Comp.- Health Care

Comp.- Health Care - Health Care Supplement 2 Organization...

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Health Care Supplement 2
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Organization Health Care Unlike pensions, healthcare produces positive current outcomes for organization Organization receives higher productivity, lower absenteeism from healthy workforce Organization has choice of paying higher wages or making workplace safer, healthier This called a compensating wage differential 3
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Medical and Other Health Benefits Overview Per Capita Expenditures 1960: $ 143 1993: $3,651 2008: $7,681 US Total Expenditures (billions) 1960: $ 27.1 1993: $ 917.3 2008: $2,300. 4
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Sources of Health Coverage in the U.S. - 2008 Employment Based – 61% Public – 19% Individual – 6% Uninsured – 17% Source: Employers, Workers and the Future of Employment-Based Health Benefits. EBRI Issue Brief 339, February 2010. p. 4 5
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Firms Offering Health Benefits (2009) Large Firms (200+ workers): 98% Small Firms (3 – 199 workers): 59% Smallest Firms (3 – 9 workers): 46% Source: Employers, Workers and the Future of Employment-Based Health Benefits. EBRI Issue Brief 339, February 2010. p. 5 6
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Average Employer Costs Number of Employees Average Total Health Benefit Cost per Employee 10 – 49 $7,720 50 – 499 $8,779 500 – 999 $9,276 1,000 – 4,999 $9,412 5,000 – 9,999 $9,589 10,000 – 19,999 $9,067 20,000 or more $9,146 7 Source: Mercer Consulting, cited in Employers, Workers and the Future of Employment-Based Health Benefits. EBRI Issue Brief 339, February 2010. p. 6
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Employer Actions if Health Care Reform Increases Employer Costs Likely Employer Action % Responding Very Likely/Likely Reduce benefits 87% Increase prices for customers 38% Reduce employment 30% Reduce salaries/direct compensation 27% Accept reduced profits 11% Other 6% 8 Source: Towers Perrin Health Care Reform 2009, cited in Employers, Workers and the Future of Employment-Based Health Benefits. EBRI Issue Brief 339, February 2010. p. 17
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Individual Determinants of Health Care Utilization Age Gender Sense of responsibility for personal health Clinical risk factors Personal perceptions of state of health Personal health behavior Attitudes about personal health Attitudes about health care use 9
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Organizational/Environmental Determinants of Health Care Utilization Extent and scope of insurance coverage Point of use cost sharing Geographic access to services Regional or local practice patterns Provider incentives affecting diagnosis and treatment decisions New technologies State and federal offerings/coverage mandates 10
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Typical Coverage Providers Self insurance Insurance companies Blue Cross/Blue Shield HMOs PPOs 11
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HIPPA Rules May not refuse to cover employee or dependent from coverage under group plan for these reasons Health status Medical condition (physical, mental) Claims experience Receipt of health care Medical history Genetic information Evidence of insurability Disability 12
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Changes in Health Care Offerings Year Conv. HMO PPO POS HDHP 1988 73% 16% 11% 1993 46% 21% 26% 7% 2003 5% 24% 54% 17% 2009
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Comp.- Health Care - Health Care Supplement 2 Organization...

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