Mental Health Parity Rules will be a game changer

I am attending the Scott and White Prescription Services 8Th Annual Conference. Dr Mike Forrester from BHM presented a thought provoking and at times anxiety provoking look at what the  Federal Mental Health Parity Rules which were recently released. He covered the top 6 areas and how they will impact consumers, providers and payers.  The focus was a general overview as well as some details on the pharmacy management component of these new rules that take effect plan years starting after July 2010.  Dr. Forrester correctly predicts that this will be a game changer and that it will increase cost as well as complexity in an already complex area. It was very well received and the audience had a number of thought provoking questions.  We will be release both the slide deck as well as a video of the talk as soon as available.  Please sign up for  BHM Healthcare Solutions’ newsletter to receive access to this very insightful and informative presentation.

Military’s health care costs boomimg.

I am attending and presenting at the Fall Managed Care Forum in Orlando and after a workout began to read the USA today. They reported that Military health care costs rose 167% from 2001 to 2011. The reported increase was due to two causes one the surge in behavioral and physical problems for troops that have been deployed multiple times due to two wars. The other that is most problematic is the rise in retiree costs.  This is reportedly due to retired military leaving civilian insurance programs as the insurance companies and businesses prepare for and  get realigned for the recently passed healthcare reform law.  I suspect we will see more of this as the impact of the law and how businesses adjust and prepare for it. 

US Miliary healthcare spending increased twice as fast as US healthcare spending as a whole.  US healthcare spending increased by 84% over the same time period.  US military spending on healthcare increased from 6% to 9 % of the military’s budget.  They expect this to continue to increase. The Military is considering increasing the cost through fee hikes.

Pay for Prevention: A Strategy for Healthcare Prevention Shows Promise

With all the talk of healthcare or health insurance reform. There are lofty goals and a likelihood that cost will increase.  We will need to think outside the bx to have any real impact on healthcare cost. An idea that focuses on personal responsibility and health as opposed to illness is Pay for Prevention. A few large employers are working on Pay for Prevention. Pay for Prevention is a new strategy aimed at eliminating chronic health conditions associated with bad behavior by offering monetary incentives for leading a healthy lifestyle.  Recent studies have shown that 50 percent to 70 percent of the nation’s health care costs are preventable.  Such costs are usually associated with bad behaviors such as diet, lack of exercise, and smoking.  Healthcare providers, Insurers, and Employers are all jumping on board and the latest indications show that rewards for good behavior are much more effective than punishments for bad behavior.

The unintended consequences of healthcare reform

There has been so much written as well as discussed on the news about healthcare reform.  We at BHM have begun the long process to fully evaluate the 2700 plus page bill and the impact to consumers, payers and providers of healthcare.  The bill has other aspects that are attached that are not directly related to healthcare but that is a discussion for another day and blog.  Most of what I have  read about the bill was politically slanted either for or against depending on the political leaning of the reporting organization. I read, a few days ago, an article from Newsweek which I found interesting and wanted to share. From Newsweek one would expect to be leaning in favor of the new legislation.  The article ” A Cost Control Mirage“ Obama is telling people what they want to hear about health care, not what they need to know by Robert J. Samuelson | Newsweek Web Exclusive.

The jest of the article is that healthcare reform as passed will increase cost with potential little improvement in overall health of the nation. Mr Samuelson begins to discuss the standard payment method used in this country ( fee of service) and how it pays providers for procedures and office visits when patients are sick. This payment structure possibly encourages increased utilization and does not encourage providers to help  patients maintain or improve their health.  He focuses on medical economics and the misperceptions that are held about health insurance reform. Until  we can empower consumers with information and reward healthy choices, we will probably not see change. BHM’s April newsletter that will be addressing Behavioral Economics/Pay for Prevention. This will be released April 6, 2010. You can sign up and the newsletter will be emailed  every other month.

The Wellpoint Mugging by WSJ 1 18 10

The Wall Street Journal reported today about the very controversal Wellpoint rate hike in CA. It appears that everyone is jumping on the evil health insurance band wagon.  We have discussed that even if health status and health cost per person in america was stable that the current recession will drive up healthcare costs. As employees loss their jobs, they and their family do some quick math.  What are my monthly known medical expenses and what is the current cost of COBRA.  Families that have high health care cost in relation to the premiums they will be charged for COBRA keep their insurance where as those that have low or no real healthcare cost ( ie the healthy population) chose to take the risk of a major medical event while uninsured.  This has a double impact on health insurers, decreased revenue due to lost members( layed off employees) and increased expense ( health insurance companies biggest expense is their members health care cost). In response to this I suspect we will see large increases in health insurance premiums over the next few years.  The WSJ went on to say that the recently proposed health insurance reform will led to very similar rate hikes.  Any type of healthcare reform has to take very seriously the unintended consequences.