DOL FAQ on Mental Health Parity Offers Guidance for Grandfathered Plans

Click here to read Buck Consultants' summary of how recently released DOL FAQ (click here to read) on mental health parity impacts grandfathered status under health reform.

PWC Report Forecasts 2011 Employer Health Benefit Trends

PricewaterhouseCoopers’ Health Research Institute surveyed 700 U.S.-based companies, small through jumbo sized, to gauge their perspectives on health care costs and benefits program priorities for 2011. Interviews were conducted in the first quarter of 2010. Click here for a copy of the report.

Major findings include:

• Medical costs are projected to increase 9% in 2011.
• More employers will move away from co-payments & toward co-insurance at the point of care.
• Hospitals, getting less from Medicare, will cost-shift to employers/commercial to make it up.
• Providers will merge and consolidate, creating greater leverage in negotiations with health plans.
• Employers plan to add more worksite wellness & health promotion programs.

Implementing Mental Health Parity

Click here to check out Milliman's new resource on implementing mental health parity.


Issues covered include:

Deductibles and out of pocket limits
Coordination with EAP services
Separate coverages or benefit packages
How to deal with providers, specialists, primary care
Quantitative vs. non-quantitative benefits (very controversial)
Compliance

More Updates on MBGH's Health Reform Resource Center

Click here to go to MBGH's Health Reform Resource Center to see the latest information posted on:

• Employer uptake on early retiree reinsurance program
• How employers are handling expanding coverage to <27 year olds
• Guidance on Extension of Children's Health Coverage to Age 26
• New resource on health reform provisions that apply to grandfathered plans
• How employers are reacting to Health Reform

And more!! Check back often as the resource center is updated as important information becomes available.

Mercer Reports on How Large Employers Are Reacting to Health Reform

Click here to read results from Mercer's survey of 800 large employers which shows that:

■Early estimates of cost impact range from moderate to severe, with 30% of employers surveyed still in the dark
■Even so, the excise tax on high-cost plans – which doesn’t kick in until 2018 – tops employers’ list of concerns
■Retailers concerned about cost of expanding coverage to more part-timers
■Employers considering several options for offsetting cost of covering adult children
 
Most large employers are waiting unitl their new plan years to implement coverage for <27 year olds. Click here to read an NPR article on this aspect of the survey results.

More Resources on Grandfathered Plans & Early Retiree Reinsurance Now on MBGH Health Reform Resource Center

Great resources from national experts now uploaded on MBGH's Health Reform Resource Center on our temporary website. Click here to access the following:

Proskauer's presentation on Grandfathered Plans & Exception for Collectively Bargained Agreements (4/29/10)
Groom Law Group chart identifying sections effective for Grandfathered Plans (4/2/10)
Groom Law Group Memo on Interim Final Regulationson Retiree Reinsurance Program (5/6/10)
Buck Consultant's summary of HHS Interim Final Regulations on Retiree Reinsurance Program (5/6/10)
Paul Hasting's "Early Retiree" Retiree Health Insurance Initial Observations & First Guidance (5/4/10)

Check Out New Postings on MBGH's Health Reform Resource Center

Click here for the latest information posted on MBGH's Health Reform Resource Center:

• IRS guidance on tax-free employer-provided heatlh insurance for children under 27
• HHS Releases Regulations on Early Retiree Reinsurance Program from Buck Consultants
• How Will Reform Affect Large Employers? from Jenny Ivy at Benefits Selling
• Employee Benefit News is Establishing Health Reform Study Groups

While on the temporary website, check out the Tobacco Cessation Benefit Tools & Solutions Center & the Diabetes Benefit Tools & Solutions Center. Next new Center will focus on Pharmacy Benefits!!!

Memphis Employers Using Incentives & Data to Control Health Benefit Costs

Check out MBGH's comments on how Memphis-area employers are controlling health benefit costs through employee incentives and providing data to make informed choices. Click here to read the Memphis Business Journal article.

Get the latest on Retiree Reinsurance Program

Click here to check out Sebelius' address on retiree reinsurance program. Important information for employers!!

Curious About How Part-Time Employees Are Addressed in Health Rerform?

Click here to get the latest from MBGH on Health Reform. Latest addition to our resource center is a summary from Bass Berry & Sims about how part-time employees are addressed in health reform.

MBGH Presents on Health Reform to Tennessee Personnel Management Assoc.

Click here to check out MBGH's Health Reform presentation to the Tennessee Personnel Management Association on April 15, 2010 for a reminder on why there was such a push for health reform, how we got health reform, how what we got addressed the issues that pushed reform to happen, and some key provisions impacting employers.

Latest on How Employers Are Preparing (Reacting) to Health Reform

As the dust begins to settle on what actually was passed in health reform, employers are reacting and beginning to prepare to deal with what appears to lie ahead. Greatest concern is being voiced over extending dependent coverage to age 26; extending coverage to part-time employees that work 30 hours/week; caps on FSAs; and the elimination of tax deductability for Mediare Part D subsidies for retiree health plans and on lifetime and annual limits, all of which will increase employer costs.

But many say the version that passed is less onerous than previous versions with delays in implementation of controversial issues including the excise tax on "cadillac" plans and the inclusion of some positives in terms of payment & quality demonstrations. Plus, employers "dodged" the strong employer mandate that had been in the House bill.

In addition to all of these changes, and more, employers will take on additional administrative tasks, which, as we all know, end up costing employers significantly in compliance issues.

Read these two article to get a feel for how employers are preparing and reacting as the dust begins to settle.
Click here for "Employers Scamble to Catch Up with Health Reform's Immediate Impact" and here to read "Benefit Managers Eye Impact of Health Reforms".

More on How Health Reform Impacts Employers: Latest from SHRM

Click here to get the latest on how health reform impacts employers. Includes SHRM April 5, 2010 HR Week Health Reform Update. Please note, some of the links on SHRM's update are for SHRM members only.

Resource for Employers to "Navigate Health Reform"

The Groom Law Group slides presented at the American Benefits Council on March 31, 2010 are a good resource to navigate the recently passed health reform legislation and identify what self-insured as well as insured plans must do to comply. Click here to access the slides as well as other resources on health reform.

Employers: Focus on These Aspects of Health Reform NOW!!!

Click here to hear Steve Wojcik, vice president of public policy for the National Business Group on Health, offer his take on what employers should have top of mind between now and when the biggie components of the Patient Protection and Affordable Care Act take effect in 2014 and 2018.

MBGH Says: Real Cost Reform is Still to Come

Memphis Business Group on Health's work is highlighted in the April 1, 2010 Memphis Business Quarterly blog. The posting focuses on the need for real cost reform -- saving dollars and improving quality by preventing things that should not happen and improving health and saving dollars by doing things we should be doing to take better care of ourselves.

There is also a link to the Leapfrog Hospital Survey results for Memphis hospitals.

Check the Memphis Business Quarterly blog out regularly for other Memphis business-related postings.

Find Out How Health Reform Impacts Self-Insured Employers

The dust is beginning to settle a little. Find out what we know now about how health reform impacts self-insured employers.  Click here to go to MBGH's Health Reform Updates website & download the Employer Implementation Summary provided by National Business Coalition on Health.

Corporations Push For Repeal of Redeuced Tax Deductions in Health Reform Law

Key corporations claim that health reform bill's repeal of employer tax deductions for retiree drug subsidies will hurt their bottom lines.

Click here to read the NY Times article.

What Do Physicians Think Employers Should Do?

What do physicians think employer's should do?

82% think employers should offer employees incentives to manage their chronic diseases and/or stay healthy
70% think employers should reduce or waive copays to increase adherence on medications

These strategies are consistent with the current emphasis on "value-based benefit design" which uses benefit design to motivate employees to use high value services which will keep them as healthy as possible for as long as possible.

What do physicians want from employers?

62% want to know about worksite and employer-based programs so they can counsel patients on participation
47% think benefit design should "be an extension of the physician's treatment program" leaving them in control of treatment decisions.

The study, conducted by the Midwest Business Group on Health, also concludes that communication between employers, employees and physicians is critical to improving/maintaining health.

Check out an article on the study by clicking here.

Unnecessary Angiograms Are Very Costly to Your Health Plan

Recent study released in the New England Journal of Medicine shows that 62% of 400,000 patients that had no known heart disease and were not receiving emergency heart care had no significant heart blockage found in their angiogram results. The study suggests that physicians should do a better job of identifying those patients that need an angiogram, especially for the 20-30% of the patients that have no symptoms.

Medicare pays about $1,400 for an outpatient angiogram and $3,000 for an inpatient angiogram. Private payors typically pay more. So performing angiograms on patients that do not have significant heart blockage is very costly to you as an employer. For these 62% of the patients, payments could be an estimated $446 million (note: estimated by MBGH. Although the test may have not shown any significant blockage, it may still have been appropriate for some of these patients)

So, what can you do about this?

• Encourage your employees to discuss less invasive alternatives, and the risks associted with these as well as angiograms, with their physician.
• Check with your health plan to see what type of decision support tools they are offering your employees and how they let your employees know these tools are available. Also ask them how many employees actually use these tools.
• Consider plan design triggers that require accessing decision support services for non-emergencies through the plan prior to scheduling invasive tests.

Click here to read the Yahoo article which includes a link to the New England Journal of Medicine.