Our Chapter had its yearly joint meeting with the Risk & Insurance Management Society (RIMS) and it was very informative for everyone in attendance.
Antoine Jackson and Sarah Kochis of Big Brothers Big Sisters (BBBS) of Metro Detroit shared the vision and mission of their organization and gave a great overview of the good works they do to mentor and assist youth in Metro Detroit. Students who have a big brother or big sister are 93% more likely to graduate on time and are positively impacted by the one on one interaction with an adult volunteer. The BBBS organization has various opportunities for mentoring whether it is one on one or through corporate sponsors who come in to work with to students to improve their lives. Individuals and corporations also work hard to raise money to support this great cause. Anyone interested in becoming involved can contact www.bbbsdetroit.org.
Healthcare Reform – Risk Implications was the meeting topic presented by Janet M. Vermuelen, CEBS and Jeremy Pecora, FCAS, MAAA of Towers Watson. They gave a detailed overview of the Patient Protection & Affordable Care Act (ACA) also known as “Obamacare”. Some of the major points were :
•Health Care Reform Act has a triple aim: to reduce costs, improve care for the individual and improve health for the entire population.
•Everyone gets insurance; not much will change with seniors but young people will likely pay more.
•Coverage is available during special enrollment periods and no insurance will result in a penalty
•Not all states are on board with the health care act even though they can obtain health insurance tax credit if they meet the financial criteria.
•Results through 12-31-13 are 2.2 million are signed up versus the 7 million expected in the first year. Many are expected to sign up at the last minute to meet the deadline of March 31, 2014.
•Accountable Care Organizations (ACO’s) are examining delivery of care and will be results oriented. Change in delivery of care to promote prevention and quality is the goal. Getting to approaches that work will be the key focus.
•Demand for medical services is a source of risk and uncertainty for the insurance industry. It is too early to know what the liability outcomes will be. Mandated coverage decreases uninsured population and focus on primary care and preventative medicine will increase demand. The impact on health care delivery systems will increase use of non -physician practitioners such as nurse practitioners, physician assistants, and pharmacists as health care extenders.
•The adoption of the health care reform initiative will give large incentives to providers to adopt electronic medical record capability and computerized physician order entry for easier coordination of care and better data for tracking and analysis.
•Coordination of care will cut out duplication of testing and provide better communication between physician and patient which may lead to better protocols.
•The private health insurance market faces uncertainty as it prepares for 2014 due to: Guaranteed issue/elimination of medical underwriting; modified community rating; minimum coverage requirements; limitations on out of pocket maximums, annual/lifetime limits and a transparent marketplace and rate stabilization programs.
•Public programs such as Medicare and Medicaid benefit from some reforms and provide platform for pilot programs.
In conclusion, the speakers said it is still too early to determine the actual impacts of Health Care Reform on coverages. The impacts will vary by state due to how health care is regulated/provided at the state level as well as tort and no-fault provisions. As insurance professionals we can prepare now to collect, analyze and monitor data which will allow us to be prepared to react in a timely manner.