IOM: Cost Key To Formulating Essential Benefits Package

In its 297-page report, the Institute of Medicine recommended that cost should be a factor in deciding what benefits will be included in plans sold on the health law's new insurance exchanges.

The New York Times: Panel Says U.S. Should Weigh Cost In Deciding 'Essential Health Benefits'
The National Academy of Sciences said Thursday that the federal government should explicitly consider cost as a factor in deciding what health benefits must be provided by insurance plans under President Obama's health care overhaul, and it said the cost of any new benefits should be "offset by savings" elsewhere in the health care system (Pear, 10/6).

Kaiser Health News: Advisory Panel Says Essential Benefits Package Must Be Affordable
The government moved a step closer Friday toward defining what "essential benefits" would be offered by companies selling coverage to millions of Americans in new insurance exchanges. In a 297-page report, the Institute of Medicine, a federal advisory panel, laid out criteria and methods the Department of Health and Human Services should use in developing the package. But, as expected, the report left to HHS the job of deciding specific benefits (Galewitz and Appleby, 10/6).

The Washington Post: Health Care law Benefits Must Be Limited To Ensure Affordability, Panel Says
An advisory panel of experts on Thursday recommended that the Obama administration emphasize affordability over breadth of coverage when it comes to implementing a key insurance provision of the 2010 health-care law. Obama officials charged with stipulating what "essential benefits" many health plans will have to cover should make it a priority to keep premiums reasonable, even if that means allowing plans to be less comprehensive, counseled the committee of the National Academy of Science's Institute of Medicine (IOM) (Aizenman, 10/6).

The Wall Street Journal: Panel Urges Affordable Health Plans
Requirements for health-insurance plans offered through new government-run exchanges should be tailored to what small businesses can afford, a key report to the Obama administration recommended. The report — from the Institute of Medicine, an independent board that advises the government on health policy — will play a pivotal role in determining how the Department of Health and Human Services decides what benefits must be covered under plans offered on state-run insurance exchanges starting in 2014 (Radnofsky, 10/7).

Reuters: U.S. Advisers: Keep Health Benefits Affordable
An advisory group urged U.S. officials to formulate a set of essential health benefits under President Barack Obama's health care overhaul that is in line with cost of insurance in a typical small employer plan. The Institute of Medicine report issued on Thursday also recommended the Department of Health and Human Services be as specific as possible in deciding what health benefits should be required in individual and small group plans as the reform rolls out in 2014 (Selyukh, 10/6).

National Journal: Essential Health Benefits Should Rely On Budget, Institute Says
The only way to build a set of insurance requirements that are comprehensive and affordable is to start with a budget target, an advisory panel told the Department of Health and Human Services in a highly anticipated report on what benefits should be considered "essential" for new health insurance plans. Instead of laying out a detailed list of benefits, the Institute of Medicine panel gave the government a framework for developing its own list. The panel suggested a process for public comment and review and recommended a deadline: May 2012. The Institute was tasked with making recommendations for how HHS should define the required "essential health benefits" that every health plan carried on a state exchange must offer by 2014. It appointed an independent board of medical experts and health care economists to do it. The guidelines requirement was designed by legislators to ensure that all health plans were reasonably comprehensive — but they must also be affordable to individuals who must buy insurance without help from an employer (Sanger-Katz, 10/6).

The Hill: IOM Recommends Health Law Benefits Be Pegged To Typical Small-Employer Plan
A highly anticipated Institute of Medicine report released late Thursday recommends that the health care law's guaranteed benefits reflect "the scope and design of packages offered by small employers today" rather than an exhaustive list of benefits. ... The law left it up to the Health and Human Services secretary to determine what are and are not EHBs, however — with input from the IOM. The new report urges regulators to carefully weigh the cost of benefits before requiring that health care plans cover them" (Pecquet, 10/6).

The Associated Press: Feds To Design Health Insurance For The Masses
The federal government is taking on a crucial new role in the nation's health care, designing a basic benefits package for millions of privately insured Americans. A framework for the Obama administration was released Thursday. The report by independent experts from the Institute of Medicine lays out guidelines for deciding what to include in the new "essential benefits package," how to keep it affordable for small businesses and taxpayers, and also scientifically up to date...The advisers recommended that the package be built on mid-tier health plans currently offered by small employers, expanded to include certain services such as mental health, and squeezed into a real-world budget (Alonso-Zaldivar, 10/7).