Posts Tagged ‘Kaiser Permanente’

600,000 Young Adults Already Taking Advantage of Healthcare Reform Law Provision

Tuesday, June 14th, 2011

More than 600,000 young American adults are taking advantage of the healthcare law provision that allows people under 26 to remain on their parents’ health plans, a pace that appears to be faster than the government expected.

WellPoint, which insures 34 million Americans, said the dependent provision was the reason why 280,000 new members were enrolled.  That was approximately one-third of its total enrollment growth in the first three months of the year.  Other large insurers have added thousands of young adults.  Aetna added approximately 100,000; Kaiser Permanente, about 90,000; Highmark Inc., about 72,000; and Health Care Service Corporation, about 82,000.  The Department of Health and Human Services (HHS) believes that about 1.2 million young adults will sign up for coverage in 2011.

The (college) coverage will probably end in August, but students should check the date,” said Aaron Smith, co-founder and executive director of the Young Invincibles,  a Washington-based non-profit healthcare advocacy group for young adults.  “It’s an important piece of information.  They could have a gap in coverage.”  The group has created guidelines to help new grads understand their health insurance options.  Thanks to the ACA, young adults can remain on their parents’ health insurance until their 26th birthday, even if they’re in school, financially independent and even if they’re married.  The sole exception is if they have health coverage through their own employer.  In those situations — even if the policy is bad — they can’t remain on their parents’ plan.  Young adults have one of the lowest coverage rates, estimated at as much as 30 percent.  The healthcare reform overhaul has helped make a dent in that figure.

Adding young adult coverage increases the average family premium by approximately one percent, according to federal estimates.  Unfortunately, graduating students who are currently uninsured don’t get a special enrollment opportunity under the law, says Smith, and must wait until the next annual enrollment period to sign on with their parents’ plan.

Not surprisingly, some employers are concerned about having to pay for additional coverage for their employees’ offspring.  Helen Darling, CEO of the National Business Group on Health, which represents more than 300 large employers, said employers generally don’t like adding anything to their health costs.  “I don’t think anyone is eager to spend more money,” Darling said.  “This is not something employers would have done on their own.”

According to insurers, the growth in young-adult enrollment comes as the industry began reporting 1st quarter earnings shows better than expected profits.  Carl McDonald, a Citigroup analyst, said that the higher profits aren’t related to the new enrollees but rather because most of the increase in young people’s enrollment has occurred among self-insured employers; in those firms, insurers act as administrators and assume no financial risk.  McDonald said the majority of insurers’ profit increases is due to their customers using fewer health services, particularly hospital care.

“We are pleased to see the embrace of this key provision of the Affordable Care Act,” said Jessica Santillo, a spokeswoman for HHS.  “Young adults are more than twice as likely to be uninsured than older adults, making it harder to get the health care they need, and putting them at risk of going into debt from high medical bills.”

Medical Residents Need Enhanced Training, Shorter Work Hours

Tuesday, February 15th, 2011

Medical residents should receive expanded training as part of an effort to make America’s healthcare more effective.  Dr. Jay Crosson, senior medical director of the Permanente Foundation at Kaiser Permanente, who served on the Medicare Payment Advisory Commission, announced the initiative.  According to Crosson, medical residents will now receive additional training in office-based care competencies, care coordination, continuity of care; leadership and management skills; providing analysis by identifying needs and priorities; increasing the number of primary-care providers; investing in top-quality training; and placing physicians in under-served areas.  “Which of these can we expect from residency programs, and what is naturally on-the-job training?” Crosson asked.

The advanced training could be funded in part by $320 million in grants authorized by the Patient Protection and Affordable Care Act.  Department of Health and Human Services Secretary Kathleen Sebelius said “Investing in our primary-care workforce will strengthen the role that wellness and prevention play in our healthcare system.  With these grants, Americans from all backgrounds will have new opportunities to enter the healthcare workforce.”  Mary K. Wakefield, Ph.D, R.N. and administrator of the Health Resources and Services Administration (HRSA) says “These grants will provide much-needed support for increasing primary-care capacity by expanding training programs for primary-care providers, vital to our future healthcare workforce.”

In another move that will impact their training, medical residents now work slightly shorter shifts and have tighter supervision in a bid to improve quality. According to Kaiser Health News, “The Accreditation Council for Graduate Medical Education’s (ACGME) board of directors approved new rules for more than 110,000 new physicians being trained at American hospitals.  The goal is to improve patient safety and reduce medical errors caused by junior doctors working extremely long hours.”  Doctors in their first year of residency will be limited to 16 consecutive hours of work with “strategic napping.  The maximum shift length remains 24 hours for residents in their second year of training and beyond.  Also, medical residents are to tell patients they’re being supervised by more experienced physicians, and the hierarchy should be spelled out to patients,” according to the revised rules.

“My body is not made to work 30 hours or more,” said Dan Henderson, a third-year medical student at the University of Connecticut. “If I’m truly going to do no harm as I pledged, I need a system to protect patients against errors caused by my fatigue.”

“Resident physicians working 30-hour shifts make 36 percent more medical errors caring for women in the intensive care unit…including 460 percent more serious diagnostic mistakes than those scheduled to work for 16 hours,” said Chuck Czeisler, M.D., of Harvard and Brigham and Women’s Hospital.  “They are also 73 percent more likely to stab themselves with a scalpel or needle.”

RN Turnover Costs Hospitals An Estimated $9.75 Billion Annually

Wednesday, June 2nd, 2010

Nurse burn-out – a result of working in high-stress environments – is bad for patient care and expensive for hospitals.  According to the American Organization of Nurse Executives (AONE), “a conservative estimate” of the price of hiring a new nurse totals $10,000 in direct recruitment costs.  In a hospital with 400 RNs on staff, it is no stretch to theorize that as many as 80 new nurses must be recruited and trained every year, adding up to $800,000 annually – and that’s just the direct costs.http://www.afscme.org/publications/2211.cfm

These direct costs – which include recruiting a new nurse, hiring the optimal candidate and training that individual — represent only a small portion of the expense of hiring and training a nurse.  It is the hidden costs – such as signing bonuses and other incentives, lost productivity because of the vacant position, and the expenses associated with training – that drive up the price of replacing RNs.  Additionally, hospitals pay more to hire agency nurses versus employing nurses directly on their staff.  A survey of hospital CEOs found that “agency nurses are often not familiar with policies, protocols and standards, and staff nurses then find that they have the additional burden of trying to educate these nurses on the unit.”

According to AONE estimates, the real cost of replacing a medical/surgical nurse is $42,000 and $64,000 for a specialty nurse.  Kaiser Permanente places an even higher price tag on nurse turnover — $47,403 for a medical/surgical nurse and $85,197 for a specialty nurse.  For the hypothetical 400-nurse hospital, the cost of replacing just 80 nurses annually could total $4 million in direct and hidden costs.  Nationally, it is estimated that 1.3 million RNs are employed by hospitals.  With an average turnover rate of approximately 15 percent, that translates to 195,000 nurse positions turning over every year at an estimated total cost of $9.75 billion.