2012 February

Archive for February 2012

2011: A Record Year of Uninsured

The burden this type of news places on hospitals and hospital staff is incredible. With the number increasing and the poor state of the economy, hospitals need to help as many patients as possible with Medicaid and Charity assistance. R&B Solutions can help with that process, either through our RAMP tool that automates this process, or our patient services that add expertise to the assistance process in addition to a strong legal backing to challenge any unjust denials.

2011: A Record Year of Uninsured

By Dina Overland

Fierce Health Payer

More and more Americans lack health insurance, and the percentage of those uninsured rose faster last year than in 2010, according to a survey released Tuesday.

A Gallup poll indicates that 17.1 percent of Americans were uninsured in 2011, up from 16.4 percent in 2010. Last December had the highest monthly percentage of uninsured adults at 17.7 percent, reported LifeHealthPro.

The rate of uninsured has increased for the last four years. During that time, the most uninsured people have been Asians (4.2 percent), individuals earning less than $36,000 (4.1 percent), individuals aged 26 to 64 (3.8 percent) and Hispanics (3.7 percent), Politico reported.

The good news for insurers is that the Gallup figures support other conclusions that young adults have more insurance coverage under the health reform law. About 25 percent of 18- to 25-year olds were uninsured in 2011, compared to 28 percent uninsured in 2008, according to The Hill’s Healthwatch.

“Although this group is still among the most likely to be uninsured, it is the only group Gallup tracks that has seen a significant decline in the percentage of uninsured in 2011,” Gallop analyst Elizabeth Mendes told LifeHealthPro.

To learn more: - see the Gallup survey: http://www.gallup.com/poll/152162/Americans-Uninsured-2011.aspx

- check out the Politico article: http://dyn.politico.com/printstory.cfm?uuid=A06AF4FC-E6C9-4FAB-99E0-C859B5883913

- read The Hill’s Healthwatch article: http://thehill.com/blogs/healthwatch/health-insurance/206091-gop-cites-new-survey-showing-rising-number-of-uninsured-under-obama

- see the LifeHealthPro article: http://www.lifehealthpro.com/2012/01/24/gallup-uninsured-rate-continues-to-rise

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Sorting the Reform Law Options Before the Supreme Court

This begs the question on where states currently lie in their progress on building Health Insurance Exchanges, or if they are waiting for the Federal Government to institute their own for them. Would they would stick with the HIE regardless of the outcome? Or would some end their research? What do you think?

Sorting the Reform Law Options Before the Supreme Court

Joseph Goedert

JAN 25, 2012 4:05pm ET

Health Data Management

President Obama in March 2010 signed into law the Patient Protection and Affordable Care Act, implementing enormous changes in the U.S. health care industry.

Almost immediately, opponents of the law filed lawsuits challenging its constitutionality. Those suits have wound through the courts and now the Supreme Court will have its say, with oral arguments in January and an opinion expected by this June. The core issue for the Court is whether the individual mandate requiring all persons have health insurance is constitutional-whether Congress exceeded its authority.

There are three basic scenarios for how the court could rule, and each will affect provisions of the law, including at least seven provisions with a strong focus on health information technology. The scenarios for a ruling are:

* The individual mandate is constitutional so the law stands as is;

* The individual mandate is unconstitutional but everything else in the law is constitutional; or

* The individual mandate is unconstitutional and as a result, that renders the entire law unconstitutional.

In the first scenario, the obvious effect is that nothing changes with the health care reform law. Things will get tricky, however, under the other scenarios. But first, a look at where the case stands.

The Court decided to review a Court of Appeals ruling that the individual mandate in the reform law is unconstitutional and cannot be severed, or separated, from the rest of the law and therefore the entire law is void.

Judge Roger Vinson, senior judge in the Northern District of Florida, Pensacola Division, ruled with considerable reluctance that the mandate was not severable from the rest of the law because while the mandate was “necessary and essential” to the law as written, it is not “necessary and essential” to health care reform in general.

“Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void,” Vinson ruled. “This has been a difficult decision to reach, and I am aware that it will have indeterminable implications. At a time when there is virtually unanimous agreement that health care reform is needed in this country, it is hard to invalidate and strike down a statute titled, ‘The Patient Protection and Affordable Care Act.’”

Vinson in his ruling seemed to try to set the terms of what the Supreme Court should consider. He made clear that his ruling was based on constitutionality issues and not the merits of the reform law itself. “I emphasized once before, but it bears repeating again: this case is not about whether the Act is wise or unwise legislation, or whether it will solve or exacerbate the myriad problems in our health care system. In fact, it is not really about our health care system at all. It is principally about our federalist system, and it raises very important issues regarding the Constitutional role of the federal government.”

In addition to the Florida case, the Supreme Court also will consider parts of other Appeals Court rulings. On the question of the individual mandate, the Supreme Court could punt and not rule on the issue, declaring the question of constitutionality to be premature.

Under the mandate, the government would issue tax penalties to people not insured by 2014. The Court will consider arguments that the federal Anti-Injunction Act prohibits legal challenges until taxpayers start to pay a penalty. An Appeals Court in Virginia ruled opponents to health reform did not have legal standing because penalties have yet to be paid. The Supreme Court further will consider the constitutionality of significant expansion of state Medicaid programs.

A story in the January issue of Health Data Management, “Next Stop for Reform: Supreme Court,” examines the effect of various rulings on health information technology initiatives, speculation on how the Court may rule, and what provisions could be resurrected by Congress if the Court throws out the law.

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Uninsured climbs, putting pressure on providers

It is very important to note that the PPACA expands Medicaid coverage so more of the uninsured will be eligible in these hard economic times. However, there is an added burden to hospitals that must be resolved: how do you effectively manage and assist more and more patients that are uninsured in a quick and cost-effective manner? Automating internal processes is one way to make internal staff more productive, and should certainly be researched more thoroughly as a viable solution.

Uninsured climbs, putting pressure on providers By Ron Shinkman Fierce Health Finance The nation’s uninsured continued to climb in 2011, putting more financial pressures on the hospital sector, reported Politico. The percentage of the nation’s inhabitants lacking health insurance rose to 17.1 in 2011, or about 51 million people in all. That’s the fourth straight year the percentage has risen. In 2007, the rate of uninsured was 14.8 percent.

Demographically, the biggest increases in uninsured occurred among Asian-Americans and Latinos, and those who earn less than $36,000 a year.

Those few groups that reported increases in coverage included individuals earning more than $90,000 a year, those between the ages of 18 and 25, and those age 65 and over. The last two groups presumably made gains due to a provision of the Affordable Care Act that allows young adults to remain on their parents’ policy until they turn 26 and meeting the age of eligibility for the Medicare program.

The rising rates means more patients lacking insurance are being admitted to hospitals, requiring the institutions to devote more resources to charity care or writing off charges as uncollectible. According to a report by the U.S. Department of Health and Human Services, only 12 percent of hospital services can be paid for by an uninsured patient.

The data was collected by the Gallup polling organization, surveying more than 350,000 Americans during December 2011.

For more information: - read the Politico article - study the Gallup data - read the HHS study

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