New on the Web 27: June 2005
We've collected information on several new reports and other resources available on the Web that we hope you'll find interesting and useful. Descriptions and links appear below.
From the BlueCross BlueShield Association: "Association Health Plans: No State Regulation Means Loss of Protections for Consumers, Small Employers and Providers"
From the Center for Studying Health System Change: "More Americans Willing to Limit Physician-Hospital Choice for Lower Medical Costs," "An Update on Americans' Access to Prescription Drugs"
From the Center on Budget and Policy Priorities: "Out-of-Pocket Medical Expenses for Medicaid Beneficiaries are Substantial and Growing"
From the Commonwealth Fund: "Insuring the Healthy or Insuring the Sick? The Dilemma of Regulating the Individual Health Insurance Market"
From the Kaiser Family Foundation: "Navigating Medicare and Medicaid, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates," "Keeping Medicare and Medicaid When You Work, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates," "A new fact sheet, Medicaid's Role in Long-Term Care: Q & A," "The Medicare Health Plan Tracker," "The Medicare Prescription Drug Improvement and Modernization Act Implementation Timeline"
From the Kaiser Family Foundation, the Commonwealth Fund, and Tufts-New England Medical Center: "Survey Finds Four in 10 Seniors Do Not Take Medications as Prescribed;" "Poor Experiences with Drugs and Costs Contribute to Non-Adherence"
From Mathematica and AARP: "Early Effects of the Medicare Modernization Act: Benefits, Cost Sharing, and Premiums of Medicare Advantage Plans, 2005"
From the Urban Institute: "Uninsured Americans with Chronic Health Conditions: Key Findings from the National Health Interview Survey," "Ebbing and Flowing: Some Gains, Some Losses as SCHIP Responds to Third Year of Budget Pressure"
From the BlueCross BlueShield Association
Released along with an array of patient groups such as the American Diabetes Association and the American Academy of Pediatrics, Association Health Plans: No State Regulation Means Loss of Protections for Consumers, Small Employers and Providers examines the impact of Association Health Plans (AHPs). The report states that AHPs will do little to cover the uninsured and will allow insurers to drop coverage for certain medical services. (May 2005)
From the Center for Studying Health System Change
An Update on Americans' Access to Prescription Drugs: According to this new study, more Americans-especially those with chronic conditions such as diabetes, asthma, and depression-are going without prescription drugs because of cost. The proportion of all American adults reporting problems affording prescription drugs increased between 2001 and 2003, which likely resulted from higher prescribing rates and increased patient cost-sharing. (May 2005)
More Americans Willing to Limit Physician-Hospital Choice for Lower Medical Costs: Between 2001 and 2003, the proportion of working-age Americans with employer coverage willing to trade a broad choice of providers for lower costs increased from 55 percent to 59 percent-after the rate had been stable since 1997. While low-income consumers were most willing to give up provider choice in return for lower costs, even higher-income Americans reported a significant increase in willingness to limit choice. (March 2005)
From the Center on Budget and Policy Priorities
Federal and state officials are discussing possible ways to reduce Medicaid expenditures, and one common proposal is to increase the copayments Medicaid beneficiaries must pay. Out-of-Pocket Medical Expenses for Medicaid Beneficiaries are Substantial and Growing explains that out-of-pocket medical expenses for low-income, adult Medicaid beneficiaries have grown twice as fast as their incomes in recent years. These individuals now spend more than three times as much of their incomes on out-of-pocket medical costs as middle-class adults with private health insurance. (May 31, 2005)
From the Commonwealth Fund
The market for people who buy their own coverage has long been a troubled segment of the health insurance industry. Many states have attempted to reform their individual health insurance market by requiring carriers to sell coverage to all applicants regardless of age or health; creating high-risk pools for those with preexisting conditions; and placing limits on the extent to which premiums can vary by age, sex, or health status. Insuring the Healthy or Insuring the Sick? The Dilemma of Regulating the Individual Health Insurance Market assesses the effectiveness of such regulatory reforms in seven states. (February 2005)
From the Kaiser Family Foundation
Medicare and Medicaid provide health coverage and long-term care services to roughly one-third of the 53 million people with cognitive, developmental, physical, and mental disabilities. Navigating Medicare and Medicaid, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates explains the critical role the two programs play in the lives of people with disabilities. The guide is intended to be understandable to people who are completely unfamiliar with Medicare and/or Medicaid. (February 2005)
The program rules for Medicare and Medicaid with regard to work are complex. Recently, Congress has enacted additional legislation to remove more of the disincentives to working and to continuing to receive health care coverage through these two programs. Keeping Medicare and Medicaid When You Work, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates explains many of the complex issues and policies that can be used to help people with disabilities keep their health coverage and seek employment. (February 2005)
Financing long-term care for the nearly 10 million Americans who need services and support to assist them in life's daily activities continues to be a challenge. While Medicaid is the nation's major source of financing for long-term care services, paying for over 40 percent of total long-term care, its role is not well understood. A new fact sheet, Medicaid's Role in Long-Term Care: Q & A, provides basic information on Medicaid's role for those with long-term care needs. (May 13, 2005)
The Medicare Health Plan Tracker is an interactive tool that provides basic information about Medicare Advantage (Medicare HMO and other private) plans. Data include plan participation and beneficiary enrollment at the national, state, and county levels, as well as payment rates for 2005 and previous years. (January 2005)
The Medicare Prescription Drug Improvement and Modernization Act Implementation Timeline presents important dates and deadlines for key implementation activities related to the new Medicare prescription drug benefit. (March 2005)
From the Kaiser Family Foundation, the Commonwealth Fund, and Tufts-New England Medical Center
Survey Finds Four in 10 Seniors Do Not Take Medications as Prescribed; Poor Experiences with Drugs and Costs Contribute to Non-Adherence: According to this national survey, four in 10 seniors say they have not taken all the drugs their doctors prescribed them in the previous year, either because the costs were too high, because they did not think the drugs were helping them, or because they did not think they needed them. Nationally, slightly more than one in four seniors (27 percent) reported that they did not have any prescription drug coverage at the time of the survey. Full article available with subscription. (April 2005)
From Mathematica and AARP
The Medicare Prescription Drug, Improvement and Modernization Act, enacted in December 2003, made several significant changes in the Medicare Advantage (MA) program that were expected to have a long-lasting impact on Medicare spending. Early Effects of the Medicare Modernization Act: Benefits, Cost Sharing, and Premiums of Medicare Advantage Plans, 2005 examines the early effects of changes in the MA program. (April 2005)
From the Urban Institute
Uninsured Americans with Chronic Health Conditions: Key Findings from the National Health Interview Survey examines the well-being of uninsured adults with chronic health problems. The analysis, which is based on the 2003 National Health Interview Survey, finds that almost half of uninsured adults with chronic conditions forgo needed medical care or prescription drugs at much higher rates than their insured counterparts. (May 2005)
Heading into 2004, SCHIP recorded its first-ever decline in enrollment. Ebbing and Flowing: Some Gains, Some Losses as SCHIP Responds to Third Year of Budget Pressure concludes that policymakers are using the flexibility built into Title XXI to cut or expand their SCHIP programs as fiscal conditions permit. The report also explores how child health insurance policies shifted in response to ongoing budget pressures during 2004. (May 2005)
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