New data show major improvements in health care access, affordability, and quality in Tennessee under the Affordable Care Act
Tennessee families saved $2,100 from slower growth in employer premiums since 2010
New studies released this week show Tennesseans are experiencing slower growth in health care premiums, increased access to coverage, and higher quality of care under the Affordable Care Act (ACA).
· More Affordable: The average premium for families with employer-sponsored health plans grew just 3.4 percent in 2016, according to the Kaiser Family Foundation and Health Research and Educational Trust survey, extending a period of unusually slow growth since 2010. The White House Council of Economic Advisers calculates that the average family premium in Tennessee was $2,100 lower in 2015 than if premiums had grown at the same rate as the pre-ACA decade.
· Greater Access: Only 10.3 percent of people in Tennessee went uninsured in 2015, new Census data show, down from 14.4 percent in 2010. That dramatic drop means 266,000 more Tennesseans had coverage in 2015.
· Better Quality: Hospital readmissions for Tennessee Medicare beneficiaries dropped 8.7 percent between 2010 and 2015, according to new data released by the Centers for Medicare and Medicaid Services. In 2015, that drop translates into 2,905 times Tennessee Medicare beneficiaries avoided an unnecessary return to the hospital.
“Affordability, access, and quality are how we measure success in the health care system,” said Secretary Sylvia Mathews Burwell. “This week’s data show Tennessee is making progress on all three under the Affordable Care Act.”
Making Health Care More Affordable for Tennessee Consumers
An independent analysis released this morning by the Kaiser Family Foundation finds that the average family premium for the 150 million Americans with employer-sponsored health plans increased by only 3.4 percent in 2016. Since 2010, the average family premium has increased an average of 4.7 percent per year, compared to 7.9 percent from 2000 to 2010 – a 40 percent reduction in growth.
Workers’ contributions to premiums have also increased an average of 4.7 percent per year since 2010, compared to 9.5 percent during the previous decade. Meanwhile, another Kaiser study found that total enrollee cost sharing (counting deductibles, coinsurance, and copayments) increased an average of 4.1 percent per year from 2010-2014, compared to 7.1 percent from 2004-2010.
Using data from both the Kaiser Family Foundation Survey and the Medical Expenditure Panel Survey, the White House Council of Economic Advisers analyzed how the slowdown in premium growth has benefited families in Tennessee. Between 2010 and 2015, family premiums for the 3,369,000 Tennesseans with employer-sponsored coverage grew an average of 4.2 percent per year, compared to 6.9 percent from 2000 to 2010. That slowdown saved Tennessee families $2,100 in 2015. If Tennessee premiums grew at the national average of 3.4 percent for 2016, those savings will grow to $2,800.
Other metrics of health care cost growth have also slowed sharply since the ACA was enacted. For example, health care prices have grown at the slowest rates in 50 years, and Medicare spent $473 billion less from 2009 to 2014 than it would have if previous spending trends had continued. As independent experts have noted, the ACA has contributed to the health care cost slowdown through Medicare provider payment reforms that have had spillover benefits for the rest of the health care system; through direct incentives for health care providers to improve quality and reduce costs, for example by reducing hospital readmissions and hospital-acquired infections; and by laying the groundwork for more fundamental delivery system reform.
Expanding Access to Coverage in Tennessee
Last week, new data showed that the national uninsured rate fell to a record low of 8.6 percent in the first quarter of 2016, following the Health Insurance Marketplace’s third open enrollment season. Yesterday, the Census Bureau released its first detailed data on how the ACA’s coverage expansions have benefited Tennessee in 2015. Tennessee’s uninsured rate was 10.3 percent in 2015, a sharp reduction from the 14.4 percent the same survey showed for Tennessee in 2010.
The dramatic drop in the uninsured rate means that 266,000 more Tennesseans had coverage in 2015. That increase reflects the combined effects of the ACA’s coverage reforms, including the creation of the Health Insurance Marketplace, tax credits that help families afford coverage, the end of coverage exclusions for people with pre-existing conditions, and letting young adults remain enrolled on their parents’ plans. But if Tennessee followed 31 other states and adopted the ACA’s expansion of Medicaid, an additional 180,000 Tennessee residents would gain coverage, according to Urban Institute estimates. In 2015, that would have brought Tennessee’s uninsured rate to 7.5 percent.
These gains are on top of other improvements in access to coverage and care for Tennessee residents thanks to the ACA. For example, no matter where they get their health insurance, consumers now have access to free preventive services, and their plans now have limits on out-of-pocket costs and no annual or lifetime limits on coverage.
Improving the Quality of Care for Tennessee Patients
Beyond gains in affordability and access, the ACA is also helping deliver better outcomes for patients. For example, hospital readmission rates have fallen sharply as new incentives put in place by the ACA took effect. New data released yesterday by the Centers for Medicare and Medicaid Services show that hospital readmissions dropped by 8.7 percent for Tennessee Medicare beneficiaries since 2010. That means that Tennessee Medicare beneficiaries avoided 2,905 readmissions just in 2015, compared to if readmissions had stayed constant at 2010 rates.
Programs that prevent unneeded readmissions are just one part of the Administration’s broader strategy to improve the health care delivery system by paying providers based on the results they achieve, unlocking health care data, and finding new ways to coordinate care and improve quality. Thanks primarily to the ACA, more than 30 percent of traditional, or fee-for-service, Medicare payments now flow through alternative payment models that reward quality over quantity. This is helping to catalyze a system-wide shift toward better care, smarter spending, and healthier people.
While the impact of these changes will grow over time, health care quality has already improved since the ACA was enacted. For example, since 2010, the rate of patient harm in U.S. hospitals has fallen by 17 percent. Cumulatively since 2010, this translates into 2.1 million avoided patient harms, like infections and medication errors, an estimated 87,000 avoided deaths, and over $20 billion in savings.