Word: milliman
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Dates: during 2000-2009
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...image as an earthly paradise. But Miami's reputation for dysfunction is on display again this spring as the Obama Administration shifts health-care reform into high gear - and a spate of studies slams the Magic City as the poster child for exorbitant medical costs. This week the Milliman Medical Cost Index listed the 2008 average private-provider costs for a Miami family of four - $20,282 - as the highest among the 14 major U.S. cities it studied, adding that more than 40% of that amount came out of Miamians' own pockets. That echoes recent analyses by Medicare, Dartmouth College...
...almost a third of those savings could be achieved by targeting Miami and other warped medical markets like it. Miami's inordinate health-care outlay - 20% more than the national average - "is not a pretty picture," says Kate Fitch, a principal and health-care consultant for the Seattle-based Milliman Inc. consulting firm and a co-author of its Index. That's especially true since Miami-Dade County also has one of the country's lowest median incomes ($43,495). "If the [Miami] area's practice patterns continue as they are," says Fitch, "employees there could be approaching a breaking...
...Reports like the Milliman Index, however, point up the just as troubling relation between high health-care costs and low-wage demographics like Miami's. Cities and regions with higher income and education rates tend to have access to more efficient health-care plans. In turn, they bear health-care costs that, while they might seem high in places like New York City (which is second behind Miami in the Milliman Index), are usually more in line with what residents can afford and require relatively less out-of-pocket contributions. Locales like Miami, by contrast, often offer residents "less access...
...Fitch of Milliman notes, the most urgent prescription is to get payers and providers in cities like Miami "to be more penalized and incentivized" on the cost-savings front. Even if health-care plans stopped paying hospitals for unnecessary inpatient stays, others says, that kind of abuse still won't end if the plans don't also stop paying patients' doctors for visits during those stays - a major moneymaker for physicians. Those doctors should instead be motivated, financially or otherwise, by plans to focus more on preventive health-care treatments. Either way, when it comes to reforming health-care albatrosses...
That's not to say that if you are fit you don't need a financial plan. "Good health has a high value in dollars," says Bruce Pyenson, an actuary at health consultants Milliman. "But it's not enough for you to stop saving." He says your savings goal, if you are healthy, should be 10 times your final salary, and significantly more if you suffer a chronic health problem such as cardiovascular disease or diabetes...