Medical home models. Incentives to wellness. And the much-balleyhooed health insurance exchanges.
With elements of the Affordable Care Act, sometimes called Obamacare, set to go into effect in January, businesses have been adjusting budgets and making other preparations to meet its mandates that those with at least 50 employees provide health insurance to all who work at least 30 hours per week.
For smaller businesses, the decisions that come along with those preparations might overwhelm a manager whose main job isn’t taking care of human resources, said Logansport Memorial Hospital president Dave Ameen.
It’s those smaller businesses he’s hoping to educate at a health insurance reform seminar Oct. 17 that’s focusing on the health insurance exchanges.
A survey conducted by the International Foundation of Employee Benefit Plans indicated most organizations think they understand ACA fairly well, but still need to analyze it further. Meanwhile, two in five are emphasizing wellness and wellness initiatives more because of ACA’s impact, survey results indicated, and 17 percent of respondents are already starting to redesign their health insurance plans to avoid an excise tax scheduled to be triggered in 2018 for high-cost health insurance plans.
The act “really requires preventive care and wellness to be covered,” said Ameen, who’s one of the three speakers scheduled to address seminar attendees later this month. However, on the provider side, reimbursing entities like Medicare are pushing for those measures to be carried out — and documented.
“Like in diabetes, they want us to document that we’re measuring the hemoglobin A1C levels,” he said, referring to a blood test that gauges a person’s average sugar levels over the past three months, and “that not only are we prescribing medicines, that they’re also getting the medicines filled.”
Ameen, Indiana Chamber representative Mike Ripley and Anthem Blue Cross Blue Shield executive Greg Leffler are slated to speak at the lunch seminar from 11:30 a.m. to 1 p.m. Oct. 17 at Ivy Tech-Logansport, 1 Iv Tech Way. Ameen said he planned to focus on how health care organizations are responding to health care reform.
At Logansport Memorial Hospital, he said, physicians are transitioning to a “medical home” model, pulling a term from the 1960s to describe sharing records among a primary care physician and other medical personnel, like a dietitian or health coach, who might help a patient understand what they can do about a chronic illness or how they can prevent one.
Ameen called the act “the next step in health care,” moving insurance away from sick care and into wellness — or preventive measures, like regular exams and healthy habits.
As it is, insurance’s focus on kicking in when someone gets sick, and its limited scope — some 16 percent of Cass County residents are uninsured or underinsured, he said — mean costs for taking care of someone who’s sick and uninsured are shifted around, ultimately falling onto insured people or government aid agencies.
“We give away about $800,000 worth of care every month,” Ameen said, and tries to make up for it through seeking reimbursements wherever possible.
He expects getting more people onto fuller health insurance plans to shift people’s focus from panicking when they get sick to taking steps to keep them from getting acutely sick in the first place, he said.
Those steps come with an additional cost, admitted hospital human resources manager Lynda Murphy.
“It’s a tightrope that you walk as an employer, because it’s going to hit employees in the pocketbook one way or the other,” she said. “But it’s not all about cost. It’s the right thing to do.”
Employers who’ve begun emphasizing wellness behaviors — and instituting incentives, or discounts on insurance, to push employees to change their behaviors to match — have judged the cost worth it, she said. “They’ve seen enough studies to show that it pays for itself.”
However, not all employers are willing to cough up the extra funds to cover employees who previously weren’t eligible for company health insurance. One of the largest in the Cass County area was Ivy Tech Kokomo Region, which announced in June it was cutting the hours of some of its adjunct faculty to avoid having to provide them with health insurance.
It was either cut hours or find another $10 million to provide insurance to adjunct faculty previously ineligible for the college system’s health insurance coverage, Kokomo regional chancellor Steve Daily has said.
Other employers have taken a different tack, said Murphy, viewing the additional insurance coverage or wellness incentives as a long-term investment in their workforce — which, if it’s healthier longer, can continue working at an older age, bringing with them the experience and knowledge they’ve gained.
“A lot of employers are getting that picture,” she said.
To register for the seminar at Ivy Tech-Logansport, call the Logansport-Cass County Chamber of Commerce at 574-753-6388. Cost for lunch is $5 and seating is limited to the first 100 attendees.
Sarah Einselen is news editor at the Pharos-Tribune. She can be reached at email@example.com or 574-732-5151. Twitter: @PharosSME
WHAT: Healthcare reform seminar answering questions about health insurance exchanges WHEN: 11:30 a.m. to 1 p.m. Oct. 17 WHERE: Ivy Tech-Logansport, 1 Ivy Tech Way COST: $5 for lunch INFO: The seminar will cover Indiana health insurance exchanges, Accountable Care Organizations, Medical Home Models and the future of patient care, as well as how to communicate necessary information to employees. It's targeted toward management positions in any business setting. RSVP: Call Teresa Zimmerman at 574-753-6388 or email firstname.lastname@example.org