Managed Care - October 2008 - (Page 9) NEWS AND COMMENTARY found that overall health care costs for the targeted episodes continued to increase in the population at an average rate of 4.5 percent per year. These increases were mostly attributed to increased costs per episode, with only a small increase in the number of episodes in a population with a fixed size. Marcus Thygeson, MD, vice president and medical director for consumer health solutions at HealthPartners, says, “We found the total cost for care for these five episodes has not gone down. We’re not convinced that use of retail clinics is going to be a cost-saving measure. From the perspective of a health plan medical director looking at population health costs, it’s not clear to us that these clinics will [save money].” How do Medicare benefits stack up? ow does Medicare stack up against the typical health plan offered by large employers? Hewitt Associates was commissioned to compare the actuarial value of benefits under the original fee-for-service Medicare program to two prototype large employer plans provided to active employees: the Blue Cross Blue Shield standard nationwide preferred provider organization (PPO) option available to federal employees through the Federal Employees Health Benefits Program (FEHBP) and a typical employer PPO plan. The researchers found that even with its new drug benefit, Medicare on average provides less generous benefits to seniors than they would receive under a typical large employer health plan or the most popular plan available to federal employees. H Comparing Medicare costs and value Medicare Large employer PPO 15% 74% 85% FEHBP option 17% 83% 26% Candidates’ Plans Hurt Workers? Corporate benefits specialists — regardless of political affiliation — are not enamored of either John McCain or Barack Obama’s health care proposals, according to the American Benefits Council and Miller & Chevalier Chartered 2008 Corporate Health Care Policy Forecast Survey. The group says McCain’s proposal to repeal the tax exclusion for employer-provided health coverage and Obama’s proposal to compel employers to “pay or play” would hurt workers. “The people responsible for structuring and managing employersponsored health plans, which cover more than 130 million Americans, are deeply skeptical about key elements of both presidential candidates’ reform proposals,” says James A. Klein, president of the American Benefits Council. According to the survey, 74 percent of respondents say a repeal of the employee tax exclusion for employersponsored health coverage, proposed Costs paid by plan Costs paid by individuals Medicare benefit value as a share of large employer PPO or FEHBP option 87% 90% Medicare PPO Medicare FEHBP Percent of prescription drug costs Medicare Large employer PPO FEHBP option 51% 73% 80% Source: Hewitt Associates analysis for the Kaiser Family Foundation, 2008 OCTOBER 2008 / MANAGED CARE 9
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