For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress

For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress  | KFF

Source: Kaiser Family Foundation, by Cynthia Cox and Krutika Amin

Health insurers are now submitting to state regulators proposed 2023 premiums for plans offered on the Affordable Care Act (ACA) Marketplaces. Changes in these unsubsidized premiums attract a lot of attention, but what really matters most to the people buying coverage is how much they pay out of their own pockets. And the amount ACA Marketplace enrollees pay is largely determined by the size of their premium tax credit. Generally speaking, when unsubsidized premiums rise, so do the premium tax credits, meaning out-of-pocket premium payments hold mostly steady for people getting financial assistance.

For just over a year, ACA Marketplace enrollees have benefited from enhanced tax credits under the American Rescue Plan Act (ARPA), which Congress passed as temporary pandemic relief. The enhanced assistance lowers out-of-pocket premiums substantially, and millions of enrollees saw their premium payments cut in half by these extra subsidies. ACA Marketplace signups reached a record high of 14.5 million people in 2022, including nearly 13 million people who received tax credits to lower their premiums.

Soon, the vast majority of these nearly 13 million people will see their premium payments rise if the ARPA subsidies expire, as they are set to at the end of this year.

The ARPA subsidies were enacted temporarily for 2021 and 2022 as pandemic relief, but congressional Democrats are considering extending or making the expanded subsidies permanent as a way of building on the ACA, as President Biden had proposed during his 2020 campaign. If Congress does not extend the subsidies, out-of-pocket premium payments will return to their pre-ARPA levels, which would be seen as a significant premium increase to millions of subsidized enrollees. In the 33 states using HealthCare.gov, premium payments in 2022 would have been 53% higher on average if not for the ARPA extra subsidies. The same is true in the states operating their own exchanges. In New York, for example, premiums for tax credit-eligible consumers would be 58% higher if not for the ARPA. Such an increase in out-of-pocket premium payments would be the largest ever seen by the millions receiving a subsidy. Exactly how much of a premium increase enrollees would see depends on their income, age, the premiums where they live, and how the premiums charged by insurers change for next year.

For states, the timing of Congressional action on ARPA subsidies matters both for rate review and state enrollment systems. State-based exchanges – as well as the federal government, which operates HealthCare.gov – will need to reprogram their enrollment websites and train consumer support staff on policy changes ahead of open enrollment in November. States will start making these changes as soon as this month. Additionally, as insurers submit premiums for review, state insurance commissioners and other regulators must assess the reasonableness of 2023 rates, and some of that determination will depend on the future of ARPA subsidies. The non-partisan National Association of Insurance Commissioners (NAIC) wrote to Congress asking for clarity on the future of ARPA subsidies by July.

For insurers, the timing matters because 2023 premiums get locked in later this summer. Last summer, when insurers were setting their 2022 premiums, some said the ARPA had a slight downward effect on their premiums, based on the risk profile of enrollees. Insurers are now in the process of setting 2023 premiums and some might factor in an upward effect on premiums if they expect ARPA subsidies to expire. Premiums for 2023 are locked in by this August, so if Congress does not act before its August recess, whatever assumptions insurers make about the future of ARPA subsidies will be locked in to their 2023 premiums. Additionally, although this is not necessarily at the same scale of the uncertainty seen in 2017 surrounding the ACA repeal and replace debates (when many insurers explicitly said that uncertainty was driving their premiums up), it is possible that some insurers will price 2023 plans a bit higher than they otherwise would, simply because of uncertainty around the future of the ARPA’s enhanced subsidies. The NAIC letter to Congress warned that “uncertainty may lead to higher than necessary premiums.”

For enrollees, the timing matters both for knowing how much they will pay and for maintaining continuous coverageNearly all of the 13 million subsidized enrollees will see their out-of-pocket premium payments rise if the ARPA subsidies expire. But if the subsidies are renewed by Congress, but not until the end of the year right before subsidies are set to expire, there could still be a disruption if states and the federal government do not have enough lead time to update their enrollment websites to reflect the enhanced subsidies. In this scenario, the millions of enrollees who currently have access to $0 premium Marketplace plans might have to pay a premium in January – putting them at risk of losing coverage due to non-payment. Similarly, middle-income enrollees might temporarily lose access to advanced payments of the tax credit in the month of January, making it unaffordable for them to maintain coverage.

Congress’s action or inaction on ARPA subsidies will have a much greater influence over how much subsidized ACA Marketplace enrollees pay for their premiums than will market-driven factors that affect the unsubsidized premium. Even if unsubsidized premiums hold steady going into 2023, the expiration of ARPA subsidies would result in the steepest increase in out-of-pocket premium payments that most enrollees in this market have seen. This would essentially be a return to pre-pandemic normal, but the millions of new enrollees and others who have received temporary premium relief may not see it that way.

Payers, Providers And States Likely Have More Time Until COVID-19 Health Emergency Ends

Payers, providers, states have more time until COVID emergency ends

Source: Fierce Healthcare, by Robert King

The healthcare industry likely has until this fall to face the end of the COVID-19 public health emergency (PHE) as a key deadline came and went with no notice Monday.

 

The Department of Health and Human Services (HHS) promised to give states a 60-day notice when the PHE will end, giving a vital heads-up for when a slew of regulatory flexibilities that have been in place for more than two years will go away. The current PHE will run until July 16, and HHS did not provide any notice that it won’t be extended again for another 90 days.

The decision to not give a 60-day notice comes after an intense lobbying effort from healthcare providers that are worried about the flexibilities of the PHE going away amid a potential new surge of COVID-19.

“The risk from COVID-19 variants remains, and case rates are currently rising across the country,” said the letter from 16 health groups to HHS leadership dated May 10. “Throughout the pandemic, we have painfully learned that the rapid global spread of new variants has resulted in significantly increased transmission rates and infections in the U.S.”

Some health groups and state Medicaid officials have asked HHS Secretary Xavier Becerra to give them more than a 60-day notice of the PHE going away. A key reason is that states agreed to get a 6.2% increase in federal Medicaid matching funds in exchange for not dropping anyone off Medicaid for the duration of the PHE. Once the PHE ends, states will have up to 14 months to fully redetermine whether Medicaid beneficiaries are still eligible.

Becerra has shot down giving more notice, previously saying the PHE can only be extended for 90 days at a time. Becerra has also said that any decision on the PHE will be made via the science.

 

The PHE brought a series of major regulatory flexibilities that could go away once it expires, chief among them in telehealth. The Centers for Medicare & Medicaid Services temporarily removed barriers that include originating site requirements and audio-only restrictions for telehealth services, enabling providers to get reimbursement from Medicare for the new technology.

The flexibilities, however, only last through the PHE. Several bills introduced this session aim to offer to extend the telehealth flexibilities for several months past the PHE to determine what should be made permanent.

Income Impacts How Employees Use HDHPs

Income impacts how employees use HDHPs | BenefitsPRO

Source: BenefitsPRO, by Willa Hart

One of the biggest benefits a company can offer its employees is health insurance. But that health insurance isn’t necessarily used by all employees in the same way. A new study released earlier this month in the American Journal of Managed Care suggests that low-salary employees on high-deductible health plans tend to have lower utilization of primary care services than higher-salary employees, while also having a higher utilization of acute care services.

High-deductible health plans, or HDHPs, have become popular in recent years as a replacement for traditional health plans. HDHPs are thought by some to be beneficial as they offer lower premiums to employees. However, some have cautioned that HDHPs can discourage patients to seek out preventive care, and can lead to worse outcomes for patients as a result.

The new study, “Disparities in Health Care Use Among Low-Salary and High-Salary Employees,” analyzed administrative and medical claims data from employees at a large corporation to determine how low-salary versus high-salary employees utilized their HDHPs. It found that low-salary employees, defined as those making less than $75,000 a year, were significantly less likely to use outpatient services than higher-salary workers. However, low-salary employees were much more likely to require inpatient or ED services, resulting in a 40% increase in spending on ED care by employees making less than $50,000. Study authors speculate that the higher utilization of ED care might indicate that low-salary patients’ health conditions are not as well managed as their higher-salary counterparts’.

Other findings of the study include:

  • * High-salary employees are more likely to seek outpatient care. The highest salary earners the study tracked, who made more than $100,000 a year, were more likely to utilize primary care services than employees of the middle salary group making $75,000-$100,000 per year.
  • * Low-salary employees are less likely to fill prescriptions. Employees making less than $75,000 a year were less likely to utilize pharmacy services than employees with higher salaries.
  • * Low-salary employees see higher rates of preventable inpatient stays. Employees who made less than $50,000 per year were more likely to utilize inpatient services for a preventable issue.

The study authors note that avoiding primary care services can be concerning. “This pattern of health care utilization may lead to delayed diagnosis of health conditions and potentially miss the window and benefits of early diagnosis or prevention,” the authors write.

Past research has suggested that some patients, including low-salary patients, prefer health care plans with spending that is more evenly distributed over time, such as traditional health care plans with lower deductibles. When plans have higher deductibles, patients may have lower costs overall but will have less predictable month-to-month spending, a pattern that can be difficult for low-salary workers without substantial savings, the study says.

Newsom Signs Compromise Law Raising The Limit On Medical Malpractice Damages

Governor Newsom Signs Historic Legislation to Restore Patient Access to  Justice, Update 47-Year-Old Medical Malpractice Damage CapSource: San Francisco Chronicle, by Bob Egelko

California’s $250,000 limit on damages for pain and suffering caused by medical malpractice, a ceiling enacted by lawmakers in 1975 at the insistence of doctors and insurers, will be lifted next year. Gov Gavin Newsom signed compromise legislation Monday, sponsored by consumer advocates and supported by medical groups, that will not remove all limits on malpractice damages but will raise them to account for some of the inflation in the past 47 years.

Under AB35 by Assembly Majority Leader Eloise Gómez Reyes, D-Colton (San Bernardino County), the new limits for noneconomic damages in 2023 will be $350,000 for nonfatal medical malpractice by a physician and $500,000 for malpractice causing death. The maximum will rise gradually over the next decade, to $750,000 for non-death cases and $1 million for fatal cases, and increase by 2% a year thereafter for inflation.

When a doctor and other medical institutions, such as hospitals, commit acts of malpractice on the same victim, the limits will rise to as much as $1.05 million next year and $2.25 million in 10 years in non-death cases, with higher caps for fatal cases.

The current $250,000 damage limit would have been worth about $50,000 in 1975. The 1975 law, the Medical Injury Compensation Reform Act, or MICRA, does not restrict damages for a patient’s economic losses, such as wages and medical expenses.

“For decades, medically injured patients suffered from both the pain of being wrongfully injured and the unfairness of a system that severely restricted their access to justice,” said Craig M. Peters, president of Consumer Attorneys of California. “This historic agreement will ensure patients are more fairly compensated when their rights have been violated.”

“After decades of negotiations, legislators, patient groups, and medical professionals have reached a consensus that protects patients and the stability of our health care system,” Newsom said in a statement.

AB35 was also endorsed by the California Medical Association and the California Hospital Association as an alternative to a proposed November ballot initiative that would have increased the damage limit to $1.25 million, and removed all limits on damages for malpractice causing catastrophic injury or death. The sponsors of the initiative dropped it after lawmakers reached their agreement.

MICRA, signed by then-Gov. Jerry Brown, was sponsored by medical groups that said it was needed to keep doctors from leaving the state for fear of being bankrupted by unlimited damage awards.

Consumer groups contended the law rewarded incompetent doctors and their insurers at the expense of their patients. But previous efforts to modify or repeal MICRA failed in the Legislature, and in 2014 two-thirds of state voters rejected Proposition 46, which would have substantially increased the damage limits and required physicians to undergo drug and alcohol testing.

The law can have a drastic impact on individual cases. Two-year-old Steven Olsen of Chula Vista (San Diego County) slipped and fell on a walk in the woods with his family in 1992 and was treated for a sinus injury by doctors who failed to conduct a scan that would have detected brain injuries, a consumer group said. He wound up with lifelong blindness and brain damage and was awarded $7 million by a jury for pain and suffering — an amount slashed to $250,000 under MICRA.

“Although it is too late for my family to benefit from this change, at least others won’t have to endure the same suffering ours did three decades ago,” said Steven’s father, Scott Olsen, a board member of the nonprofit Consumer Watchdog and a sponsor of the now-shelved November ballot measure.

Dr. Robert Wailes, president of the California Medical Association, said the agreement was reached “because the two sides of the ballot measure campaign put differences aside, found common ground and recognized a rare opportunity to protect both our health care delivery system and the rights of injured patients.”

Employers Pay 224% Of Medicare Prices For Hospital Services

Employers pay 224% of Medicare prices for hospital services | BenefitsPRO

Source: BenefitsPRO, by Scott Wooldridge

Employer-sponsored health plans paid on average 224% of what Medicare paid to hospitals for the same services at the same facilities, according to a new study from RAND Corporation. The report covers billing for hospital inpatient and outpatient services in 2020.

The study said that there were significant variances in prices across states or geographic areas and added that the difference in cost seemed to be linked to hospital market share rather than hospitals’ share of Medicare and Medicaid patients.

The researchers found that in Hawaii, Arkansas, and Washington, relative prices were under 175% of Medicare, while other in states, such as Florida, West Virginia, and South Carolina, relative prices were at or above 310% of Medicare.

In addition, the study found that prices for COVID-19 hospitalization were similar to prices for overall inpatient admissions and averaged 241% of what was paid for Medicare patients.

“Employers can use this report to become better-informed purchasers of health benefits,” said Christopher Whaley, the study’s lead author and a policy researcher at RAND, a nonprofit research organization. “This work also highlights the levels and variation in hospital prices paid by employers and private insurers, and thus may help policymakers who may be looking for strategies to curb health care spending.”

Cost variation: a “defining characteristic” of US health care

The researchers described the wide variation in prices paid for medical services as “a defining characteristic of the U.S. health care system.”

In 2019, the study said, spending on hospital services accounted for 37% of total health care spending for privately insured Americans and came to approximately $434 billion. “Hospital price increases are key drivers of growth in per capita spending among the privately insured,” the study added.

RAND researchers found the difference between employer prices and Medicare prices was actually a bit lower since a previous study in 2018, when employers paid 247% of Medicare costs. The researchers said the change was because of an increase in claims among states that generally pay lower rates for hospital costs.

Transparency in pricing has been a challenge for the health care industry. Despite efforts by both providers and government regulators to create more transparency, both employers and consumers lack useful information on pricing. And the public data that does exist has gaps, due in part to the fact that many hospitals have not yet complied with recent regulatory requirements.

An Indiana case study: employer pressure lowered prices

The study concludes by looking at efforts in some states to address relatively high hospital prices. In Indiana, employers in the Fort Wayne area were able to prompt price changes at the Parkview Health System in that community, which the RAND study had identified as having some of the highest prices in the country.

“Equipped with information on negotiated prices, employers were able to place pressure on a large hospital system and TPAs to achieve lower prices for their workforce,” the study said. “Other employer and policymaker pressures in Indiana led the Indiana University Health system to announce plans to reduce prices to the national average rate.”

Hospital association response: “Unfounded conclusions”

The American Hospital Association (AHA), however, quickly released a statement saying the RAND conclusions were an over-reach and unfounded.

“The report looks at claims for just 2.2% of overall hospital spending, which, no matter how you slice it, represents a small share of what actually happens in hospitals and health systems in the real world,” said AHA President and CEO Rick Pollack. “Researchers should expect variation in the cost of delivering services across the wide range of U.S. hospitals – from rural critical access hospitals to large academic medical centers. Tellingly, when RAND added more claims as compared to previous versions of this report, the average price for hospital services declined.”

Lowering Medicare Age Comes With Big Price Tag

Democrats push bill to lower Medicare eligibility age to 60 - CNNPoliticsSource: Axios, by Adriel Bettelheim

Giving Americans over 60 access to Medicare would add about 7.3 million people to the program’s rolls and swell the budget deficit by $155 billion over a five-year period, the Congressional Budget Office and Joint Committee on Taxation project said in a new analysis.

Why it matters: While it’s a popular idea with voters, the big price tag illustrates why Medicare expansion isn’t gaining centrist support and remains a legislative long shot.

What they’re saying: Lowering the eligibility age would result in about 3.2 million fewer people having employer-sponsored health coverage, with most transferring to Medicare.

  • * That would put the federal government on the hook for a larger share of medical spending while lowering per-person spending for work-based health plans.
  • * The policy would halve the uninsured rate for the newly eligible group, from 8% to 4%.

Flashback: While President Biden didn’t initially run on expanding access to Medicare, he agreed to support lowering the age from 65 to 60 in April 2020, when his campaign worked on a unity platform with Sen. Bernie Sanders (I-Vt.).

  • * The idea lost traction as centrists led by Sen. Joe Manchin (D-W.Va.) scaled back Biden’s social spending ambitions and the Build Back Better agenda.

NAHU CEO: ‘Medicare For All’ Moves From Congress To The States

NAHU CEO: 'Medicare For All' Moves From Congress To The States –  InsuranceNewsNet

Source: InsuranceNewsNet

Congress has backed off “Medicare for All” for the time being. But legislators in several states are now taking up the charge.

In California, Democrats call for “a universal, single-payer health care system” as part of their party platform. A bid to install such a system failed in the California Assembly at the end of January, but the Golden State’s leaders have promised to make another run at it.

At least a dozen other states are considering bills that would ban private health insurance and establish single-payer health care. That’s bad news for ordinary Americans. It makes little sense to force nine in 10 Americans off their current health plans as part of a drive to bring about universal coverage.

About two-thirds of insured Americans currently depend on private health insurance plans. About 177 million people receive coverage through an employer, and about 34 million people purchase private coverage directly.

A single-payer system could do away with all those plans.

Moreover, Americans like their private plans. In a recent study of people with employer-sponsored coverage, more than two-thirds said they were satisfied with their insurance. More than three-quarters felt confident it would protect them during a medical emergency.

Research by the Kaiser Family Foundation found that what support there is for single-payer declines when people consider its attendant consequences like higher taxes and treatment delays.

Analyses of specific state single-payer plans suggest the downsides would be severe.

The New York Health Act, for instance, would reduce employment in the Empire State by 315,000, according to research published last year by the Foundation for Research on Equal Opportunity. Another report found that if the bill became law, New York residents would have to pay some $250 billion in new taxes.

 

Further, single-payer will lead to lower-quality care. That’s because government payers rely on lower payments to hospitals and doctors to keep costs in check. Look no further than Medicare. The American Hospital Association says hospitals receive just 87 cents for every dollar they spend treating Medicare beneficiaries.

That’s obviously not sustainable. If a single-payer system — and its low payment rates — were adopted widely, doctors and hospitals would respond by reducing the supply of care they’re willing to provide.

That diminution of supply, combined with unlimited demand stoked by making health care free at the point of service, could lead to long waits.

Just ask the Congressional Budget Office. According to a recent CBO analysis, a single-payer system would result in more “unmet demand” for health care services, “greater congestion in the health care system” and “lower payment rates.”

Lawmakers in several states have responded to concerns like these by championing a supposedly more moderate public option — a government-run insurance plan that would supposedly compete against private options.

But any public option would also reimburse providers at lower rates than private plans do. The public plan would use that pricing power to set premiums and deductibles below those of private insurers. As people gravitated toward the cheaper public option, private insurers would gradually leave the market, until only the public plan remained.

A public option is just a slower way of introducing single-payer. And single-payer health care is a cure worse than the disease.

Janet Trautwein is CEO of the National Association of Health Underwriters. This piece originally ran in the Boston Herald.

Rising Google Searches For Procedures Suggest Recovering Demand, Analysts Say

Google Accused of Enabling Piracy With Images Search Feature | TimeSource: Healthcare Dive, by Nick Paul Taylor

Dive Brief:

  • * Searches on Google for 20 common, nonemergent procedures are above pre-pandemic levels, providing another data point that indicates demand is recovering, according to analysts at Needham.
  • * The analysts believe Google Trends data may indicate the level of consumer interest in certain procedures, leading them to track the resource to understand changes over time. U.S. searches for orthopaedic, general surgery and cardiovascular procedures were at 114%, 112% and 101% of their pre-pandemic levels, respectively, in the last analysis.
  • * Earlier analyses suggest the data may bode well for future sales at medical device companies. The data previously have correlated with medtech financial results, with slumps and rises in search numbers in step with drops and increases in revenue.

Dive Insight:

The most recent medtech industry earnings season was characterized by improving results. After struggling with the impact of omicron early in the year, many companies had a recovery in demand as the quarter progressed, leading some orthopaedic businesses to post sales that matched or topped pre-pandemic levels and businesses across the industry to report that the recovery continued into April.

Google search data potentially provides a window into what is coming next. The idea is that the search results show whether consumer interest is falling or rising and, in doing so, offer insights into future sales of medical devices.

The latest analysis found nonemergent procedure searches are up on both the pre-pandemic period, defined as the first seven weeks of 2020, and on a trailing 90-day basis. Over the 90 days through last week, Google searches for the 20 procedures tracked by the Needham analysts rose 8%, with hernia repair having the greatest improvement and nephrectomy faring the worst.

Searches related to orthopaedics, general surgery and cardiovascular procedures gained 12%, 6% and 9%, respectively, over the analyzed period. The figures are similar to the analysis covering the 90 days through the end of April, with orthopaedic searches decelerating by one percentage point and general surgery and cardiovascular gaining two percentage points and one percentage point, respectively.

The rise in orthopaedic searches over the past 90 days suggests the recovery in demand seen during the first three months of the year may have continued into the second quarter. Still, patient demand likely is just one of the forces that will shape results in the second quarter and after, company executives have said.

“We do expect that staffing pressure will continue to be a challenge throughout the year, just not as intense, I think, as what we thought when we started the year,” Zimmer Biomet CEO Bryan Hanson told analysts on a quarterly results conference call.

Leapfrog Group: Patients report worse hospital experiences during COVID-19 pandemic, raising safety concerns

Leapfrog sees 'significant' infection increases across its largest-to-date  release of hospital safety grades | Fierce HealthcareSource: Fierce Healthcare, by Dave Muoio

The latest batch of hospital patient safety ratings from the Leapfrog Group shows a general decline among “several” hospital safety measures concurrent with the onset of the COVID-19 pandemic, according to the healthcare safety watchdog.

 

Released Tuesday, the scores are accompanied by a report from Leapfrog that highlights a “significant” decline in the experiences of adult inpatients at acute care hospitals during the pandemic, with many areas “already in dire need” prior to the pandemic deteriorating even further.

“The healthcare workforce has faced unprecedented levels of pressure during the pandemic, and as a result, patients’ experience with their care appears to have suffered,” Leah Binder, president and CEO of the Leapfrog Group, said in a statement.

 
 

Leapfrog’s twice-annual reports assess more than 30 patient safety measures and component measures compiled from the Centers for Medicare & Medicaid Services (CMS) and Leapfrog’s hospital surveys between July 2018 and March 2021. The most recent release assigns letter grades to nearly 3,000 U.S. general hospitals and is the second collection of scores to incorporate safety and experience data from the COVID-19 pandemic.

This time around, Leapfrog assigned 33% of hospitals an “A,” 24% a “B,” 36% a “C,” 7% a “D” and less than 1% an “F”—a roughly equivalent distribution to those given in the fall.

Eight states had 50% or more of its hospitals receive an “A” grade, with North Carolina (59.8%) and Virginia (59.2%) leading the way.

 

On the other end of the spectrum, Wyoming, West Virginia, North Dakota and the District of Columbia had zero hospitals that received an “A” from the watchdog.

As before, Binder said that the “significant variation in safety performance” across different facilities underscores the need for public access to hospital assessment tools “so patients can make the best decision for themselves and their loved ones.”

Alongside the scores, Leapfrog placed a spotlight on patient experiences in a report comparing Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) scores across more than 3,500 U.S. hospitals before (2019) and during (mid-2020 to mid-2021) the COVID-19 pandemic.

The group found statistically significant declines between the survey periods in the average percentage of hospital patients who gave the most favorable responses for nine of the 10 HCAHPS measures.

 

The greatest decline was seen among patients’ experiences with hospital staff responsiveness (a 3.7 percentage point decrease), followed by communication about medicines (a 2.9 point decrease), and cleanliness of the hospital (a 2.9 point decrease).

Leapfrog noted that these patient experience areas and others—like understanding care transitions (which already claimed the least favorable responses)—are directly tied to patient safety events and likely took a hit due to pandemic strains on the healthcare workforce.

“We commend the workforce for their heroic efforts these past few years and now strongly urge hospital leadership to recommit to improved care—from communication to responsiveness—and get back on track with patient safety outcomes,” Binder said.

The inpatient experience report is the second in a series of three such analyses from Leapfrog focused on patient experience during the pandemic. The first report, released in early April, focused on a decline in favorable patient ratings for communications about procedures across ambulatory surgery centers and hospital outpatient departments alike.

Leapfrog’s broader Hospital Safety Grade rankings are available online as a free resource for patients and their families. The organization said its analyses are independently assessed and peer-reviewed, with the methodology of the scoring available online for review.

The prior round of ratings highlighted “significant” declines in hospitals’ performance on preventable hospital-acquired infections. Those findings echoed similar concerns from patient experience intelligence firm Press Ganey and the Centers for Disease Control and Prevention.

New Data Show Estimated Uninsured Rate In 2021 Recovers Slightly From Highs Of 2020

Uninsured rate in 2021 down from the highs of 2020

Source: Fierce Healthcare, by Robert King

An estimated 30 million people did not have insurance coverage last year, bringing the uninsured rate to 9.2%—only slightly below the major high of 9.7% from 2020, new federal data show.

The National Center for Health Statistics released its latest report Thursday on estimates for health insurance coverage last year. The data showed slight gains in insurance coverage from public programs.

The report showed that last year, among adults 18 to 64, there were 13.5% who were uninsured at the time of the interview while 21.7% had public coverage and 66.6% got private insurance.

 
 

Among children up to 17 years old, 4.1% were uninsured, 44.3% had coverage from a public program and 53.8% were in private coverage.

Even though the uninsured rate dipped slightly compared to 2020, there were minimal changes among certain age groups.

For instance, the percentage among adults 18 to 64 didn’t change that much from 2020 (13.9%) to last year at 13.5%. But there was a significant difference between the percentage of adults who were uninsured in 2019, 14.7%, but declined to 13.5% last year.

There was also a boost among adults that had public insurance coverage in 2021, with 21.7% getting such coverage last year compared with 20.5% in 2019.

The increase in public health coverage comes amid major moves by the federal government and Congress to increase affordability of coverage on the Affordable Care Act’s exchanges. Increased subsidies from the American Rescue Plan Act helped spur a record-breaking 14.5 million in sign-ups for the exchanges this year.

Other pandemic-related flexibilities included a boost to federal matching rates for Medicaid coverage and a requirement that states not disenroll anyone from their Medicaid rolls.

However, the eligibility redetermination freeze is expected to last until the end of the public health emergency, which could expire this summer. The enhanced subsidies are also expected to go away after this year, but there is an effort in Congress to extend them.

 

The center emphasized that the report only contains early release estimates that still could change. The estimates are based on data from the 2021 National Health Interview Survey, which is based on information collected from nearly 30,000 adults and 8,293 children.

Last Updated 05/25/2022

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