Friday, August 31, 2012

Should Doctors Be More Sensitive To Costs?

Interesting article written by  Alicia Caramenico on the value of training interns on being aware of the cost of their decisions for medical care. It's a fine line but an interesting idea. See what you think!  Here is the article as it appears in Fierce Healthcare. 

The Hippocratic oath requires physicians to abstain from doing harm--but does that include financial harm?

With medical bills as the number once source of personal bankruptcy, teaching hospitals are encouraging students to consider health costs, the Chicago Tribune reported.

Some, including the University of Chicago's Pritzker School of Medicine, want to take it a step further and add "do no financial harm" to the Hippocratic oath.Vineet Arora, an assistant dean and associate professor of medicine, is developing training videos to make medical students more aware of how the costs of their decisions will affect patients.

"We are totally insulated from price, what medical care actually costs the patient," Andrew Levy, a recent med school graduate who is working with Arora, told the Tribune. "I can't tell when a test I order becomes a bill or if and when my patient gets charged by it, and that's absurd."

Medicals schools already have started incorporating cost control into future doctors' curriculum, according to first-year Harvard Medical School student Ilana Yurkiewicz. But in her Scientific American blog post, she acknowledged that it may be more difficult to include cost in decision-making when face-to-face with patients than during hypothetical scenarios in a classroom.

Moreover, cost considerations can become a slippery slope between reducing unnecessary medical costs and rationing care. So healthcare educators emphasize teaching medical students to look for alternatives that their patients can afford, the Tribune noted.

However, it's not only prospective doctors that can benefit from cost awareness. Reminding practicing physicians how much money blood tests cost could cut unnecessary medical spending, according to a study published last year the journal Archives of Surgery.

Saturday, August 25, 2012

California Health Insurance Rate Regulation News!

This is important for all to know regarding California health insurance.  The article is written by Sandy Kleffman of the Bay Area News Group. Here you go ..... 

An initiative that would bring health insurance rate regulation to California has qualified for the November 2014 ballot, setting the stage for a vigorous and costly battle between insurers and consumer groups. 
The measure, sponsored by Consumer Watchdog, would give the state insurance commissioner the power to deny certain premium increases if they are deemed excessive. The insurance commissioner has little control over such rate hikes now.
The initiative would apply to the individual and small group health insurance markets, but large employer group plans would be exempt."We're thrilled that voters will get the chance to decide whether or not it's time to rein in outrageous rate hikes," said Carmen Balber, a spokeswoman for the Consumer Watchdog campaign."We expect a battle royale," she added. "We have no doubt that the health insurance industry will throw down tens of millions of dollars to oppose this."

Opponents have already begun to organize their campaign.
"This flawed, costly measure is not real health reform," said Patrick Johnston, president and CEO of the California Association of Health Plans, in a statement. "This measure would give one politician too much power over health coverage, do nothing to address the underlying costs driving health care premiums and create an expensive and duplicative state bureaucracy that will be paid for with higher health insurance premiums."

Consumer Watchdog had hoped to qualify the initiative for this year's ballot. But after a random sample of petitions failed to produce enough valid signatures, counties did a full signature check, pushing the count past the deadline for this November's election. On Thursday, the Secretary of State's office announced that Consumer Watchdog had gathered the required 504,760 signatures.
Balber said having the election in 2014 may be good timing because it will occur as the national health reform law takes full effect, including a mandate that most Americans have coverage."The price and affordability of health insurance will be at the top of Californians' minds," she said."

Friday, August 24, 2012

Employer Wellness Programs - A Good Thing!!

Saw this post written by the editorial staff at EBN, Employee Benefit News and wanted to share it with you, especially if you are an employer offering group health insurance for employees.  Even small businesses can provide some sort of "wellness" program for their employees and it appears to be a "good thing!"  Read on ....

"The Principal Financial Group, in its annual ranking of the 10 best American companies for employee financial security, has seen a marked increase in wellness initiatives. An independent panel of judges selected firms they saw as leaders in worker long-term fiscal stability, and the winners ranged from a Maryland nonprofit to a pair of Arizona credit unions. What all 10 had in common was employee wellness programs.

“When the program began 11 years ago, we saw some companies attempting wellness,” says David Wray, president of the Plan Sponsor Council of America and one of the seven judges, “but today all winners offer wellness programs in some meaningful way.”

Apart from any direct medical benefits, companies reaped rewards for their efforts in a variety of ways. For example, with comprehensive engagement and communications that include wellness programs, Principal’s top 10 saw an average voluntary turnover rate of 9.8%, compared to a national average of 24%. And those of sound body also had sound portfolios.

“Healthier employees spend less on medical care, leaving to more to save,” says Luke Vandermillen, Principal vice president. “Beyond physical health, these companies offer a number of ways to impact the long-term financial health of their employees through income protection and retirement programs with generous employer matches and contributions.”

The Principal program honors growing companies, or those with between five and 1,000 employees. This year’s winners were:

  • American National Bank of Texas, Terrell, Texas
  • Arizona State Credit Union, Phoenix, Ariz.
  • Cypress Creek Emergency Medical Services,  Spring, Texas
  • Dunmore Corporation, Bristol, Pa. (manufacturing)
  • Flow Science, Inc., Santa Fe, N.M.; (software development)
  • M3 Insurance, Madison, Wis.
  • nLogic, LLC, Huntsville, Ala. (information technology/software)
  • The United States Pharmacopeial Convention, Rockville, Md. (nonprofit )
  • Vantage West Credit Union, Tucson, Ariz.
  • WHR Architects, Inc.,  Houston, Texas

Tuesday, August 21, 2012

How Well Do Your Employees Understand Their Healthcare Benefits?

Thought the following post written by Christine Dugas of USA Today was very interesting and wanted to share with you.  If you are an employer offering health insurance to your employees make a special effort to read this.  It is about how little employees know about what they choose for their health insurance benefits.  Employers would be smart to offer some education on the benefits as well as the benefits themselves. 
Here we go  ... from the written hand of Christine: 
As the open-enrollment season for health benefits approaches, many workers will be making some bad choices, according to a new survey.
"Far too many people don't really understand their benefits," says Audrey Tillman, executive vice president of Corporate Services at Aflac. "In fact, most employees are on autopilot." The majority of American workers — 56% — estimate that they waste up to $750 each year because of costly mistakes they have made with their health insurance benefits, according to the Aflac WorkForces Report, a July survey of more than 2,000 consumers released today.  That could represent four months of the grocery budget for a single person.
"Health insurance is complicated with all of the different terminology that goes along with it," says Carrie McLean, a consumer specialist at "And people have gone through open enrollment with their eyes closed."   This is the second year Aflac has conducted a health care survey, and the situation is getting worse, Tillman says. In 2011, 24% of workers were confident about their decisions, vs. 16% this year.
Among common errors that Aflac found:
Many employees, 89%, say that they simply elect the same benefits options every year.
Nearly half of workers (47%) say that they rarely or never exceed their deductible costs.
Only 16% contribute the right amount to flexible spending accounts
Americans clearly understand that it's an important issue. Rising out-of-pocket medical expenses are one of the most costly financial burdens they face, say 43% of workers, Aflac found. As benefits change, workers need to pay closer attention to their selections during open enrollment, the experts say. This year, many plans have increased the in-network deductibles, emergency room co-payments and prescription drug co-payments, said the PwC Health Research Institute annual report published in May. And nearly six of 10 employers (57%) are considering increasing employee contributions to health plans, the PwC report says.
There also are some new plan benefits that could help workers as more companies offer financial incentives to promote wellness and health-improvement programs. Although workers need better health plan information so they can make smart choices, what employers tend to do is give them a packet of 20 to 50 pages, and say read through this and decide which option you want to pick, McLean says.
"It was shocking to me when I saw that 52% of employees in our survey said that their company does not communicate with them at all about the open-enrollment process," Tillman says. "But if the benefits are not appreciated, or understood, or utilized in a way that is meaningful to employees, it's a waste on the employers as well," Tillman says
End of Christine's article.  
What do "you" think?  How up to par are your employees in their understanding of their health care benefits?  Are you doing your part in helping them choose what's best for their individual needs?  Taking the time to do so can come back to you in the form of strong loyalty!   Sounds like a good employee quality to me!

Monday, August 20, 2012

Future Of Medigap

Came across a question recently pertaining to the future of medigap policies under the new healthcare law.  Something very interesting to be aware of.  Read on and pay attention to the "good" reasons for lessening the full coverage terms of some medigap plans. Think you'll be as amazed as I. Here is the question as found in Kaiser Health News: 

Q. How will the new health law affect Medigap policies? I’m on Medicare with a Medigap Plan F. Premiums are rising 20 percent a year. It’s a real strain for me.

A. The health care overhaul doesn’t make any immediate changes to Medigap policies, but it sets the stage for potential changes to Plans C and F in 2015.

One in five Medicare beneficiaries has a Medigap policy to supplement their coverage under the traditional Medicare program. The standardized policies, which are identified by letters, cover coinsurance, deductibles and services not covered by Medicare to varying degrees.

Plan F and Plan C are the most popular Medigap plans, chosen by nearly two-thirds of beneficiaries. Those are also the policies that provide significant "first dollar" coverage: they pay the deductibles for both the hospital and outpatient portions of the traditional Medicare program (Parts A and B) as well as the 20 percent coinsurance required for doctor visits, and cover other services as well. People with these supplemental plans may pay virtually nothing for medical services beyond their premiums.

And that has policymakers concerned. If people don’t have to pay anything out of pocket for doctor visits and other medical care, there’s no financial incentive to get only the care they really need. Studies have shown that people get less medical care when they have to make some sort of financial contribution, though they skimp on both necessary and unnecessary care.

A 2009 study conducted for the Medicare Payment Advisory Commission found that medical costs for people with Medigap policies were 33 percent higher than the costs of beneficiaries without supplemental insurance.

"So the thinking has been that if you prohibit first dollar coverage and require some cost sharing when beneficiaries see a physician, it might encourage them to see the physician only when they need to," says Gretchen Jacobson, a principal policy analyst with the Program on Medicare Policy at the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

There have been a number of proposals put forward in recent years that would reduce Medigap coverage in some policies and require beneficiaries to pay more. To date, nothing has changed.

But the health care overhaul opens the door to changes in the future. Under the law, the National Association of Insurance Commissioners is required TO evaluate the benefit packages of Plans C and F with an eye toward adding nominal cost sharing by 2015.

Even if that happens, however, it’s unclear whether it would affect you or other current policyholders, says Jacobson.  "The changes might only apply to new policyholders," she says.

By Michelle Andrews
Kaiser Health News

Saturday, August 18, 2012

Retail Clinics Are Happening!

The Los Angeles Time recently reported  on Retail Clinics as follows - "Retail clinics received a significant profile boost last month, when the UCLA Healthcare System inked a deal with MinuteClinics in Southern California to help promote chronic disease management and share electronic health records."

However, the use of retail clinics compared to physician offices and traditional outpatient clinics remains quite low.

"The rapid growth of retail clinics makes it clear that they are meeting a patient need. Convenience and after-hours accessibility are possible drivers of this growth. However, retail clinics make up a small share of overall visits in the outpatient setting, which include 117 million visits to emergency departments and 577 million visits to physician offices annually," reported Health Affairs, which published the Rand study.

But the study's researchers do say the clinics are serving an important role. "Retail medical clinics continue to grow rapidly and attract new segments of users," study lead author Ateev Mehrotra, M.D., an associate professor at the University of Pittsburgh School of Medicine and a Rand researcher, said in an announcement. "They remain just a small part of outpatient medical care, but appear to have tapped into patients' needs."

Sixty percent of those people who have been patronizing clinics said they did not have a relationship with a primary care physician, Drug Store News reported.

The above written by 
By Ron Shinkman, @FierceHealth