Many Employers to Offer “Skinny” Insurance Plans in 2015

According to a survey by the National Business Group released earlier this month, as many as 16 percent of large employers will seek to minimize their healthcare costs next year by offering low-benefit, or “skinny”, plans to their employees.

The companies that will offer skinny plans versus fully ACA-compliant plans were not identified by their industries in the survey; however, traditionally companies with a high percentage of low-wage employees have taken the most advantage of those plans. Skinny plans are considered “minimum essential coverage” by ACA standards by virtue of being employer-provided, but are often lacking other key features that roll into that distinction.

Skinny plans allow employers to avoid a penalty by simply offering a plan, and purchasing one allows the employee to avoid individual mandate penalties by enrolling in a healthcare plan with lower premiums. Unfortunately, the benefits to individuals end there. Some plans cover nothing but preventive care, and all plans feature exorbitant deductibles that can make actually seeking care an unaffordable option should the employee ever require it.

Another significant blow to employees at these companies is that they will not qualify for subsidies to purchase better coverage on state or federal exchanges because their employer offers an ACA-compliant plan, regardless of whether they enroll in that plan or not.

The effect of skinny plans on healthcare costs to providers and vendors remains to be seen.

PRN Funding offers a variety of customized healthcare factoring solutions to healthcare vendors in order to cover operating costs – including providing insurance. To learn more about healthcare factoring or medical receivables factoring and apply for service, contact PRN Funding today.

CHS Data Hack: Is Your Company’s Information Secure?

While the tech security industry’s discovery of the Heartbleed bug in April made few mainstream headlines, its impact on information security became front-page news this week. Community Health Systems announced a massive security breach in which hackers gained non-medical information about approximately 4.5 million patients in their database.

According to a source “close to the CHS investigation”, the group responsible for the breach gained access by exploiting an unpatched occurrence of the Heartbleed bug in a Juniper device used by the hospital group. Once in, the attacker logged in via a VPN and was able to move deeper into the network.

The Heartbleed vulnerability was discovered in April in networking equipment distributed by Cisco and Juniper – unarguably two of the largest names in business networking equipment. The bug compromised the security of data encryption on IP networks, both internal and external. A patch was quickly developed, yet by June more than half of the infected sites on the internet had failed to apply it.

Security breaches are troublesome in every industry due to the potential for financial loss and identity theft, but in the healthcare industry there could be legal repercussions as well. Healthcare providers and vendors could be in violation of HIPAA regulations governing patient privacy even if the information compromised does not include details of their care.

Is your company’s information secure? Below are some best practices to ensure security now and in the future.

Make sure you’re secure.

Conduct an audit of your security as soon as possible. If you don’t have in-house IT professionals, schedule an appointment with a reputable third-party consultant to review your system. The IT professional will identify areas of potential vulnerability to address, as well as best practices to employ moving forward.

Educate your staff.

Human error accounts for a large portion of security breaches, so be sure that your employees are vigilant about information security. Remind them of basic protocol, such as not opening email attachments from unfamiliar email addresses, and advise them to be careful when downloading any extraneous programs onto their system. (In fact, you may simply prohibit the use of non-work-related software.)

Staff adherence to security procedures extends to their use of company hardware outside the workplace. Emphasize the importance of keeping work computers and devices safe when they are in the employee’s personal possession – after all, if a work laptop is stolen from an employee’s car then your information is equally at risk.

Use multiple layers of security.

Use different passwords for different programs, and give them an increased level of complexity – letters, numbers, and characters combined will help to thwart “dictionary attacks” run on the words within passwords. There are a number of passcode generators that you can use for a string of random characters. Reset your passwords regularly, and don’t write them down.

Update your anti-virus and antispyware software regularly to benefit from new definitions, and use an intrusion detection program to identify and block illegitimate attempt to access the system.

Encrypt your data

Protect the information in your network no matter where it goes. For communications including sensitive information, use an email encryption to secure the data against prying eyes.

Back up your data!

Always have a working hard copy of your data that you can use to restore the system in case the information is lost or compromised in a security breach. There are reputable online backup services that you can use as well, but the best practice is to also have a copy offline that you can access manually.

Protect mobile devices connected to your network.

If you work away from your office, either on a home network or a mobile device (laptop, tablet, phone), make sure that the security settings on those devices are also up to date. If it is an option, restrict the use of business-related information to devices that are owned and distributed by the business.

Have an updated security policy.

All of the above tips should be regular practices in your security policy, which you should always follow and periodically reevaluate. Other policies to consider may include:

  • Restricting who can access your network via VPN and when
  • Prohibiting staff from sharing security information over the phone, no matter what
  • Requiring that work hardware not be taken off the premises without authorization

Information security is a large investment of both time and money, but it is one of the most critical investments you can make in the longevity of your business. While you may not be able to thwart every potential attack on your data, having established security practices and following them will help you to recover more quickly and minimize the damage that an attack can cause.

If you lack the cash flow to invest in information security, PRN Funding can help. Our comprehensive healthcare factoring and medical accounts receivable factoring programs help healthcare companies from nurse staffing agencies to medical billing companies and more turn their open invoices into working capital that they can use to support their business – including its information security. Contact PRN Funding to learn more about healthcare factoring and medical accounts receivable factoring services.

Should Voluntarily Uninsured Patients Lose Charity Care?

Now that the Affordable Healthcare Act’s healthcare marketplaces and policies are in effect, hospitals are considering whether those who decline health coverage should benefit from charitable care.

The issue of whether to discontinue charity care for the voluntarily uninsured is tricky and, according to some, more a question of whether their denial of insurance indicates unwillingness to pay or an inability to pay. Some patients fall into the gap between Medicaid coverage and affordable subsidized care, while others who may be eligible for subsidized insurance are still unable to afford the high deductibles featured in lower-tier plans.

Other questions include whether patients were aware of available coverage options or if they were able to sign up during open enrollment. On the other hand, a significant though unsubstantiated concern about charitable care programs is that uninsured patients will be dissuaded from enrolling in a healthcare plan if they know that charitable care is an option. This could result in greater financial difficulty for hospitals receiving less government assistance to cover uninsured patients, particularly in states that declined Medicaid expansion.

For the moment, many hospitals are considering the effects of a change and have therefore not made any updates to their charitable care policies. Hospitals that have changed their programs have done so in a number of ways:

  • Reducing income threshold for additional assistance
  • Requiring a “nominal” contribution for care
  • Requiring patients to apply for coverage before they can benefit from charitable care (note: this is an existing practice in most hospitals)
  • Disqualifying aid to patients that refuse to enroll in coverage for which they are eligible (including Medicaid)

Regardless of hospitals’ decisions, all hospitals are required to clearly state their charitable care policies in compliance with the ACA and they must make “reasonable efforts” to qualify patients for aid before pursuing them for collections.

As hospitals absorb the financial changes of full ACA implementation, healthcare vendors must be prepared for any changes in payments. PRN Funding’s dynamic healthcare factoring options help healthcare vendors working with hospitals, doctors’ offices, and other healthcare facilities to shore up their cash flow by converting open invoices into immediate cash. Contact PRN Funding today to learn how healthcare factoring can help your company and to get started right away.

Walmart: Rolling back prices…on healthcare?

It started with a discount prescription medication program, offering generic drugs to patients for as little as $4 or even for free. It expanded in recent years to include retail clinics in conjunction with local hospital systems and partnerships with leading national hospitals. Now, it could be a tipping point for the future of accessible health care.

“It” is Walmart’s deepening involvement in health care, marked by the opening of five primary-care clinics in Texas and South Carolina – right in the store. They plan to increase the number to approximately 12 by the end of 2014.

At $40 for a walk-in visit (less for employees), Walmart clinics boast a lower price point than most primary-care clinics. In addition, they are open longer: one clinic in Texas, for example, is open for 12 hours on weekdays. The clinics are staffed by nurse practitioners in an agreement with QuadMed.

A number of experts have pointed out the wisdom of Walmart’s primary-care strategy and its consistency with other corporate strategies. The company has opened clinics slowly, after significant planning, and has begun developing clinics in areas that are in the greatest need of affordable health care.

Texas and South Carolina both have cost-related problems with primary care access: neither state approved a Medicaid expansion, leading to a larger uninsured population, while both states have higher percentages of poverty and other adverse contributing factors such as obesity and substance abuse. In these environments, clinics that provide not only easy but low-cost access will likely prove to be competitive with their traditional healthcare counterparts.

The initial incongruity of Walmart’s involvement in healthcare is actually a reflection of a new trend toward retail healthcare, which we touched on briefly in our last post on bidding for medical procedures.

In order to remain competitive as health care and insurance change in the coming years, healthcare vendors must be prepared to adapt and seek out new opportunities for providing care. PRN Funding offers a number of dynamic healthcare factoring options to help you build the working capital to expand your operations. To learn more or complete an application, contact PRN Funding today.

Patients can Shop Online for Medical Procedures

Consumers can shop online for cars, clothes, and even romantic partners – but medical care?

Yes, medical care.

Medibid, an auction site founded by Ralph Weber, offers patients the opportunity to solicit bids for a variety of medical procedures from doctors enrolled on the site. For a tiered subscription fee, patients and doctors alike can either place or bid on single requests or unlimited requests. Once the patient accepts a bid that covers the full cost of the procedure, they make arrangements directly with the physician and pay for services by cash or credit card in full.

Proponents of bidding for medical service, including Weber, argue that this development is an organic evolution of the online marketplace that will allow consumers to take control of their healthcare spending in a way that insurance providers and hospital systems do not. Medibid providers, who are largely in small practices or run their own surgery centers, are able to charge lower fees without compromising their profit margins because they can skip the costly step of billing insurance plans.

However, a number of critics point out several drawbacks to the online auction approach to medical care despite acknowledging the difficulty of navigating (and paying) hospital prices. Red flags include fewer regulations of physician-owned outpatient centers, lack of “quality indicators” to support the doctors bidding on procedures, and the potential for complications that are not covered by the Medibid agreement.

Hospitals may be getting the message – a number of hospitals around the country are beginning to post their procedure prices (minus surgeon’s fees) on their Web sites. The aim of hospitals that choose to do so (and the states that have mandated the practice) is to help patients make the best decisions for the care based on price and quality.

PRN Funding offers a number of healthcare factoring options to help healthcare vendors close the cash flow gap. Learn more about healthcare factoring solutions for your company and apply today.

Technology is Changing Healthcare as We Know It

Technological advances in healthcare have been touted as game-changers: advanced equipment for better results and faster care. For every updated practice that truly improves efficiency and lowers cost, however, there are a handful of other developments that simply raise the cost to patients without creating better solutions.

Unfortunately, inefficient and expensive advances have created new revenue streams by complicating the care process for patients and making more follow-up appointments necessary. On top of that, many healthcare systems pass on the cost of large equipment to their patients by raising the cost of different procedures.

All of that could change as the economics of healthcare change. New technologies such as exam adapters for mobile devices and 3D printing are already in production and may be the new wave of efficient and low-cost patient care, but in order to embrace these technologies and remain relevant in a value market hospitals and health care systems will need to completely transform the way they do business.

In hospital fee structures that move away from the traditional fee-for-service format, for example, practitioners will have to shift their focus to doing what works best to treat a patient rather than doing what they can bill more for. Moreover, the entire infrastructure of care must be adapted to incorporate new technologies so they are not only accessible but also secure and compliant with federal privacy regulations.

That said, if hospitals and medical groups choose to move toward integrated technology they have the potential to make healthcare not only less expensive in the long run, but truly better.

PRN Funding provides immediate working capital to help healthcare vendors cover expenses and invest in new technologies. Learn more about how healthcare factoring can transform your company and request a free factoring quote now.

Federal Court Rulings Could Threaten ACA Subsidies

Two divergent Circuit Court rulings last week on the legality of ACA subsidies could spur the Supreme Court to consider the case, with potentially lethal implications for the law’s mandates.

The Affordable Care Act provides for subsidies, or tax credits, to qualifying individuals purchasing healthcare plans on an online exchange. These subsidies have since been given to consumers on both state-run and federal exchanges, greatly increasing the ability of those individuals to purchase coverage that would otherwise be too expensive.

In two separate cases, Halbig v. Burwell (D.C. Circuit panel) and King v. Burwell (Fourth Circuit, Texas), judges considered whether the ACA’s rule on subsidies is applicable to all qualifying individuals or only those who purchased their insurance on state-run exchanges. Last Tuesday, each court handed down a decision based on its interpretation of the rule in question.

The Fourth Circuit ruled that the subsidy should be available to all consumers, whether their state’s exchange was state-run or federally administered. Their ruling is based on the legal doctrine of deference, which allows federal agencies to carry out a law as it sees fit if the language is ambiguous. The D.C. Circuit, however, relied on a literal reading of the law’s text to limit subsidy qualification to only the states that run their own exchanges.

Before the issue proceeds to the Supreme Court, the Department of Justice will request a review of the ruling by D.C.’s three-judge panel by the entire D.C. Circuit bench. It is possible that an en banc review will overturn the panel’s decision and bring the ruling in line with the Fourth Circuit.

This ruling has critical implications for not only the availability of subsidies, but also the individual and employer mandates of the ACA. Only 14 states chose to create their own healthcare exchanges; if the Supreme Court steps in and upholds the original D.C. ruling, as many as 90 percent of individuals in the other 36 states lose access to an affordable health care option.

Those who will be unable to purchase an affordable plan will also be exempt from the individual mandate, including the significant demographic of young and healthy consumers that are necessary to balance insurance costs. Furthermore, employers in the affected states may be exempt from their mandate.

As with other provisions of the ACA in dispute, it will likely be some months before there is a concrete decision. We will provide updates as they become available.

PRN Funding’s competitive healthcare factoring services transform the cash flow of healthcare vendors in a number of sectors. Contact us to learn how healthcare factoring can help you cover operating costs such as insurance and to get started today.

Would “Copper” Healthcare Plans Actually Be Worthwhile?

Several months ago, Senator Mark Begich (D) of Alaska proposed that the Obama administration add a new tier to the Affordable Care Act’s available healthcare plans. While the administration and other legislators weigh the benefits, significant potential issues have presented themselves.

The new “copper” plans would feature lower premiums than those for bronze plans – currently the least expensive full coverage available – and would cover 50 percent of consumers’ health costs. Patients would be required to pay the balance out of pocket. Copper plan subscribers would likely have a higher spending limit on out-of-pocket expenses than the current $6,350 individual/$12,700 family cap but would also be eligible for tax credits and subsidies.

Higher out-of-pocket costs are just one major concern with the idea of copper-level plans. Another associated issue is whether copper plans would be able to offer lower prices and still offer the comprehensive coverage required by the ACA. Jay Angoff of the Department of Health and Human Services questions whether passing on half of the cost of care to consumers can legitimately constitute “decent coverage”.

Furthermore, enrollment statistics through the March 31 deadline this year indicate that consumers are not particularly fond of low premium-high deductible plans. Approximately 65 percent of consumers chose subsidized or unsubsidized silver plans in the marketplace, while only 20 percent enrolled in bronze plans. Enrollment in catastrophic plans was even lower, at only two percent.

Copper plans would also pose a threat to healthcare spending in facilities and systems, turning back the reductions in spending reported by many systems thanks to newly enrolled patients. As copper plans are meant to attract young adults and others who have found even the bronze plans to be unaffordable, the risk of defaulting on higher deductibles is akin to the risk of non-payment by uninsured patients.

If the administration allows the creation of copper plans, consumers should expect to wait until at least the 2016 enrollment period to see these plans for purchase on the marketplace.

Does your healthcare company need more working capital to provide quality health coverage to your employees? Healthcare factoring helps vendors working with hospitals and other healthcare facilities to close the cash flow gap and invest in their business and employees – including in their health. Read more about PRN Funding’s healthcare factoring programs and contact us to begin today.

2015 Health Insurance Rates Vary by State

As health insurance companies begin establishing premium rates for the 2015 enrollment year, some insurers are pursuing substantial hikes while others are proposing modest increases and even some reductions.

Increases proposed by CareFirst in Washington, D.C. range from as little as four percent for higher-tier plans to more than 24 percent for a catastrophic plan. Other providers are also proposing mixed updates to increase certain plan premiums and reduce others. At the same time, UnitedHealthcare is proposing a reduction in all of their rates. Meanwhile, the average increase in New York is around 13 percent according to the state’s Financial Services Department.

Rate proposals in these and other states appear to be heavily tied to a number of factors, including the number of buyers who chose plans on different tiers during this year’s open enrollment period and the rising cost of medical care. Many insurers are attempting to compensate for larger populations of sick patients who use more care and for differences in health care markets.

However, some states’ proposals are more encouraging for consumers. Georgia, for example, has one statewide provider on their healthcare exchange but will welcome two more for the 2015 enrollment period. In addition, the current provider – Blue Cross and Blue Shield – has proposed statewide rate decreases.

Initial rate proposals are typically revised downward during pre-approval reviews by state regulators, so it is unlikely that the highest rates among those reported will go through as proposed. Also, patients who qualify for federal insurance subsidies through the healthcare marketplace will likely see those subsidies rise to match any rate increases.

Small business owners are likely to see at least modest increases in healthcare rates for 2015, among other rising costs of care. If you need a boost in working capital to meet these expanded operating costs, healthcare factoring with PRN Funding can close the gap. Explore the many healthcare factoring options for your company and contact us today to get started.

Bundled Payments May Be the Future of Hospital Billing

If you reside firmly in the 21st century you are likely very familiar with bundling. You can bundle your car insurance with your home and life insurance policies, your cable with internet and phone services – even your soda with your pizza. Hospital billing is picking up on the trend, and soon bundled hospital bills may become the norm.

Typical hospital billing involves individual charges for each element of a given stay or procedure, down to individual doses of ibuprofen. Provider services are billed separately. In a bundled billing plan, however, hospitals would consolidate these charges to a single fee for everything involved in a typical procedure.

Not only do bundled payments offer savings to patients, but they also provide an incentive to hospitals to provide efficient, high-quality care. Hospitals would keep the net funds remaining after a procedure completed under cost, but would be required to absorb any additional costs for extra care or complications.

Medicare is working with more than 300 health care organizations to provide bundled hospital payments for large-scale procedures such as heart surgeries, and other facilities are expected to follow. In the future bundled payments may include those for chronic conditions as well. Rob Lazerow of Advisory Board Co. points out bundled price tags can help hospitals “compete on cost and quality” for patients shopping around.

Hospitals that shift toward bundled payments will need to work with high-quality vendors to provide the best care to their patients. If you want to expand your healthcare company to work with these hospitals, PRN Funding’s healthcare factoring programs can provide the working capital you need to get everything in order. Contact PRN Funding to learn more about healthcare factoring in every sector and to get started today!

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