MEDICARE TRUSTEES REPORT HAS GOOD NEWS AND BAD NEWS

 

As Medicare approaches its 50th anniversary next week, the federal program got some welcome financial news Wednesday: Its giant hospital trust fund will be solvent until 2030, and its long-term outlook has improved, according to a report from the program’s trustees.

But the report warned that several million Medicare beneficiaries could see their Medicare Part B monthly premiums skyrocket by 52 percent in January — from $104.90 to $159.30. Medicare Part B, which is paid for by a combination of federal funds and beneficiary premiums, generally covers physician and outpatient costs.

The huge rate hike is predicted because of two factors: Medicare Part B costs increased more than expected last year, and Social Security is not expected to have a cost of living increase next year. By law, the cost of higher Medicare Part B premiums can’t be passed on to most Medicare beneficiaries when they don’t get a Social Security raise. As a result, the higher Medicare costs have to be covered by just 30 percent of Medicare beneficiaries. This includes the 2.8 million Medicare enrollees new to the program next year, 3.1 million Medicare beneficiaries with incomes higher than $85,000 a year and 1.6 million Medicare beneficiaries who pay their premium directly instead of having it deducted from Social Security. An additional 9 million people affected by the higher rates are so called “dual eligibles” — those on Medicare and Medicaid. States pay the Medicare Part B premium for duals.

HHS Secretary Sylvia M. Burwell said she will examine her options and make a final decision on rates in October. “Seventy percent of enrollees in Part B will have no change in premiums,” she said at a briefing with other program trustees.  (Kaiser Health News)

URGENT CARE CENTERS MAY NOT GIVE PATIENTS CLEAR INSURANCE INFORMATION

 

Patients who choose Urgent Care Centers instead of hospital emergency departments may face unexpected bills if the center is not clear about participation in insurance networks. Patients who call and ask whether a given Urgent Care Center accepts their coverage may misunderstand the response and expect an in-network co-pay, not balance billing. The New York State attorney general's office recently told some clinics their website insurance information may be deceptive. If you plan to use an Urgent Care Center make sure you tell them specific details about your health plan when asking what they accept.  Better yet, check with your health plan to see if the Urgent Care Center is “in-network.”

DIET HIGH IN VITAMIN C MAY REDUCE CARDIOVASCULAR RISK

New findings published in the American Journal of Clinical Nutrition reveal that eating fruits and vegetables can help lower your risk of early mortality, by decreasing the likelihood for certain illnesses like cardiovascular disease.

For the study, researchers at the University of Copenhagen and Herleve and Gentofte Hospital collected data on 100,000 Danes, examining their intake of fruit and vegetables.

They discovered that high vitamin C concentrations in the blood were associated with a 15 percent reduced risk of cardiovascular disease and a 20 percent reduced risk of early death.

"Eating a lot of fruit and vegetables is a natural way of increasing vitamin C blood levels, which in the long term may contribute to reducing the risk of cardiovascular disease and early death. You can get vitamin C supplements, but it is a good idea to get your vitamin C by eating a healthy diet, which will at the same time help you to develop a healthier lifestyle in the long term, for the general benefit of your health," Boerge Nordestgaard, a clinical professor at the Faculty of Health and Medical Sciences at University of Copenhagen, said in a news release.

AETNA TO PURCHASE HUMANA FOR $37 BILLION

Health insurer Aetna, Inc. on Friday said it would buy smaller rival Humana, Inc. for about $37 billion in cash and stock, in the largest ever deal in the insurance industry.

The combination will push Aetna close to Anthem’s No.2 insurer spot by membership, and would nearly triple Aetna's Medicare Advantage business.

The deal will face antitrust scrutiny but if it goes through it would dwarf the previous largest insurance deal announced just this week, where Swiss property and casualty giant ACE Ltd. announced it was buying Chubb Corp for $28 billion. It would also dwarf Anthem's purchase of WellPoint in 2004 for $16.6 billion.

Analysts have said that M&A activity in the healthcare sector had been waiting for last week's Supreme Court ruling on Obamacare, which upheld key subsidies that underpin the reform and thus gave more certainty to healthcare insurers.

The bigger the insurer, the more power it has negotiating prices and improving its doctor networks.
Anthem has offered to buy Cigna Corp to create the largest insurer in the country, toppling UnitedHealth Group, Inc.

Media reports have also said UnitedHealth could be eyeing Cigna and Aetna. On Thursday, Centene Corp said it would buy smaller rival Health Net, Inc. for $6.3 billion.