Ensayos de concreto endurecido

499 Personal Communication. Harriette Clark, Administration-Billing, State of Connecticut Department of Public Health Laboratory. August 24, 2010.

500 Fixr. Lead Pain Removal costs. Tigerdirect and Loma Linda company. Available at: http://www.fixr.com/costs/lead-paint-removal. Accessed November 4, 2010.

501 Estimate assumes a per house inspection charge of $280 plus 40% of houses are encapsulated at $1,125 (2,000 sq ft x $0.50), 20% abated for

$7,000 (LAMPP allocation), 25% abated at $16,000 (2,000 sq ft x $8 sq ft), and 15% abated at $30,000 (2,000 sq ft home x $15 sq ft).

prevention or early detection of disease or illness related to such coverage.

Based on BLS claims data from 2007, 2008 and 2009, Ingenix Consulting projected $187,202 as the total cost of health care related to BLS in 2010. Of this amount, medical claims accounted for $152,049 and cost-sharing accounted for $35,153. As noted in section V-2, BLS utilization in 2009 was not at the level it would be if all children in fully insured plans accessed BLS screenings to the extent specified under the “duty of physicians” statute.

The potential savings to insurers and employers resulting from prevention of lead poisoning varies by severity of poisoning. For the severe cases, the direct costs of immediate treatments used to decrease EBLLs can be high. Chelation therapy (ChT) can cost as much as $8,000 (average $2,418 to $4,711). These treatments often require extended hospital stays and sometimes need to be repeated. Costly long-term treatments for central nervous system and developmental conditions may also be required for both lead poisoning requiring ChT and lead poisoning at lower exposure levels. Assessing BLLs in the first year of life and again prior to a child turning three targets the critical development period for children and offers the chance for early detection. The earlier the detection of lead exposure, the more likely duration and dosage of exposure can be reduced for the child. In turn, early detection could lead to a lower proportion of the population leading lives while managing costly deficits caused by lead exposure.

8. The impact of the mandated health care benefit on the cost of health care for small employers, as defined in § 38a-564 of the general statutes, and for employers other than small employers.

Prior to BLS becoming a mandated benefit, the average cost of BLS-related claims for the fully insured population contributed an average of $0.01 or less to premiums on a PMPM basis. In the initial year following the mandate, the cost of BLS spread out on an annual basis over the fully insured population was $0.03-$0.04. However, the cost under the mandate did not differ statistically from the period prior to mandate enactment, so it is unlikely that the mandated health benefit would impact the cost of small employers.

Although unlikely, the impact of the net new cost for BLS may vary based on employer size. Since the overall cost for small group plans tends to be lower than large group plans, as a percentage of total paid medical cost, the cost of this mandate will be somewhat greater for small employers. Regardless of size, strategies for offsetting health insurance premium costs include increasing cost-sharing, reducing the number of non-mandated benefits covered or no longer offering health insurance plans.

9. The impact of the mandated health benefit on cost-shifting between private and public payers of health care coverage and on the overall cost of the health care delivery system in the state.

The overall cost of the BLS mandate on Connecticut’s health care delivery system is projected at $218,163 for 2010.⁵⁰² This amount includes all projected medical claims and cost-sharing plus administrative fees and insurer profit/reserves. Given the lack of a significant difference when comparing BLS claims before and after the mandate, it is expected that almost all of the projected spending may have occurred in the absence of the mandate.

The provision for fully insured plans to cover BLS may or may not result in a shift of costs between the private and public payers of health care. If BLS is obtained through private insurance plans by those who otherwise would use publicly funded mechanisms if the mandate were not in place, then a shift in cost to the private sector would occur. Arguably, a large share of the benefits of early detection and prevention of lead poisoning accrue to the public sector through a reduction of the resources necessary to provide support for

502 Ingenix Consulting. Actuarial Report for the State of Connecticut on Set Two of the Health Insurance Mandates Covered by Public Act Number 09-179. December 10, 2010. Located in Appendix II.

Volume II. Chapter 8

children with lead poisoning (e.g. special education, criminal justice).

Addendum

Calculations and assumptions for financial impact V-2.

Assumptions:

• Population size:

Annual birth cohort size assumption is 43,000 for all children less than 72 months (per DPH), of which 63 percent are not enrolled in Medicaid. Of the non-Medicaid population (27,305), approximately half are fully insured (13,653).

• 9-12 months: The maximum potential for screening listed is the size of the fully insured birth cohort for each given year. 13,653 is used.

• 24 months: With the exception of 2009, during all subsequent years, the fully insured population turning 2 is the maximum for BLS (13,653 is used).

• At risk: With the exception of 2009, the at-risk population is 33 percent of the fully insured child population for a 4-year period (13,653*4*33 percent).

• Catch up screenings for fully insured 12-35 month olds is calculated based on the product of the cohort size (13,653) and the proportion of the population that didn’t obtain a BLS between the ages of 1-2 years old. (2006 cohort*0.553)+(2007 cohort*0.518)+(2008 cohort*0.488)

• Catch up screenings for fully insured 36<72 month olds is calculated similarly as the product of the cohort size and the proportion of the population that didn’t obtain a second BLS by 36 months.

(2005 cohort*0.68)+(2006 cohort*0.7)+(2007 cohort*0.73)

Estimating maximum utilization of BLS among the fully insured population.

Year 9-12 mo 24 mo At risk Catch up 12 ≥35 mo Catch up 36-72 mo

2009 13,653 4,010 21,284 28,807

2010 13,653 13,653 18,021 0 0

2011 13,653 13,653 18,021 0 0

2012 13,653 13,653 18,021 0 0

2013 13,653 13,653 18,021 0 0

2014 13,653 13,653 18,021 0 0

2015 13,653 13,653 18,021 0 0

Volume II Chapter 9

Low Protein Modified Food Products,