IHA Daily Briefing: March 9

Friday, March 9, 2018

CMS Publishes 2018 Federal Poverty Level Standards
Study: Higher Risk of 2019 Premium Hikes in States
Did You Know?
Briefly Noted

CMS Publishes 2018 Federal Poverty Level Standards
This week, the Centers for Medicare & Medicaid Services (CMS) released an informational bulletin with the 2018 Dual Eligible Standards chart, which displays the new standards for Medicare Shared Savings Program categories. These standards are also available on CMS’ Medicaid website.

The standards are derived from the 2018 poverty guidelines, which were updated earlier this year:

  • $12,140 in annual income for a household/family of one;
  • $16,460 in annual income for a household/family of two;
  • $20,780 in annual income for a household/family of three
  • $25,100 in annual income for a household/family of four;
  • $29,420 in annual income for a household/family of five;
  • $33,740 in annual income for a household/family of six;
  • $38,060 in annual income for a household/family of seven; and
  • $42,380 in annual income for a household/family of eight.

For households/families with more than eight people, $4,320 is added for each additional person.

Study: Higher Risk of 2019 Premium Hikes in States
A new analysis from Covered California, the state’s health insurance marketplace, finds that every state in the nation is at risk for higher-than-normal premium increases over the next three years due to continued health insurance policy changes and uncertainty at the federal level. It estimates that without federal action, premium increases for every state could range from 12 to 32 percent in 2019, with cumulative increases from 2019-2021 potentially ranging from 35 to 90 percent.

Specifically, 17 states are identified as at a higher risk of cumulative premium increases of 90 percent or more, and 19 states, including Illinois, are categorized as at a higher risk of hikes of 50 percent. The analysis draws on each state’s marketplace enrollment trend and its Centers for Medicare & Medicaid Services risk score, which measures the overall health of the consumer pool in the state’s individual market and how it compares to the national average.

The report identifies several policy actions at the federal and state levels that could potentially ease uncertainty in the market, provide stability and mitigate the impacts of rate changes:

  • Instituting a federal state-based invisible high-risk pool or reinsurance program, which could reduce premiums in 2019 between 10 and 20 percent;
  • Directly funding cost-sharing reduction subsidies;
  • Providing additional subsidies to consumers to purchase insurance;
  • Increasing marketing and outreach investments, which could reduce premiums between 6 and 8 percent over three years; and
  • Introducing state-level policies.

For more information, see Covered California’s interactive map and press release.

Did You Know?
It’s often been said that an ounce of prevention is worth a pound of cure—a concept the Illinois Dept. of Public Health (IDPH) took to heart when it organized the first Better Baby Conference in 1915. In an effort to further the precepts of preventive medicine, the department arranged for physicians and nurses to publicly examine 250 children at that year’s Illinois State Fair—in full view of thousands of curious fairgoers. History does not record any controversy over patient privacy concerns: In fact, children with a clean bill of health were awarded blue ribbon certificates.

As demand for information about preventive healthcare grew, the Better Baby Conference was expanded to venues beyond the state fair throughout the 1920s. In 1923 alone, IDPH staff examined 7,851 children at 79 conferences. However, according to IDPH, by the late 1930s, the conferences had devolved into “baby shows” and had limited educational value. The department eventually discontinued these events in favor of more effective public education campaigns.

Alongside IDPH, Illinois hospitals and health systems have a long and distinguished history of medical firsts and achievements that have been critical to the health and well-being of the state and its citizens for the past 200 years.

As the state continues a yearlong celebration of its 200th birthday (Dec. 3, 2017 – Dec. 3, 2018), hospitals and health systems are encouraged to share stories about their notable achievements—including medical/healthcare firsts—that have played a major role in the state's history.

If you are interested in contributing your hospital's/health system's historical achievement(s), please contact IHA.

Briefly Noted
For hospitals that have designated IHA as their payee for the Managed Care Organization Hospital Access Program (MCO-HAP), IHA has executed an electronic funds transfer (EFT) in accordance with banking instructions provided by each hospital. The effective date for the EFTs is March 9 for both the March Assessment MCO-HAP payments and the February Affordable Care Act MCO-HAP payments. Hospitals may access reports of the payments on the IHA website (password required).

The U.S. Bureau of Labor Statistics released its February jobs report today noting that the U.S. economy added 313,000 jobs during the month. The unemployment rate was unchanged at 4.1 percent. Healthcare added 19,000 jobs for the month, with hospitals adding 9,000 of those jobs.