Medicare helps Aetna's ailing income

As reported by the Associated Press, Aetna faced third quarter losses this year. Although they saw their third quarter profits decrease 44% to $277.3 million, they still saw their revenue increase in healthcare premiums which doubled 8% to $5.09 billion. Medicare premiums increased to $1.21 billion and Medicaid raced ahead to $154.3 million, which accounted for an increase of 72%. Membership of Medicaid also increased 1% to 17.7 million members, which balances out the loss of those with a Medicare membership.

DragNet Technologies Helps Health Care Providers

For the past 10 years, Medicare and Medicaid physicians have seen their profit margins shrink from 25% to just under 6%. Much of this change has been attributed to increasing complexity in recording and coding systems. Mentioned here, DragNet Technologies has

"announced the availability of their downloadable medical billing code lists directed toward the needs of healthcare providers all across the United States, especially in the Home Health arena." The article further mentions that "DragNet's goal is to arm healthcare providers in our country with the necessary information to get paid - and get paid quickly - for the services they have provided to Medicare and Medicaid patients"

Hopefully this will help Medicare and Medicaid physicians, and create a trickle down effect to help patients. With increased ease, more physicians maybe inclined to participate in these programs.

Cost of Health Care

In a recent report from the Centers of Medicare & Medicaid Services, they announced that Medicaid spending will grow at a rate of 7.9% over a 10 year period, with the cost estimated at $674 billion in 2017. It was also noted that the growth rate of the economy at 4.8%, and of health expenditures at 6.7% is lower. By 2013 it is expected that this cost will compromise 8.4% of federal budget in comparison to last years cost of 7%. It was noted in this article that

"Health and Human Services Secretary Mike Leavitt said the analysis was a reminder that Medicaid spending is on an unsustainable path that might threaten the health of the nation’s most vulnerable citizens."

Nothing is Free: The Problem with Free Drug Samples

Many altruistic doctors give patient drug samples to uninsured patients; thereby, helping the patient to receive the proper medication and save the patient money. Doctors may not be aware that they are actually causing the cost of prescriptions to rise for the uninsured by having a plethora of prescriptions at hand in the office.

This problem does not affect Medicaid directly, as its common practice for Medicaid patients to receive generic prescriptions.

David P. Miller, M.D., lead researcher and internal medicine physician at Wake Forest Baptist said, that "One possible explanation, Miller said, is that because Medicaid patients rarely receive samples, doctors' prescribing decisions for these patients were based purely on what drug they thought was best and not on what samples happened to be available in the closet."

For the uninsured or those that receive free samples; they can be doing wonderfully on the prescribed drug given to them in sample form. But what happens when the samples at the doctor's office run out? Filling the prescription at the pharmacy would crash their budget and may cause health problems.

Overall, patients need to speak with their doctor about their financial and insurance situations. Doctors can then prescribe patients with low-cost/generic drugs for treatment; instead of what is readily available in the office supply closet.

How do you feel about free samples at the doctor's office? How do you think this will affect Medicare patients?

Sources:
News-Medical.Net
CNN
US News & World Report

Marketing Documents for Medicare Prescription Drug Benefits is Confusing

The Wall Street Journal blog discusses how marketing brochures for Medicare prescription drug plans are doing a bad job of meeting guidelines set forth by the feds in this latest post.

A report published by the inspector general’s office in the Department of Health and Human Services found that 85% of marketing materials did not meet guidelines set out by the Center for Medicare and Medicaid Services. Some problems with the documents are that a lot of marketing documents that are produced in conjunction with an insurer and a pharmacy fail to mention that other pharmacies are available. This is required by law. Another problem is that some documents do not include required information on the subsidy that is available to beneficiaries with low incomes.

Medicare and Medicaid Rise to the Top

The Wall Street Journal blog reports that while the share of Americans that got health insurance through work or bought it on the private market last year declined, the number of Americans insured through Medicaid and Medicare has increased. These are numbers based on the latest report from the US Census Bureau.

This change shows that there is an overall decline in the percentage of Americans who are uninsured, and this goes against recent trends of rising uninsurance rates. See the full report here.