As The Health Law Reshapes The Marketplace, Concerns Emerge

Narrow networks and other steps to control costs are gaining media attention.

The Wall Street Journal: Many Health Insurers To Limit Choices Of Doctors, Hospitals
Many of the plans [offered on the new health marketplaces] will include relatively few choices of doctors and hospitals. In some cases, plans will layer on other limits, such as requirements that patients get referrals to see specialists, or obtain insurer authorization before pricey procedures. A McKinsey & Co. analysis of 955 consumer exchange-plan filings, from 13 states that were among the earliest to make them public, found that 47% were health-maintenance organizations or similarly designed plans. Such plans generally don't pay for care provided outside their networks. A number of other plans, though classed as preferred-provider organizations, or PPOs, will also have limited choices of doctors and hospitals in their networks (Mathews, 8/14).

The Associated Press: Businesses Seek Cure For Health Care Cost Surge
A year ago, Teresa Hartnett was on the verge of expanding her small business. The company had hit $1 million in sales, and requests from clients were flowing in. She planned to transition from nearly 30 freelancers to a full-time staff of 60 by 2014. Then the reality of the Affordable Health Care Act hit. Hartnett realized she might not be able to afford to carry out her plan. … The expected surge in health insurance costs under the ACA has many small business owners changing the way they operate. For many like Hartnett, hiring and expanding is going on the back burner. Others expect to cut back on some of the services their companies provide, raise prices or cut employees' hours and bonuses (Rosenberg, 8/14).

Kaiser Health News: Talking Scales And Telemedicine: ACO Tools To Keep Patients Out Of The Hospital
When Bill Hill prepares to weigh himself each morning, a mechanical voice speaks to him from a small box on his nightstand that is connected to the scale on the floor. … For Hill, who was diagnosed with heart failure more than seven years ago, the morning weigh-in has become as routine as putting on his shoes. Like countless other patients nationwide, he's becoming more involved in his healthcare. That's a major goal of the federal health care overhaul. Essentia Health has been taking care of patients like Hill with telehealth tools like the special scale since 1998. And now it is an Accountable Care Organization, or ACO. That means it takes responsibility for the health of a population of Medicare beneficiaries and can share any savings created by keeping people like Hill out of the hospital (Stawicki, 8/15).

Reuters: U.S. Schools Face Tough Decisions On Obamacare Benefits
Hit by years of budget cuts, some U.S. public school boards are looking to avoid providing health benefits to substitute teachers and supporting staff under President Barack Obama's reform law, education officials say. According to the law, employers will have to offer health coverage to all full-time employees, defined as those who work an average of 30 or more hours per week each month, or else pay a fine starting in 2015 (Abutaleb, 8/14).

Also in the news -

The New York Times: The Challenge Of Helping The Uninsured Find Coverage
Like many organizations across the country, Ms. Daily's agency, Northern Virginia Family Service, is hoping to win a federal grant to help uninsured people in the state sign up for coverage under President Obama's health care law. With the money, she hopes to hire at least a handful of "navigators" — a new category of worker created under the law to educate consumers about new health insurance options and, starting in October, to walk them through the enrollment process (Goodnough, 8/14).

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