Healthcare Roundup: Resident Physicians Unionizing, Higher Health Insurance Premiums Possibly Ahead & More

Resident Physicians Unionizing in CA, Other States

Resident physicians pushed to the brink during the coronavirus pandemic along with nurses and other healthcare workers, have been unionizing in California and other states to demand better wages, benefits, and working conditions.

Since March, resident physicians - those who have finished medical school and are in the process of completing the three to seven years of additional training under the supervision of a teaching physician required before they can practice on their own - have formed unions at Stanford Health Care and the Keck School of Medicine in California, as well as the University of Vermont Medical Center. And resident physicians and interns at three hospitals in Los Angeles County recently voted to strike over labor practices at those facilities.

None of the new chapters have negotiated contracts yet, according to the Committee of Interns and Residents, a national union that represents resident physicians and is part of the Service Employees International Union. But resident unions that have been around a little longer have had some successes. A resident union at the University of California, Davis, for instance, obtained parental leave and housing subsidies through contract negotiations last year. (FIERCE HEALTHCARE)

Smaller ACA Rebates Signal Higher Health Premiums Ahead

Health insurers will issue $1 billion in rebates in 2022 under the Medical Loss Ratio (MLR) provision of the Affordable Care Act, with most of that sum going to enrollees in the individual market, according to an estimate from the Kaiser Family Foundation. The MLR provision limits the amount of income from premiums insurers can keep for administration, marketing and profit, and requires insurers to return excess profit to enrollees in the form of rebates.

While substantial, the $1 billion in rebates is less than half the $2.1 billion in rebates last year. Kaiser said this year’s lower rebate total suggests premiums on the ACA exchanges and individual market may be going up more next year.

“After years of relatively flat premiums in the individual market, the higher loss ratios seen in 2021 may foretell steeper premium increases in 2023, as some insurers will aim for lower loss ratios to regain higher margins,” Kaiser’s analysis said. (KAISER FAMILY FOUNDATION, FIERCE HEALTHCARE)

AZ Doctors Seeking Advantage in Surprise Billing Disputes

Doctors in Arizona are working on a ballot measure that would extend new federal protections against surprise medical bills to patients with insurance plans operating in the state. But as drafted, the initiative would also remove a key element of the arbitration process provided for by the new federal surprise billing law, potentially allowing doctors to collect higher payments in disputes with insurers over out-of-network charges. The initiative has been tabled in Arizona for the time being, but it could spur similar measures in other states. (STAT)

NC Senate Approves Medicaid Expansion Bill

A healthcare access bill (HB 149) that includes Medicaid expansion received nearly unanimous approval in the GOP-led North Carolina Senate last week, marking a major shift in the state, where Medicaid expansion has been blocked by Republicans for the past decade.

“Medicaid expansion has evolved to the point that it’s good state fiscal policy,” said Sen. Ralph Hise (R), who formerly opposed expansion but helped draft the expansion bill.

Despite the decisive action in the Senate, House Republicans said they weren’t planning to take up the issue during their annual work session expected to end next month, which would likely leave the issue unresolved until next year. (ASSOCIATED PRESS, NEWS & OBSERVER [RALEIGH])

Study Finds Hospitals Overused During Pandemic

Hospitals across the country performed over 100,000 “unnecessary and potentially harmful” surgical procedures on older patients during the first year of the COVID-19 pandemic, according to a study by the Lown Institute, believed to be the first to measure hospital overuse during the public health emergency. Among the eight “low-value” procedures examined in the study were stents for stable heart disease, hysterectomies for benign disease, and spinal fusions for back pain. (LOWN INSTITUTE)

-- Compiled by KOREY CLARK