In Brief: Shortage of Pediatric Subspecialists
UCLA Examines Pediatric Subspecialty Shortage
A new study by the UCLA Center for Health Policy Research has determined that there is a severe shortage of medical specialists for the state's 1 million children with serious illnesses.
Although the new policy briefing concluded that 60% of California's children with special healthcare needs have health insurance coverage, nearly 40% of those have coverage that is
“inconsistent or inadequate to meet their needs.” And there is a pittance of such subspecialists in California: Just 1,701 in California, or one for every 588 children who have special healthcare needs.
According to the briefing, the shortage of pediatric subspecialists is tied to a lack of compensation for such physicians compared to other specialties – particularly from the Medi-Cal program – as well as a lack of integrated care. This is despite the fact that there is a correlation between reduced costs and increased quality when there is a greater access to pediatric subspecialists.
The report suggested that the use of telehealth and electronic consultations could ease the shortage. Additional payments and grants as part of the Affordable Care Act and other initiatives could also ease the shortage after 2014, according to the briefing.
Stanford: Chronically Ill Employees Pick More Expensive, Less Effective Health Plans
A new study by Stanford University’s business school suggests that health insurers are providing poor financial incentives to employees with chronic health conditions.
The study indicated that employees with chronic health issues tended to avoid health maintenance organizations, even though such a structure tended to provide the most coordinated care versus other kinds of health plans, and was often the least expensive option.
Within HMOs that had the tightest networks, the cost of caring for such enrollees averaged $309 a month, but was $413 a month within a preferred provider organization, and $509 a month for an HMO with a looser network.
As a result, costs for treating enrollees with chronic care issues rose by as much as 18% because enrollees were not receiving the optimal coverage or care.
The study's authors suggested that prices be adjusted so that the relative benefits of an HMO become clearer for high-risk employees. That could mean giving them an added discount for picking the HMO, or charging them an extra premium for choosing an alternative plan, according to the study’s authors.
Survey Says Tax Penalty Won’t Prompt Coverage Purchase
A new consumer survey by the Sunnyvale-based firm Healthpocket concluded the tax penalty imposed next year to encourage Americans to buy health insurance will be ineffective.
According to the more than 1,000 people surveyed, just 8% said the $95 tax penalty would be enough to encourage them to buy health insurance, while more than two-thirds said it would not.
The penalty will rise to a minimum $695 by 2016.
