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A recent study by the nonpartisan Center for Studying Health System Change (HSC) in Washington, DC, found that beauty really is in the eye of the beholder, at least when it comes to what people think about their health plans. In other words, people rate their overall satisfaction levels with their health care programs according to what type of plan they think they have. Not surprisingly, people who think they have HMO plans ranked their overall satisfaction level as lower than that of non-HMO participants (or those who thought they were), and expressed a lesser degree of trust in their doctors. In fact, those who believed (correctly or incorrectly) that they were in an HMO rated the thoroughness of their last doctor’s visit as fair to poor, and said they doubted that they would be referred to a specialist even if they needed it.
According to James Reschovsky, lead author of the study, people’s "perception of what kind of health plan [they] are in colors [their] perception of what kind of care [they] receive and, ultimately, [their] level of satisfaction."
The study asked some 20,000 privately insured people the type of health insurance they had (which HSC later verified), as well as their feelings about their most recent medical visit, their trust in their doctors, and their overall satisfaction with the care they receive. The study found that nearly 25% of those surveyed incorrectly reported the type of plan they have; 11% believed they were in a plan other than an HMO when they really were, while 13% incorrectly believed that they were in an HMO.
The study looked at 10 criteria, and in every case, those who believed incorrectly that they were in a certain type of plan, whether HMO, point-of-service, or preferred physician organization, gave similar ratings to those who actually were in the plan. Interestingly, when researchers adjusted for those who had incorrectly identified their type of coverage, differences in health care ratings between HMO and non-HMO enrollees shrunk and in many cases, disappeared.
The Department of Health and Human Services inspector general’s office earlier this month released its annual work plan detailing its planned audits and inspections of hospitals. The 103-page plan outlines 19 areas the office will concentrate on, most of them carried over from the prior plan. Additions include Medicare payment for satellite long-term-care units, reporting of patient restraint deaths, and follow-up on peer review organizations’ complaint process. The plan also includes a greater emphasis on contractor compliance.
The Department of Health and Human Services (HHS) has announced the 2001 rates for the Medicare Part A deductible and Part B monthly premium amounts paid by beneficiaries.
Beginning in January, Medicare recipients will see their premiums rise $4.50 from the previous year to a total of $50. This is the first increase since 1999 when the premium rose $1.70. There was no increase in 1998. In fact, in the past six years, premiums have risen less than $1 when accounting for inflation. Part B premiums cover physician services, hospital outpatient care, durable medical equipment, and other services outside hospitals.
In addition to health care costs, this year’s increase reflects legislative changes that increase Part B spending. The beneficiary-paid Part B premium represents 25% of total Part B spending. Although premiums are rising by more than $4, this increase is considerably less than projected. Earlier predictions following the enactment of the Balanced Budget Act of 1997 (BBA) saw premiums rising from $43.80 in 1997 to $59.40 in 2001.
The Part A deductible for inpatient hospital care will rise by $16 to $792, a 2% increase reflecting savings from reductions in Medicare hospital payments and other program changes resulting from the BBA.
Last year, the deductible rose by $8. HHS estimates that the daily cost to beneficiaries for hospital days 61 through 90 in a benefit period is rising by $4, to $198 per day, and by $8, to $396 per day, for hospital days beyond the 90th in a benefit period.
The skilled nursing facility daily coinsurance amount, which must be paid after the first 20 days of such care in a benefit period, is rising by $2, to $99 per day.
The Part A premium, paid by only a small percentage of beneficiaries, is decreasing again, this time by $1, to $300.
That amount is paid by seniors with less than 30 quarters of Medicare-covered employment (and by certain people with disabilities who are under age 65, have lost disability benefits because of work and earnings, and have less than 30 quarters of Medicare-covered employment).
Seniors with 30 to 39 quarters of Medicare-covered employment (and certain people with disabilities who are under age 65, have lost disability benefits because of work and earnings, and have at least 30 quarters of Medicare-covered employment) are entitled to a reduced monthly premium, which is falling by $1 to $165.