Debbie Perlman Blog

The fast paced way of life has put our health on the back burner, leading to an increased risk of illnesses. While the healthcare industry is getting better in terms of quality of care available, the cost the treatments have also increased significantly. Even a small illness can lead to huge spending on your part. A good way to be prepared for any such medical emergency is to get a health insurance plan.  A good health insurance plan in USA will usually include a host of benefits, covering expenses such as the doctor’s fee, ambulance charges, pre- and post-hospitalization charges, cashless service among others. For making the right selection, it is highly advisable that you compare the health insurance plans available in USA, and choose the one that suits your needs and requirements the best. The best health insurance plan for you will depend on various factors, like the kind of coverage you want, and how much premium you can afford to pay. Types of Health Insurance...

Medicare is vital to the health of nearly 60 million Americans. Yet many of its benefits are overlooked, underused or misunderstood. Consider the annual "wellness" visit, during which a doctor will assess your health risks, take your blood pressure and other routine measurements, check for cognitive impairment, and offer personalized health advice. It's free. Yet less than 11% of Medicare beneficiaries took advantage of the benefit in 2012, according to the Dartmouth Institute for Health Policy and Clinical Practice. Recent research suggests that number hasn't budged much since then. That's not the only Medicare benefit left lying on the examining table. Many healthy seniors pass up a host of free preventive services, ranging from bone mass measurement to cancer screening–"the kinds of things that people don't generally think of if they're not sick," says Bonnie Burns, a consultant at California Health Advocates. Other benefits, such as...

Most Americans have private health insurance. This is a big monthly expense and one that many would prefer to do without. But what are the advantages and disadvantages of a country using this type of health care system? Read below to find out. Advantages: 1. You Choose Your Doctor In the private healthcare system, you often have more flexibility in choosing a doctor as well as a medical facility. For patients that want the same doctor all the time, this can be a very important advantage of this type of system. 2. Shorter Wait Times If you are having surgery that is necessary but not life-threatening, there are often long wait times. In a private health insurance system, the patient will often have shorter wait times because the medical facility is less busy. And even if there are a lot of people waiting, you can often bypass the line by paying a little bit extra for faster medical attention. 3. Improved Facilities Unfortunately, because the public sy...

The cost of your Medicare Part D-covered drugs may change throughout the year. If you notice that prices have changed, it may be because you are in a different phase of Part D coverage. There are four different phases—or periods—of Part D coverage: Deductible period: Until you meet your Part D deductible, you will pay the full negotiated price for your covered prescription drugs. Once you have met the deductible, the plan will begin to cover the cost of your drugs. While deductibles can vary from plan to plan, no plan’s deductible can be higher than $415 in 2019, and some plans have no deductible. Initial coverage period: After you meet your deductible, your plan will help pay for your covered prescription drugs. Your plan will pay some of the cost, and you will pay a copayment or coinsurance. How long you stay in the initial coverage period depends on your drug costs and your plan’s benefit structure. For most plans in 2019, the initial coverage period ends after you have ...

During the 2018 mid-term elections, candidates faced off with bold claims to fix the broken healthcare system. So what is the new congress doing to improve healthcare and fix the gridlocked political system? Beyond political maneuvering, 2018 saw material changes in the business of healthcare, including the increased pace of mergers and acquisitions as well as new measures from CMS to support transparency, interoperability, and a continued shift to value-based payments. These changes have significant ramifications for health systems in 2019 as the pace of change continues to increase. Health systems constantly have to adapt to changes in their communities, populations, politics, and reimbursement structures. Understanding the current climate and the upcoming healthcare trends can help them stay abreast of important changes and be prepared for the future in order to stay financially viable. This article examines the impacts of the biggest changes to the healthcare landscape in ...

We have been writing the predictions for healthcare every year now for the past 10 years. We also review back how we did each year and each year we are getting to be more accurate. The 2018 predictions that were released in December 2017 were almost 98% accurate and each one of them panned out during the course of the year. Globally, 2019 will be a year of value-based care as we expect the ‘outcomes-based care’ focus to globalize. This will trigger maturation of risk-sharing in solution contracting between providers and drug/device original equipment manufacturers (OEMs), driving business value for providers. Furthermore, access to affordable and quality care will be key political agendas for upcoming 2019 elections in emerging markets such as Asia, Africa and, Central and Eastern European countries. As the lines between retail, IT and healthcare industries continue to blur, during 2019, Google, Apple, Facebook and Amazon (GAFA) in the West, and Baidu, Ali Health, Tencent (BAT) ...

State legislative sessions in 2019 bring new opportunities to advance policy that improves health care coverage, value, and equity. With new governors in 17 states, and hundreds of freshman lawmakers, 2019 also brings opportunities for states and advocates to improve health care and health overall through legislative action. This advocacy agenda offers options for improving health and health care at the state level during the 2019 session. Bills passed and considered in the 2018 session provide a foundation for health care policymaking in 2019, but there are also new frontiers to explore for health care coverage, equity, and value this year. Here we provide state policy options to consider in 2019 regarding private insurance coverage, Medicaid, oral health coverage, health equity, prescription drugs, surprise medical bills, and health care value. Improving Private Insurance Coverage Efforts to undermine the framework of private health insurance have threate...

As health care industry leaders look to shape the future of care and establish a sustainable smart health community, how can they better collaborate with stakeholders—both within the health care ecosystem and those in converging industries? As the US health care industry moves toward a financial model that is based on value rather than volume, keeping people healthy and out of the hospital will be key. In a fee-for-service (FSS) model, health systems generate more revenue when patient volume increases. But under a value-based model, a person who shows up at an emergency room or a doctor’s office becomes an expense rather than a source of revenue. Rather than seeing people as patients, health systems should treat them more like members. This shift can help strengthen customer loyalty, build brand and reputation, and even improve the health of our nation. As the industry continues to move toward this value-based system, here are a few trends US health care organizations s...