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Life Health > Health Insurance

3 things to know about PPACA World news

By Allison Bell

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A group of five private exchange firms have hired Leavitt Partners to help them set up a new trade group, the Private Exchange Coalition (PEC).

PEC hopes to develop and share data standards and give information to consumers, employers, insurers and policymakers, organizers say.

See also: Health insurers choose their pipes

The founding member companies are Array Health, Bloom Health, ConnectedHealth, Connecture and Softheon.

The founding co-chairs are Simeon Schindelman of Bloom Health, who has also been an executive at Medica Health Plans and UnitedHealth Group Inc. (NYSE:UNH), and Ryan Howells, a Connecture executive. 

The founding leadership team also includes Jonathan Rickert of Array Health; Paul Neutz of Array Health; Ann Mond Johnson of ConnectedHealth, Eugene Sayan of Softheon, Michael Hendershot of Softheon, and several representatives from Leavitt Partners, including Rich McKeown.

For more news from a health insurance market reshaped by the Patient Protection and Affordable Care Act (PPACA), read on.

Time clock

Who’s working how much?

ADP, a payroll and human resources company, looked at aggregated data for about 75,000 U.S. client organizations with 10 million employees and found evidence that reports of PPACA leading to the demise of the full-time job may be exaggerated.

PPACA defines a full-time worker as a worker who works 30 or more hours per week, and some have suggested that employers will try to reduce exposure to the PPACA “play or pay” employer mandate by taking aggressive steps to hold down worker hours.

ADP analysts found that that the share of people in its sample who were working less than 30 hours per week fell to 13.3 percent in 2014, from 13.6 percent in 2013, and that the share of workers who were working 30 to 34 hours per week fell to 4.2 percent, from 4.7 percent.

The share who were working 35 or more hours per week increased to 82.4 percent, from 81.7 percent.

Even in the leisure and hospitality industries, which are viewed as being dominated by employers keen on limiting full-time equivalent counts, the percentage of workers working fewer than 30 hours per week increased only modestly, to 34.2 percent in 2014, from 33.5 percent in 2013, ADP says.

The hours of leisure and hospitality workers who typically worked about 20 to 29 hours per week varied about as much in 2014 as in 2013, and that also suggests that any efforts to limit hours were similar in 2013 and in 2014, ADP says.

See also: ADP: Major employers quickly learning to play by PPACA rules

Toothpicks

How skinny are those networks?

Dan Polsky and Janet Weiner, analysts at an institute affiliated with the University of Pennsylvania, report in a paper distributed by the Robert Wood Johnson Foundation that exchange plan networkers really do seem to be much narrower for cancer doctors than for primary care doctors.

The analysts came up with a system for classifying networks as extra-large, large, medium, small or extra-small.

The analysts found that about 8 percent of the silver-level preferred provider organization (PPO) exchange plans had extra-small provider networks, overall, compared with 14 percent of the silver health maintenance organization (HMO) exchange plans.

About 14 percent of the silver plans had extra-small primary care physicians networks, and only 7 percent had extra-small dermatology and ophthalmology networks. But 28 percent of the plans had extra-small oncology networks.

Only 23 percent of the silver plans had large or extra-large oncology networks. For the other categories of providers reviewed, such as primary care physicians and surgeons, at least 44 percent of the silver plans had large of extra-large networks.

The analysts say they believe that they have shown that it’s possible to come up with a simple plan to help consumers understand how big various plans’ networks are, and that helping consumers compare network size will be important to helping consumers understand coverage options. 

See also: California may add provider network checkers

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