Tag Archives: health insurance

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In Florida and everywhere, a big shift is underway. It’s changing the way we go to the doctor.

Jewell Hamilton, left, and Andre Curry attend the front desk at Florida Blue in Tampa, where consumers can get wellness checks in addition to buying insurance. [MARTHA ASENCIO RHINE | Times]

By Justine Griffin for the Tampa Bay Times 

The health care business in Florida and across the nation is the midst of monumental change as insurers, hospital chains and even retailers begin to venture outside their traditional roles.

Hospitals are getting into the insurance end of the business. Insurers, along with drug stores, are delivering front-line health care.

And consumers, confronted with blurring lines and a host of new options, may need a scorecard to keep up. The shifting ground continues to change where and how they go to the doctor.

BayCare, which operates 15 hospitals in Tampa Bay and the surrounding area, next month will become the second health system in the state to sell Medicare Advantage plans, the privately offered insurance policies through which many people receive their Medicare benefits.

Two other chains, Florida Hospital and Orlando Health, are providing HMO insurance plans to thousands of Disney employees this year, with hopes of expanding the model to include other employers.

Meanwhile insurance companies, from Florida Blue to UnitedHealth, are gobbling up physicians practices and creating large networks of doctors offices that offer clinical services under new company banners.

And retailers like CVS and Walgreens continue to push more toward the front lines of health care, offering online doctors’ visits and an expanding list of other medical services.

It all adds up to an industry in the middle of a shake out, executives and experts say, with players on all edges trying to stay relevant by expanding what they do.

“This is a trend that’s been emerging over the last five years,” said Peter Young, a hospital consultant. “It’s increasing each year as providers discover that they need to move up the food chain.”

Driving many of the changes is the Affordable Care Act, which helped usher in a shift in thinking about the cost of health care. Hospitals are penalized more often by insurance companies and the government when patients have more frequent stays. The focus now, Young said, is keeping patients out of the emergency room.

“What we’re seeing is that ER visits are flattening or declining all over America as health systems begin to focus on prevention,” he said. “They are redirecting non-emergent people to urgent care, and urgent care is perfect for that. That’s also why you see CVS and Walgreens getting into and expanding their clinic business.”

Read more here. 

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Tampa Bay Times: At Moffitt, a push to ease cancer’s toll in the workplace

By Justine Griffin

Cathy Bishop, a retired teacher and assistant principal in Hillsborough County, is in remission after treating stage IV colon cancer at Moffitt Cancer Center in Tampa. The disease affected key decisions about her career and retirement. [Photo courtesy of Moffitt Cancer Center]

Cathy Bishop worked as a teacher and assistant principal at Hillsborough County schools for nearly 35 years when she found out she had colon cancer.

Diagnosed after a routine colonoscopy, she had to make a tough decision about how she was going to let the disease impact her career. She would rely on the health insurance offered to her through the school district to pay for medical bills that stacked up because of chemotherapy and surgery. But ultimately, Bishop chose to work through her diagnosis and treatment plan instead of taking medical leave.

“My retirement is a teacher’s pension, which is half a salary. Basically, not much,” Bishop said. “I have two sons, and one of them was in law school at the time. I had to make a decision that was best for my family.”

Bishop told her story Monday to a room full of professionals from some of the Tampa Bay region’s largest employers. Tech Data, Port Tampa Bay, the YMCA and the city of Orlando government were just a few of the organizations in the audience at the Moffitt Cancer Center in Tampa. Moffitt hosted its first ever “Employer Forum,” where doctors and administrators shed light on the cost of cancer and its huge impact on the workforce. They also proposed a new way of collaborating with insurers to make treatments more affordable for patients like Bishop.

“It’s a topic that’s hardly ever mentioned in the workplace, but the employer plays a big role in terms of support for the patient and their family,” said Dr. Louis Harrison, chief partnership officer at Moffitt and one of several physicians who shared stories about how difficult it can be for patients to balance work and cancer.

“Just recently I was treating a patient with neck and head cancer who was worried a test was going to take too long,” he said. “He told me he had to get back to work or else they were going to be angry with him. What a predicament.”

Read more here.

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Tampa Bay Times: For many, rising premiums for Part B Medicare will erase Social Security gains

By Justine Griffin

Christopher Wittmann, a physician assistant, examines a patient for lower back pain at Trinity Pain Center in Pasco County. Outpatient health care visits like this are covered under Medicare Part B, which will see premium increases of more than 5 percent on average in 2018. Medicare open enrollment begins Sunday and runs through Dec. 7, with a special extension to Dec. 31 for people affected by the recent hurricanes. [Times | 2014]

More than 2.4 million seniors in Florida rely on Medicare, and a good chunk of them could face rising health care premiums next year.

With Medicare’s annual open enrollment period beginning Sunday, most of the changes to plans and services seem slight for 2018. But experts say Floridians will be among the millions affected nationwide by anticipated rising premiums for Part B plans, which cover outpatient care, doctor bills, physical therapy and more routine health services.

Part B is optional to enroll in and costs most people a monthly premium, which was on average around $134 in 2017, depending on the enrollee’s income. However, participants paid around $109 a month if they chose to have the monthly fee deducted from their Social Security checks. These are the prices that will rise in 2018, analysts say.

And, for many, the hike will eat up most of the 2 percent increase in Social Security payments that the government announced on Friday. Typical recipients will get $27 more in their monthly check in 2018, but experts estimate that Part B premiums paid through Social Security will likely be $20 to $30 more a month.

Read more here.