Posts Tagged ‘Health Care Reform’

Consequences of Heath Care Reform

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Expert Perspective by Grahall’s OmniMedia Editorial Board

Richard Alonso-Zaldivar’s article, Could overhaul undermine employer health coverage?, for The Associated Press published by MSNBC October 24, 2010 defiantly raises the issue of possible unintended (or maybe even intended) consequences of Heath Care Reform.  He writes: “The new health care law wasn’t supposed to undercut employer plans that have provided most people in the U.S. with coverage for generations. But some employers are weighing the options.” 

Frankly, if we had the luxury to “start from scratch” with Heath Care in this country it is certain that all the experts would steer away from a system that is employer based. 
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Unintended Consequences: Could McDonald’s Demand for Reduce MLR Launch a Public Option?

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Expert Perspective by Grahall’s OmniMedia Editorial Board

Of course we all know there is no requirement that employers offer their employees heath care insurance or pensions or any of those once imagined “entitlement benefits”.  McDonalds, for all they might be contributing to the obesity epidemic in our country is a company that takes care of its restaurant workers.  The fact that they provide health insurance to restaurant workers is remarkable especially since their workforce tends to be transient.  
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Prevention may still better (and cheaper) than the cure even with Health Care Reform

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Expert Perspective by Grahall’s OmniMedia Editorial Board

It likely didn’t come as a surprise to anyone that the Kaiser Family Foundation Employer Health Benefits 2010 Survey, according to the article September 2, 2010 article in the New York Times by Reed Abelson (Employers Push Costs for Health on Workers), found that “Workers’ share of the cost of a family [health insurance] policy jumped an average of 14 percent, an increase of about $500 a year. The cost of a policy rose just 3 percent, to an average of $13,770… Since 2005, while wages have increased just 18 percent, workers’ contributions to premiums have jumped 47 percent, almost twice as fast as the rise in the policy’s overall cost.”

Clearly there are forces at play here that have been around for a long, long time. Health care reform is supposed to fix some of those problems.  But with little happening before 2014, companies and consumers are left to wonder what reform will mean for the overall health of Americans and that of their wallets. 
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The Winners & Losers of Healthcare Reform—a Preliminary View by Steve Karp

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Expert Perspective: Health Care Reform

Since late March of this year when the Health Care reform bill because law Americans have been wondering just who will be the winners and who will be the losers from this “sweeping piece of social legislation.” (Time Magazine, March 23, 2010).  In his recent article for Heath Care Reform Magazine The Winners & Losers of Healthcare Reform Steve Karp begins to help us understand the answer to this question.   Read Steve’s article  to find out where you and me along with American businesses, politicians, and the health care industry fall in the “win and lose” columns.
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Your Questions About Health Care Reform Answered NOW

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Ask the Experts about Health Care Reform Legislation

Our clients have many questions about the implication of the recent Health Care Reform Legislation. 

Just a few of the questions posed by clients and answered at our recent seminar on Health Care Reform Legislation were:

1 If I already offer coverage, can we keep the same plan under reform?
2 Are there new reporting requirements, such as on the W-2?
3 How are preexisting conditions handled under healthcare reform?
4 How does the change in preexisting condition exclusions affect the coverage I offer my employees?
5 Will waiting periods still be allowed?
6 How will the new high-risk pool work and when will it be available?
7 What if my State already has pools?
8 Will insurance through the new high-risk pools be more affordable than that through existing pools?
9 Does the law affect coverage for early retirees?
10 Does the law offer incentives to create or participate in wellness programs?
11 Will there be limits on what insurance companies can charge me or my employees?
12 What does the new law do to control costs?
13 Will there be malpractice reform under this new law?
14 Are there changes to Health Spending Accounts (HSAs), Flexible Spending Accounts (FSAs) and Archer Medical Spending Accounts (MSAs)?
15 How will simple cafeteria plans work for small business owners?

For the answers to these and many more questions on the new legislation (including answers to questions about Health Care Exchanges and the Small Business Tax Credit) go to http://www.grahall.com/knowledge/event-transcripts/ and download information from the June 2nd seminar including an audio recording of the discussions, all presentation materials, and other information.

Or you can contact the presenters to discuss your specific questions and concerns:

Contact Robert Cirkiel at rcirkiel@uhy-us.com   or 201 337 0009
Contact  Todd C. McDonald at tmcdonald@aisling-partners.com or 508 799 9100
Contact Pate Steele at pate.steele@grahall.com or 508 269 4065 Contact Grahall’s OmniMedia Editorial Board at edie.kingston@grahall.com

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Grahall’s 2nd Webinar on Health Care Reform Reveals Key Provisions that You Must Address NOW

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Ask the Expert about Health Care Reform Legislation

There are no fewer than 20 key provisions of the health care reform legislation that take effect between now and January 1, 2011.  These provisions were thoroughly discussed during the second in a series of webinars sponsored by Grahall, LLC held June 2, 2010.   Presenters  Robert Cirkiel, Chief Actuary, UHY Advisors, Todd C. McDonald, President, Aisling Partners Insurance Brokerage and  Pate Steele, Consultant, Grahall Consulting Partners advised webinar participants that that these changes are significant and extensive. Developing a full understanding of these provisions is critical for employers to ensure the optimal approach is taken to addressing the new requirements including:


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Competent to the Core

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Expert Perspective by Grahall’s OmniMedia Editorial Board

We were saddened to read the foot note at the end of the column “Why Is It So Hard to Tackle the Obvious?” from the Harvard Business review published in Bloomberg’s Business Exchange, that author C.K. Prahalad had passed away.  (Click here to read his obituary from the Washington Post). Prahalad was one of the most accessible theorists of business strategy and, along with co-author Gary Hamel, was the first to coin the now ubiquitous term “core competencies,” which encouraged companies to view organizations as a whole rather than simply by products or services.

In the article mentioned above, Pralahad writes: “Companies should stop looking at threats and opportunities through the lens of the dominant logic. Instead, the moment they spot signs of change, executives must decide what they can preserve—and what they must discard—in the dominant logic as they prepare to transform the organization.”

Grahall’s Joe Davidson points to health care insurers as examples of organizations that have known for months, if not years, that transformational change would be required of them.  But many of these companies failed to initiate change even though they were aware that it was coming.  Company leadership might be shocked at the changes demanded by health care reform legislation but they certainly cannot say they are surprised. Insurers are facing unprecedented transformation — both immediate and long term.
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Filed under: Expert Perspective - Organization Development



UPDATE: Heath Care Reform Redux

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Expert Perspective UPDATE by Robert Cirkiel of UHY and a member of Grahall’s Editorial Board 
Wednesday May 26, 2010

Robert Cirkiel writes: “Since publishing the blog Health Care Reform Redux (below), “interim final regulations” have been issued regarding the age 26 dependent coverage requirement.  These are not proposed regulations, and the “interim final” tag means that they are final but the agencies are accepting comments. 

If you think this means that comments will have no impact and therefore commenting is a waste of time I can’t disagree. 

Regardless, my actuarial group will be issuing a comment letter nonetheless, as we believe we have uncovered a number of potential “unintended consequences”.  Also, if the use of “interim final” is a portent of things to come, it means that the time honored process of issuing regs in proposed form that are subject to change may be curtailed. Stay tuned.”

____________________________________________________________________________________________________

Expert Perspective by Grahall’s Editorial Board
Monday May 24, 2010 

In his May 15, 2010 New York Times article Health Insurance Companies Try to Shape Rules  author Robert Pears writes:  “Health insurance companies are lobbying federal and state officials in an effort to ward off strict regulation of premiums and profits under the new health care law. The effort is, in some ways, a continuation of the battle over health care that consumed Congress last year. Insurance lobbyists are trying to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care… The health care overhaul provides a classic example of how the impact of a law depends on regulations needed to interpret it.”

Weighing in at over 900 pages in length, the Patient Protection and Affordable Care Act provides little insight, however, into what employers, insurers and individuals must do to comply.  (For a little “light reading” you can access the bill at http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf). 

With such limited information and ambiguity in the bill, the regulations will be key to how both providers and users of healthcare are impacted.  Regulators have a long way to go to get the regulations drafted. Even for those elements of the bill with 2010 effective dates , there has been nothing provided other than some narrow  “guidance.”  And like any other regulatory process, once regulations are drafted, comment periods, hearings and redrafting will follow, based on input from constituent groups.    And lobbying will be part of this process.

Let’s take a closer look at the two areas that Health Insurance providers find so unpalatable: regulating premium increases and increasing medical loss ratio (MLR) requirements.  What’s the problem with these two areas as far as Health Insurance companies are concerned? 
Continue reading “UPDATE: Heath Care Reform Redux” »

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Grahall Announces the 2nd in a Series of Seminars on Health Care Reform

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Grahall Announces the 2nd in a Series of Seminars on What Health Care Reform Means For Your Business:  Wednesday, June 02, 2010 11:00 AM – 12:30 PM (Eastern Time)

Delve deeply into the immediate concerns affecting your plans in 2010 and 2011.  Takeaways include strategies on dealing with rate hikes, dependent status, small business tax credits, and keeping your grandfathered status.

Who Should Attend?
    • Owners
    • CFOs
    • HR managers
    • Benefit managers

Presenters
    • Robert Cirkiel, Chief Actuary, UHY Advisors
    • Todd C. McDonald, President, Aisling Partners Insurance Brokerage
    • Pate Steele, Consultant, Grahall Consulting Partners

To download information from the first seminar in this series including a recording, all presentation materials, and other information go to http://www.grahall.com/knowledge/event-transcripts/.  (Note that the conference content begins about 6 ½ minutes into the recording.)

Contact Grahall’s OmniMedia Editorial Board at edie.kingston@grahall.com

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Heath Care Reform: What You Need to Know NOW #2

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Ask the Experts: Pate Steele, Robert Cirkiel and Todd McDonald Discuss Health Care Reform and What it Means For Your Business

On May 4, 2010, Grahall hosted a webinar on the new heath care reform bills signed into law in March 2010.   Presenters Pate Steele of Grahall, Robert Cirkiel of UHY Advisors  and Todd McDonald of Aisling Partners  reviewed the main provisions of the reform, discussed the timeline of events and actions required, and shared information and tools needed to respond to health care reform.

As Robert Cirkiel said pertaining to the Health Care Reform bill, “What you like about the Massachusetts plan you will like about the Federal plan, what you don’t like about the Massachusetts plan you won’t like about the Federal plan”.  Essentially, Massachusetts provides a barometer to gauge the Federal plan’s impact on challenges and opportunities that will face every state in the coming years.

Key issues to look for 2010 and 2011 include:

• Changes in dependent status
• Small employer tax credits
• Reinsurance program
• Grandfathered plans affected by some provisions and not others
• Fall 2010 communications for 2011 open enrollment
• Proceeding with caution to avoid losing your grandfathered status

Todd McDonald shared that, yes, Massachusetts did insure the uninsured and now boasts the highest coverage rate in the country up from 83% to over 97%, but the goal of reducing heath care costs was not achieved.   Healthcare costs for Massachusetts have increased 68% from $1 billion in 2006 to an estimated $1.7 billion in 2010.

There were important lessons learned from the Massachusetts reform including:
• Merger of non-group and group – Increases cost
• Employer mandate – Socially responsible, not necessary
• Minimum creditable coverage – Full disclosure is the issue
• Administrative responsibilities – Keep it simple

Complete recording of the conference call, all presentation materials, and other information are available for download on the Grahall website.  To listen to the session and access the presentation materials, go to http://www.grahall.com/knowledge/event-transcripts/.  The conference content begins about 6 ½ minutes into the recording.

Or contact our presenters:

Pate Steele at pate.steele@grahall.com
Robert Cirkiel at rcirkiel@uhy-us.com
Todd McDonald at tmcdonald@aisling-partners.com

Filed under: Ask the Expert