With over half of American adults relying on smartphones for everything from mapping trips to buying groceries, it should come as no surprise that many want to use their devices to make health care simpler.
HealthDay News reports that many Americans are already using phone applications to record and organize personal health information – and that’s just the tip of the iceberg. Many companies are designing apps along with specific types of equipment that will enable the user to can help diagnose everything from ear infections and eye diseases to irregular heartbeats and malaria.
And once the smartphone has gathered the information? A recent poll compiled by Harris Interactive/HealthDay reports that more than one-third of respondents said they are “very” or “extremely” interested in using their phone or tablet to ask their medical provider questions, make exam appointments and retrieve test results.
Of course, for such an app to be effective would require your provider to have the proper systems in place, noted Titus Schleyer, who heads the Center for Biomedical Informatics at the Regenstrief Institute. “This poll shows us that the public is interested in using these apps. But the health-care system has to make it easier for them to do it,” he said.
The national average of claims incorrectly processed by heath plans dropped to 7.1% in 2013, according to a new National Health Insurer Report Card released by the American Medical Association (AMA). It contines a trend of falling inaccuracy rates, from more than 19% in 2011 to 9.5% last year.
The timeliness of medical claims processed has also improved by 17% since the AMA first started its report card in 2008.
MedPage Today reports that, based on AMA estimates, processing claims accurately and expediently could have saved more that $43 billion since 2010. Administrative waste also accounted for billions of dollars lost in that period.
At MedBen, we recognize the importance of getting claims paid right the first time, and getting them processed quickly. Our proprietary claims software conducts over 400 automatic checks, keeping a virtual eye peeled for inconsistencies and errors. The software also “rebundles” miscoded claims and coordinates benefits with other insurance companies.
Independent CPAs review every procedure related to MedBen’s claims operating system, and have repeatedly reported no findings in annual SSAE 16 audits. In addition, internal staff members review 5% of each examiner’s claims every day – a level unmatched by other health benefits managers.
And how does MedBen’s claims processing abilities compare to the national average? In 2012, we had a 99.6% accuracy rating. Moreover, 97.2% of claims were handled within 15 days of receipt.
A new study supports the importance of colon cancer screenings, HealthDay News reports. Researchers found that patients whose cancer was detected by a colonoscopy tended to be in an earlier stage at the time of diagnosis, and therefore had a better survival rate.
“The findings provide yet another compelling reason for asymptomatic, average-risk individuals over the age of 50 to get screened by colonoscopy,” said Dr. David Carr-Lock, chief of the division of digestive diseases at Beth Israel Medical Center in New York City.
The study, led by Ramzi Amri of Massachusetts General Hospital and Harvard Medical School, reviewed the case studies of 1,100 colon cancer patients. Amri concluded that of the 1,100 cases, 217 were detected early by a colonoscopy. The study also revealed those patients who did not have their cancer detected by a colonoscopy had odds that doubled for an invasive tumor, and had three times a greater risk of metastasized cancer spread.
The American Cancer Society recommends that people with an average risk of developing colon cancer get screened starting at age 50. MedBen Worksite Wellness members can check their compliance with colonoscopies and other critical wellness examinations by visiting the MedBen Access website and clicking on the Wellness Plan link under “My Plan”.
Following a statement by the Justice Department earlier this month that it would not appeal a federal judge’s order to allow girls of any age to buy Plan B One-Step without prescriptions, the Food and Drug Adminstration has approved expanded access to the so-called “morning after” pill.
“Over-the-counter access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States,” read Thursday’s statement from Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research.
According to the Los Angeles Times, U.S. District Judge Edward Korman of New York reluctantly gave approval last week to a request from the FDA and the Department of Health and Human Services to approve Plan B One-Step for over-the-counter sales, but not other versions of the drug. The change will take affect once the drug’s manufacturer Teva has changed all its packaging to reflect the new rules – a process that could take several months.
Plan B One-Step, which blocks ovulation and impedes the mobility of sperm, retails for about $60 a dose. It will not work if a woman is already pregnant, nor will it harm a developing fetus.
Every year thousands of patients undergo surgery they don’t need, according to the findings of a USA Today investigation. In some specialities, unnecessary surgeries might account for 10% to 20% of all operations.
Six of the most common unnecessary surgeries, based on medical research and government databases:
MedBen helps protect against certain unneeded surgeries with comprehensive care management. This service ensures plan members receive the correct treatment for such conditions as cardiovascular disease, cancer and kidney disease.
Care management is necessary to ensure that the medical procedures a physician/provider is proposing for patient’s condition are the best options from an effectiveness and patient risk perspective, and maximize benefits under his or her health care plan. To learn more, contact MedBen Vice President of Sales and Marketing Brian Fargus at email@example.com.
If you don’t take a prescription drug, chances are you know one or two people who do… or three, or four, or more, Drug Store News reports.
According to a new study by the Mayo Clinich, nearly 70% of Americans use at least one prescription drug, and more than half are taking two. Most of the drugs are antibiotics, antidepressants and opioid painkillers, followed by medications to control blood pressure and vaccines.
“Often, when people talk about health conditions, they’re talking about chronic conditions, such as heart disease or diabetes,” study author Jennifer St. Sauver said. “However, the second most common prescription was for antidepressants; that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a big concerning considering their addicting nature.”
The study also found that women receive more prescriptions, and nearly 25% of women aged 50 to 64 are on an antidepressant. Older adults also account for a large number of prescriptions overall, escpecially cardiovascular drugs. Antibiotics and asthma drugs were most commonly prescribed to those younger than 19 years, while antidepressants and opioids were most common among young and middle-aged adults.
According to The Hill’s Healthwatch blog, legislation has been introduced in the Senate to modify the employer mandate in the Affordable Care Act.
The mandate, which will take effect in 2014, requires businesses to offer health insurance to their employees who work 30 hours or more. The bipartisan bill would move the working hours from 30 to 40 hours to match the traditional definition of a full-time worker.
Critics of the current mandate believe it will hurt small businesses, as employers will be forced to reduce workers’ hours. Proponents of the bill say that changing working hours to 40 per week ensures that all people have access to affordable health care.
“Businesses are baffled by the definition of 30 hours,” said Susan Collins (R-Maine), a co-sponsor of the bill. She noted that other federal laws generally define a full-time employee as someone who works at least 40 hours per week.
Some liberal Democrats say that they will not consider the change, as setting the employer mandate at 30 hours per week was the best way to ensure that people who work 30 to 40 hours per week have access to health care.
Smarter use of prescription medications could have saved Americans $200 billion in 2012, according to a new study from the IMS Institute for Healthcare Informatics. These “avoidable costs", as the study calls them, lead to millions of unnecessary hospital admissions, outpatient and emergency room visits and prescriptions.
“Access to medications is a very important priority,” Murray Aitken, executive director of the IMS Institute for Healthcare Informatics, said during a call with reporters. “We believe that the responsible use of those medications is equally important.”
Modern Healthcare reports that the single biggest avoidable cost was medical nonadherence – not following a doctor’s instructions for taking drugs properly cost Americans an estimated $105 billion last year. Cost, a patient’s lack of information about long-term effects of certain diseases and fear of a drug’s side effects all contributed to nonadherence.
Misuse of antibiotics, medication errors and suboptimal use of generic drugs were among the other avoidable cost addressed by the study.
The study did note that improvements have been made that address some of these problems. Generic drug usage, for instance, is on the rise and the percentage of patients who are inappropriately prescribed antibiotics for the cold or flu dropped to 6% in 2012, compared with 20% in 2007.
A recent government study conducted by the Centers for Disease Control (CDC) has found that the proportion of U.S. adult smoking has dropped to 18% within the last two years, the Associated Press reports. Overall smoking rates have fallen over the past seven years, but this marks the first time the habit has dipped under 20%.
The study analyzed surveys taken from 35,000 US adults. Smokers were identified by how many cigarettes they smoke in their lifetime and how often. The rate was only 9% for people of age 65 and older, but 20% for younger adults. The study also determined that about 16% of high school students smoke.
Patrick Reynolds, executive director of the Foundation for a Smoke Free America,
said he felt that many factors have contributed to the decline in adult smoking, such as the federal tobacco taxes, a campaign launched by the CDC to strike against smoking and more laws banning smoking in public.
Smoking is the leading cause of preventable illness and death in the United States. A major contributor to lung cancer, smoking kills 440,000 people each year.
A January 2013 study in the New England Journal of Medicine found people who quit smoking before age 40 lived as long as people who never smoked. Research also supports that smoking can cut 10 years off a person’s life.
The federal government could miss the October 1 deadline to enroll in health insurance exchanges, a report by the non-partisan Government Accountability Office (GAO) released today said.
According to Reuters, the report noted that the key parts of the framework of the online marketplaces, including those that addressed consumers’ eligibility for federal subsidies, management and monitoring of insurance plans and consumer assistance, had not been completed. Additionally, many states have not completed many of the tasks assigned for implementation.
“Additional missed deadlines closer to the start of enrollment could (affect implementation),” the report concluded. “Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined.”
Despite the concerns raised by the GAO, the Department of Health and Human Services is confident the exchanges will be ready on time. “We are working every day to establish individual and small business marketplaces, where many Americans will have access to quality, affordable coverage for the first time. We have already met key milestones and are on track to open the marketplace on time,” HHS spokeswoman Joanne Peters said.
Health care costs will see slow growth next year, according to a new report by the accounting and consulting firm PwC.
The Associated Press reports that the recend trend of lower cost increases will continue, in spite of an improving economy and the prospect of millions of additional Americans receving coverage under the Affordable Care Act, Any cost spikes, the report says, should be contained within a relatively narrow market segment.
“There are some underlying changes to the system that are having an impact, and we can expect lower increases as we come out of the recession,” said Mike Thompson of PwC’s Health Research Institute, which produced the study. Cost “is still going up, but not as much as it used to.”
The report pointed to several specific factors influencing downward costs, including increased use of clinics in retail stores and higher employee deductibles. Conversely, the high cost of specialty drugs to treat chronic illnesses will keep cost increases from going even lower.
Regardless of national trends, MedBen can work with you to develop a health care plan that keeps cost increases low without sacrificing desired benefits. And our compliance team will help to keep you informed of regulatory developments that may affect your plan design, as well as your bottom line. To learn more, call Vice President of Sales and Marketing Brian Fargus at firstname.lastname@example.org.
In a 5-3 ruling, the Supreme Court ruled yesterday that the Federal Trade Commission can give additional scrutiny to so-called “pay-for-delay” arrangements between generic and brand-name drug companies, The New York Times reports. Justice Samuel Alito recused himself for the decision.
Brand name drug manufacturers sometimes pay competitors to keep generic versions of their products off the market. While the court did not address the legality of such agreements, it did effectively overturn a lower-court ruling that said they were lawful, so long as a deal did not keep a generic drug off the market beyond the term of the brand-name drug’s patent.
The FTC, which has fought pay-for-delay for over a decade, had hoped the court would find that the practice violated antitruat laws. But the ruling did give the agency – as well as consumer groups, drug retailers, wholesalers and insurance companies – the ability to challenge any deals it deemed questionable.
Justice Stephen G. Breyer, writing for the majority, said that “a court, by examining the size of the payment, may well be able to assess its likely anticompetitive effects along with its potential justifications without litigating the validity of the patent.”
In order to hold down health care plan costs, employers are considering new approaches to promoting plan member use of providers with the best medical outcomes, Business Insurance reports.
According to an Aon Hewitt survey of about 800 large and midsize employers, 59% of respondents said they intend to direct members, through plan design or lower costs, to hospitals or physicians with demonstrated high quality for specific procedures or conditions. “Employers want to drive employees to providers with the best outcomes,” Jim Winkler, chief innovation officer for health in Aon Hewitt’s Norwalk, Connecticut, office.
Partners Community Health Plan is the perfect solution for employers who value high quality at lower costs. MedBen has partnered with community hospitals throughout Ohio and Kentucky to provide a level of care comparable to that found in major metropolitan areas, often at a fraction of the price.
In addition to the most comprehensive provider network available, Partners offers a worksite wellness program and the best pharmacy plan discounts you can find. Members also have access to a community wellness network that offers discounts from neighboring businesses on a variety of products and services. In short, it’s better care at a better cost.
Partners Community Health Plan is available to both fully- and self-insured groups. To learn more, e-mail MedBen Vice President of Sales & Marketing Brian Fargus at email@example.com or contact a participating Partners agent.
With two-thirds of US adults defined as overweight or obese, The American Medical Association is considering whether to recognize obesity as a disease, Forbes reports.
The potential classification has already created debate. “More widespread recognition of obesity as a disease could result in greater investment by government and the private sector to develop and reimburse obesity treatment,” states the AMA’s Council on Science and Public Health.
Opponents counter that obesity results from personal choices and is not an illness. “We understand obesity as a condition and a risk factor for other diseases,” said Susan Pisano, spokeswoman for American’s Health Insurance Plans. “The important thing is to get programs and supports in place to address it, as health plans have done and are doing,”
The debate will continue during the AMA’s House of Delegates meeting, which will conclude on June 19. While the group does not have any legal authority, its delegates do have standing with many policymakers in Washington.
UPDATE (6/18/13): At the AMA’s annual meeting on Monday, the Council on Science and Public Health said that partly because obesity is hard to define, it cannot be classified as a disease. To do so could undermine prevention efforts and will do little to impact its treatment, according to a report issued by the council.
UPDATE 2 (6/19/13): Despite the Council’s recommendation, the AMA voted Tuesday to classify obesity as a disease, HealthDay News reports. “Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,” AMA board member Dr. Patrice Harris said in a statement Tuesday.
Employers aren’t overly optomistic that the Affordable Care Act will help their bottom line, finds a new survey by benefits consultant Mercer.
According to The Wall Street Journal, just 9% of the 881companies surveyed feel the health care reform law will add less than 1% to their costs next year. That represents a significant drop from 2012, when 20% felt they would see little impact come 2014 – which in itself marked a decline from 25% in 2011.
Conversely, an increasing number of employers expect costs to go up by 5% or more – 19%, compared to 15% in 2011.
About a third of the companies Mercer surveyed currently don’t provide coverage. But with the upcoming ACA rule requiring all employees working 30 hours or more a week to be eligible for insurance, almost 60% of those who don’t say they intend to, and 30% expect to add a new, lower-cost plan.
Nearly 80% of employers also expressed concerns about communicating the law to their employees, while 70% said the requirements to educate their employees on plan changes and to help them make informed decisions are a “significant concern.”
Mercer surveyed 281 companies with fewer than 500 employees, 418 with 500 to 5,000 employees and 182 who have more than 5,000 employees.
A recent Reuters article notes that at the annual meeting of the American Society of Clinical Oncology earlier this month, doctors “heard groundbreaking data on a new class of immune system boosters” that shrank tumors in patients with advanced melanoma and lung cancer. Such drugs could potentially become the main treatment for more than half of all cancers in the next 10 years.
Naturally, such innovations don’t come cheap: Citigroup analysts expect the drug treatment to cost around $110,000 for a year’s worth of treatment. And while those costs will be somewhat offset by reduced hospitalization fees, the National Cancer Institute estimates that the total cost of caring for U.S. cancer patients will rise to $174 billion in 2020 from $125 billion in 2010.
So how will group health plans balance these cost increases for cancer treatment while allowing proper care for the patient AND respecting the physician’s right to direct care? MedBen already has a proven solution.
Comprehensive Oncology Care Management offers cancer patients an additional advocate to provide professional guidance and counseling for their condition. The service ensures that patients receive appropriate cancer treatment that is in accordance with current standards of care and backed by reliable evidence.
Care management works with physicians to make sure that care is appropriate and eligible for coverage, while always giving them the final say as to the course of care. To learn more, contact MedBen Sales & Marketing Vice President Brian Fargus at firstname.lastname@example.org.
The MedBen Sales & Marketing Department is pleased to announce the recent addition of Kelly Thran to its team. A seasoned veteran of the benefits management company, Thran will serve as the department’s Marketing Project Coordinator.
In her new position, Thran will work with other members of the Sales & Marketing staff in the creation of client reports and analyses, sales proposals, marketing flyers and other materials. She will also contribute daily content to the MedBen Blog, which offers company news, regulatory updates and other information of interest to customers.
“I’m very pleased that Kelly has chosen to join our team,” said Brian Fargus, MedBen Vice President of Sales & Marketing. “She brings a tremendous amount of experience and knowledge to the job, and I look forward to working with her.”
Thran joined MedBen in 2000 as a member of the Underwriting Department, for which she performed such duties as generating proposals for fully-insured employer groups and assisting with sold group write-ups. Prior to joining Sales & Marketing, she served as the company’s Network Coordinator, acting as a liaison between current and prospective clients and provider network partners.
A graduate of Salve Regina University, Kelly currently resides in Newark, Ohio.
The fact that surgical costs differ from one hospital to another may not come a total surprise. But the recent introduction of a Medicare Provider Charge database by Health and Human Services, containing prices charged by more than 3,000 hospitals, has brought such cost variances under closer scrutiny.
WebMD recently compiled an FAQ examining hospital costs. Among the questions asked: Why is there such a big cost difference for the same services?
Hospital rates are based on a number of factors, according to the American Hospital Association, including:
The difference in costs between one hospital and another is a “byproduct” of the marketplace, says the AHA.
Caroline Steinberg, the AHA’s vice president of trends analysis, believes the focus should shift from pricing to what hospitals actually collect for their services. Medicare and private insurer payments to hospitals are typically far lower than the stated cost. Medicare sets the rate of reimbursement, even though it adjusts the rates according to factors like the number of poorer people the hospital serves, Steinberg says.
But economist William Custer, PhD, director of health services research at the Institute of Health Administration at Georgia State University, says these factors can’t explain the cost variations.
“Hospitals have historically set prices based on their own methodology. One hospital can set prices three times greater than another; there’s no real pattern,” says Custer. “If we had a healthy health services market, you would expect those prices to be much closer aligned.”
Prospective employee consider a company’s apporach to health and wellness when making a job decisions, a new survey reveals.
According to Small Biz Advisor, the survey of approximately 1,300 businesses and 10,000 employees found that 87% claim that health and wellness programs play a role in determining their employer of choice. Most of the business surveyed – 4 out of 5 – said they offer some level of wellness benefits.
In regard to wellness and working conditions, 70% of employees surveyed say that such programs positively influence the culture at work. Also, providing a little additional encouragement helps: 61% of employees say incentives are a key reason they participate, while 78% claim they are interested in participating in incentive-based programs while at work.
MedBen Worksite Wellness can provide employers of all sizes a program designed to address specific employee needs. We focus on the promotion of early detection testing for chronic conditions, while emphasizing the importance of annual member wellness exams. And our disease- and prevention-based approach encourages healthier lifestyles and provides customized coaching.
Our worksite wellness program also features extensive employer reporting, showing ongoing compliance rates for early detection testing, the clinical progress of members enrolled in health coaching, and your financial return on the program. To learn more, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
Avik Roy warns Ohioans covered under individual health plans to prepare for some serious sticker shock next year:
“Democrats continue to try to dismiss the evidence that Obamacare will dramatically increase the cost of insurance for people who buy it on their own. But on [June 6], the Ohio Department of Insurance announced that, based on the rates submitted by insurers to date, the average individual-market health insurance premium in 2014 will come in around $420, ‘representing an increase of 88 percent” relative to 2013. ‘We have warned of these increases,’ said Lt. Gov. Mary Taylor in a statement. ‘Consumers will have fewer choices and pay much higher premiums for their health insurance starting in 2014.’
“It’s called ‘rate shock,’ but it’s not shocking to people who understand the economics of health insurance. In August 2011, Milliman, one of the nation’s leading actuarial firms, predicted that Obamacare would increase individual-market premiums in Ohio by 55 to 85 percent. This past March, the Society of Actuaries projected that the law would increase premiums in that market by 81 percent. Like good players on ‘The Price is Right,’ they both came in just under the Dept. of Insurance’s figure.”