Older Americans Oppose Approval Process for Home Care Services

Eighty-three percent of seniors oppose a Medicare policy that requires a government contractor to approve claims for physician-prescribed home health care, according to a poll sponsored by Bring The Vote Home. The Centers for Medicare & Medicaid Services (CMS) recently implemented a pre-claim review demonstration that imposes documentation requirements on home health agencies and referring physicians. Doctors have to provide a broad array of eligibility-related documentation and clinical support for review by government contractors. Home health leaders warn that the new requirements could delay care and increase healthcare costs. Seniors say that requiring a government contractor to approve home heath care will have the following results:

  • 80% say it will delay care.
  • 77% say it will increase Medicare costs.
  • 75% say that will increase out-of- pocket costs.
  • 45% say it will decrease fraudulent home health claims.

For more information, visit bringthevotehome.org.

More Americans Seek Guaranteed Income in Retirement

To address inflation risks, many Americans want financial products that provide guaranteed income in retirement as well as opportunity for increasing income, according to a study by Allianz Life. Eighty percent are interested in a product that offers income for life, and 86% are interested in a product that offers guaranteed income for life plus the opportunity for income to increase over time.

Seventy-seven percent prefer a guaranteed income option that has a lower income rate, but offers the possibility of increases, over one that has a higher starting income rate with no opportunity to increase. Fifty percent say that it’s very or extremely important for a product to offer the possibility of income increases. Allianz Life vice president of Consumer Insights Katie Libbe said, “Many people depend on an annual pay raise to cover various increasing expenses, and build long-term savings. Consumers facing retirement will need to explore options that create a similar income strategy by using a portion of their portfolio to get guaranteed income for life with the chance for increases.” Annual pay increases are an important part of maintaining financial security for many Americans. In fact, 67% say they got a pay raise at least half of the time during their working years. Yet, if faced with a frozen income that offered no chance for an increase in annual salary, 53% say they would be very worried or even panicked as to how they would pay for everyday expenses.

Twenty-eight percent of those surveyed (41% of people earning less than $50,000) worry that they won’t be able to pay for basic needs, such as housing, food, and medical care. Considering the critical role of pay raises in managing rising costs, this scenario provides a glimpse into the situation of retirees who are on a fixed income. Libbe said, “Clearly, there is strong consumer appetite for guaranteed income and increasing income solutions in retirement. It’s important that these benefits are available so Americans can have more confidence in their ability to manage rising costs when pay increases are no longer an option.”

Recent research on Allianz Life annuities reveals that income benefits – built-in or through an optional rider at an additional cost – have delivered income increases to many customers. Income from Allianz Life fixed index annuities has helped address inflation. Purchasing power actually increased over time. Ninety-three percent of clients who are receiving income from these fixed index annuities got an increase. Sixty-seven percent of these clients got a payment increase every year

Americans Are Not Confident About Their Approach to Saving and Investing

Many participants in defined contribution plans are not confident in their approach to saving and investing, according to a study by J.P. Morgan Asset Management. There is a disconnect between participant intent and action. Also, a misconception about participant support for automatic features and strategies may be holding plan sponsors back from strengthening their defined contribution (DC) plans. The survey of 1,001 DC plan participants finds that most are still uncertain that they will have a financially secure retirement. More immediate financial demands interfere with their ability to save for the future; many don’t have a clear understanding of how to set a retirement savings goal; and most are not confident in their ability to make investment decisions.

Sixty-eight percent say that their 2015 contributions were less than they should have been. Eighty-one percent are interested in doing financial planning for retirement. Forty-five percent do not have a financial plan. Forty-eight percent say they don’t spend enough time planning for retirement. Twenty-eight percent have never rebalanced their 401(k) account, 31% never changed their initial choice of investment options, and 18% never increased their contribution.

Catherine Peterson of J.P. Morgan said, “Plan sponsors have an opportunity to strengthen their plans and help provide…catalysts for transforming intent to action…This can be done through automatic…strategies, such as automatic enrollment, automatic contribution escalation, and re-enrollment with a qualified default investment alternatives, such as a target date fund.” The survey also reveals the following:

  • 74% favor automatic enrollment and automatic contribution escalation or are neutral about it.
  • 67% favor a combination of these two features or are neutral.
  • 90% like target date funds.
  • 82% favor re-enrollment or are neutral.
  • 96% of those who enrolled automatically in their plans are satisfied, and 31% would not have enrolled without automatic enrollment.
  • 97% of those with contribution amounts that increase 1% to 2% automatically each year are satisfied; and 15% say they probably would not have escalated their contributions without the automatic feature.
  • 73% of those who went through a re-enrollment allowed their assets to be moved to a target date fund. Also, 99% of those whose funds were moved are satisfied.

Americans Want Personal Advice With Technology

Technology cannot easily replace human advice in financial planning, according to Northwestern Mutual’s 2016 Planning & Progress Study. When asked how they would prefer to get financial advice, 54% said the ideal solution combines a human relationship with technology while 33% prefer a human relationship above all else. The appetite for a fully automated (robo) solution appears low across all age groups, even for Millennials, with fewer than two in 10 opting for robo advice. Tim Schaefer of Northwestern Mutual said, “As people’s financial and personal lives become busier and more complex, they want expert guidance tailored to their needs and access anywhere at any time. Technology transforms the road map to financial security into a 24/7 financial GPS.”

The nearly 50% of respondents who had no interest in robo advice gave the following as their top reasons:

  • 48% want a human advisor who can answer questions and discuss options.
  • 40% don’t trust a robo advisor.
  • 38% value the knowledge and expertise that a human advisor can provide. Interestingly, this factor was most pronounced for Millennials, suggesting that even those who rely heavily on technology value human expertise in financial planning.
  • 50% of women are not interested in robo advice compared to 43% of men.

Americans Greatly Underestimate the Cost of Homecare

The average American underestimates the cost of in-home care by almost 50%, according to a Genworth study. Thirty percent say that home care costs less than $417 a month when the national median rate is $3,861 a month for an in-home aide or $3,813 a month for homemaker care. Homemaker costs are up 2.6% from 2015, marking the highest year-over-year increase across all care categories. In comparison, home care aide services rose modestly at 1.25% since 2015. Over the past five years, home maker costs have risen 11% and 6.6% for health aides.

Interestingly, people who stand to be affected most by long term care events are more likely to underestimate the cost of care. This includes women (who are more likely to enter caregiving roles), single adults (who may not have a partner to rely on for caregiving needs), and younger adults (aged 25 to 45), who are more likely to deal with the reality of a parent needing care).

The national median cost of care rose across all care settings, except adult day care, which decreased slightly. The monthly cost of a private nursing home room is $7,698, up 1.24% from 2015. The cost of a semi-private room is up 2.27% to $6,844 a month. Assisted living communities saw a slight increase in costs of .8% to $3,628 a month. Adult day care costs fell 1.25%.

The Majority of Uninsured Americans Have a Chronic Condition

Sixty-two percent of Americans have been diagnosed with a chronic health condition, according to a survey commissioned by the Transamerica Center for Health Studies. The most common conditions are being overweight, having high blood pressure, and having high cholesterol. The study finds the following:

  • 82% of Americans say they can afford routine health expenses compared to 41% of the uninsured. However, 41% report an increase in premium costs over the past one to two years.
  • 71% say they can afford a $100 monthly premium.
  • 66% say they can’t afford a premium of $300 or more per month.
  • Since the implementation of the Affordable Care Act, the number of uninsured Americans has dropped from 21% in 2013 to 11% in 2015.
  • 82% of Americans are very or somewhat satisfied with the healthcare system, compared to 73% in November 2013.
  • The most common reason cited among for not getting health coverage is low awareness of the ACA insurance mandate (26%). Eighteen percent do not know how to apply, and 21% are willing to pay the tax penalty for not having health insurance.
  • 30% of  Americans say the ACA directly affected their health coverage; those who did tended to report a positive effect.
  • 48% have no strong opinion of the ACA.
  • White Americans (67%) are most likely to are diagnosed with a chronic health condition.
  • African Americans have the highest rates of high blood pressure and Type 2 Diabetes (24% and 10%, respectively).
  • At 41%, Asian Americans are the least likely to have a chronic health condition.

How States Can Expand Volunteer Health Care

Millions of poor Americans are still uninsured or lack access to affordable health care options, but a simple local reform is already changing thousands of lives, and if enacted across the country, could help millions, says a report by the Foundation for Government Accountability (FGA). The report shows how every state can offer legal protections for health care professionals, like doctors, nurses, dentists, pharmacists, surgeons, and more, who provide free health care to low-income patients and their families.

Using Florida’s Volunteer Health Services program as a case study, the report shows how low-income residents in the Sunshine State benefitted from $1.3 billion in donated medical goods and services from 2010 to 2014. In 2014 the state netted a $614 to $1 return on its investment, spending just under $500,000 to administer the program, leading volunteers to provide nearly $300 million worth of care.

“There are so many charitable, caring people working in our health care system who want to help those in need, but feel constrained by frivolous liability concerns, which keeps them from donating valuable care to the poor,” said Tarren Bragdon, FGA CEO.

Volunteer care reforms are incredibly popular with the public, with 84% of voters supporting incentivizing and protecting health care professionals who provide free treatment. If volunteer care reforms are widely adopted, almost 4 million Americans could benefit from greater access to health care services each year. “We’ve already seen how transformative this program can be for people’s lives,” said Andrew Brown, a senior fellow with FGA. A Florida truck driver, who lost his job because of severe diabetes, got free treatment under the program, which helped him get back on the road. He now has a steady income and is able to provide stability for his family, and health insurance.

Americans Embrace Health and Fitness Technology

Sixty-three percent of consumers who use fitness or health monitoring technologies say it has changed their behavior significantly. Forty percent have shared their fitness or monitoring information with their doctor, according to a survey by the Deloitte Center for Health Solutions.

Twenty-two percent used technology to access, store, and transmit health records in the past year, up from 13% in 2013. Use was higher for those with major chronic conditions (32% compared to 19% in 2013). Sixteen percent who needed care went online for cost information, up from 11% in 2013. Technology use among Millennials increased the most (27% versus 17%). Further, 71% of all those surveyed have not gone online for cost information, but are very or somewhat likely to use a pricing tool in the future.
Twenty-five percent used a scorecard to compare the performance of doctors, hospitals, and health plans, up from 19% in 2013. The rate was highest in the youngest cohort, with 49% of Millennials who received care in the last year using a scorecard compared to 31% in 2013.

Greg Scott of Deloitte Consulting said, “Health care is becoming more digitized and consumer oriented. It’s not an overnight change, but more like how summer turns into fall – gradual yet very perceptible. The specter of a more customer-driven industry is causing many health companies to transform into retail-focused organizations, impacting everything from strategy and scale to operations and human capital…This is about more than a cool app; this is about making the…changes needed to better identify and engage a more empowered purchaser.”

Americans Are Divided on the ACA

This month, 41% of Americans surveyed have a favorable view of the Affordable Care Act and 45% have an unfavorable view. Not surprisingly, opinion of the law continues to vary by political party identification, with most Democrats reporting a favorable view (67%), most Republicans reporting an unfavorable view (73%), and independents falling in the middle with 47% reporting an unfavorable view and 41% reporting a favorable view.

Twenty-five percent want Congress to expand what the law does; 18% want Congress to implement the law as it is; 11% want the law scaled back; and 31% want Congress to repeal the law.

Americans Want More Transparency in Health Plan Data

The ACA requires plans to disclose how often claims are denied or appealed, the availability of network providers, and what consumers will pay out-of-pocket for care out-of-network. Under the law, transparency reporting requirements were to take effect in 2010 for plans outside of the marketplace and in 2014 for marketplace plans. But these provisions have not yet been implemented. A recent notice proposes to delay implementation further, though it has not yet been finalized, according to a report by the Kaiser Family Foundation.

The public largely supports requiring health insurance companies to release data points, including data on the availability of in-network doctors and hospitals (84%), data on how often claims are denied or appealed (83%), data on how quickly the company pays claims (82%), and data on what a typical person pays to see a doctor who is not in the plan network (73%). Seventy percent say they would be at least somewhat likely to this information when shopping for a health insurance plan.

Last Updated 09/12/2019

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