Healthcare News of Note: Americans have less confidence in the nation’s healthcare system

• Gallup: Americans are less confident in major U.S. institutions, including the nation’s healthcare system, than they were a year ago.
• The median proposed health insurance premium increase for 2023 is about 10%, according to a Peterson-KFF review of the preliminary rate filings of 72 insurers in 13 states and the District of Columbia.
• Lack of oral care in hospitals is believed to be a leading cause of hundreds of thousands of cases of pneumonia a year in patients who have not been put on a ventilator.

Over the last few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.   

1. Fewer Americans express a great deal of confidence in the country’s healthcare system and 10 other U.S. institutions

“Americans are less confident in major U.S. institutions than they were a year ago, with significant declines for 11 of the 16 institutions tested and no improvements for any,” according to a July 5 Gallup News article.

The country’s healthcare system saw a decrease in confidence, with 6% fewer survey participants indicating they had “a great deal” or “quite a lot” of confidence in it, according to the article. Only 38% of those surveyed had high confidence in the nation’s healthcare system, compared with 44% in 2021.

Similarly, confidence in the police and in organized religion dropped by six percentage points, with the former moving from 51% to 45% and the latter from 37% to 31%.

“Americans’ confidence in institutions has been lacking for most of the past 15 years, but their trust in key institutions has hit a new low this year,” wrote author Jeffrey M. Jones. “Most of the institutions Gallup tracks are at historic lows.”

According to Gallup, the country’s healthcare system in 2022 ranks fourth among the institutions in which survey participants showed the “highest confidence”:

1. Small business (68%)
2. The military (64%)
3. The police (45%)
4. The medical system (38%)
5. The church/organized religion (31%)

“Gallup summarizes Americans’ overall confidence in institutions by taking an average of the ratings of the 14 institutions it measures consistently each year — all but small business and large technology companies,” wrote Jones. “This year’s 27% average of U.S. adults expressing ‘a great deal’ or ‘quite a lot’ of confidence in those 14 institutions is three points below the prior low from 2014.”

2. Analysis highlights the projected average premium increase for ACA marketplace health plans in 2023

For health plans participating in the Affordable Care Act (ACA) marketplaces in 2023, the median proposed premium increase is about 10%, according to a Peterson-KFF Health System Tracker report. Published July 18, the report reviewed the preliminary rate filings of 72 insurers in 13 states and the District of Columbia. 

Peterson-KFF reviewed rate filings from plans participating in the ACA marketplaces “to track what insurers say will be driving premium growth in the coming year,” wrote the report authors.

“Most premium changes insurers are requesting for 2023 fall between about 5% and 14% percent,” wrote the authors. Compared to recent years, relatively few insurers have requested to lower their premiums, “with only 4 out of 72 insurers filing negative premium changes, and the remaining 68 insurers requesting premium increases.”

The report indicates there are several factors that could drive costs in 2023, such as:

• Health cost trends (which include health sector inflation and changes in utilization)
• The COVID-19 pandemic
• Changes in federal policies, including the possible expiration of the American Rescue Plan Act subsidies, the implementation of the No Surprises Act and the administrative fix to the Family Glitch

The authors noted that these filings are preliminary and may change during the review process. The rates are expected to be finalized in late summer, and the actual average percentage increase in premiums will not be known until early fall.

3. Better oral care of hospitalized patients can significantly reduce rates of hospital-acquired pneumonia

“Hospital patients not getting their teeth brushed, or not brushing their teeth themselves, is believed to be a leading cause of hundreds of thousands of cases of pneumonia a year in patients who have not been put on a ventilator,” according to a Medical Word Council article published July 21.

The article stated: “Pneumonia is among the most common infections that occur in health care facilities, and a majority of cases are non-ventilator hospital-acquired pneumonia, or NVHAP, which kills up to 30% of those infected,” according to experts.

The article continued, “Many cases of NVHAP could be avoided if hospital staffers more dutifully brushed the teeth of bedridden patients, according to a growing body of peer-reviewed research papers. Instead, many hospitals often skip teeth brushing to prioritize other tasks and provide only cheap, ineffective toothbrushes, often unaware of the consequences, said Dian Baker, a Sacramento State nursing professor who has spent more than a decade studying NVHAP.”

According to the article, Baker said two things can make all the difference in the occurrence of NVHAP: “Brushing teeth and getting patients mobilized.”

The results of a few studies detailed in the article “show those two strategies can lead to sharp reductions in infection rates,” including:

• An almost 70% reduction in rates of hospital-acquired pneumonia was seen in a study in which oral care was reprioritized and patients were gotten out of bed at 21 Kaiser Permanente hospitals in California.
•  Better oral care reduced NVHAP cases by a yearly average of 35% at Sutter Medical Center in Sacramento.