More than six in 10 adults reported obtaining their health care through their employers. However, out-of-pocket costs have continued to rise over the years which has made health care increasingly unaffordable. A CDC-sponsored study revealed that on average, women had less affordable health care services than men.
A reason for this inequality could be that women have lower incomes and higher health care needs. Over the past two decades, however, health care has become less affordable for both men and women. Approximately 6% of women in 2020 found health care unaffordable compared to 3% in 2000. Additionally, 3% of men in 2020 believed health care was less affordable compared to 2% in 2000.
A new law that went into effect in Jan. 2023 says that insurance companies must provide online calculators for patients to get more details about what their final bill will be, including deductibles and copayments. There are approximately 500 nonemergency services that are considered “shoppable, " meaning patients will have time to weigh their options.
When a patient needs treatment, drug, or service, they will be able to log into the cost estimator on a website provided by their insurance company—or employer. The patient can then find the billing code based on the procedure. They can also enter in the name of a drug or dosage amount and receive pricing information.
Starting in 2024, these tools will need to be available on all treatments and drugs.
Source: Kaiser Family Foundation
Long-Covid is an illness that scientists are still learning more about. A recent study by the School of Public Policy and Urban Affairs at Northwestern University determined that certain socio-economic factors can be predictors of long-Covid.
These factors include lower income, being divorced or separated, being Hispanic, being female, and being gay or bisexual. The study found that a long-Covid diagnosis is more likely to lead to unemployment, financial problems, and an increase in mental health issues including anxiety and depression.
Unfortunately, there aren’t any standardized treatments or best practices for long-Covid which can make insurance coverage uncertain. According to the study, 14% of adults in the United States suffer from long-Covid.
Source: Fierce Healthcare
Chicago-based Jellyvision developed a platform for employees to choose the benefits that matter the most to them. Jellyvision recently acquired Picwell, which also helps employers provide better benefits for employees. Picwell uses predictive analytics to help employees choose the benefits that would be the most helpful to them.
Jellyvision developed and uses the ALEX platform, which uses behavioral science to guide employees to an optimal health plan. Continued use of behavioral science and even artificial intelligence will help employees refine their health care plans to best meet their needs.
Source: Built In Chicago
A new drug called Leqembi for Alzheimer’s Disease has been approved by the FDA, but those who need it will have to pay $26,500 per year. This price tag will limit the number of people who could benefit from the drug. Currently, there are an estimated 6 million people living with Alzheimer’s Disease in the United States.
CMS, which governs Medicare, will only cover the drug for patients who are currently in clinical trials for Leqembi. The drug slows the progression of Alzheimer’s Disease by targeting amyloid plaques in the brain. According to experts, it could cost CMS billions if they opened up coverage to those with Alzheimer’s who qualify for Medicare.
The standard for CMS to cover a drug is less about "is it effective and safe" and more about "is it reasonable and necessary” for the Medicare population. Current studies indicate Leqembi provided modest efficacy, therefore CMS is awaiting more studies before making a final decision.
Source: NBC News
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