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Health Management Technology News
  May 13, 2014
In this issue:
 

 Health Management Technology’s Resource Guide sign-up

 The next big healthcare issue

 A healthcare showdown in Virginia

 Mental, physical healthcare should go together

 3 Seattle doctors among 50 'most influential' in healthcare

 Healthcare crisis looms as China faces elderly dementia upsurge

 Aussie healthcare stocks could take a hit from budget


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The next big healthcare issue

The next big brouhaha for the Affordable Care Act will be how much premiums go up in the non-group insurance market. Premiums for 2015 are starting to be released by state insurance departments as insurers submit them and will continue to dribble out over the year. Here are two things to keep in mind as this issue unfolds:

First, 85% of those who purchase insurance in the new marketplaces will get a government subsidy in the form of a tax credit to help defray the cost of the premium. That means that most people buying in the exchanges won’t pay much even if their premium cost goes up significantly. Here is an example.

“Fred” is a 35-year-old who lives in Miami and makes $27,000 a year. He picked the second-lowest-cost “silver” plan on HealthCare.gov this year and his premium was $3,089. But he qualified for a government premium tax-credit subsidy that lowered his required payment to about 7.5% of his income, or roughly $2,000. If insurers in Miami raise premium costs by double-digit percentages, the premium in Fred’s plan could go up by hundreds of dollars. However, because Fred is eligible for a subsidy, he would still pay almost the same amount, assuming his income does not change.

Now, there are millions who buy coverage on their own outside the exchanges–we don’t yet know the exact number–and they do not get a tax credit. But about 6.8 million of the 8 million people who enrolled in the exchanges will get a subsidy. Of course, when premiums rise sharply the government and taxpayers pay more for people’s tax credits. That’s the big reason rising premiums in the marketplaces are a problem.

Read the full blog entry from The Wall Street Journal here

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A healthcare showdown in Virginia

In Virginia, there are 400,000 low-income people who can’t afford health coverage but don’t qualify for federal insurance subsidies. If they lived across the state line in Maryland, West Virginia or Kentucky, which have expanded their Medicaid programs, they could get the coverage they need. Terry McAuliffe, the Virginia governor, campaigned on bringing an expanded Medicaid program to Virginia, too.

But it hasn’t happened, and the reason is a group of recalcitrant Republicans in the House of Delegates who have blocked Medicaid expansion at every opportunity. They are so determined to keep poor people from getting health care that they are preventing passage of a two-year budget for the state for the fiscal year beginning July 1. If an agreement isn’t reached by then, they seem fully prepared to let the state government shut down, furloughing employees and shuttering services just as their counterparts in Washington did last fall.

Virginia is at least debating the issue. Nineteen Republican-dominated states, mostly in the South and Midwest, have flatly said no. To accept expanded Medicaid in their view is to accept the Affordable Care Act and let the public witness its benefits. They cannot allow that to happen. One Virginia Republican said his colleagues were openly hoping to limit the number of people covered by the law.

“They are trying to exhibit their disdain for the Affordable Care Act,” State Senator John Watkins, a supporter of expansion, told The Washington Post. “They feel if enough people refuse to use it, somehow it’s going to go away, that it will fail.”

Read the full article from The New York Times
here


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Mental, physical healthcare should go together

For far too long, physical and mental health concerns have been diagnosed and treated separately. Mental health care providers have historically treated patients from the neck up, and other providers — primary care physicians and a range of specialists — have handled health concerns from the neck down. Today, we know that mental health is inextricably linked to physical health and that treating one without considering the other hinders our ability to fully understand and improve a person’s overall health.

As a psychiatrist and pediatrician, I know this firsthand. In addition to positively impacting quality and lowering costs, effectively integrating mental and physical health care can help create better outcomes for patients and even increase one’s life span.

Alarmingly, statistics show that people with serious mental illness die an average of 25 years earlier than people without mental illness. The cause of death among this population is not, as many assume, suicide, violence or accident. Rather, these deaths are primarily attributed to preventable and treatable physical health conditions, including heart disease, diabetes, infections, respiratory disease and obesity.

Read the full article from The Tennessean
here


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3 Seattle doctors among 50 'most influential' in healthcare

Three doctors from the Puget Sound area have been named to Modern Healthcare's2014 list of the 50 most influential physicians and executives in the U.S.

Highest ranking at No. 3 is Dr. Gary Kaplan, chairman and CEO of Virginia Mason Health System in Seattle. The hospital organization is widely known for using a Toyota-inspired lean production system and was the only Washington state hospital to be listed among America's 100 best hospitals in 2014 by Healthgrades.

Dr. Susan Desmond-Hellmann, the new CEO of the Bill and Melinda Gates Foundation, was ranked No. 13 on the list. She takes over this month at the Seattle-based foundation. Desmond-Hellman, an oncologist by training with a background in public health policy and biotech, most recently served as chancellor of the University of California, San Francisco.

Listed at No. 25 is Dr. Rodney Hochman, president and CEO of Providence Health and Services, a Renton-based system with operations in five states. Hochman was serving as CEO of the Swedish hospital system in Seattle when it affiliated with Providence in 2012, and he became CEOof Providence in March 2013.

Read the full blog entry from Puget Sound Business Journal here  

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Healthcare crisis looms as China faces elderly dementia upsurge

In little more than half a century the average Chinese life span has almost doubled. Life expectancy in China is now 76 years, nearly on par with the U.S.’s 79 years. Yet this tremendous boon comes with a dark side: an aging population.

China’s one-child policy throttled population growth so successfully that the proportion of elderly Chinese is now soaring. A 2011 report from the Chinese Academy of Social Sciences predicts that the percentage of the population that is 65 or older will triple between 2000 and 2050. With an aging population comes a greater burden of diseases, chief among them neurodegeneration. Already China has more than nine million people with some form of dementia and more cases of Alzheimer’s disease than any other country, according to a 2013 paper in The Lancet. Its authors dubbed dementia “the single largest challenge to health and social care systems” in China.

The consequences of this trend are profound, and the country has only recently begun to prepare for them. In 2009 the government committed $124 billion to overhauling health care, with a goal of providing basic health insurance for 90 percent of its citizens. The plan also highlighted mental health services as a top priority for the first time. Last year China implemented its first mental health law, which expands psychiatric services throughout the country. Although the policy does not explicitly mention dementia, it underscores the urgent need for community mental health clinics, which could end up aiding families struggling to cope with a relative’s dementia.

Read the full article from Scientific American
here


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Aussie healthcare stocks could take a hit from budget

Sweeping changes are expected in Australia's healthcare sector when Prime Minister Tony Abbott's government unveils its first budget on Tuesday and investors are eyeing the potential impact on healthcare stocks.

The government is looking to rein in healthcare costs, among other expenditures, after an audit of the economy released in early May recommended cuts and broad structural changes to stem what the government warns is a looming "fiscal crisis".

Health makes up roughly 16 percent of federal government spending, so many healthcare companies' fortunes are linked to government spending.

"It's a major issue for the healthcare sector because nearly every part of the sector is intertwined with government policy," said Bill Keenan, general manager of equities and researcher at stockbroker Lonsec, which holds shares of healthcare supplier Ansell.

"Overall there's obviously going to be some negatives coming out after the healthcare stocks, it's one sector where you need to see the budget before investing more money in it."

Read the full article from Reuters here

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