Good Neighbor Insurance, www.gnazhealth.com and www.gninsurance.com , is a leading health insurance broker for those in Arizona and those living and traveling outside the U.S.  Here is some notable health news to keep in mind:

HHS (Health and Human Services) loosens electronic health records standards.  This relaxation of healthcare regulations is a push to create jobs without waiting for Congress.  The U.S. Government believes the best use of health information technology will help doctors and hospitals in delivering the right care to the right patient at the right time.  Northeast Ohio is home to one of the strongest networks of electronic medical records in the nation.  

Healthcare reform is said to be benefitting West Virginia Medicare Members.  More than 25,000 West Virginia Medicare members have saved more than $13 million in Rx drugs in 2011 as a result of the Affordable Care Act.  The infamous “doughnut hole” in the Medicare Part D Rx drug benefit is being eliminated over the next few years which is helping save Rx drug cost.

This is not just happening in West Virginia but also throughout the country as stated by many officials in each state.  They are echoing that “Medicare’s prescription coverage gap is getting noticeably smaller and easier to manage this year for millions of older and disabled people with high drug costs.”  The “doughnut hole,” an anxiety-inducing catch in an otherwise popular benefit, will shrink about 40 percent for those unlucky enough to land in it, according to new Medicare figures provided in response to a request from The Associated Press.

Group medical benefit rates still are on a rise but the increases have moderated.  Eighteen months after passage of the Patient Protection and Affordable Care Act (PPACA) group medical benefits costs rose one again according to a recent survey.  The survey finds that the largest accounts – groups with more than 500 employees, benefitted most from the new law.  Most of the group increases ranged from one percent to ten percent. 

Many employers state that the rate increase was lower but that was due to many employers moving to higher deductibles and copays to offset rate increases, which means passing the cost to the employee when using medical insurance.  However, one big emerging development since the passage of the PPACA in 2010 is that carriers and employers are offering fewer options compared to pre PPACA.  As health care costs continue to rise, employers are looking for new ways to promote and maintain a healthy workforce. Demand for wellness tools among employees is also increasing.

California is trying to make its Pre-Existing Condition Insurance Plan (PCIP) go in the black.   The PCIP will morph into California’s exchange program in 2014.  The number of enrollees is still much lower than expected and the average amount of claims per enrollees much higher than expected. PCIP is supposed to provide comprehensive health coverage for people with health problems for a price similar to the price of ordinary individual commercial health coverage.  Eligibility is not base on income and the risk pools cannot charge higher rates for people with more sever health problems.  Congress let states choose between running PCIP risk pools themselves or letting HHS provide PCIP risk pool services for their residents.  To avoid crowding out existing commercial health coverage and government-provided coverage, including existing state-funded risk pools, PPACA drafters required that PCIP enrollees have gone without any form of health coverage, including state risk pool coverage, for at least 6 months.  

Currently only 23,000 people have enrolled into the PCIP program.  The enrollees have been averaging claim cost of $3,100 per member per month, officials say.  The high cost means that, unless more funding surfaces, the program can afford to serve only about 6,800 enrollees at a time, not 23,000, officials say.  The state has found that 19% of the enrollees are ages 29 or under, 41% are ages 30 to 49, and 39% are ages 50 to 64.  The plan administrator is processing 91.5% of clean clams within 10 business days, compared with a goal of 90%.

Seniors go to social sites in droves to share their feeling and opinions on Medicare. They are the fastest growing group of users on sites like Facebook, LinkedIn, and Twitter. They have expanded their share of the social networking areas by more than 150 percent over the past two years.  One of the things seniors want is education.  They often go online to see advice about a program that is constantly changing, like Medicare.  A senior mentioned on one of the post “Who can explain and make all these rules and restrictions easy to read.”  Next to education seniors also want to make sure that the information is trustworthy and not just a sales pitch for a special Medicare benefit.

Seniors spend a lot of time talking about Medicare plans types and supplements.  Medicare Part D comes first as the hot topic then a close second is about Medicare supplements.  Seniors are constantly confused by changes to private plans and so vent their frustrations on the insurance companies handling the Medicare advantage or supplement plans.  However, as the insurance companies explain, a majority of the new rules and changes have come down the U.S. government and they must comply with all these added rules.   The new PPACA health rules signed into law in March 2010 is why most of the changes and new rules have come from. 

A new trend is happening in the U.S., “doctors do not do old.” A looming shortage of geriatricians adds another wrinkle to dealing with long-term medical care issues.  Older people tend to need more medical care than younger people, and the average age of a U.S. resident is going up.  But because the U.S. government reimburses doctors less money through Medicare than what the going rate is for private practice less and less doctors want to venture into this profession.  It comes down to dollars and cents says many doctors.  “We have to follow extra government laws handed down by the PPACA, Congress, and the department of Health and Human Services.  And to top it off we get paid less on the dollar for Medicare patients, since the government reimburses us most of the time we see those who are 65 and over, than through private insurance.”  Medicare primarily covers those who are age 65 and over in the U.S.  So more work for Medicare clients and getting paid less by the government is causing a shortage of geriatricians in the U.S.   

One of the ways to counter this trend is for the government to improve the state of geriatric education by requiring hat every medical school it helps have an affiliation with a nursing home as well as with a teaching hospital.  Currently there is only around 3% of medical schools that have required classes in geriatrics.  Some say that that must increase because “out of sight out of mind” sets in.   Having geriatrics more front-and-center in medical school will help bring more doctors into this field.  However, again, many if not most decisions are based on income potential.  As an official at a local medical teaching hospital stated “as long as Medicare reimbursement to doctors is less than the open market there will always be a shortage of geriatric doctors.”  Many things change but math calculations never change. 

Doug Gulleson loves to scuba dive overseas and makes sure he has his US health care and overseas health care, www.gnazhealth.com , information with him at all times when he travels   Keep our blog close by you, www.gntravelinsurance.com, for continual updates on US and international health care.