The state will review whether hospitals are following the rule and compliance could become an issue in a facility’s licensing review. But the state is not focused on enforcement right now.
A new analysis of costs for health plans offered through the Affordable Care Act’s insurance marketplaces has good news for many people signing up in the second enrollment period: Nationwide, marketplace premiums for 2015 did not increase at all from 2014, though average premiums grew substantially in some states and fell in others.
The researchers also found that average premiums for the second-lowest-cost silver plan—the benchmark for calculating the federal subsidy in a given state—were unchanged.
Meanwhile, the average deductible for a marketplace plan increased 1 percent year to year.
Kaiser Health News
Medicare is penalizing 721 hospitals with high rates of potentially avoidable mistakes that can harm patients, known as “hospital-acquired conditions” or HACs
Penalized hospitals will have their Medicare payments reduced by 1 percent over the fiscal year that runs from October 2014 through September 2015.
To determine penalties, Medicare evaluated three types of HACs.
- One is central-line associated bloodstream infections, or CLABSIs.
- The second is catheter-associated urinary tract infections, or CAUTIs.
- The final one, Serious Complications, is based on eight types of injuries, including blood clots, bed sores and falls.
Here are the Washington state hospitals that are being penalized:
|Cascade Valley Hospital||Arlington||WA||Snohomish|
|Deaconess Medical Center||Spokane||WA||Spokane|
|Harborview Medical Center||Seattle||WA||King|
|Kadlec Regional Medical Center||Richland||WA||Benton|
|Multicare Auburn Medical Center||Auburn||WA||King|
|Multicare Good Samaritan Hospital||Puyallup||WA||Pierce|
|Northwest Hospital & Medical Center||Seattle||WA||King|
|Peacehealth St Joseph Medical Center||Bellingham||WA||Whatcom|
|Providence Holy Family Hospital||Spokane||WA||Spokane|
|Providence Sacred Heart Medical Center||Spokane||WA||Spokane|
|Providence St Mary Medical Center||Walla Walla||WA||Walla Walla|
|Swedish Medical Center – First Hill/Ballard||Seattle||WA||King|
|Swedish Medical Center / Cherry Hill||Seattle||WA||King|
|Valley Medical Center||Renton||WA||King|
|Wenatchee Valley Hospital||Wenatchee||WA||Chelan|
|Yakima Regional Medical And Cardiac Center||Yakima||WA||Yakima|
Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
By Michelle Andrews
When shopping for health plans, the dollar amount of the deductible is usually easy to find in plan materials.
But with family coverage it may be necessary to dig deeper to find out how much you’ll owe before insurance kicks in to cover your costs.
Is there one deductible for the whole family or separate deductibles for each family member embedded within the family deductible? The answer could make a big difference in your out-of-pocket costs.
Public Health Insider: Behind-the-scenes of the agency protecting the health and well-being of all people in Seattle & King County
New York City has them, so does L.A. Even Toronto has them. So why aren’t there food safety inspection grades posted outside of restaurants in King County?
The answer? Food safety performance placarding is coming, and when it does, it will give patrons and establishments alike information that is meaningful, clear, and motivating.
Diners need to know actual risk
There’s a lot on the line: Studies show that restaurant placards influence consumer behavior. But research on the systems that give A-B-C grades shows that A-B-C placards don’t communicate what consumers are expect. Continue reading
New and Renewing Customers Must Select and Pay for a Plan by Dec. 23, 2014
The Washington Health Benefit Exchange is reminding residents today to select and pay for a Qualified Health Plan throughwww.wahealthplanfinder.org by 5 p.m. on Dec. 23 for coverage that begins on Jan. 1, 2015.
While Dec. 15 was the national deadline to enroll in health insurance, individuals and families who would like to sign up for a Qualified Health Plan can still check out their options and see if they qualify for tax credits to lower the cost of their health coverage. Enrollment in Washington Apple Health (Medicaid) is year-round.
In anticipation of the expected enrollment surge this weekend, the toll-free Customer Support Center (1-855-923-4633) will be open on Saturday and Sunday from 7:30 a.m. to 4 p.m. Continue reading
From Health Affairs
Since the Affordable Care Act (ACA) was signed into law, some of its critics have predicted that businesses would discontinue offering employer-sponsored health insurance, moving employees into the individual Marketplaces.
If widespread dropping of employer-sponsored health insurance were to occur, government costs could increase since many low-wage workers would qualify for federal subsidies in the Marketplaces.
A new study, released today as a Web First by Health Affairs, examined data from the Health Reform Monitoring Survey for June 2013 through September 2014, assessing any early changes of employer-sponsored insurance under the ACA.
Study found that the percentage of workers with employer offers for health insurance was basically unchanged.
There were no changes in offer, take-up, and coverage rates among low- and high-income adults working at small (fewer than fifty workers) or large firms.
This is the first peer-reviewed study to analyze changes in employer-sponsored insurance after the ACA was implemented and the launching of the health insurance Marketplaces.
By Jordan Rau
In its toughest crackdown yet on medical errors, the federal government is cutting payments to 721 hospitals for having high rates of infections and other patient injuries, records released Thursday show.
Medicare assessed these new penalties against some of the most renowned hospitals in the nation, including the Cleveland Clinic, Brigham and Women’s Hospital in Boston, the Hospital of the University of Pennsylvania in Philadelphia and Geisinger Medical Center in Danville, Pa.
One out of every seven hospitals in the nation will have their Medicare payments lowered by 1 percent over the fiscal year that began Oct. 1 and continues through September 2015. The health law mandates the reductions for the quarter of hospitals that Medicare assessed as having the highest rates of “hospital-acquired conditions,” or HACs.
These conditions include infections from catheters, blood clots, bed sores and other complications that are considered avoidable.
The penalties, which are estimated to total $373 million, are falling particularly hard on academic medical centers: Roughly half of them will be punished, according to a Kaiser Health News analysis.
By Michael Ollove
A temporary bump in Medicaid fees paid to primary care doctors, an Affordable Care Act provision intended to get more physicians to accept Medicaid patients, will expire at the end of this month.
Congress did not extend the higher rates, so unless states take action themselves or the new Congress revisits the issue, primary care doctors in Medicaid will see their fees fall by an average of nearly 43 percent starting in January, according to a new report from the Urban Institute.
Unless action is taken primary care doctors in Medicaid will see their fees fall by an average of nearly 43 percent starting in January.
“It’s expiring before it’s been evaluated,” said Sandra Decker, a researcher at the National Center for Health Statistics, an arm of the Centers for Disease Control and Prevention.
Decker, who has published widely on the Medicaid physician workforce, said she will analyze the impact of the fee increase, but doubts her results will be complete before the end of next year.
Still, she noted, past evidence indicates that Medicaid pay increases spur participation by physicians. She predicted that the lower fees will make it harder for Medicaid patients to find doctors willing to see them or that they will have to endure long waits to see doctors who accept Medicaid patients.
By Fred Mogul, WNYC
Sandra Lopez and her Chihuahua, Coco, were inseparable. He followed her everywhere, and kept Lopez’s mood up when she was in pain – which was often.
On Oct. 15, Lopez, died at age 49 of pancreatic and vaginal cancer that had slowly spread throughout her body over two years. She left behind a 15-year-old daughter and little Coco. But with hospice care, she spent her last weeks where she wanted to be — at home, with her pain under control.
Sandra was in and out of the hospital in 2014, but for the months she was home, a hospice nurse from Metropolitan Jewish Health System visited once a week to help manage the pain, backed up by a 24-hour, nurse-staffed phone line that Lopez called often.
“Some days the pain is so excruciating,” she told me in August from the couch in her Brooklyn apartment, “that the pain overrides the medication.”
But despite evidence that hospices can greatly relieve discomfort, extend life and save money, and despite a generous hospice benefit available through both Medicare and Medicaid, relatively few people in New York take advantage of it, compared to elsewhere in the country.