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.

AHIP Presses Congress, White House To Ramp Up Scrutiny Of Private Equity Provider Deals

AHIP presses Congress, White House to ramp up scrutiny of private equity  provider deals | Fierce Healthcare

Source: Fierce Healthcare, by Robert King

Health insurance trade group AHIP is calling for the White House and Congress to increase scrutiny of private equity control of providers, which the group worries could impact quality and costs.

 

The group earlier this week released letters sent to the White House and congressional leaders outlining parts of a new policy road map and priorities (PDF). Chief among them was more transparency surrounding private equity deals, which has grown in popularity across certain parts of the provider industry.

“While improving transparency of health care prices at the federal level has been a major focus, only the recent executive order related to nursing home care has applied to the activities of private equity entities of the health care marketplace, which have vastly different business models than other health care organizations,” the letter to President Joe Biden said.

AHIP wrote that there needs to be more transparency on private equity control of physician specialty groups and how the deals can impact quality and costs for patients.

The group noted in a white paper that back in 2018 private equity made up 45% of all health mergers and acquisitions. While initial deals applied to certain specialties like orthopedics and urology, AHIP said targets have expanded.

AHIP wants Congress to pass legislation that requires the public reporting of all private equity and hedge fund purchases of specialty groups and other providers such as emergency room physicians or ambulance providers. They also want the federal government to study any anticompetitive impact on the acquisition of providers by private equity firms.

 

Other key priorities in AHIP’s road map include:

  • * Advance use of site-neutral payments to ensure payments are the same no matter the site of care. The Centers for Medicare & Medicaid Services has cut Medicare payments in recent years to off-campus hospital clinics to bring the payments in line with those paid to physician clinics. But the effort led to a legal fight with the hospital industry.
  • * Support the expansion of home-based advance care via “value-based care and payment models,” the road map said.
  • * Remove barriers to telehealth access, which exploded in use since the onset of the pandemic; but, now, regulators are figuring out what to make permanent. AHIP wants the federal government to have network adequacy regulations to account for the availability of telehealth and to ban billing of “distant site facility fees for telehealth services.”

AHIP’s push to scrutinize private equity deals comes as the federal government has delivered more scrutiny of hospital merger deals. The Federal Trade Commission also launched a probe into physician practice acquisitions back in January 2021 to examine their impact on market competition.

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.

Unprecedented Budget Surplus Is Focus of May Revision

Despite surplus, analyst warns of California 'fiscal cliff'

Source: CalChamber, by Loren Kaye

To nobody’s surprise, Governor Gavin Newsom on Friday announced another upward revision in the state’s general revenues—a $55 billion bump since January. To the surprise of many, this means that discretionary surpluses for three consecutive fiscal years will top $100 billion. Nobody had this number on their bingo card as the state tumbled into the pandemic recession just two years ago.

This unprecedented and unexpected streak of budget surpluses has been amassed in large part from the strong economic performance by key California economic sectors and entrepreneurs. This creativity and adaptability by employers, along with the commitment of millions of California workers, has seen the state through the tragedy of COVID-19, with extra revenues to bolster the social safety net.

Experience with the California budget teaches that what goes up must come back down, so the Governor prudently sets aside $37 billion into various reserve funds, and calculates that 94% of all spending from surplus funds is dedicated to one-time purposes.

Since the state budget is pushing against the so-called Gann Limit, which caps annual expenditures from the state budget, the Governor targeted several of his initiatives toward spending exempt from the limit, in particular, infrastructure and tax relief.

Noting the toll that inflation has recently taken on individual family budgets (not to mention the already high cost of living endemic to California), the May Revision calls for more than $18 billion in various tax relief or rebate programs, including:

  • * A $400 rebate to households based on registered motor vehicles.
  • * A temporary reduction to the diesel sales tax.
  • * Funding for rental assistance and payments for outstanding utility arrearages built up during the pandemic.
  • * Covering all family fees for subsidized child care programs as well as continued health care subsidies for the middle class if federal subsidies expire.
  • * Retention bonus payments to approximately 600,000 workers in hospitals and nursing homes.

The Governor is also proposing some targeted tax benefits for businesses, including:

  • * Extending the CalCompetes tax credit program for five years at $180 million per year, and extending the CalCompetes grant program for another year at $120 million.
  • * Fully conforming California law to the extended federal Paycheck Protection Program (PPP), which prevents these federal grants from being subject to state taxation.
  • * Another $500 million for a grant program administered by the Small Business Advocate to provide additional relief to small businesses most affected by the pandemic, focusing on the top ten industries hardest hit by the pandemic.

California will receive $13.9 billion in new federal funds from the Infrastructure Investment and Jobs Act that will support transportation, broadband and other projects over the next five years. On top of that, the May Revision will target another $17 billion (on top of $20 billion from the January budget proposal) for electric vehicle infrastructure and clean energy innovation, transportation projects, broadband build-out, and reducing wildfire risk and supporting drought resiliency.

Schools automatically receive a portion of every new general tax dollar, courtesy of a 1988 ballot measure, Proposition 98. The May Revision includes total funding of $128.3 billion for all K-12 education programs—more than $20,000 per student. This is $20 billion more than the Governor proposed in January, and a stunning $35 billion higher than the current year budget. Some $8 billion of this amount is a one-time allocation that schools can use to address the continuing effects of the pandemic by supporting students’ mental health and learning challenges and to take actions to preserve staffing levels.

The Governor made good on his pledge to give annual budget increases of 5% to the University of California and California State University systems over the next five years. In exchange, the systems will be expected to make progress and report annually on goals including improved graduation rates, growing enrollment, making college more affordable and preparing more students for high-demand careers.

Governor Newsom increased his spending commitment for programs related to climate change and drought mitigation, adding $9.5 billion to a $23.5 billion multi-year commitment made in January. The spending will cover drought relief and water projects, investments in clean energy, and subsidies for electric vehicle purchases and charging infrastructure.

The Governor made no changes to his January proposal to transfer $3 billion to the Unemployment Insurance Fund to offset future employer tax liabilities.

Employers Pay Hospitals Billions More Than Medicare

How Much More Than Medicare Do Private Insurers Pay? A Review of the  Literature | KFF

Source: Axios, by Adriel Bettelheim and Caitlin Owens

Employers and private insurance plans in 2020 paid hospitals 224% of what Medicare paid for the same services, with rates for inpatient and outpatient care varying widely from site to site, a new report from RAND finds.

The intrigue: The report found that hospital prices had no significant correlation with hospitals’ share of Medicare and Medicaid patients, which hospitals say factor into private rates. Price did positively correlate with hospital market share.

Why it matters: Hospitals account for about 37% of health spending for the privately insured — and even people who don’t use hospital services foot some of the bill through their premiums.

The big picture: Annual per-person spending growth for workplace health coverage has exceeded spending growth for government programs in nine of the past 13 years, largely because enrollment and demand for services among the commercially insured has barely changed.

  • * The divergence in pricing has been linked to mergers and acquisitions, affiliation agreements and other consolidation that increases hospitals’ leverage.
  • * In 2021, the average premium cost of an employer-sponsored family plan was more than $22,000, an increase of 47% from 2011, according to the Kaiser Family Foundation.

What they found: The report draws on medical claims data from employers and state databases from 2018 to 2020 covering 4,102 hospitals and 4,091 ambulatory surgical centers that account for $78.8 billion of spending.

  • * States like Hawaii, Arkansas and Washington had relative prices below 175% of Medicare prices, while others including Florida, West Virginia and South Carolina had prices at or above 310% of Medicare levels.
  • * In 2020, COVID-19 inpatient hospitalizations averaged 241% of Medicare, which is similar to the relative price for all inpatient procedures.
  • * Prices for common outpatient services performed in ambulatory surgical centers such as imaging and colonoscopies averaged 162% of Medicare payments. However, Medicare pays the centers less than it pays hospital outpatient departments for the same services, the study notes, and the ratio would be lower if centers were paid the same way.
  • * Medicare per-procedure payments to hospital outpatient departments were 2.1 times higher than payments to ambulatory surgical centers and commercial payments were 2.6 times larger, the study found.
  • * If the same providers were paid Medicare rates for the same services, employers and private plans would have saved $49.9 billion, researchers said.

The other side: Hospitals say Medicare reimbursement rates are too low, so they have to charge privately insured patients more to make ends meet. The pandemic has also disrupted many hospital business models — for example, by forcing the cancellation of elective procedures.

The bottom line: Health costs are likely to keep rising for those with private insurance as employers use higher deductibles, copays and coinsurance to offset some of the rising costs.

  • * While employers back reforming how workplace health care is paid for, they don’t agree on many of the details or how significant changes would be.
  • * The more information about pricing disparities that becomes public, the more likely it is that pressure on hospitals to justify their prices will build.

Employee Productivity Is Up, But So Is Burnout

Employee productivity, stress, burnout are all up among remote workers |  BenefitsPRO

Source: BenefitsPRO, by Jessica Mach

Remote work has resulted in a boost in productivity, according to a new report, but worker burnout has also skyrocketed.

That’s according to a survey of 175 HR executives in the U.S. recently released by The Conference Board.

Sixty-two percent of organizations with primarily remote workforces said they’ve seen productivity grow since the start of the pandemic, the report said. While organizations that have on-site work policies also have reported productivity increases, this was the case for only 47% of respondents.

At the same time, 77% of respondents say they’ve seen an increase in employees who identify as burned out—up from 42% in September 2020.

Employees are also using fewer vacation days, feeling less engaged, and have lower morale. More are seeking support for their mental health as they work a greater number of hours.

“Since the outbreak of the pandemic, employee well-being has declined and burnout is on the rise,” said Rebecca Ray, executive vice president of human capital at The Conference Board.

“To retain workers, HR leaders will need a strong focus on improving the employee experience. That includes both allowing and encouraging employees to integrate their work and personal lives in a way that works best for them.”

Respondents did note some areas of improvement in organizational culture, however.

More than 70% of respondents said that since the start of the pandemic, commitment to corporate social responsibility, genuine caring by managers, transparent communication by leaders, and collaborative technology have changed for the better.

Meanwhile, more than 60% of respondents said they’ve seen improvements in the quality of leadership at their organizations, as well as inclusivity, commitment to innovation, and articulation of mission and purpose.

However, 25% of respondents said the level of trust between organization leaders and employees has declined since the start of pandemic.

Last Updated 05/25/2022

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