April 20, 2018
The first problem in proving the value of wellness programs, of course, is that the data, while considerable, is also anecdotal. Further, the use of wellness does not necessarily correlate to some of the results claimed. Finally, though this is one good reason to do it anyway, is that you can’t quantify the results based on what diseases or injuries you would have prevented. A recent study in Health Affairs, which is the leading journal for health care theory and practice, said care coordination and management initiatives have not been drivers of savings in Medicare, and an earlier study shows that even if 90% of consumers utilized preventive services (much higher than the current takeup rate) the total effect on health care spending would be just under 0.2% – a lot of money overall, but not much money as part of the system. Cynics also point out that if we let people live longer, they will consume more health care services. This is, of course, a good societal thing, but if you want to look purely at how to save money and how to improve care, there is always contention with the “law of unintended consequences’ Overall, the argument should be about improving quality and not saving costs. Oh, well.
April 20, 2018
Well, now the concerns are over. Jamie Dimon JP Morgan, Jeff Bezos from Amazon and Warren Buffet from Berkshire Hathaway have all teamed up to solve our nation’s health care problems. There are no details at this point, of course, but they say they plan to hold down costs by bringing “their scale and complementary expertise to this long term effort” They will create an independent company “free from profit making incentives and constraints” to focus on technology solutions” This is great, except for the fact that technology is only one part of the problem (but definitely worth fixing) and that the scale these companies bring will really only benefit a narrow slice of consumers – their companies. By the way, Steve Case of AOL tried this years ago and failed miserably, but who remembers Steve Case any more?
April 11, 2018
Under the new Tax Act, and effective January 1, 2018, non profit employers must pay a corporate tax (defined as 21% under Section 13703 of amended section 512(A) of the Tax Code) for the following benefits made available to employees on a cost free basis:
- Qualified transportation plan
- Parking facilities used in connection with qualified parking
- On premises athletic facilities
March 20, 2018
Insurance carriers are dismayed that the individual mandate is being repealed for the simple reason that the ability of individuals to opt out of coverage will cause a negative spiral in health care costs, as the pool of covered people devolve into those who are more in need of services. Some states, however, including California, are fighting back and considering a state mandated mandate. We shall see.
March 6, 2018
In the swirl surrounding the new Tax Act, there was some good news on the benefits front.
The Cadillac tax, which was given a lot of time to germinate and grow on everyone, was kept in but the deadline for meeting it was pushed back from 2018 to 2020. As rates continue to rise, the specter of this tax, which penalizes plans that have a value exceeding a certain dollar threshold, nags at employers, particularly those in high cost states like California. The tax does not vary based on geographic factors, so once again the left and right coasts get hit. What’s puzzling is that the tax was supposed to help pay for the ACA, so why don’t they just get to it?
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