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August 31, 2006
Aetna Helping Health Savings Account Owners with Access to Care Price, Quality Data
For consumers trying to budget their medical costs, one obstacle has been the extreme difficulty of getting advance price information for even the most routine procedures. Aetna is changing all that by offering its members access to what they will pay -- before they enter a doctor's office.
The company expects pricing information will likely be most helpful to people who have a Health Savings Account (HSA) tied to a high-deductible insurance plan.
Aetna recently began allowing its members in the Washington area and several other markets to access prices for "30 of the most widely accessed services" and care-quality information via the company's member services site, http://www.aetna.com/.
"Most consumers have no idea of the true cost of their health care," said William Fried, Aetna's medical director for the mid-Atlantic region. "And most consumers don't know how to evaluate their health care... It's a resource to assist members in making informed health care decisions."
The posted prices are the rates that care providers have agreed to accept as payment for services to Aetna members; prices for patients who are not Aetna members may be higher.
Health analysts generally applauded the move, saying that any step that makes more information available to consumers is a good one. But one expert noted that there are still relatively few HSA users -- estimates place the number at 4 million nationwide, though that is expected to grow.
"This transparency helps some people but doesn't help a lot of other people," said Arthur Levin, director of the Center for Medical Consumers, a New York-based nonprofit organization. "Many people have no interest at all [in] what the arrangement is between the plan and the doctor. They really want to know, 'What's the arrangement between the plan and me?' " -- particularly when a patient sees a provider who is out of network, he said.
The program is also not useful for the nation's 45 million uninsured and those insured by non-Aetna plans, experts noted.
The service, begun a year ago in Cincinnati, allows the estimated 1 million Aetna members in the District, Maryland and Virginia to log on to the company's Web site, pull up a provider's name and view price and quality information. Another 1.3 million members in other parts of the country also gained access to the new service. The Washington-region debut, initially slated for Friday, was delayed until Sunday because of computer system problems.
Aetna members in those markets can view -- from any computer with Internet access -- how much specific services will cost them at their provider's office.
For example, a listing for District internist Theresa A. Stone shows rates of $127.62 for a "new patient office visit for moderate problems," $69.95 for an "established patient office visit for low to moderate problems" and $109.31 for an "established patient office visit for moderate to severe problems." A "periodic comprehensive well visit for an established patient ages 40-64" is $141.78.
At that same provider, a "test for blood in stool" is $3.43, an "incision and drainage of abscess, simple or single" is $125.22 and the "administration of [a] single immunization" is $25.13.
A search of the site yesterday suggests it may be worthwhile to compare prices. A listing for Horacio G. Schapiro, another District internist, includes lower rates than those listed for Stone's office. Schapiro's listing shows rates of $108 for a "new patient office visit for moderate problems," $59 for an "established patient office visit for low to moderate problems" and $93 for an "established patient office visit for moderate to severe problems." A "periodic comprehensive well visit for an established patient ages 40-64" is $120.
An advisory on the site reminds members that posted rates are the "maximum amount allowed by Aetna. Depending upon your particular plan, your actual out-of-pocket costs may be less (for example, co-pays, co-insurance and/or deductibles)."
Quality information is drawn from Aetna's "Aexcel" network, described on the company's Web site as a "designation for specialist physicians . . . who have demonstrated effectiveness in the delivery of care based on a balance of measures of clinical quality and efficiency." Quality ratings are available for providers who specialize in 12 areas: cardiology, gastroenterology, cardiothoracic surgery, general surgery, obstetrics and gynecology, neurology, neurosurgery, orthopedics, otolaryngology, plastic surgery, vascular surgery and urology.
The quality information is divided into three categories: clinical quality, volume and efficiency, according to the company. Clinical quality is based on 30-day hospital readmission rates, number of complications during hospital stays, use of recommended screenings such as Pap tests and breast cancer screening, and compliance with recognized treatments for certain patients such as prescribing beta blockers for those with a history of heart attacks and using ACE inhibitors in cases of chronic heart failure.
Volume is rated by determining whether the provider has seen at least 20 Aetna members in the past two years, a number the company chose because it is "important to have a minimal number of cases to have a reasonable sample" from which to gather ratings, Fried said.
The efficiency standard is a "measure of cost-efficiency of care compared to [the provider's] peers," Fried said. The rating is based on the total costs of tests, inpatient and outpatient care and medications -- "anything that goes into the cost of care for a specific diagnosis," he said.
"We look at the total claims experience in managing a patient for a specific condition and compare that," Fried said. Those who more "efficiently" treat patients pass this measure.
A search of Aetna's site yesterday showed that District cardiologist Elizabeth Ross passed all quality measures -- indicated by a checkmark placed next to each of the three categories. But listings for some other providers included no quality or efficiency results.
Regardless of such ratings, Aetna's Web site cautions, "there is no guarantee as to the quality of the service you receive from that doctor, or the outcome of any treatment by that doctor." Instead, the site states, "the Aexcel designation is one of many factors that you may consider when making health care decisions."
Even a doctor who failed to reach the quality standards would not necessarily be dropped from the insurer's roster of providers, said Aetna's Fried.
That was bothersome to Sidney Wolfe, director of the Health Research Group at Public Citizen, a District-based consumer advocacy group. "It pretty much says there's little if anything a doctor can do that would keep them from being a participating provider," he said. Aetna said it's rare for a provider to be removed as a participating provider; situations that warrant removal typically involve patient safety, fraud, crime and loss of medical license or hospital privileges.
Wolfe also said the quality information could be expanded significantly to include other publicly available information, most notably from state medical boards. "I don't want to sound like this isn't a good start," Wolfe said. "It just could be more. They're providing just a fraction of the information that they could be providing."
While this information is not available to all Health Savings Account owners now, it is encouraging to see health insurance companies get started in this direction. With any luck, these type of services will be available to all HSA owners sooner rather than later.
Posted by Wiley Long at 08:01 AM | Comments (0)
August 29, 2006
Health Savings Accounts Growing at a Rapid Pace
Defying critics and demonstrating resilient expansion, Health Savings Accounts (HSAs) continued their strong growth trajectory with indications that this fall's sign-ups will blow passed estimates.
Information Strategies, Inc. quarterly survey of more than 150 HSA custodial advisors indicates that total accounts will pass 3.6 million by January 2, 2007 managing $5.2 billion.
In its latest survey, ISI found substantial growth in deposits, particularly from industry leaders such as HSA Bank reporting 7,000 new accounts in this quarter raising its total accounts to 157,814.
Other custodians report similar increases. It is the new custodians reporting for the first time that indicate growth in HSAs has not slowed but rather deepened.
Based on its collecting of data from more than 150 custodians and reflecting some changes in HSA purchaser patterns first reported in May, ISI is estimating that 1.7 million total accounts will have put away $2.4 Billion in deposits by the end of the second quarter.
From the end of April to the beginning of July, almost all providers reported an increase in the total number of HSA accounts with average deposits growing to $1,940 for those accounts opened more than a year and $1,090 for those opened less than a year, on average.. All banks reported an increase in deposits with $1,200 being the average deposit for each account, though deposits ranged from $450 to $2,316.
Much of the deposited money is staying in the account. The majority of banks surveyed said at least 40% of deposited funds are staying put. Blackhawk Bank, for example, estimates that less than 10% of the money deposited into its HSAs is actually being spent.
Of the providers tracking such information, the majority report more family than individual HSAs. Several reported an even division between family and individual account while many said a majority of accounts were held for individuals. Some banks reported they were heavily focused on individual accounts. American Bank, for example, reported 100% of its accounts are individuals.
Another bank seeing the benefit of individual accounts is Preferred One. Eugene Sako said his bank just started offering individual groups in July 2006 and feels that growth will come through the individual and smaller business markets.
In that vein, surveys by ISI of its business readers surfaced a large swell for HSAs by smaller organizations. Of 1,100 small businesses contacted, less than 10% said they were reducing healthcare expenditures but 55% said they were poised to offer HSAs either as a single option or as part of a suite of healthcare insurance options.
Employers and companies continue to be the source of HSAs for the majority of providers. American Bank, though, reported only 10% of its accounts come from companies or employers, as did Thrivent Financial Bank.
HSA providers are also noticing anecdotal trends within the industry. Many report that education on HSAs has increased so they are opening more accounts for people seeing the benefits of HSAs.
Another anecdotal trend that Blackhawk Bank and Resource Bank reported was a slight increase in HSA fund usage that occurred at the same time gas prices increased. Paula Colling at Blackhawk Bank also pointed out that her bank sees more accounts from states offering a state tax deductibility, like Tennessee, Kentucky and Georgia. States that without such tax deductibility, like Wisconsin, where her bank is located, tend to lag behind, she said.
Visit http://www.health--savings--accounts.com to purchase a high deductible health insurance plan to go with your health savings account.
Posted by Wiley Long at 09:02 AM | Comments (0)
August 27, 2006
Creative Ideas Starting to Benefit Health Savings Account Owners
Bid for Rx, a free online auction service designed to reduce consumers' prescription drug costs by 20-40 percent, is now available at BidforRx.com. Consumer with a legitimate doctor's prescription can log onto the site, click on information about their prescription requirements to create a patient profile, and then participating, licensed pharmacies compete to provide the required prescription at the lowest total price.
Consumers with tax-advantaged Health Savings Accounts (HSAs) will save money that they can divert to other healthcare needs and receive a receipt from Bid for Rx to submit expenses under their HSA plan.
Consumers include all their prescription and non-prescription medications in their patient profile, so Bid for Rx technology can alert pharmacies to potential drug interactions.
Pharmacies see only the prescription requirement and not any personal data about the consumer during the auction. The consumer, though, can see the name and address of all participating pharmacies and the pharmacies' prices, plus any shipping.
After the auction is completed, consumers choose whether to release their personal information to a selected pharmacy to fill their prescription. Auctions take 24-72 hours at the consumer's discretion. Longer auction times generally result in lower prices.
The reverse-auction technology for healthcare is patented, free to both consumers and pharmacies and completely secure.
Kevin Moshayedi, CEO of Bid for Rx's parent company Medicine Online Inc., said: "Bid for Rx reduces prescription prices by increasing the number of pharmacies who can consider the consumer's requirement, any discount coupons from pharmaceutical companies, etc., and by placing the pharmacies in an explicitly competitive marketplace. Beta testing confirms savings of 20-40 percent off list prices and proves the security and confidentiality of the process." Approximately 120 pharmacies are participating in Bid for Rx now with company plans to increase participation to 1,000 pharmacies nationwide by year end.
Bid for Rx is designed for prescription drugs, as well as vitamins and alternative healthcare products. Bid for Rx expects that most of the participating consumers will seek auctions on their long-term - and usually expensive - prescription requirements. Consumers with tax-advantaged HEALTH SAVINGS ACCOUNTS (HSAs) and FLEXIBLE SAVINGS ACCOUNTS (FSAs) will save money that they can divert to other healthcare needs and receive a receipt from Bid for Rx to submit expenses under these plans.
"During beta testing, Bid for Rx received 320,000 page views per month from all across the country as well as a flood of e-mails asking for a full roll out," Moshayedi said. "Among the most frequently asked questions were participation of Canadian pharmacies, whose prescription drug prices are much lower than in USA. Currently, Canadian pharmacies cannot legally supply prescription drugs to USA addresses. Our mission is to reduce pharmacy prices significantly for American consumers while abiding by all federal and state laws and regulations."
Bid for Rx is a division of Medicine Online Inc. (MOL) which pioneered reverse-auction technology for healthcare in 2000. Medicine Online's owners include board-certified physicians and dentists, who are actively seeking ways for more people to afford better healthcare.
Medicine Online operates a consumer healthcare Web site www.medicineonline.com with 25 million page views per month, and a professional healthcare provider Web site www.mol.net. Medicine Online also introduced Bid for Surgery in 2000, a popular and once-controversial auction site for plastic surgery that continues today, using the same reverse-auction technology as Bid for Rx.
Learn more about how Health Savings Accounts can benefit you at http://www.health--savings--accounts.com
Posted by Wiley Long at 01:53 PM | Comments (3)
August 25, 2006
Health Savings Accounts Bring Cost-Sharing
Proponents of Health Savings Accounts believe they can reduce medical spending by making consumers more sensitive to the costs of care. In keeping with this argument, Health Savings Accounts together with high-deductible health plans should encourage consumers to make prudent treatment decisions because they are spending their own money. However, a new Commonwealth Fund–supported study finds that because of the tax subsidies accountholders receive, Health Savings Accounts may actually lower effective out-of-pocket costs for some enrollees.
In "How Much More Cost-Sharing Will Health Savings Accounts Bring?" (Health Affairs, July/Aug. 2006), Dahlia K. Remler, Ph.D., a professor at Baruch College School of Public Affairs, and Sherry A. Glied, Ph.D., chair of the department of health policy and management at Columbia University, evaluate consumer cost-sharing under traditional health policies compared with cost-sharing incurred under HSAs coupled with high-deductible health plans.
Remler and Glied find that HSA/high-deductible health plans actually reduce cost-sharing for people who spend the least and the most on health care, while increasing cost-sharing for individuals in the midrange of spending. In particular, those patients responsible for half of all medical spending—7.7 percent of the population—would see no change, or even a decline, in cost-sharing under HSAs.
Cost-Sharing Compared
For the study, the researchers modeled cost-sharing levels in three types of plans: a typical comprehensive plan ($350 deductible, 20% coinsurance, and $1,800 out-of-pocket limit); a typical high-deductible policy without an HSA (no coinsurance and $2,500 deductible); and the same high-deductible policy, but with an HSA.
In the comprehensive plan, maximum out-of-pocket spending would occur at total medical outlays of $7,600. But for someone with a high-deductible policy without an HSA, maximum out-of-pocket spending would occur at $2,500 of medical spending. Thus, while the high-deductible policy has greater cost-sharing before the $2,500 deductible is met, the comprehensive policy has greater marginal cost-sharing above $2,500.
Moving to high-deductible plans with HSAs changes the cost-sharing picture. Because HSA contributions are shielded from federal and state income taxes as well as payroll taxes, consumers in effect receive a subsidy with which to purchase care. With a marginal tax rate of 40 percent (35% income tax bracket, 6.2% Social Security, and 1.45% Medicare tax), for example, very healthy individuals would have lower cost-sharing under an HSA than under the comprehensive plan; only those with expenses between $700 and $2,500 would see an increase in cost-sharing.
Effects by Spending Level
The lion's share of health spending is concentrated among a small portion of the population. In 2001, 30.2 percent of the population was responsible for just over 1 percent of all medical spending. By comparison, 7.7 percent of the population represented fully half of all medical spending.
According to the authors of the Health Affairs study, HSAs with high-deductible plans would entail an increase in cost-sharing for those in the middle of the health care spending distribution. However, the accounts would bring a decrease for those at the very low end and in much of the high end. In fact, the authors note, maintaining or introducing an out-of-pocket maximum while increasing the deductible would greatly reduce cost-sharing for high spenders, who are responsible for a large share of overall medical spending.
Conclusions
The researchers note that cost-sharing at the point of service has been rising over the past several years. Most health plans today already incorporate cost-sharing and utilization review to control consumer spending. HSA plans as currently structured do not appear to greatly increase cost-sharing and may actually lower cost-sharing when tax subsidies are considered.
To make HSA/high-deductible polices more effective in controlling medical spending, the authors say that cost-sharing would have to be raised substantially among the people who spend the most on health care. But a large increase in cost-sharing would make care unaffordable to those needing it the most. "Raising incentives for cost-consciousness necessarily increases financial risk," the authors warn, "and it might undermine the access to care that we wish to preserve."
Learn more about Health Savings Accounts at http://www.health--savings--accounts.com
Posted by Wiley Long at 10:14 AM | Comments (0)
August 23, 2006
United Healthcare Introduces Integrated Health Savings Account Card
To simplify how Health Savings Account owners manage and pay for their health care, and to help medical professionals reduce their administrative burden, United Healthcare is enhancing its health benefit card technology. The Company's new technology will provide the information needed to promptly administer benefits and facilitate health transactions and payments, thus simplifying the process for patients and providing health care professionals with an administrative resource.
The card will also convey essential health records that support care interventions. From a Health Savings Account perspective, these services transcend benefit plan boundaries and traditional geographic limits, enabling HSA owners to have their information and financial resources follow them across products or across the country.
The United Healthcare health card benefits:
-- Fully integrated card will offer access to portable health record, financial accounts and line of credit
-- Electronic eligibility and debit capabilities help simplify the health care experience for consumers
-- Capabilities transcend geographies and product types
Nearly 20 million people already have unique magnetic strip ID cards in their wallets. That card, which was first introduced by United Healthcare three years ago to replace traditional paper ID cards, can verify eligibility and copay amounts with a simple swipe of the card. United Healthcare, through its Exante Financial Services business, is now enhancing its card technology by combining both health care and financial information on a single card in order to support more informed health care consumers.
"By combining health and financial information, we have greatly simplified a series of fragmented and time-consuming experiences for health care consumers," said John M. Prince, CEO of Exante Financial Services. "People are being asked to exercise much more control over how they spend their health care dollars, so it is imperative that we give them the necessary tools to do that in a simple and efficient way."
Eligibility
The integrated card will feature enhanced eligibility verification over the original ID card, providing real-time confirmation of a patient's benefits coverage via the UnitedHealthcareOnline(R) provider portal with a single swipe of the card through a standard card reader. The enhanced eligibility verification will include more extensive benefit plan information than previously available when swiped, thus helping to speed the submission and processing of claims.
"Multi-Purse" Debit Card
Today, even advanced types of benefit ID cards typically contain only health benefit information. Consumers who have a health financial account must carry a separate debit card to access it. Exante's new integrated card will combine these two capacities into one card, while also expanding account access to multiple health accounts, known as a "multi-purse" capability. Combining these onto a single card will not only improve ease of use, but will also enable consumer access for the first time to multiple health accounts (i.e. Health Savings Account, Flexible Spending Account) using the same card. This feature will enhance the patient's ability to pay at point of service in the doctor's office or other care facility.
As United Healthcare prepares to launch a real-time claims adjudication capability, which will enable care providers to process a claim and immediately determine the amount owed by the patient, the ability to pay from any eligible health account at the point of service will become critical. This card will respond to that emerging need.
Portable Personal Health Record
In addition to multiple account access, United Healthcare's new cards will also provide access to an individual's Personal Health Record, making critical health information highly portable. This will allow patients to provide their physicians with secure access to an online medical history summary (currently available via the myuhc.com(R) website). A swipe of the card will give a physician access to the Personal Health Record. That Personal Health Record uses claims data and other data elements to automatically compile a comprehensive summary of medical conditions, medication history, significant medical interventions and laboratory results. In addition, it can be augmented by patients who choose to provide details such as allergies, immunizations and family history.
Line of Credit
Consumers will also soon be able to apply for a line of credit attached to their existing health account debit card to cover eligible health care expenses when funds are not available. This is a common concern for individuals with Health Savings Accounts (HSAs) who may incur medical expenses early in the year, in part because HSAs are funded incrementally over the course of the year. The line of credit will help bridge those early expenses while providing an affordable alternative to putting those charges on a standard personal credit card account.
While many elements of the new card are currently being utilized by United Healthcare-affiliated customers through their existing health benefit cards today, the new fully-integrated card will be made broadly available by United Healthcare beginning in the first quarter 2007.
Visit HSA for America at http://www.health--savings--accounts.com for more information on this new card.
Posted by Wiley Long at 10:23 AM | Comments (0)
August 21, 2006
No Health Savings Accounts in Canada
Canadians have to suffer tremendous waits for health care services due to their single-payer healthcare system. Fortunately, Health Savings Accounts will save the U.S. from the same fate. First hand experience of Canada's single-payer system shows why we need to depend more on Health Savings Account plans.
Last week I was vacationing in Banff, Canada, and saw this letter to the editor in the Calgary newspaper:
Re: “woman miscarries in ER”, July 25.
Hospital wait times have become ridiculous. Two weeks ago, my grandpa was taken to Foothills via ambulance complaining of extreme stomach pain and we had to wait 12 hours to see a doctor. This is insane.
Insane – yes, but unexpected – no. Anytime a single-payer system is tried, and competition no longer exists, prices go up, quantity and quality go down. Canada’s single-payer healthcare system has resulted in routinely long waits – sometimes even weeks or months – to receive medical care. A much smarter system is to let doctors and hospitals compete for the consumer’s business, just as happens in every other business.
Because Health Savings Accounts put buying decisions in the consumer’s hands, the natural result will be greater competition by healthcare providers for the consumer’s dollars. The growing use of HSAs should ensure that Americans never have to suffer from the poor healthcare system that has developed in Canada. Let’s hope so.
Learn more about Health Savings Accounts at: http://www.health--savings--accounts.com
Posted by Wiley Long at 10:30 AM | Comments (0)
August 18, 2006
Golden Rule Uses Exante Bank to Introduce New Health Savings Account Features
United Healthcare's Golden Rule Insurance Company, pioneer of health savings accounts (HSAs) in the individual market, announced that it has begun offering its HSA customers a broad selection of high-quality mutual fund investment options as well as an innovative debit card and online account management and bill paying services through Exante Bank.
Golden Rule Health Insurance helped pave the way for HSAs when it introduced the first medical savings account more than a decade ago. More than 41 percent of Golden Rule's customers currently are covered by health insurance plans that include health savings accounts. As of June 30, 2006, these customers had accumulated more than $170 million in their health savings accounts; the average account balance exceeded $2,400.
With Exante Bank serving as custodian, Golden Rule HSA customers earn 4 percent to 5 percent interest on their FDIC-insured accounts. Once the balance in their health savings account reaches $2,000, customers now have the option to invest any amount in excess of $2,000 in a choice of eight no-load mutual funds, all of which have a Morningstar rating of 4-Stars or higher.
New online account management tools mean that Golden Rule HSA customers also can monitor and change their investments at any time, check balances, pay bills and withdraw funds. The customer, at no charge, can set up automated recurring mutual fund purchases to occur whenever the account balance exceeds $2,000.
Moreover, the Exante MasterCard(R) Prepaid Debit Card provides Golden Rule customers with multiple ways to access their HSA funds, including use at participating pharmacies and doctors' offices or through ATM withdrawals. In addition to the debit card and online bill paying features, customers can use wire transfers as well as a more traditional checkbook if they choose.
"The mutual fund options greatly enhance the long-term savings potential for our HSA customers, while other new consumer-friendly capabilities expand consumers' choices and the ease of using their HSA," Golden Rule CEO Rich Collins said.
Collins said that the application process is a seamless one for consumers, and that HSA deposits are set up on the same payment plan as premiums for the Golden Rule health insurance coverage.
"Our experience shows that customers are saving for current and future health care needs as Congress intended when it passed enabling legislation for HSAs," Collins added. "Today's announcement is the next step in giving consumers additional tools and resources to manage their own health care spending."
Health savings accounts pair a high-deductible health insurance plan with a tax-advantaged savings account. Because HSA plan premiums typically cost significantly less than more traditional health insurance plans, consumers can place some or all of the money saved on premiums into the savings account that can be invested and withdrawn to pay the insurance deductible and other qualified medical expenses. Unspent dollars in a health savings account accumulate year over year, and earn interest like an IRA. The consumer owns the HSA account and decides when to save and when to spend.
Importantly, HSAs offer triple tax advantages: Contributions to health savings accounts go in tax-deductible, grow tax-deferred and can be withdrawn tax-free as long as they are used for qualified medical expenses including vision and dental services.
For more information about United Healthcare and Golden Rule plans, please visit us at http://www.health--savings--accounts.com
Posted by Wiley Long at 10:41 AM | Comments (0)
August 16, 2006
HSA Bank Reports Health Savings Account Balance Growth in 2006
HSA Bank announced its accountholders' average balances have increased by more than $350 to nearly $1,940 during the first six months of 2006. HSA Bank attributes the increase in balances to both a greater number of accountholders saving their HSA funds and an increased level of contributions to individual accounts.
In the first six months of 2006, nearly 52 percent of accountholders saved at least half of their Health Savings Account contributions. The average contribution surpassed the average distribution in 2006 by more than $100 per month, an increase of more than $40 during all of 2005.
"These statistics demonstrate that HSA Bank accountholders are learning how to manage their accounts and in many cases are able build savings for future health care costs," said Kirk Hoewisch, president of HSA Bank.
HSA Bank serves customers in every state in the nation and is one of the first financial institutions nationwide to offer health savings accounts. HSA Bank combines convenience, service and savings with low account maintenance fees, high interest rates for investments, 24-hour account access online or through an automated telephone system and outstanding personal service. For more information about HSA Bank, visit our HSA Bank webpage at http://www.health--savings--accounts.com/admin-hsa-bank.htm.
HSA Bank is a division of Webster Financial Corporation which is a holding company for Webster Bank, National Association and Webster Insurance. With $18.0 billion in assets, Webster provides business and consumer banking, mortgage, insurance, financial planning, trust and investment services through 160 banking offices, 308 ATMs, telephone banking and the Internet. Webster Bank owns the asset-based lending firm Webster Business Credit Corporation, the insurance premium finance company Budget Installment Corp., Center Capital Corporation, an equipment finance company headquartered in Farmington, Connecticut and provides health savings account trustee and administrative services through HSA Bank, a division of Webster Bank, Member FDIC and equal housing lender.
Find more HSA Administrators on our website: http://www.health--savings--accounts.com/
Posted by Wiley Long at 10:46 AM | Comments (2)
August 13, 2006
More Price Transparency Tools Now Available to HSA Owners
As Health Savings Accounts continue to become a preferred option for health care consumers, a great need is being created for transparency in pricing within the health care industry. With over 4 million health care consumers taking charge of their own health care costs via Health Savings Accounts, and even more consumers remaining uninsured - the number of patients who are price sensitive to routine medical procedures is growing exponentially. New websites are now being created to supply Health Savings Account owners with more price transparency information.
In an effort to address the needs of Health Savings Account owners, a team of health care industry, insurance, and technology professionals have created a solution -- DoctorPricing.com.
“We know that the greatest drawback to the consumer driven health care movement is that consumers have no way to comparison shop for routine health care procedures,” said, William Short, President. “DoctorPricing.com is the final piece of the puzzle when it comes to consumers taking power for their own health care decisions back in to their own hands.”
DoctorPricing.com is a comparison shopping engine that is free to use for health care consumers and providers. With a current database of over 700,000 physicians, doctorpricing.com is already the premier doctor search on the Internet.
“Doctors stand to benefit from this service as much as patients,” said Craig Clayton, CTO, “we’ve done a lot of the work, as far as creating profiles, technology, and providing the marketing push for this. All physicians need to do to drive these cash based consumers to their practices is to log in and add their pricing information.”
DoctorPricing.com runs on a proprietary search technology that allows consumers to comparison shop by location and by specialty. For example, a health care consumer in Billings, Montana can find prices for a basic office visit to all the doctors in their area -- allowing them to make a more informed decision when it comes to pricing.
DoctorPricing.com is owned and operated by Medical Commerce Direct LLC, a Delaware-chartered company based in Kansas City, MO. The ultimate goal of Medical Commerce Direct LLC and DoctorPricing.com is to make tools that aid in the consumer driven health care revolution available to consumers and doctors at no charge.
If you are looking for a high deductible health insurance plan to go along with your health savings account, you can visit us at: http://www.health--savings--accounts.com
Posted by Wiley Long at 11:48 AM | Comments (1)
August 11, 2006
Voluntary Medical Benefits Market Hot because of Health Savings Accounts
Employer and employee concerns over rising health care costs is spilling over into the voluntary benefits arena, driving demand for insurance products that will lower out-of-pocket medical expenses. Insurers and brokers are responding by increasing voluntary benefit offerings and putting new spins on old standards. All of this is being driven by Health Savings Accounts.
"What we're seeing is a much more aggressive focus on voluntary benefits from carriers," says Bonnie Brazzell, vice president of Eastbridge Consulting Group, a marketing advisory firm in Avon, Conn. "This is changing the mix of products and the level of competition in this area. And the employer is the winner here."
Every two years, Eastbridge conducts a survey of insurance carriers to determine worksite product trends. Its 2006 report, released in May, shows that critical illness and supplemental insurance, disability insurance, and limited benefit medical plans are expected to be the top-selling voluntary benefits for in the near future.
Critical illness insurance topped carriers' list of "emerging" products, those not traditionally included in insurers' core voluntary portfolio. The second-strongest growth products are expected to be supplemental medical ("gap") insurance and limited benefit medical plans. (See Figure 1.)
Fifty-three percent of the survey respondents said that CI would be the top-growing voluntary product over the next few years, and 35% added that they expect to introduce a CI product in the next year or two.
However, despite carriers' bullishness on future employer and employee demand for critical illness plans, most deemed CI the industry's top "under-performer," indicating disappointment in current sales.
"Thirty-two percent of the carriers surveyed named critical illness as the product that has not grown as expected," says Brazzell. "This is even more interesting when we consider that Eastbridge's 2006 U.S. Worksite Sales Survey showed that the critical illness line of business grew at one of the faster paces in 2005. Sales were up almost 13% over 2004."
There's ample room for growth: According to the Society for Human Resource Management, the number of employers offering critical illness coverage has been growing slowly but steadily in recent years. Thirty-two percent of organizations offered CI in 2002, and 39% are providing this coverage in 2006.
Employer and employee interest in voluntary medical still does not extend to long-term care, though. Only 8% of carriers expect LTC to be a growth area in 2006, compared to 28% in 2002 and 16% in 2004. Though insurers will continue to offer LTC, nearly a third of the Eastbridge survey respondents indicated these plans are unprofitable for their company.
One reason that insurers are sticking with LTC is that they are optimistic that health savings accounts will breathe life into moribund sales, since LTC and other voluntary product premiums can be paid with HSA funds.
"Carriers are hopeful that HSAs will have some positive impact on LTC sales, but it won't be gangbusters because employee interest is limited," Brazzell says.
Insurers tried in recent years to make LTC products more appealing by creating lifecycle products, such as disability insurance that would "morph" into a long-term care plan.
"Carriers tried these morphing products, but it didn't go over as well as they'd expected," she says. "It's usually an affordability issue." A combination product "is a great idea," she adds, "but it's obviously more expensive than plain vanilla disability, so people don't buy it."
The problem may not be lack of interest, but lack of education. Often, Brazzell says, brokers don't inform employers and employee-consumers about newer products.
"Brokers have a comfort level with the products they're selling and how they fit into their existing voluntary benefits portfolio, and it often takes awhile for them to pick up on new [offerings]," she says.
In addition, brokers are under pressure from employers and employees to keep costs down and provide the best value for the least cost. This makes them leery of bringing in something new, Brazzell notes.
Life lags
Perhaps the most startling change reflected by the survey is the sharp drop in demand for life insurance products. In Eastbridge's 2004 survey, nearly six in 10 insurers said universal life would be the top growth product for their company over the next few years. This year, though, only 11% of carriers chose universal life as a growth product, and just 16% thought sales of term life policies would grow.
"Growth in life overall is flatter in 2006," says Brazzell, which will lead to increased competition among carriers.
LIMRA International, another market research firm, reports that for the past five years, growth in group life sales has averaged just 2%. (See related story on page 17.) SHRM's 2006 Benefits Survey Report shows that the number of employers offering life insurance actually has declined from 98% in 2002 to 94% this year. Sixty-five percent provide life insurance for dependents.
Vision goes voluntary
What carriers are excited about is the growing employer interest in vision care as a stand-alone voluntary product. Eastbridge survey respondents ranked vision third on their list of emerging voluntary products. Thirty-one percent of the carriers said they will offer voluntary vision plans in the next few years, up from 22% in 2002.
Vision care is extremely popular; SHRM reports that 73% of organizations offer vision insurance. According to research by the Hay Group, the percentage of companies offering vision benefits has increased by about 20% since 1999, but the percentage of voluntary programs has jumped from 27% to 39%.
According to EBN sister-magazine Employee Benefit Adviser, vision is an obvious candidate for a voluntary arrangement because it is inexpensive and doesn't necessarily affect the majority of employees. Vision also is well-received as a voluntary benefit; Ron Dutton, a Kansas City, Mo. benefits adviser, told EBA he has been able to maintain 70% participation for formerly employer-sponsored vision plans, though 50% to 60% participation is the norm.
Many carriers are bundling vision with other products, particularly dental, to enhance their appeal to both brokers and employers.
Rethinking and repackaging
With employers demanding more defined contribution benefits and competition intensifying among voluntary benefit providers, more product repositioning is likely. One idea that's taking root is to present voluntary medical products such as disability, CI and LTC as part of the overall retirement savings strategy.
"I view voluntary benefits as a way to preserve current income, and protect current and future savings," says MetLife Vice President Randy Stram. "Said another way, if an individual is diagnosed with a critical illness or become disabled or needs long-term care - institutional care - during their income years ... that would have a very severe consequence, a negative effect on retirement savings."
Employees should be receptive to such an approach. Many financial advisers already include some benefits, particularly long-term care, in retirement planning discussions with their clients, and HSAs commonly are considered good retirement savings vehicles, because they allow pre-tax dollars to be used for long-term care premiums, Medicare premiums and out-of-pocket costs.
However, while many benefit advisers believe this is a viable tactic to market benefits, it is not in wide use, in large part because it can be difficult to get the one-on-one time needed to explain this strategy to each employee.
"I think that as the workforce continues to age, it will become apparent that part of the worksite process is providing America with solutions to their future," says Marc Lower, Colonial Life's regional sales manager for the Western region. "The complexity of retirement planning will require more time with the employee.
"The challenge is getting the employer to agree to the time necessary to do that," concludes Lower. "There needs to be individual attention to find out what the needs of the employee are and to help the employee come up with solutions from a product standpoint."
Posted by Wiley Long at 10:16 AM | Comments (0)
August 09, 2006
U.S. Treasury Issues Final Health Savings Account (HSA) Comparability Rules
The Treasury and IRS just issued final regulations of Health Savings Account (HSA) comparability rules that will give employers more flexibility in designing HSA style health plans. The final regulations state that when an employer makes a contribution to employee's Health Savings Account, they must contribute a comparable amount to all employees who are eligible.
Jim Snyder, President of Great Lakes HSA and one of the leading authorities on HSA regulations, said “the final regs are a clear sign the Treasury is trying to make it easier for employers to adopt an HSA style health plan by giving them added flexibility when designing a HSA health program. This flexibility will translate into additional options for employees and higher enrollment rates for HSA plans in 2007.”
Jim highlighted some of the new features of the final regulations below:
• Collectively bargained employees receive an exception from the comparability regulations.
• The ability to make different comparable contributions based on different variations of family coverage.
• Eligible employees now have a right to elect to receive cash in lieu of all or a portion of an employer HSA
contribution,
• Employer contributions to the employee's HSA made through a cafeteria plan are excluded from the
comparability rules.
• An excise tax on an employer if it fails to make comparable contributions to employees' HSAs.
One of the most important aspects of the final regulations is the Treasury’s effort to clarify other HSA comparability issues through numerous examples that illustrate the application of the rules. “This is the first time I can remember when the Treasury issued final regulations that didn’t make the original regulations more complicated to understand and manage at the employer level. Once HR professionals digest the final HSA regs, I they will begin 2007 with a positive outlook on the future of HSA plans within their organization.
Jim also mentioned that employers who currently have a HSA plan in place and vary employer contributions by location, categories of coverage or employee group, should review their plan design to insure it meets the final comparability regulations. The regulations will apply to employer contributions made on or after January 1, 2007.
Learn more about Health Savings Accounts.
Posted by Wiley Long at 09:31 AM | Comments (0)
August 07, 2006
Update on Blue Cross Blue Shield Health Savings Account Software
Blue Cross Blue Shield announced the creation of Blue Health Intelligence (BHI), a unique resource that will help to improve healthcare quality through opportunities to share critical health information initially with employers, and in the future, with health savings account owners and providers. BHI is the premier health intelligence resource in the nation and will strengthen the movement to greater healthcare transparency by ultimately providing unmatched detail about healthcare trends and best practices.
The secure, HIPAA-compliant database is comprised of claims information (with no personal identifiers) from 79 million lives -- significantly larger than existing healthcare databases. Twenty Blue Cross Blue Shield plans currently are participating in BHI (see list below). Access to the aggregate data will be available only to the participating Plans.
"BHI will play a central role in transforming the present healthcare system into a focused, knowledge-based healthcare system," said BCBSA President and CEO Scott P. Serota. "In the near term, BHI will support the efforts of employers to better manage the healthcare benefits they offer their employees. Eventually, BHI will provide consumers with the information they need to make informed healthcare decisions and will heighten collaboration with providers as they deliver high-quality, evidence-based care to their patients."
"Blue Health Intelligence will ultimately provide an unparalleled depth and breadth of information about a range of health trends and measures. This information will help Blue Cross and Blue Shield Plans work with their customers to develop and offer more valuable employee benefits," said Gail K. Boudreaux, Health Care Service Corporation's executive vice president for external operations, and BHI board co-chair. "The amount and level of information offered by BHI will enhance patient care and greatly inform healthcare decision making. We are proud to have contributed to the development of what will be a great asset to healthcare in this country."
Consumers are playing an increasing role in managing their healthcare, but they still need better knowledge-based tools to help them make the right decisions. "An empowered healthcare consumer needs access to credible information to make more informed choices," said Robert J. Greczyn, Jr., president and chief executive officer, Blue Cross and Blue Shield of North Carolina, and co-chair of the BHI board. "When fully operational, BHI will offer consumers useful information as they consider their healthcare options. BHI will set the industry standard."
The development of BHI over the last several years responds to the demands of employers, consumers, and providers who are calling for credible and actionable data to drive informed, evidence-based decision making. BHI is currently being pilot-tested and will be operational by 2007.
As BHI evolves, the resource will provide a number of benefits to employers, consumers, providers and other stakeholders, such as:
- Sharper insight into healthcare trends and best clinical practices;
- Information about the efficacy of certain treatments and new medical technologies as well as emerging trends in healthcare practice and delivery;
- Benchmarking data to assist in conducting comparative analyses across a number of healthcare components; and
- Opportunities for health services research.
To listen to the media conference call announcing Blue Health Intelligence, call 954.797.0718, participant code - 867443.
BHI Participating Plans offered at HSA for America
- Blue Cross Blue Shield of Tennessee
- Blue Cross Blue Shield of Arizona
- Blue Cross Blue Shield of Colorado
- Blue Cross Blue Shield of Texas
- Blue Cross Blue Shield of Nevada
- Blue Cross Blue Shield of Illinois
- Blue Cross of California
- Blue Shield of Califorina
Learn more about Health Savings Accounts at: http://www.health--savings--accounts.com
Posted by Wiley Long at 09:38 AM | Comments (0)
August 05, 2006
Microsoft Entry into Health Care Software will Benefit HSA Owners
Microsoft plans to offer software tailored for the health care which will help everyone in the industry, but especially Health Savings Account owners interested in price transparency.
The company's first step is to purchase clinical health care software developed by doctors and researchers at a nonprofit hospital in Washington, D.C. Microsoft is also hiring two of the three doctors who created the software system, and 40 members of the development team at Washington Hospital Center.
The purchase price, which was not disclosed, was most likely small by Microsoft’s standards. But the company has larger ambitions in the fast-growing market for health care information technology. Hospitals, doctors and policy makers worldwide have high hopes for saving money and improving the quality of care by moving health care into the digital age, handling patient records and tracking treatments electronically.
“This represents a change in our strategy,” said Peter Neupert, Microsoft’s vice president for health strategy. “This is the start for Microsoft. We’re just getting started.”
The Microsoft model in the past has been to supply operating systems, database software and programming tools that outside companies use to make software packages for specific industries. The idea is that Microsoft provides the underlying technology platform, but then partners build programs for industries like health care and banking.
Mr. Neupert, 50, is leading Microsoft’s new strategy in health care. In 1998, after 11 years at Microsoft, he left to become chief executive of Drugstore.com, an online retailer of pharmacy and health products. From 2003 to 2005, Mr. Neupert served on President Bush’s Information Technology Advisory Committee and helped run a subcommittee focused on technology in health care.
Mr. Neupert returned to Microsoft last September, after convincing Steven A. Ballmer, the chief executive, and Craig Mundie, a senior strategy executive, that Microsoft should be doing more in health care.
“I’ve had an opportunity to see how messed up the health care system was,” Mr. Neupert said. “And to really have an impact, you need a footprint like Microsoft’s.”
The software system Microsoft is buying, Azyxxi (pronounced ah-zik-see), is designed to retrieve and quickly display patient information from many sources, including scanned documents, E.K.G.’s, X-rays, M.R.I. scans, angiograms and ultrasound images. It was first used in Washington Hospital Center’s emergency department in 1996, and has since been adopted at six other hospitals, including the Georgetown University Hospital, that are part of the MedStar Health group, a nonprofit network in the Baltimore-Washington region.
The Azyxxi software, Mr. Neupert said, will be “our foundation,” adding, “You’ll find us expanding to a suite of health care solutions.”
The Microsoft plan, analysts say, could be risky. The software it is buying is a homegrown system that has not been used outside of a few hospitals. It has no installed base of customers, and there are already several established suppliers of clinical information technology systems, including Cerner, Epic Systems, GE Healthcare, Eclipsys and others.
Most of the big health care software suppliers, analysts point out, are also big customers for Microsoft operating systems, databases and programming tools. “This puts Microsoft in the uncomfortable position of potentially competing against its major customers,” said Dr. Thomas J. Handler, a health technology analyst at Gartner.
Dr. Craig F. Feied, a principal designer of the software, describes Azyxxi as mainly a “data exploration engine” that typically works with existing clinical systems rather than replacing them.
Analysts and health care experts who have seen the software work in the Washington hospitals say it is impressive technology. Many hospitals and clinics, they say, have various kinds of patient information in electronic form, but the different computer systems and software programs cannot share the data. That is the principal problem the Azyxxi system addresses, analysts say.
The need to quickly collect, sort and display health information from many sources, they say, is a vital requirement in developing regional and national health information networks — a policy goal in the United States and dozens of other countries.
At Washington Hospital Center, the system has done its job, Dr. Feied said. In 1995, before the system was introduced, the emergency ward handled 37,000 patients a year, waits stretched up to nine hours, and there seemed to be an urgent need for more doctors and rooms, he recalled. Today, the emergency department handles nearly 80,000 patients a year and 70 percent of them get a diagnosis, are treated or are admitted in three hours or less. The staff has increased only 5 percent, and few rooms were added.
The problem, Dr. Feied said, was mostly that patients were waiting in rooms because doctors could not quickly find the patient records, treatment history and other information to treat them.
“We weren’t doctor-poor or bed-poor,” he said. “We were information-poor.”
Whether that experience can be widely repeated and be made commercially successful under Microsoft, however, is uncertain.
“This is extremely interesting as a signal of Microsoft’s intentions in health care, but we’ll have to see what comes next and how this plays out,” said Dr. Blackford Middleton, an assistant professor at the Harvard Medical School and a health technology expert at Partners Healthcare, a nonprofit medical group that includes Massachusetts General Hospital in Boston.
This is just the beginning of Microsofts venture into the health insurance industry. In the long run, Health Savings Account owners will benefit from their software solutions.
Posted by Wiley Long at 10:03 PM | Comments (0)
August 02, 2006
More Walk-In Clinics Will Help HSA Owners
Retail health clinics are spreading fast in supermarkets, drugstores and big-box chains across the country, luring Health Savings Account owners with walk-in treatment for minor ailments like strep throat -- at about half the cost of a typical doctor visit, says the Wall Street Journal.
Now, traditional medical providers are stepping up to the counter, driven by the threat of new competition, the opportunity to recruit new patients -- and real concerns about the quality of care.
- In southeastern New Jersey, for example, AtlantiCare, the region's largest health care system, will open its first in-store HealthRite clinic next month in a Somers Point, N.J., ShopRite supermarket; it's the first of seven initially planned, and the company may also franchise stores to other health systems.
- Geisinger Health System, of Danville, Pa., with hospitals, physician practices and other health services, is opening its first CareWorks Convenient Healthcare clinic in the Weis Markets grocery chain next month, and will open as many as 75 sites throughout the region in the next five years.
- Memorial Baptist Health system in South Bend, Ind., is operating Medpoint express centers in local Wal-Mart Super Centers.
Staffed mainly by nurse practitioners who are licensed to treat a wide range of minor illnesses and prescribe medications, retail clinics have grown rapidly over the past five years as retailers, including CVS, Kroger, Wal-Mart Stores and Walgreen, have signed up with more than a half-dozen clinic operators.
By the end of the decade, the number of clinics could grow nearly tenfold to 10,000, says Peter Miller, chief executive officer of Take Care Health which plans to open 1,400 clinics by 2009. "We're offering health care on patients' terms instead of on the health-care system's terms," says Miller.
This is great news for Health Savings Account owners. Learn more about the advantages of Health Savings Accounts at: http://www.health--savings--accounts.com
Posted by Wiley Long at 12:02 PM | Comments (0)