SHOP – the online marketplace for small business

Amid the many stories about individual marketplaces launching October 1, one story has received less attention. In addition to the marketplace for individuals, there will be a new, separate marketplace launched for small businesses. Currently, small businesses have few options to find competitively priced health insurance for their employees. That is the purpose of SHOP (Small Business Health Options Program), to enable small business owners to offer health insurance for their employees.

The following story does a great job of summarizing this new marketplace.

Underage Drinking Report – Revised

The Center for Health Policy strives for a high level of accuracy in all our work. Recently we discovered that our report on underage drinking, originally published late July 2013, needed revision to the prevalence data. This report was subsequently submitted for rigorous external review by the state health department and revisions implemented. The revised report, dated August 2013, is now posted here. The Center is confident that this report accurately represents the prevalence of underage drinking in Nebraska and can be a helpful resource for policymaking.

Questions States Need to Ask for Self-Driving Cars

Self-driving cars are a new technology that is currently in the testing phase. There are a few states that have authorized self-driving cars to be tested on public roads. This issue is riddled with several interesting policy questions that each state legislature will need to address. This story lists the major questions that state policymakers need to consider with self-driving cars.

Hospitals Can Cut Costs of Superusers

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Source: fiercehealthcare.com/

Hospitals can cut costs and improve patient care by setting up care delivery models that target Medicaid patients who have complex, unaddressed health issues and a history of frequent encounters with healthcare providers. These Medicaid “super-utilizers”–patients who accumulate large numbers of ED visits and hospital admissions that might have been prevented by inexpensive early intervention and primary care–are a relatively small group, yet they account for the majority of Medicaid spending, according to The Center for Medicaid and CHIP Services (CMCS).

Five percent of Medicaid beneficiaries account for 54 percent of the program’s total expenditures
One percent account for 25 percent of the program’s total expenditures
Eighty-three percent of the top 1 percent of users has at least three chronic conditions
More than 60 percent of the top 1 percent has five or more chronic conditions

The agency highlights the details of six of the 10 programs in its 39-page informational bulletin.

Read more: How hospitals can control Medicaid ‘super-users’ – FierceHealthcare

Preventive Services and the ACA

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Source: CDC

Did you know that under section 1001 of the Affordable Care Act, many insurers will be required to provide many types of preventive services without cost sharing? Any preventive service rated as A or B by the US Preventive Services Task Force will be provided without cost-sharing (e.g. out of pocket payment). This requirement is now in effect and applies to Medicare, new private insurance plans, and existing plans that have not been “grandfathered.” Persons covered under Medicaid expansion will also be covered under this requirement. However, persons under the existing Medicaid program may not and need to check with their state Medicaid office.

You can see a complete list of all preventive services covered without cost sharing here (list includes 51 services as of this writing).

HHS releases final rules on insurance marketplace navigators

The Health and Human Services Department on Friday finalized rules for training and certifying the “navigators” who will help people make sense of their options under health reform. Navigators will provide in-person assistance to people trying to figure out their coverage options through the healthcare law’s newly created insurance exchanges.

 

Read more here