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.

SUPREME COURT UPHOLDS NATIONWIDE HEALTH CARE LAW SUBSIDIES

WASHINGTON (AP) -- The Supreme Court on Thursday upheld the nationwide tax subsidies underpinning President Barack Obama's health care overhaul, rejecting a major challenge to the landmark law in a ruling that preserves health insurance for millions of Americans.

The justices said in a 6-3 ruling that the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live, as opponents contended.

The outcome was the second major victory for Obama in politically charged Supreme Court tests of his most significant domestic achievement. And it came the same day the court gave him an unexpected victory by preserving a key tool the administration uses to fight housing bias.

Obama greeted news of the decision by declaring the health care law "is here to stay." He said the law is no longer about politics, but the benefits millions of people are receiving.

Declining to concede, House Speaker John Boehner of Ohio said Republicans, who have voted more than 50 times to undo the law, will "continue our efforts to repeal the law and replace it with patient-centered solutions that meet the needs of seniors, small business owners, and middle-class families."

At the court, Chief Justice John Roberts again voted with his liberal colleagues in support of the law. Roberts also was the key vote to uphold it in 2012. Justice Anthony Kennedy, a dissenter in 2012, was part of the majority on Thursday.

STATES COULD POSSIBLY "LEASE" HEALTHCARE.GOV

CHICAGO, IL - June 16, 2015
A hospital group in cash-strapped Illinois says the state might be able to set up a health insurance exchange at a lower cost by "leasing" the federal government's technology, an option that could appeal to as many as 34 states where subsides could be jeopardized by an unfavorable U.S. Supreme Court decision.

President Barack Obama has said there is no backup plan if the Supreme Court strips federal subsidies from the law in Illinois and the 33 other states that haven't created their own exchanges. The administration didn't respond Monday to the AP's requests for comment on the possibility of leasing HealthCare.gov.

"We do believe that the administration is quietly discussing a healthcare.gov lease option with the states and that it will roll out more specific guidelines in the event that the Supreme Court strikes down the subsidies," said Caroline Pearson, who follows the health law for the market analysis firm Avalere Health.

The four-page Illinois memo is the clearest plan yet for how the state could create a state-based exchange quickly should the justices rule that only people living in states with their own exchanges can get federal financial help.

The Supreme Court ruling is expected later this month, and the subsidies could end later in the summer unless Congress acts. Leading congressional Republicans are promising to help consumers who lose subsidies, but it's unclear Congress could pass any fix that Obama would sign.

TYPE 1 DIABETES PATIENTS BENEFIT FROM PHYSICAL ACTIVITY

 

A German study in Diabetes Care revealed that patients with type 1 diabetes who engaged in regular physical activity had better glycemic control and reduced cardiovascular risks, and the authors say patients should be encouraged to exercise. Researchers found inverse correlation between physical activity and HbA1C levels, diabetic ketoacidosis, dyslipidemia, hypertension and body mass index, as well as an inverse association between physical activity and retinopathy, microalbuminuria and severe hypoglycemia with coma. PhysiciansBriefing.com/HealthDayNews