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.

Health Reform Resources Added in June

Quite a bit of activity in June related to health reform. You can click the following links to access the latest information. Don't forget to click here to go to MBGH's Health Reform Resource Center for the 30+ postings on health reform information important for employers.

Click here to read Health Reform GPS's summary of Health Insurance Reforms & Grandfathered Plans (6/26/10)
Click here to read the HHS press release on regulations for grandfathered plans (6/14/10).
Click here to read the HHS Q&A on the regulations for grandfathered plans (6/14/10)
Click here to read National Business Coalition on Health's Action Alert on the release of the official application & application instructions for the early retiree reninsurance program (6/29/10)
Click here to read Milliman's assessment of the impact of health reform on Large Employers (6/11/10)
Click here to read FAQ's about health reform from Buck Consultants (6/21/10)

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.

Pushing for Market-Level Health Plan Performance Reporting

I attended my first NCQA Purchaser Advisory Council today and it was a great meeting. NCQA is addressing the latest in health reform issues, including exchanges, accountable care organizations, relative resource use and furthering its work in wellness/health promotion and medical home. I am excited about the tools and information NCQA is working on, most of which measure and report performance at a plan or vendor level.

But I am struck by the fact that although reporting at the plan or vendor level often works for individual employers, those of us involved in community-level change need this valuable information cut in a different way. For example, health plans in TN report their HEDIS measures at a statewide level. Works for employers that have employees across the state, but does not work for those of us wondering how plans are peforming in Memphis specifically. Another example is the wealth of information that will become available through NCQA's relative resource use reports, which, once again, look at the plan's performance across the entire state.

It is great to know how health plans perform, in general across TN, but it would be even more powerful and actionable to know how they perform in each market in TN. That would tell us more about our own providers and their performance and help identify what we need to improve locally and may even give us hints about how to improve it. Because of contracting methods here in Memphis, where plans contract either with Baptist or Methodist, but generally not with both, we could even begin to understand if there are any real differences in the quality and resource use between our two major hospital systems and their affiliated physicians.

Understanding whether these differences exist between Baptist & Methodist is critical to local employers, and their employees, in knowing where to go for safe, high quality, efficient care.

NCQA is pushing itself to be relevant, vital, and address the current issues that are even more important due to health reform. The next challenge will be how to make this information relevant and usable by communities as well as individual employers. I hope I can bring this perspective to NCQA as I continue to serve on their Purchaser Advisory Council.

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!!!

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.

Not Paying for Readmissions Spurs Improvements in Patient Care

It is estimated that 75% of the Medicare admissions readmitted to the hospital within 30 days of discharge were preventable. In total, the cost of readmissions to Medicare is approximately $17.4 billion annually.

Medicare's decision NOT to pay for preventable/avoidable readmissions to hospitals has gotten attention. Significant work is now being done by hospitals to put better discharge and/or transfer processes into place to better coordinate care, ensure patients have support systems at home and get needed followup services. A good example of how aligning payments with desired outcomes serves as the main "carrot or stick" to get action. And, a good example of how poor quality care drives high cost.

Click here to read the article. The clear connection between aligning payment with expected outcomes is in the last paragrah.

Patient Safety Incidents Cost $8.9 Billion Annually

Latest Health Grade's Patient Safety in American Hospitals study finds that there was little progress in reducing patient safety incidents in hospitals for Medicare patients in 2009. They estimate that these patient safety incidents added $8.9billion to the cost of health care in 2009 and that almost 100,000 Medicare patients died as a result of these incidents.Top performing hospitals had 43% fewer incidents than poorly performing hospitals.One more example of how costly poor quality is!!!

Click here to read an article about the report.

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.

Attend University of Memphis Health Law & Public Polcy Symposium, March 26

Click here for brochure and registration

Health Law and Public Policy:
An Introduction to America's Trillion Dollar Business

History will cement this week as the one which saw the passing of the most significant health law legislation in half a century. Join us for an up-to-the-minute discussion with national authorities never before brought together in Memphis, on The Health Care Ecosystem in Transition; Biomedical Research; Health Care and Economic Development; Health Information Management, Electronic Records and E-Discovery; Perspectives on Health Care Reform; and a Leadership Panel Discussion on Health Care and Public Policy. The day's program will close with an outstanding Leadership Panel comprised of the CEOs from St. Jude Children's Research Hospital, Baptist Memorial Health Care Corporation, Methodist LeBonheur Healthcare, and St. Francis Healthcare. You don't want to miss this.

Friday, March 26, 2010

8:30 a.m. – 6:00 p.m.

To be held at the beautiful new downtown location of the

Cecil C. Humphreys School of Law

One North Front Street

Memphis, Tennessee