Focus on 2014: A Tampa Bay Economic Forecast

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Carl Patten, director of the Florida Blue Center for Health Policy, presented a forecast of the health policy environment in Florida, and how it impacts Pinellas businesses in particular. His …

Carl Patten, director of the Florida Blue Center for Health Policy, presented a forecast of the health policy environment in Florida, and how it impacts Pinellas businesses in particular. His presentation included the current state of the Affordable Care Act, and its ongoing implications for employers. For more information, visit http://ow.ly/sNeN7.

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  • We have an array of digital sites and member engagement capabilities designed to attract and educate the marketplace on BCBSF products and services:Better You From Blue – (BYfB) is a program designed to help employers motivate employees to take an active role in understanding their health status and live a healthy lifestyle. Worksite health fairs include health screenings, health risk assessments, biometric screenings, and health coaching.WorkSite Clinics Better Now Health Clinic – (BNHC) provides a medical clinic on the Deerwood campus for BCBSF employees to receive primary care services. It offers an easy and convenient way to manage your health care and time, while also reducing personal health care costs through lower fees and incentives. The Care Consultant Team (CCT) is a specialty high end call center that helps consumers with complex and important health care issues – enable consumers to make good health and financial decisions.

Transcript

  • 1. Central Pinellas Chamber of Commerce Focus on 2014: A Tampa Bay Economic Forecast Carl Patten, JD, MPH Director, Florida Blue Center for Health Policy Health Care Policy: 2014 and Beyond January 21, 2014 1
  • 2. What are we talking about? • Snapshot and outlook of the health policy environment • Brief Profile of Pinellas County • Moving forward, through the perspective of Florida Blue • The Florida Blue Center for Health Policy Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association.
  • 3. The ACA and a bit more Update and impact of the ACA Managing through change Employers and the ACA State and Federal Environment
  • 4. ACA Enrollment Snapshot 12/31/13 • Total Enrollment: • 2.153 million Overall • 158,030 in Florida • Categorized by type of marketplace • 957,000 - State-Based Marketplace • 1.2 million - Federally-Facilitated Marketplace (Supported or run by HHS) • Percentage Enrolled by age • Ages 18-34 (24%) – target is 39% of 7 million (2.2 million) • Ages 55-64 (33%) • Financial assistance • 79% overall • 83% in Florida • 80% in FFMs • 78% in SBMs Source: Department of Health and Human Services, Office of the Assistant for Planning and Evaluation Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 4
  • 5. The anticipated impact of the ACA • More money will be spent on health care • Projected share of health care spending of GDP in 2020 is 19.2%. • Projected private insurance health expenditures increase more and its proportionate share of health care spending declines more slowly • Slows projected growth of Medicare spending • Increases projected growth of Medicaid spending. Source: Centers for Medicare and Medicaid Services, Office of the Actuary Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 5
  • 6. Projections and gospel are two different things (at least in the short term) • Generally health care spending growth has slowed significantly since 2009. • In 2012 national health expenditures decreased to 17.2% of GDP from 17.3% in 2011. • Projections for 2012 were 17.9% of GDP • Annual growth for 2012 was projected at 3.9% versus actual growth of 3.7% • However the ACA will have its predicted impact, the question is to what degree Source: Centers for Medicare and Medicaid Service, Office of the Actuary Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 6
  • 7. MANAGING THROUGH CHANGE Competition 3Rs Cost-sharing Subsidies Premium Subsidies Health Insurance Tax Essential Benefit Changes Age Rating Compression New Market Rules Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 7
  • 8. To Cover or Not To Cover …? • Employer mandate delayed to 2015 • Costs and benefits of coverage • Cost of penalties • Recruitment • Tax credits for small business (sunsets in 2015). Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 8
  • 9. Small Business Health Options Program (SHOP) • Allows small employers up to 50 full time employees to purchase health insurance coverage for employees • In 2014, small employers will work directly with insurers to enroll in SHOP coverage • In 2015, a SHOP marketplace website will be available for enrollment • Employer choice model • Tax credit sunsets in 2015 Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 9
  • 10. State Environment • Alignment with ACA will not be robust – – – – Substantially done with ACA requirements to align state and federal law Redefining group size Guessing game, new world, no experience Adversarial environment is magnified • Medicaid Expansion • The safety net in Florida – Low Income Pool, Disproportionate Share Payments • Issues on the horizon – Provider scope of practice – Telemedicine – Prior authorization and step therapy Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 10
  • 11. Federal Environment • Election year environment • Implementation of the ACA – Health plan regulation • SGR Reform • Balancing responses to the ACA and antitrust concerns • Active rule making and aggressive enforcement efforts by the IRS – – – Scrutiny of nonprofit tax status Unrelated business income Engagement of political activity by social welfare organizations Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 11
  • 12. Pinellas Demographics, Public Health and Wellness
  • 13. Pinellas, Demographics and Economics • Health care is important to the economy – • Medicare – – • Pinellas is getting older. Over 25% of population will be 65 and older. Although Medicare spending will increase, there will be downward pressure on reimbursements Medicaid and Subsidies – – • 12.5% of the employees are in the health care and social assistance sector Although income is projected to increase, 14% of households will make less than $15,000 annually in 2018. 400% of FPL for a family of two is over $62,000 annually. Hillsborough – – – Robust health care sector Median age is 10 years younger than Pinellas Median household income is about $3,000 higher than Pinellas Source: Pinellas County Economic Development and U.S. Census Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 13
  • 14. Pinellas, Public Health and Wellness • Some very bright spots – – • Opportunities for improvement – – – – – • Communicable and infectious diseases, particularly STDs Infant mortality Immunization of children in kindergarten Unintentional injuries Domestic violence Pinellas indulges, but only so much (so does Hillsborough) – – • Access to care (financially and doctor to population ratio) Favorable mortality rates regarding heart disease and cancer Least favorable rating regarding overweight adults Most favorable rating regarding obese adults Hillsborough – Similar profile, worse regarding communicable and infectious diseases Source: Florida Charts Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 14
  • 15. MOVING FORWARD AT FLORIDA BLUE 15
  • 16. MISSION, VISION AND VALUES To help people and communities Mission achieve better health A leading innovator enabling Vision healthy communities Respect, Integrity, Imagination, Values Courage, Excellence 16
  • 17. HOW HEALTH CARE IS CHANGING… Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 17
  • 18. Our Delivery System is becoming a Mosaic of Value Models 2 1 Bundled Payment Pilots 2 Patient Centered Medical Homes (PCMH) 7 3,5 Medicare Collaborative Care Models 3 1 Staff Model HMOs Physician Groups 4,6 2 1 ACO Models 18
  • 19. RETAIL CENTERS 19
  • 20. Florida Blue Center for Health Policy
  • 21. Florida Blue Center for Health Policy FIVE PILLARS COST QUALITY OF PUBLIC POLICY ACCESS FREE MARKET PUBLIC HEALTH Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 21
  • 22. The Immovable Object vs. The Irresistible Force Florida Blue is an Independent Licensee of the Blue Cross and Blue Shield Association. 22
  • 23. QUESTIONS? FLORIDA BLUE CENTER FOR HEALTH POLICY • Website: www.floridablue.com/healthpolicy • Email: carl.patten@floridablue.com • Phone: 904-905-4411 • Twitter: @carlwpattenjr