Employers should consider how these new tax credits could affect their low-and moderate-wage employees. Those employees could potentially find it more advantageous to access coverage through the exchange using tax credits. But their access to employer-provided coverage would prevent them from doing so. Employers should consider the implications of such a scenario.
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
TAXES THAT ADD TO THE COST OF DOING BUSINESS New hidden taxes that will drive up premiums and health care costs The ACA establishes several new taxes that many employers know little about. MVP estimates the ACA’s new hidden taxes will cause about a 5-percent premium increase above current cost trends in 2014, and similar significant increases in subsequent years. The Health Coverage Tax The ACA imposes a health coverage tax beginning in 2014. MVP has estimated this tax will cause premiums to increase by approximately 3 percent per year in its service area. The Market Stabilization Tax Also beginning in 2014, the ACA layers a market stabilization tax on health coverage. MVP estimates that this tax will cause premiums to rise by an additional 1.5 percent above current cost trends when implemented at its maximum rate. The Device and Pharmaceutical Taxes Starting in 2011, the ACA imposes a 2.3-percent excise •8•tax on the sale of virtually every medical device. Also beginning in 2011, theACAimposes an excise tax on businesses that manufacture or import certain branded prescription drugs. This tax will be apportioned to companies according to market share. These taxes will drive up the cost of care, causing an escalation in health coverage costs. MVP will continue to urge Congress to repeal these taxes. Excise Tax on “Cadillac” health plans Beginning in 2018, a 40 percent excise tax – the so-called “Cadillac tax” – will be assessed on health coverage premiums in excess of $10,200 for individuals and $27,500 for families. Assuming current trends, health coverage that provides just average benefits would likely be implicated by this tax. Payroll tax changes affecting employers and employees Starting in 2013, individuals earning more than $200,000 and families earning more than $250,000 will pay an additional Medicare tax equal to 0.9 percent of their wages over those threshold amounts. Additionally, a 3.8 percent Medicare payroll tax will apply to investment income that exceeds the $200,000/$250,000 thresholds. Employers are not required to pay any additional matching taxes. But employers will need to adjust withholdings for affected employees. EMPLOYERS LOSE KEY TAX DEDUCTION The ACA eliminates the tax deduction currently available to employers for federal subsidies they receive to provide prescription drug coverage to their Medicare-eligible retirees. NEW LIM
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
Participatory Wellness Programs – Participatory programs are available without regard to the health of an individual. Such programs might include reimbursement for fitness center membership, attending monthly no-cost health education seminars, or taking a health risk assessment. Participatory programs have no rewards or contingencies other than participation in the program.
b. Health Contingent Wellness Programs – Contingent wellness programs usually require individuals to meet certain health standards for a reward. Examples of contingent programs might include rewards reduced tobacco use, and rewards for achievement of a specified cholesterol level or other biometric standard.
2) How do Wellness Programs Impact Employers? The most notable aspects of the wellness programs prom
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
I maintain that the Patient Protection and Affordable Care Act focuses on protection and ignores affordability. Yes, there are cost containment efforts built into the ACA , but they are not entirely up to the task.
These cost containment efforts include payment reform initiatives that seek to shift away from a fee-for-service model through capitation, accountable care organizations and bundled payments. A pilot program here, a readmission rate penalty there and a few demonstration projects—these build the case for major change rather than build major change itself. In any case, it will take time—years—before any of those innovations can make a significant dent in health care costs.
In the meantime, here’s an idea that I think would make a big difference: require hospitals and physicians to establish standard fees.
Let’s look at hospitals, for example. As it is now, not only do costs for certain procedures vary by region, they vary by hospital—and within hospitals. A widely discussed study published last spring in the Archives of Internal Medicine showed the cost of an appendectomy in California in 2009 ranged from $1,529 to $182,955. That’s nuts. And not even nuts in a predictable way, such as if that high end of the range represented, say, privately insured people in San Francisco hospitals and the low end Medicare patients at a county hospital. The median was $33,611. Within individual hospitals, the charges varied as much as $100,000.
Of course, appendectomies aren’t the only issue. A previous study, also in California, found hospital hysterectomy charges ranged from $3,500 to $65,300; gallbladder removal charges ranged from $2,700 to $36,000 and a colonoscopy screening cost anywhere from $350 to $5,805.
Wouldn’t it be great if hospitals set a price for each procedure? Sure, there might be complications, or treatment options that carry different fees, but those could be accounted for in a fee schedule that’s available to the public.
A set price would eliminate cost-shifting, wherein those with private insurance are charged more than those with Medicare (and those without insurance are charged even more). It would, in an area with competing hospitals, give patients and doctors the chance to comparison shop.
Making hospitals (and physicians) commit to a standard price for a procedure would go a long way to helping us all better understand health care pricing. And it would be a first, immediate step toward reining in health care costs.
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
I maintain that the Patient Protection and Affordable Care Act focuses on protection and ignores affordability. Yes, there are cost containment efforts built into the ACA , but they are not entirely up to the task.
These cost containment efforts include payment reform initiatives that seek to shift away from a fee-for-service model through capitation, accountable care organizations and bundled payments. A pilot program here, a readmission rate penalty there and a few demonstration projects—these build the case for major change rather than build major change itself. In any case, it will take time—years—before any of those innovations can make a significant dent in health care costs.
In the meantime, here’s an idea that I think would make a big difference: require hospitals and physicians to establish standard fees.
Let’s look at hospitals, for example. As it is now, not only do costs for certain procedures vary by region, they vary by hospital—and within hospitals. A widely discussed study published last spring in the Archives of Internal Medicine showed the cost of an appendectomy in California in 2009 ranged from $1,529 to $182,955. That’s nuts. And not even nuts in a predictable way, such as if that high end of the range represented, say, privately insured people in San Francisco hospitals and the low end Medicare patients at a county hospital. The median was $33,611. Within individual hospitals, the charges varied as much as $100,000.
Of course, appendectomies aren’t the only issue. A previous study, also in California, found hospital hysterectomy charges ranged from $3,500 to $65,300; gallbladder removal charges ranged from $2,700 to $36,000 and a colonoscopy screening cost anywhere from $350 to $5,805.
Wouldn’t it be great if hospitals set a price for each procedure? Sure, there might be complications, or treatment options that carry different fees, but those could be accounted for in a fee schedule that’s available to the public.
A set price would eliminate cost-shifting, wherein those with private insurance are charged more than those with Medicare (and those without insurance are charged even more). It would, in an area with competing hospitals, give patients and doctors the chance to comparison shop.
Making hospitals (and physicians) commit to a standard price for a procedure would go a long way to helping us all better understand health care pricing. And it would be a first, immediate step toward reining in health care costs.
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