota Hospitals

In fiscal 2013, health systems here reported about $687 million in bad debt, which was about 2.5 percent of the health systems’ combined revenue of $27.7 billion. For fiscal 2014, the Star Tribune analysis found bad debt grew to $766 million, a larger tally that grew faster than overall revenue. Some of the systems operate on the ­calendar year, and some end fiscal years on June 30.

Preliminary figures from the Minnesota Hospital Association show a roughly 3.2 percent increase in bad debt for state hospitals last year, as well as a nearly 10 percent decline in charity care. The net effect is that uncompensated care costs held roughly steady last year, according to the hospital association.

Moving the process UpFront with Enablemyhealth makes all the difference to let patient's know the estimate out of pocket costs and work with the hospital to arrange a payment plan. Validated patient insurance information is easily shared across groups and hospitals, reducing the costs for everyone. 

Check out the full article:

http://www.startribune.com/unpaid-hospital-bills-still-growing-in-minnesota/306704981/

N.Y. law protects against surprise medical bills

USA TODAY WHITE PLAINS, N.Y. — Dana Roberts was raising two children in Yonkers and suddenly found herself wasting hours on the phone fighting insurers and medical offices over a $1,500 bill.

She had to track down her medical records, talk to a lawyer and research similar cases. At one point, Roberts said she started recording conversations about settling the unexpected charge.

Her distrust seemed appropriate. Roberts, 33, said she was unconscious when the $1,500 was tacked onto her surgery cost.

"Nobody said the anesthesiologist was outside of my insurance network," she said.

Thousands of similar complaints by New Yorkers — many involving bills from specialists used unbeknownst to patients — prompted a state law seeking to protect against surprise medical charges. State regulators reported receiving at least 10,000 complaints about the problem.

The law, which took effect March 31, requires insurers and health care providers to give patients more information on out-of-network insurance charges that typically increase bills at least 20 percent.

Those higher charges apply when a patient is treated by a doctor or other provider outside their insurance plan's network. Under the new law, patients will only pay higher out-of-network bills if they choose to pursue the treatment after receiving sufficient warning.

Insurance plans are also being required to meet new standards for improving provider networks, as determined by an independent review board. When a network falls short, insurance companies and health care providers negotiate a deal and cover the out-of-network charge.

The law is considered a victory among patient advocate groups, but some of its protections don't address concerns about insurance plans sold on the Affordable Care Act exchange, called the New York State of Health.

A push to require plans sold on the government-run insurance marketplace to include out-of-network coverage failed last year. Many insurance companies and other business groups opposed the effort, saying it would have increased the up-front cost for coverage.

More than 2 million New Yorkers enrolled for 2015 in Affordable Care Act plans, many of which offer increasingly narrow provider networks that limit choice, and thus expose patients to out-of-network charges.

"New York State of Health should offer affordable out-of-network coverage options, which are particularly important for patients with complex health care needs," Chuck Bell, program director of Consumers Union, said.

Debate over amending regulations and laws affecting plans sold on New York State of Health will ramp up again in the summer and fall, when the enrollment process begins anew for 2016.

For Roberts, the current surprise medical bill law came too late. Her kidney stone surgery was in 2012, about three months after her son's birth. The collection agent called months later in 2013, seeking payment of the $1,500 anesthesiologist bill.

The debt collection shocked Roberts, who thought the bill had been settled in 2012 between her insurer, EmblemHealth, the Westchester Anesthesiologist group, in Rye Brook, and Lawrence Hospital Center, in Bronxville. She said she ended up paying $500 after reaching an agreement that reduced the bill.

Article:

http://www.usatoday.com/story/news/nation/2015/04/22/ny-law-protects-surprise-medical-bills/26212657/

Welcome to the New Enablemyhealth!

We have added new medical expense estimator features to allow physicians and hospitals to provide their patients with estimated out-of-pocket expense prior to a visit, test or procedure. Patients can view the estimate and pay online before or at the time of service. This is a revolutionary change in the medical billing process. We call this process UpFront!