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Health insurance premiums for individuals who purchase coverage on their own are soaring, as outlined by a study released Monday. When lawmakers debated the health care reform bill, health insurance companies were trying with many effort to make as much money as they could before the law's provisions kick in. Individuals facing sharp increases in their insurance premiums are trying to save money by settling for fewer benefits and higher deductibles. Meanwhile, steadily increasing insurance premiums, the recession and a drop in the number of employers offering health coverage swelled the ranks of the uninsured by nearly 3 million individuals in 2009.

Article Resource: People who buy health insurance on their own facing steep hikes

Cost trends of health insurance

Premium hikes for health insurance for individuals far exceed increases in the premiums for employer-sponsored coverage, according to a new survey on health insurance cost trends from the Kaiser Family Foundation. The Associated Press reports the non-profit foundation said premium hikes for individual coverage averaged 20 percent. Customers who got to switch to cheaper plans brought the average increase in what individuals are paying for health insurance down to 13 percent. This year's individual health insurance premium spike tops last year's 5 percent average increase for all of the employer-sponsored family coverage. Health insurance cost trends for some of the employer-sponsored single coverage held steady.

Individuals with health insurance is getting expensive

The rising cost of health insurance for individuals made news earlier this year when Anthem Blue Cross tried to raise its rates by 39 percent in California. The New York Times reports that the Kaiser study sheds light on how widespread these premium hikes are. The New York Times reports that when the proposed Anthem hikes were met with outrage from federal and state officials, there was little details about how widespread such increases were in other parts of the country. Drew Altman, the Kaiser foundation's president and chief executive, told the Times that “The survey shows the steep increases we are reading about over the last various months aren't just extreme cases.”

A long wait to health care reform

The Kaiser survey highlights the challenges that about 14 million individuals younger than 65 who purchase their coverage in the individual market will face until changes under the health care reform law kick in 2014. By then, all Americans could be required to have health insurance or risk paying a fine. In the meantime, 52 percent of respondents within the Kaiser survey who already buy their own individual health coverage said they would keep their current plan next year, when 32 percent said they are not sure. 14 percent said that they would probably switch companies to cut costs.

High deductibles on health insurance plans

People are switching plans to higher deductibles to conserve money. $ 2,500 is the average deductible. There is an annual deductible of $ 5,000 or more. The number of those with high deductibles has risen from 39 percent in 2007 to almost 47 percent in 2009.

Millions of people losing health coverage

For the 2.9 million U.S. adults who joined the ranks of the uninsured in 2009, health care reform doesn’t do very much to help them with their current needs. USA Today reports that in 2009 — the latest statistics accessible — 46.3 million American adults had no health insurance coverage, according to a new report from the U.S. Centers for Disease Control and Prevention. One in five working adults don’t have insurance. The percentage of uninsured adults of working age went way up from 19.7 percent to 21.1 percent in 2009, and 58.5 percent of American adults went without insurance for at least part of the year.

More information on this topic

Associated Press

google.com/hostednews/ap/article/ALeqM5je_4AEzpzQnfbTmeeOg1yUO9jWRgD9GFOU080

New York Times

nytimes.com/2010/06/22/business/22kaiser.html?src=busln

USA Today

usatoday.com/news/health/2010-06-20-uninsured-reform_N.htm

This summer, Hope Street Group is changing the status quo.  We are launching the first health care project of its kind, an eight-week initiative that brings together health care practitioners, industry professionals, entrepreneurs, policy-makers and members of the academic and research community to develop health care policies.  Together, we will be reinventing primary care to address resource shortages, reduce system-wide health care costs, and ensure that Americans have access to the quality health services they need most.

We are currently recruiting participants in this exciting initiative called “Policy 2.0: Using Open Innovation to Reinvent Primary Care.”  The initiative will focus on some of the most pressing, yet solvable, problems facing primary care.  If you accept this invitation, you will be able to connect your ideas with our distinguished group of advisors, including Dr Doug Henley (Executive Vice President/CEO, American Academy of Family Physicians), Peter Lee (Director of Delivery System Reform, Department of Health and Human Services, Office of Health Reform) and Dr. Bob Kocher (Special Assistant to the President, National Economic Council)  - see the full list here:  http://www.hopestreetgroup.org/docs/DOC-1781.  You will be driving research-based recommendations - designed to lead real change - that will be presented to federal and state level policy-makers, industry, and the larger health care reform community.

To help this all come together, the project will use our online platform that has been used successfully by professionals in other fields to develop policy solutions.  Hope Street Group will select participants based on their experience and expertise, so if you would like to accept this invitation please send a brief statement of interest to Diana Harris at Diana@hopestreetgroup.org by July 1, 2010.  Only a limited number of individuals can participate in the project, so do not delay.

Hope Street Group is a nonpartisan nonprofit dedicated to expanding economic opportunity for all Americans.  Our approach is simple: bring new voices to the public policy debate in innovative ways in order to develop solutions to pressing national problems.  To learn more about Hope Street Group, please visit: http://www.hopestreetgroup.org/community/healthcare and experience Policy 2.0, our customized online collaboration platform.

Or is it much needed innovation?

Many Americans are unable to obtain timely appointments for acute illnesses and often turn to urgent care and retail health clinics, and hospital emergency rooms to obtain the routine care they should be receiving from their primary care provider.

These settings often offer what primary care practices are unable to deliver— walk-in care requiring no appointment, convenient locations, and consumer-friendly hours. Urgent and retail health clinics are typically staffed by physician assistants or nurse practitioners and supervised remotely by doctors. This allows these clinics to offer lower fees, which is increasingly attractive to patients without insurance and those newly unemployed.

However, the upturn in patients utilizing urgent and retail health clinics often leads to increased fragmentation and uncoordinated medical care for patients, poor follow up after treatment, and in the event of more serious acute illnesses—a referral back to their primary care physician. Additionally, patients increasingly relying on emergency rooms has led to overcrowding and reduced availability for those who need emergency services most, and higher system-wide costs due to an upturn in hospital readmissions rates.

For a concise overview, check out Deloitte recently updated Retail Clinic Report.

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The health care reform establishes a Prevention and Public Health Fund, starting with a $500 million dollar appropriation in 2010, rising to $2 billion per year starting in 2015.  How should this money be spent?  Robert Gould (President & CEO, Partnership for Prevention) thinks it should target one major health issue, rather than being spread ineffectually across many worthy causes.  His pick:  tobacco.  He puts his case forward in Kaiser Health News.

Is he right?  What about other critical population health issues like obesity?  Should the fund concentrate on one issue at a time?  And if so, how do we know when that issue is "fixed", so that we can move on to the next big need?

What do you think?

As Hope Street Group builds momentum on “Policy 2.0: Using Open Innovation to Reinvent Primary Care” we knew we could not miss out on the launch of the new issue of Health Affairs entitled “Reinventing Primary Care”.  Not only does the title mirror the focus of our open collaboration, the new issue also proved to contain a wealth of scholarly discussion and practical policy prescriptions for the future of primary care.

Kathleen Sebelius (Health and Human Services Secretary) kicked off the launch with a keynote address setting out the Administration’s funding provisions impacting on primary care, both through the Recovery Act and the Patient Protection and Affordable Care Act.  She also acknowledged the tremendous challenges ahead in implementing the legislation, including the many places where it says, “The Secretary shall…”

The launch provided an overview of new models of primary care delivery, focusing in particular on patient centered medical homes and retail clinics.  It also highlighted the importance of interprofessional teams in primary care, looking at the way teams work (or don’t work) in primary care settings, and the roles of nurse practitioners, physician assistants and pharmacists in primary care practice teams.  The event concluded with a series of practice profiles, covering: Greenhouse Internists, the Group Health Cooperative, QuadMed, the implementation of electronic referrals to specialists, and the role of Medical Assistants in chronic disease management.

I attended the event with Monique Nadeau (Executive Director, Hope Street Group) and was impressed by the quality and breadth of the information covered and the interesting dialogue that occurred between panel members and the audience.  I would be interested in the reactions of anyone else who attended or who has had an opportunity to look at the new Health Affairs issue.

Some experts say no, but only time can tell...

PPACA incorporates a number of provisions intending to expand the primary care workforce, equip primary care practitioners with new technological capabilities, and reorient our delivery system with payment and organizational reforms. However, some experts believe that  these reforms maybe too little too late (pardon the puns):

The medical education timetable is at odds with the timetable for healthcare reform. Consider a college graduate who enters medical school this fall and plans to pursue a family medicine career because of more generous financial aid and the promise of improved reimbursement under the reform law. He or she would not graduate until the spring of 2014. Tack on another 3 years of residency training and that new family physician would not be on Main Street, ready to give an appointment, until 2017.

Check out Solving Primary Care Shortage Requires More Than New Healthcare Reform Law from Medscape Medical News to get the full picture.

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Every couple of months, Hope Street Group hosts a dinner and invites some of the most influential stakeholders in health care reform to break bread, discuss the issues, and build consensus. Over the past two years, the dinners have provided a safe-space to develop actionable solutions for health care reform. These recommendations formed our Health Care Agenda for an Opportunity Economy.  Moving forward we are working to ensure that Americans have access to the quality health serves they need most with the launch of our project: Policy 2.0: Using Open Innovation to Reinvent Primary Care.

On May 3, 2010 we will be hosting our first Bipartisan Working Group Dinner on Reinventing Primary Care. This dinner will be a “roll-your-sleeves-up” type session that brings to bear the tremendous knowledge base of our advisers to problem solve with project team leaders and devise credible paths of implementation for the Reinventing Primary Care Project.

We have already confirmed an extraordinary group of participants including:

Byron Auguste | Director, McKinsey & Company; Chairman, Hope Street Group
Dr. Sree Chaguturu | Attending Physician and Clinical Instructor, Harvard Medical School / Massachusetts General Hospital; Senior Associate, McKinsey & Company
Dr. Jeff Harris | Former President, American College of Physicians
Dr. Bob Kocher | Special Assistant to the President, National Economic Council
Peter Lee | Executive Director, National Health Policy Pacific Business Group on Health
Monique Nadeau | Executive Director, Hope Street Group
John Podesta | CEO, Center for American Progress
Dennis Rivera | Chairman, SEIU HealthCare
Diane Rowland, ScD | Executive Vice President, Henry J. Kaiser Family Foundation; Chair, MACPAC
Andy Slavitt | CEO, Ingenix        
Simon Stevens | Executive Vice President, UnitedHealth Group
Dr. Kate Tulenko | Deputy Director, CapacityPlus (USAID)
David Walker | President and CEO, Peter Peterson Foundation

We’re opening up an opportunity to all of our Policy 2.0 members to post a question that our Executive Director, Monique Nadeau will pose to the group.  With that in mind, what would you ask a major player in health care reform about Primary Care?

You post, we'll ask, and then repost the responses.

I’m sure you’re thinking, how do I get invited to one of these? Well, right now there isn’t much you can do, however we do invite top Policy 2.0 members to join these dinners from time to time, so get cracking on a question! Here are some examples to get you started:

- What are important primary care issues that have been left out of legislation that need to be addressed?

- How do we attract more practitioners to primary care? Do you agree with the methods outlined in legislation to do that?

Click Here to Post Your Question.

If you have concerns about health care legislation, you certainly not alone. Amid chants of “Kill the Bill”, several thousand Tea Party protesters stormed Capital Hill last month to voice their concerns about health care legislation and public polls indicate that most Americans are not pleased either. Ironically, many concerns are focused on bringing down quality of care, raising costs, and reducing the number of people able to purchase health insurance, directly opposing goals of the legislation. Is this just a case of lack of information about the bill? Kaiser Family Health News tackles some of these concerns and tells us, true or false.