Ohio Health Policy Review

Ohio businesses to face 6% plus insurance increases next year

According to an article in Business First of Columbus, "Insurers will seek premium increases of 9 percent to nearly 11 percent for 2008 renewals of employer-sponsored health plans, according to benefits advisers Mercer Human Resources Consulting and Segal Co., which conduct national surveys of health costs. After price negotiations and inevitable plan changes, such as higher deductibles, the final increases will average about 6 percent to 6.8 percent next year, the firms said." (Source: "Businesses take initiative to rein in rising premium costs," Sept. 28, 2007.)

Even though this increase is lower than increases earlier in the decade, and is similar to the increase this year, businesses are still worried about the long-term financial impact of heath care costs. The article quotes Curt Cooper, director of employee benefits at American Electric Power (AEP), as saying the Columbus-based utility is facing 7% increases in health care costs this year and next. "If you project that out over many years, at some point our medical costs will be unsustainable," he said.

The article also examines ways businesses are trying to rein in health costs. Ohio State University's health plan is marketing an incentive-based wellness program and eliminating co-pays for medication to manage chronic diseases. AEP began offering a higher-deductible health care plan in 2006--along with two traditional plans--and since then 37% of employees have switched to the high-deductible offering.

Health and wellness symposium on Oct. 23

Business First of Columbus and Medical Mutual of Ohio are sponsoring a health and wellness symposium on Oct. 23 in Columbus. Speakers will include Newt Gingrich, former Speaker of the U.S. House of Representatives; LuAnn Heinen of the National Business Group on Health; Kent Clapp, President and Chief Executive Officer, Medical Mutual of Ohio; Dr. David B. Nash, Chairman, Department of Health Policy, Jefferson Medical College of Thomas Jefferson University; and Dr. Alvin Jackson, Director, Ohio Department of Health.

For more information or to register, go here.

Tamper-proof prescription rule put on hold

As previously reported, a new rule slated to go in effect Oct. 1 would have required all non-electronic prescriptions for Medicaid patients be written on tamper-resistant paper. Pharmacists, doctors, and others had protested the new rule's start date, which they said left little time to adopt the new system. In response to these concerns, Congress has now extended the deadline.

According to Ohio Congressman Charlie Wilson, who helped created the new rule, "the October 1st deadline was just not enough time for states and doctors and pharmacists to be able to comply with this new requirement." (Source: "Tamper-proof prescriptions held up," Marketplace, American Public Media, Sept. 27, 2007.)

The new deadline for the change to tamper-proof prescription pads will be next April. The White House estimates that Medicaid prescription fraud costs the government $100 million a year.

Ohio physicians worried about reduction in Medicare payments

An article in the News Herald describes how Ohio doctors are worried about a proposed 9.9% reduction in payments to physicians who accept Medicare, which is slated to occur on January 1, 2008. (Source: "Doctors not liking prognosis" Sept. 23, 2007.) According to the article, an informal survey of 25 physicians in Lake County found that "17 of the 25 respondents said they would eliminate services to Medicare patients altogether if the cuts go through. The 25 physicians care for about 55,000 patients in Lake County."

The informal survey, conducted by Dr. Jay Taylor and Dr. Frank Jevnikar of the Lake County Medical Society, mirrors an earlier study by the American Medical Association (AMA). In that study, the AMA surveyed 8,955 physicians and found that "sixty percent of the respondents said they plan to limit the number of new Medicare patients they treat" if the reductions in payments go through. Congress is currently debating whether to allow the proposed Medicare payment reductions to proceed.

Legislative update

Two Congressional bills of interest to Ohioans continued to move through the legislative process. The U.S. House Ways and Means Committee approved HR 1424, which requires mental health benefits in insurance plans (including co-payments, deductibles, and annual and lifetime limits) be equivalent to medical and surgical benefits. The Senate passed a similar bill earlier this month. (Source: "Ways and Means approves mental health parity bill," Business Insurance, Sept. 26, 2007.)

In addition, on Tuesday the entire House of Representatives voted on a bill (HR976) to expand the State Children's Health Insurance Program (SCHIP). Twelve of Ohio 17 Congressional members voted for the bill. However, the bill didn't pass with enough votes to over-ride an expected veto by President Bush. The bill now moves to the U.S. Senate. Because of the veto threat, "Congress is expected to temporarily extend current SCHIP law, which otherwise will expire Sunday." (Source: Gongwer Report, Sept. 26, 2007.)

Forums on Medicaid managed care to be held around Ohio

The National Alliance on Mental Illness Ohio (NAMI Ohio) is cosponsoring a series of forums around the state on Medicaid Managed Care. As their website states, "The purpose of the forums is to provide individuals with mental health and substance abuse disorders and their families the opportunity to learn about the transition to Medicaid Managed Care and to understand how this change impacts their healthcare." Forums will be held on September 26 in Athens, October 3 in Lebanon, October 10 in Columbus, October 17 in Bowling Green, October 24 in Canton, and November 5 in Cleveland. For complete information, including locations and times, go to the NAMI Ohio website.

New website launched for Governor's healthcare reform initiative

The Ohio Department of Insurance has created a new website focusing on Governor Strickland's effort to reform Ohio’s healthcare coverage system. The goal of the Healthcare Coverage Reform Initiative "is to provide access to affordable health insurance coverage to all uninsured Ohioans with an initial goal of providing coverage to 500,000 more Ohioans by 2011. To develop reforms that achieve these goals, Governor Strickland has asked for a bi-partisan, inclusive, transparent process to develop reforms that are tailored to Ohio." (Source: "About the Initiative," accessed Sept. 26, 2007.)

The website brings together the different work being done under this initiative, including Ohio's participation in the Robert Wood Johnson Foundation State Coverage Initiative, which allows people from the Governor's administration, Ohio General Assembly, and key stakeholders to work with leaders and experts from around the country on how to cover Ohio's uninsured residents. Another aspect of the initiative is the Governor's Healthcare Coverage Initiative Advisory Committee, an advisory group to provide guidance in developing reforms.

According to the Health Coverage Reform Initiative website, "stakeholder groups are currently being formed to share information that will shape plans to cover Ohio’s uninsured residents." (Source: "About the Initiative.") Anyone desiring to join one one of these stakeholder groups should go the "Public Input" section of the website and provide their contact information and group preference.

Study: Employees will lose weight if you show them the money

A new study in the Journal of Occupational and Environmental Medicine finds that even small cash incentives can entice employees to lose weight. (Source: "A little cash can motivate diet," Cincinnati Enquirer, Sept. 25, 2007.) While employers can not be certain that "offering fitness centers or improving offerings in the company cafeteria" will help their employees be healtier--and therefore save the company money on health benefits--this study suggests that cash incentives for losing weight are an almost sure bet. "The study involved about 200 overweight employees at several colleges in North Carolina. One group received no incentives while two other groups received $7 or $14 for each percentage point of weight lost." Even though participants didn't receive help in losing weight, those employees who received the most incentives lost the most weight, an average of almost 5 pounds after three months.

Children's mental health conference at OSU on Sept. 26

Mental Health America of Franklin County (MHAFC) will hold a conference on children's mental health issues on Wednesday, Sept. 26, from 8:30 to 4:45 pm. at the Fawcett Center, Ohio State University. The conference welcomes walk-in registrations. For more info, go to the MHAFC website. The is also a related article on bipolar diagnoses in children in yesterday's Columbus Dispatch.

Do flu vaccines save elderly lives?

A new study in the British medical journal The Lancet questions if annual flu vaccines are saving the lives of seniors. (Source: "Flu vaccines may not save elderly lives: experts" Reuters, Sept. 24, 2007.) The article states that while "no studies have conclusively proven that influenza shots prevent flu-related deaths in people over the age of 65 . . . the elderly should continue to get flu shots" However, researchers said "health officials should also be looking for other ways to prevent some of the 36,000 deaths that come each year from flu in the United States alone."

Dr. Lone Simonsen of George Washington University said there is no evidence vaccination cuts deaths from flu among the elderly, primarily because older people have lower immune activity than younger people. She added, though, that "There is no question about the vaccine working in people under the age of 65." Simonsen recommended designing vaccines that better protect the elderly and more aggressive use of antiviral drugs to treat and prevent flu. Dr. Joe Bresee of the U.S. Centers for Disease Control and Prevention said his agency was "considering these and other measures--including better vaccination of health care workers and recommending the widespread vaccination of schoolchildren. "We know that school children are a big part of community transmission. They shed lots of virus. They shed it for long periods of time," he said.