KHN: Kaiser Health News

jrau@kff.org

Employees love to gripe about rising health care costs, but a new poll finds most are not willing to sacrifice to pay less for their insurance.

Only 27 percent of people with insurance provided through their employer said they would  accept a more restricted list of doctors and hospitals in their networks, according to the latest monthly poll from the Kaiser Family Foundation. (KHN is an editorially-independent program of the foundation.) Less than a third of those polled were willing to pay more for brand name drugs or pay higher deductibles in return for lower premiums.

Only one idea floated in the poll — having people participate in corporate wellness programs promoting healthy behaviors — won over a majority of employees: 68 percent said they’d be willing to take part in one of these programs in exchange for lower premiums.

The poll found that most workers don’t blame their companies for the escalating cost of health care. Two out of three said they were offered the best coverage the company could afford given financial circumstances. A whopping 88 percent reported a somewhat or very positive experience with their employer-provided health care plan. (more…)

North Carolina employers are trying to find out if there really is no place like home.

As in medical homes, that is.

For the first time, people with job-based insurance in the state will soon be offered a chance to tap into a well-known medical home network that has primarily served Medicaid enrollees since 1998.

Photo by Andy Callahan via Flickr

That network is one of the longest running and most studied medical homes, a term that encompasses efforts to better coordinate primary care, often by creating a more team-based approach that links physicians with other medical providers, such as nurse practitioners, nutritionists, pharmacists and mental health experts.

Today, drug maker GlaxoSmithKline, pharmacy chain Kerr Drug, analytics firm SAS, the state and Blue Cross and Blue Shield of North Carolina announced that their employees will be able to voluntarily enroll in the nonprofit Community Care of North Carolina network.

The network, made up of physicians, hospitals, social service agencies and county health departments,  is credited with saving the state millions of dollars since its founding in 1998.  In recent years, the program has expanded to serve some Medicare patients under a special waiver.

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Just a few weeks into his campaign, Texas Gov. and presidential candidate Rick Perry isn’t talking a whole lot about health care, except to criticize President Obama for last year’s law. And he’s not considered a health care expert. But he’s is passionate on one point: Fixing the nation’s health care system must include a major reform of the medical malpractice system.

Photo by Darren McCollester/Getty Images

In 2009, Perry and fellow GOP presidential competitor Newt Gingrich wrote in a Washington Post op-ed that Texas has successfully controlled health care costs, and at the same time has improved quality by enacting tort reforms in 2003. “Fewer frivolous lawsuits have attracted record numbers of doctors to the state as medical malpractice insurance premiums dropped by half,” they wrote.

They also mention Christus Health, a large Catholic nonprofit system with a significant presence in Texas, which reduced its liability defense payments from about $100 million in 2003 to $2.3 million last year. The savings went to expanding health-care services in low-income communities.

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With its well-regarded hospitals dominating Northern Virginia and $2.3 billion in net operating revenue last year, Inova Health System must be the envy of many hospital groups. But in a sign that even the strongest players feel pressure to save money and operate more efficiently, Inova this week trimmed many of its mid-level management positions.

Inova cut 117 management jobs, 84 through attrition, spokesman Tony Raker said in an email. “Inova is responding not only to economic challenges but to anticipated changes (as well as unknowns) within the health care reform environment,” he wrote. “While the economy is a universal challenge, hospitals and health care systems face specific hurdles as the nation struggles with escalating health care costs and, in turn, providers struggle with continuing reductions in Medicare compensation, infrastructure maintenance, higher material costs not to mention technological investments necessary to maintain service excellence.”

Raker wrote that the change was designed to reduce the levels of bureaucracy between senior managers and patients and improve patient care. After the cuts, Inova will have 889 management positions. “It should be stressed that while reducing expenses is a component of our strategy, cost reductions were not the primary driver of the management restructuring,” Raker added.

“Many hospitals are clearly feeling cost pressures,” says Alwyn Cassil, director of public information at the Center for Studying Health System Change, a Washington research group. “States are already cutting Medicaid rates and reductions in the growth of Medicare payment rates are coming, so it’s not surprising that hospitals are squirreling away nuts for the winter.”

With 1,750 licensed beds, Inova, which is non-profit and based in Falls Church, Va., last year reported more than 95,000 admissions, 786,000 outpatient visits and a third of a million emergency room visits. Inova is such a presence in the Virginia suburbs of Washington that federal anti-trust regulators successfully blocked its attempted aquisition of another hospital group back in 2008 because it would have given Inova control of nearly three-quarters of the market.

jrau@kff.org