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Higher premiums lead workers to opt out of health coverage
Workers are less likely to sign up for health insurance from their employer when they must pay a larger share of its cost, according to a recent analysis by the Kaiser Family Foundation. Research shows that workers will forgo their employer’s coverage and could end up without any health insurance if they have to pay too much for it.
An estimated 160 million Americans obtain their health insurance through their job or a family member’s job. Premiums for employer-sponsored health coverage averaged $11,500 for family coverage in 2006, with workers required on average to pay $2,900 toward the cost of that coverage. Workers’ contributions to their health premiums vary greatly, however, and this study examines how those variations can affect the likelihood that a worker will accept, or “take up,” his or her employer’s coverage. The Kaiser study looks at the rate workers take up their employer’s health coverage, based on the share of the premium they are asked to pay and the company’s size, industry and wage level. While some workers do not accept health insurance even when they have to pay nothing or a small share of the cost, the analysis shows a drop in the take-up rate among workers as their share of premiums increases—with low-wage workers generally less likely to take up coverage across the board. The data suggests that some offers for health coverage are considered less affordable to workers in low-wage jobs and could lead some to forego coverage and become uninsured.
Health professionals miss chances to improve patient care
Although the overall quality of healthcare in the United States is improving, providers are missing important opportunities to help Americans avoid disease or serious complications. The National Healthcare Quality Report and the National Healthcare Disparities Report, annual publications issued by the Agency for Healthcare Research and Quality (AHRQ), found that the use of disease prevention and management strategies lags significantly behind other gains in healthcare. According to AHRQ, the greatest quality gains occurred in hospitals, where quality improved 8 percent. Ambulatory care improved by 3 percent, and nursing home care and home healthcare improved by 1 percent.
While there have been improvements, the study also revealed some failures in patient care, especially in the areas of prevention and management of chronic or potentially deadly conditions. For example, fewer than half of obese adults reported being counseled about diet; only 49 percent of people with asthma said they were told how to change their environment, and 28 percent reported receiving an asthma management plan; and only 48 percent of adults with diabetes received all three recommended screenings—blood sugar tests, foot exams and eye exams—to prevent complications.
“It’s encouraging to learn that overall quality continues to improve,” says AHRQ director Carolyn M. Clancy. “At the same time, the message is clear: Much more can be done to prevent illness from occurring or progressing.”
Both reports are available online at www.ahrq.gov/qual/nhqr06/nhqr06.htm.
Coming to a store near you: Convenient Care Clinics
A new breed of healthcare clinics is poised to explode across the country, Nursing Spectrum magazine reports. Convenient care clinics are small healthcare facilities located in high-traffic retail outlets such as Target or CVS that provide affordable and accessible nonemergency healthcare to consumers who otherwise would have to wait for appointments with a traditional primary care doctor.
The clinics are usually open seven days a week and are staffed by nurse practitioners, physician assistants or physicians. Services range from treatment of common ailments such as sore throats or colds to preventive health screenings.
These clinics “have evolved at a time when our healthcare system is floundering and the need for accessible, affordable healthcare is at its greatest,” says a report from the Convenient Care Association, which represents the clinics. The industry has said it plans to roll out thousands of clinics across the nation in the next few years.
“The importance of the whole convenient care industry is related to patients who want quality care, access to care and convenient care,” Ken Miller, president of the American College of Nurse Practitioners and a board member of the CCA, told Nursing Spectrum.
“People need to have healthcare, but can’t afford insurance,” Miller said. Retail clinics with nurse practitioners will likely come forward to fill those gaps, Miller said. “I’m predicting that in the next five years, nurse practitioners will become the gatekeepers for primary care in this country,” he said.
