AHRQ: Health insurance premiums jumped more than 30 percent from 1996 to 2000

The average annual health insurance premium in 2000 was $2,655 for single coverage and $6,772 for family coverage in private-sector establishments, an increase of 33.3 percent and 36.7 percent respectively since 1996, according to new data from the Agency for Healthcare Research and Quality. Establishments are either businesses in a single location or individual worksites of a larger corporation.

The data from the Insurance Component of AHRQ’s Medical Expenditure Panel Survey provide detailed trend information on health insurance costs and characteristics between 1996 and 2000, as well as state-by-state breakdowns.

Details of the data include:

• Since 1997, the first year that data on retirees were measured, there has been a significant decline in the number of employers who offer health insurance to their retirees of any age. Offerings to retirees under age 65 have dropped from 21.6 percent in 1997 to only 12 percent in 2000. Offerings to retirees 65 and older have dropped from 19.5 percent to 10.7 percent over the same period.

• The proportion of private-sector establishments that offered health insurance rose from 52.9 percent to 59.3 percent between 1996 and 2000. In 2000, almost 90 percent of all employees worked for establishments that offered this coverage, compared with 86.5 percent in 1996.

• Although their employers generally offered health insurance coverage, the portion of private-sector employees actually eligible for coverage fell from 81.3 percent in 1996 to 78.9 percent in 2000. Some employees may not have been eligible because health insurance was offered only to management or was based on length of service or full-time status. Among those eligible workers, enrollment in plans dropped from 85.5 percent to 81.2 percent over the five years.

AAFP study: Number of physicians refusing to take new Medicare patients increased this year

A study released in July by the American Academy of Family Physicians reported 21.7 percent of the 1,664 physicians surveyed have stopped accepting new Medicare patients. This number is up from 17 percent last year.

“The formula used to calculate the Medicare physician fee schedule updates is seriously flawed,” the AAFP said in a press release this July. The formula resulted in a 5.4 percent reduction in the reimbursement rate for physicians and other health providers in January 2002 and more cuts are predicted if the formula isn’t changed, according to the report.

While efforts continue in Washington to reform Medicare and reverse the current schedule of reimbursement cuts, the Bush administration recently proposed more reductions in Medicare payments for a variety of drugs and medical devices. The cuts come as part of a new structure for paying hospitals for outpatient services.

TAFP Board of Directors votes to promote HeartCare Partnership

You have a 58-year-old female patient who suffered an acute myocardial infarction six months ago. She underwent revascularization and though she is stable, managing her care is complex.

An electronic tool makes monitoring and measuring just how well you care for her and all your other patients with cardiovascular disease a great deal easier. It’s part of the TMA HeartCare Partnership program. This computer software program lets you look at and evaluate exactly what kind of care you’re providing.

The tool provides HCP participants with an electronic means of collecting and reporting cardiovascular disease management data. Are you monitoring and achieving good blood pressure levels? Are you placing patients on appropriate medications? Are you counseling patients to stop smoking? Are you caring for the particular cardiovascular disease needs of your diabetic patients? These are the kinds of questions this tool lets you track and see in easy to read electronic chart form.

Your TAFP Board of Directors recently voted to support and promote HCP. As a TAFP member, the HCP software program is available to you at no cost. Logon to www.texmed.org

to download the free software. To learn more about HCP, please contact Bridget Butler at TMA by phone (800) 880-1300 ext.146, or by e-mail at heartcare@texmed.org.

Family physicians endorse Sanchez for governor

The TAFP Political Action Committee, TAFPPAC, has endorsed Tony Sanchez for governor.

“Now, perhaps more than ever before, Texas needs a governor who understands the importance of affordable, quality health care that is accessible to all Texans,” says Lloyd Van Winkle, M.D., chair of TAFPPAC and a practicing family physician in Castroville, Texas.

“Tony Sanchez’s vision for Texas is clear,” Van Winkle says. “Mr. Sanchez is committed to ensuring every child has access to affordable, quality and preventive health care. He will protect the Children’s Health Insurance Program and enact Medicaid reforms to reduce administrative burdens placed on physicians.”

According to the most recent TAFP member survey, the greatest challenge facing family physicians today is the increased cost of running a practice while contending with the slow pay, low pay, no pay tactics of the managed care companies. A major component of this increased cost is medical liability insurance.

“Rick Perry’s veto of our prompt pay bill, which was passed unanimously by the Texas Legislature and his inattentiveness to Texas’ medical liability crisis has placed patients’ access to care in critical condition,” Van Winkle says. “Tony Sanchez understands this threat and will declare professional liability and prompt payment reforms as legislative emergencies to fast-track passage by the Legislature.”

 “Quality patient care is at a critical crossroads in Texas and much is at stake for our patients,” Van Winkle says. “We believe Tony Sanchez is the best choice to protect the patients of Texas and assure access to quality health care.”

West Nile virus update

Texas is on alert in response to the recent increase in cases of West Nile virus. Three years ago, the virus appeared on the East Coast and this summer it made its first appearance in Texas, according to the Texas Department of Health.

To date, the virus has been detected in humans, horses, birds and mosquitoes. At press time 1,641 cases have been reported nationally resulting in 80 human deaths. Locally, Texas has seen 84 cases of the virus and two fatalities.

The virus, which can cause encephalitis, was first detected in the United States in New York in 1999, and has been found in 37 states and the District of Columbia. It is usually spread through the bite of an infected mosquito. Scientists have recently concluded that the virus can be transmitted through blood transfusions and trace amounts of the virus have been found in breast milk.

West Nile infections are usually mild with flu-like symptoms including fever, headache, sore throat, body aches, fatigue and swollen lymph nodes. Those most at risk are the elderly and people with weakened immune systems. Less than one percent of people who are bitten by an infected mosquito become severely ill.

TDH has developed a West Nile virus response plan with the goals of educating the public and tracking the virus. Local health departments are obligated to report all human cases with symptoms and supporting lab results for West Nile virus to TDH. Physicians with symptomatic patients should contact their TDH regional office or the TDH Zoonosis Division at (512) 458-7255 prior to inquiry about test availability and specimen submission. Diagnostic specimens of symptomatic patients should be sent to the TDH laboratory for serologic testing and confirmation.

According to TDH, the best way to reduce the risk of West Nile encephalitis and other mosquito-borne illnesses is to reduce the chances of mosquito bites. People can eliminate mosquito breeding sites by removing standing water around the house, mosquito-proof homes by checking screens, avoid outdoor settings heavy with mosquitoes and wear insect repellent if they must be outside.

For additional information contact the TDH Infectious Disease Epidemiology and Surveillance Division at (512) 458-7674 or the Zoonosis Control Division. More information can be found at www.tdh.state.tx.us.