Body mass index (BMI) is a commonly used way to gauge an individual’s risk of an early death, in spite of the fact that many medical professionals question its accuracy. Now, the results of a British study suggest an alternate measure may be more effective.
According to MedPage Today, at the European Congress on Obesity in Liverpool, England, researchers reported that waist-to-height ratio (WHtR) may be a better predictor of mortality risk than BMI. Comparing the effect of central obesity (measured by WHtR) and total obesity (measured by BMI) on life expectancy, they found that mortality risk was associated with BMI, but WHtR estimates were higher and appeared to be a more accurate indicator of mortality risk.
“The use of WHtR in public health screening, with appropriate action, could help add years to life,” Margaret Ashwell, PhD, of Oxford Brookes University said in a statement. “If health professionals included this simple measurement in their screening procedures, then many years of productive life could be saved.”
Ashwell and her colleagues added that the results support the message, “Keep your waist circumference to less than half your height.” Also, they wrote, the use of WHtR in public health screening could help add years to life.
Last year witnessed a number of popular brand name prescription drugs losing their patent protection – a circumstance that led to a decrease in U.S. pharmaceutical spending for the first time since 1957, a new report concludes.
According to The Los Angeles Times, the availability of generic versions of such top-selling drugs as Lipitor and Plavix cut the nation’s tab for prescription medications 1% in 2012 to $325.8 billion. Adjusted for inflation and population growth, the decline was 3.5%. That means average spending per person was $898 last year, down $33 from 2011.
The report by the IMS Institute for Healthcare Informatics, a pharmaceutical research group, says that the rise of generics in 2012 offered greater savings to patients – a trend that will continue this year as more drug patents are set to expire.
“The largest driver of this slowdown,” said IMS research director Michael Kleinrock, was the “unprecedented cluster of very popular and effective medicines losing patent protections and facing generic competition at the same time.”
A weaker-than-usual cough, cold and flu season also contributed to the decline, the report says.
Following a refusal by Congress to provide extra funding to set up the Affordable Care Act, the Obama administration has turned to the private sector for help.
The Washington Post reports that Health and Human Services Secretary Kathleen Sebelius has contacted health industry executives, community organizations and church groups to ask that they contribute financing to nonprofit groups that are working to enroll uninsured Americans and increase awareness of the law.
While an HHS spokesperson said it is perfectly legal to solicit donations in this manner, some Senate Republican feel differently: “I will be seeking more information from the Administration about these actions to help better understand whether there are conflicts of interest and if it violated federal law,” Sen. Orrin G. Hatch (R-Utah) said in a statement.
A New York Times article on the funding requests notes that the Robert Wood Johnson Foundation is expected to contribute as much as $10 million, while tax preparation service H&R Block is expected to make a donation of about $500,000, according to administration officials.
May 8th marks the 75th anniversary of health care benefits management company MedBen. Initially specializing in group hospitalization plans, the Newark, Ohio-based business has greatly expanded its operations to provide a variety of benefits services to employer groups of all sizes throughout the Midwest.
Chairman and CEO Doug Freeman, who has headed MedBen for the past 25 years, said that credit for company’s decades of success goes first and foremost to its employees. “The stability we’ve demonstrated begins and ends with the talented group of people who’ve worked here – both those that I’ve been fortunate to work with and those who served here before us,” Freeman said.
“Likewise, we attribute our continued success to an incredible list of clients – organizations who have challenged and pushed and worked with us over the years to make us a better company,” he added.
Also important to MedBen’s endurance, Freeman believes, is its proactive approach to health care benefits management: “We’ve established a corporate culture that builds on its history by continually looking ahead.”
One recent way MedBen has strived to stay ahead of the curve was through its introduction of Partners Community Health Plan. This unique benefits package, currently available in selected areas throughout Ohio and Kentucky, partners with local hospitals and doctors to help employers save money on health care costs. “By getting providers involved in the success of the plan, we’ve found that members get better care and employers see bigger savings,” Freeman observed.
Finding innovative methods to control claims costs is another key to the company’s longevity, Freeman added. “Saving clients money requires a proper balance of the latest technology and some really smart people. So we’ve put in place a claims surveillance system that integrates advanced software with physicians to identify every opportunity for client savings.”
Health care reform and its impact of self-funded group health coverage were among the topics at the latest MedBen University (MBU), held today at the Morrow Conference Center in Newark, Ohio.
Caroline Fraker, MedBen Vice President of Compliance, has covered a lot of miles this year to help groups navigate the twists and turns of the Affordable Care Act. In this presentation – her 15th of 2013 – she broke down two new fees that businesses will soon face under the law:
Following Fraker was MedBen Vice President of Sales and Marketing Brian Fargus, who explained the mechanics of self-funding. In his presentation, Fargus outlined the employer advantages of partially funding group health coverage, such as plan design flexibility, improved cash flow and lower administrative costs.
Fargus also gave a detailed breakdown of what to look for in a third party administrator. Among the most important qualities in a TPA, he said, is “service capabilities", including the ability to provide custom reporting, an advanced claim processing system, and strong compliance support.
MedBen will continue to offer MBUs throughout 2013. Be sure to check this blog for future opportunities to attend a session!
The economic downturn of recent years is not the overriding factor for the slower growth in health care spending, two new studies suggest. The findings contradict earlier speculation that the slowdown was due primarily to the latest recession, which lasted 18 months and ended in June 2009.
According to Modern Healthcare, one of the studies found that the economy accounted for about 37%, of the slowdown, while cuts to Medicare and a decline in privately insured patients accounted for another 8%. “The evidence is at least as strong that it’s structural as it is cyclical,” said David Cutler, a health care economist and professor at Harvard University who co-authored the paper.
The second paper, which analyzed spending by 150 large employers from 2007 to 2010, concluded that larger deductibles, more coinsurance and higher copayments accounted for about 20% of the slowdown. Co-author Michael Chernew, a Harvard health policy professor, added that the results appear to underscore a shift in culture among hospital officials and physicians who have grown more focused on greater efficiency in the last five years.
While neither paper went so far as to say that improvements in the payment and delivery of health care have had a definitive effect on spending, the authors say they believe as the economy improves, growth will continue to be slower than it was prior to the downturn.
National health spending grew at a record-slow pace of 3.9% in 2009 and the same pace in 2010 and 2011, the most recent year for which federal estimates are available.
Lest Thursday, the IRS released the cost-of-living adjustments affecting health savings accounts (HSAs) for calendar year 2014. The HSA contribution limits and high-deductible health plan (HDHP) out-of-pocket maximums will both increase. The HDHP minimum required deductibles, which went up in 2013, will reamin unchanged next year.
MedBen clients with questions regarding these adjustments are welcome to contact Director of Administrative Services Sharon A. Mills at (800) 423-3151, Ext. 438 or firstname.lastname@example.org.
Avik Roy on an Oregon study to determine whether people on Medicaid have better health outcomes than those with no insurance at all, and how the finding impact nationwide health care reform:
“Piles of studies have shown that people on Medicaid have health outcomes that are no better, and often worse, than those with no insurance at all. But supporters of Obamacare were cheered in 2011 when a lone study, out of Oregon, purported to show that Medicaid was better than being uninsured. Yesterday, however, the authors of the Oregon study published their updated, two-year results, finding that Medicaid ‘generated no significant improvement in measured physical health outcomes.’ The result calls into question the $450 billion a year we spend on Medicaid, and the fact that Obamacare throws 11 million more Americans into this broken program. […]
“I want to make clear that I’m not opposed to spending that sum of money on health care for the poor. What I’m opposed to is wasting that sum of money on health care for the poor. There are so many market-based alternatives to Medicaid, alternatives that would offer uninsured, low-income Americans the opportunity to see the doctor of their choice, and gain access to high-quality, private-sector health care.”
In proposed federal rules announced earlier this week, the Internal Revenue Service announced that worksite wellness programs offered by employer-sponsored health care plans don’t count toward minimum coverage requirements, Reuters reports. Only programs designed to prevent smoking will qualify under the Affordable Care Act.
The health care reform law requires larger employers to meet minimum coverage standards established by the federal government. Those who fail to do so must pay an excise tax penalty, and any employees affected will receive a tax credit to buy health coverage through a state health insurance exchange beginning in 2014.
Tax lawyers who have reviewed the proposed rules called them a victory to labor unions and consumer groups. Business representatives had hoped the IRS would include wellness programs as part of health coverage.
“It is a setback for employers,” Greta Cowart, a partner at Haynes and Boone LLP, said of the IRS ruling. Employers now “lose part of the bang for the buck in terms of the penalty.”
The IRS rules are open to revisions before the law goes into effect, and the public has until July 2 to submit comments to the IRS for changes.
We’re a bit late in noticing this ad (and thanks to the KevinMD.com blog for posting it) but it certainly drives its point home effectively. Part of a 2011 British campaign by the National Health Service, the ad highlights various alternatives to going to the emergency room, such as visiting a general practitioner (or primary care physician), talking to a pharmacist or treating oneself at home.
In her blog post, internal medicine resident Ishani Ganguli says that one factor driving more Americans to ER care is a shortage of primary care doctors. But there’s more to the story, she adds:
“When I shared the NHS ad on Facebook, my economist friend Willa Friedman emailed me with her analysis: ‘So there are at least two explanations: (1) People think they’re special and then under-appreciate/under-change their behavior in response to the impact their actions have on others OR (2) People really have no idea about the options.’ What I realized I liked about the ad is that it uses information and a touch of drama to address both factors and in doing so, puts some of the responsibility on patients.
“We talk a lot about patient or consumer-driven health care and, separately, about doctors’ roles as stewards of health care resources without allying the two causes and recognizing the important role patients play in this stewardship […] Instead, we have to ask and enable patients to work with doctors to use the health care system judiciously. That’s why I think this ad is so powerful, and why we in the United States could stand to learn something from it.”
You probably already suspected this, but the statistic is still somewhat dispiriting: A new study reveals that nearly 4 out of 5 Americans don’t get enough exercise.
According to USA Today, the U.S. Centers for Disease Control and Prevention says that about 79% of adults in this country don’t meet the minimum recommended guidelines for physical activity – 2.5 hours a week of moderate-intensity aerobic activity such as brisk walking (or one hour and 15 minutes a week of vigorous-intensity aerobic activity, such as jogging) plus strength training activities (sit-ups, push-ups, etc.) at least two days a week.
“It amazes me that given all the well-known benefits of physical activity that so few Americans choose to be regularly active,” says Tim Church, director of preventive medicine research at the Pennington Biomedical Research Center in Baton Rouge. “The most powerful thing you can do for your health is become active.”
As the article notes, regular exercise can lower the risk of early death, help control weight and reduce the odds of developing some forms of cancer, as well as heart disease, type 2 diabetes and many other conditions.
In addition to the 21% of adults that said they met both the aerobic and muscle-strengthening activity guidelines, 52% said they are meeting the aerobic guideline, while 29% said they are meeting the muscle-strengthening recommendation.
It seems that a good number of people aren’t too concerned about the effects of the health care reform law – namely, because they don’t even know it’s really a law, NBC News reports.
According to a Kaiser Family Foundation health tracking poll, 42% of Americans are unaware that the Affordable Care Act is currently a law. Of that group, 12% believe it has been repealed by Congress, 7% think the U.S. Supreme Court overturned it, and 23% are unsure of its status.
(Incidentally, we can report with confidence that the law is very much alive… however, we can’t say that it’s well.)
The poll also found that for those who know the ACA exists, most have a negative impression of it – 40% compared to 35% who have a favorable view. Since the presidential election, public support of the law has dropped 7%.
The findings come at a period in which the Obama Administration is scrambling to educate Americans about upcoming ACA provisions, in particular the health insurance exchanges from which individuals and small groups can buy converage starting in 2014. Meanwhile, 49% of poll respondents say they still do not have enough information about the law and how it will impact their families.
Yesterday, President Obama defended of the implementation of his signature legislative achievement: “Despite all the hue and cry and ‘sky is falling’ predictions about this stuff, if you’ve already got health insurance, then that part of ‘Obamacare’ that affects you, it’s pretty much already in place.”
Women and girls 15 years and older with a valid ID will be able to buy Plan B One-Step over the counter, MedPage Today reports. Previously, girls under the age of 17 required a prescription to purchase the emergency contraceptive.
In its announcement of the new age guidelines, the Food and Drug Administration said it based its decision on actual use studies and label-comprehension data showing that girls and women 15 and older understood that the product was not for routine use and wouldn’t prevent sexually transmitted diseases.
The change follows a recent ruling by federal judge Edward Korman that women and girls should have access to over-the-counter emergency contraceptives regardless of age, reversing the earlier Department of Health and Human Services restrcitions. The FDA didn’t address the judge’s ruling, instead acting on an application by Plan B manufacturer Teva Women’s Health that requested the OTC age be reduced to 15 years old.
Protections to limit Plan B’s sale to those 15 and older will include a label specifying age eligibility and stating that proof of age is required for purchase. Cashiers will be prompted by product code to verify the customer’s age.
“Research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States,” FDA Commissioner Margaret A. Hamburg, MD, said in a statement. About one-half of pregnancies are unintended, studies have found.
MedBen University (MBU) is in session! Members of the MedBen team as well as other health care benefits professionals are traveling the Midwest this spring to share timely information about health care issues that are of importance to employers like you.
While some of these events are invitation-only, the MBU on Tuesday, May 7 is open to all employer representatives (including non-MedBen groups). This session will run from 8:30 a.m. to 12:00 p.m. and will be held at the C. Arthur Morrow Conference Center, 1821 W. Main Street, Newark, OH 43055 (next to MedBen’s Home Office). A continental breakfast will be served.
The curriculum for this FREE seminar includes:
If you’re interested in attending this special MBU, please contact Sales Analyst Sally Wood at email@example.com or (800) 423-3151, ext. 502 no later than Monday, May 5. We hope to see you in class!
At, KevinMD.com, emergency physician Leana Wen, MD offers 12 tips to stay safe in hospitals, summarized below:
The U.S. Preventive Services Task Force has recommended that all Americans between the ages of 15 and 65 get tested for the HIV virus, regardless of their risk, Reuters reports.
Currently, the Affordable Care Act advocates coverage of HIV screening for adolescents and adults who are at high risk of infection, based on earlier USPSTFguidelines. Experts believe the new recommendation will lead to a change in the law to cover testing for every adult.
The recommendations are based on evidence showing the benefits and risks of testing and treatment for HIV, the virus that causes AIDS. Recent studies have shown that HIV treatment can reduce transmission of the virus to an uninfected partner by as much as 96%, but there is no cure for the disease.
Task force member Dr. Douglas Owens, a medical professor at Stanford University, said testing all adults within a certain age range may help reduce any stigma associated with testing and encourage people to get tested.
Although cases of HIV infection have dropped in the U.S. in the past three decades, as many as 50,000 Americans become infected with the virus each year.
The American Heart Association (AHA) predicts that one in every 33 Americans will have heart failure in 2030, causing the current cost of care to double, MedPage Today reports.
The U.S. rise in obesity rates has coincided with an increase in the prevalence of heart failure. At current levels, incidences will go from 5 million to 8 million in two decades – a 46% spike, the AHA says in a new policy statement. And direct and indirect costs could leap from the current $31 billion to $70 billion in 2033.
The statement emphasized the need for providers to adhere to evidence-based guidelines, published by the AHA and other professional societies, that outline ways to prevent and treat heart failure. Providers should also encourage patients to adopt lifestyle modifications, such as increased physical activity, that attenuate the risk factors.
To help reduce heart disease costs while encouraging healthier patient lifestyles, MedBen offers Comprehensive Cardiovascular Care Management. From review of patient medical status and alignment with medically necessary care to pre-negotiation for cost management opportunities, this service provides a clinically accountable solution focused on promoting cost-effective, safe, and integrated care management.
For more information about Cardiovascular Care Management and other care management offerings, please contact MedBen Vice President of Sales and Marketing Brian Fargus at firstname.lastname@example.org.
James C. Capretta and Yuval Levin of the Ethics and Public Policy Center argue that Congress needs to put the brakes on the health care reform rollout:
“As the implementation of the major provisions of Obamacare approaches, it is increasingly clear that no one involved is prepared, and that the unintended consequences of the law’s conflicting objectives will be painfully compounded by a rushed and poorly managed effort to put it into effect.
“Opponents of the law should not relish the coming chaos because the damage it will do to our underlying health-care system will be lasting and significant. And supporters should not underestimate the damage that the coming fiasco will do to their credibility. This mutual dread at the law’s 2014 rollout should point to a mutually appealing response: Congress should delay the law’s implementation by at least a year.
“Everyone should now understand that, if there is not a delay, next year will be the scene of an epic disaster for American health care. The trouble started, as it often does, at the top. The president insisted on passing a reform with only Democratic support. That guaranteed large-scale public opposition, which has persisted. It also left the nation’s Republican governors less than enthusiastic about becoming the law’s enablers.”
Some influential cancer specialists have had it up to here with the high cost of prescription drugs, and have banded together to make their case to pharmaceutical companies, The New York Times reports.
In a commentary published in the journal of the American Society of Hematology, the specialists accuse drug companies of making excessive profits on lifesaving cancer drugs – some of which can cost more than $100,000 per year. “Advocating for lower drug prices is a necessity to save the lives of patients” who cannot afford the medicines, they wrote.
The coalition of over 100 doctors and researchers specialize in the potentially deadly blood cancer known as chronic myeloid leukemia. In the article, they note that Gleevec, a drug used to treat the cancer, costs $90.000 a year in the United States – triple the price since it was introduced in 2001.
“If you are making $3 billion a year on Gleevec, could you get by with $2 billion?” asked Dr. Brian Druker, director of the Knight Cancer Institute at Oregon Health and Science University in an interview.
Novartis argues that few patients actually pay the full cost of the drug and that prices reflect the high cost of research and the value of a drug to patients.
The authors hope that their actions will start a dialogue on more sensible drug pricing. Novartis responded in a statement: “We recognize that sustainability of health care systems is a complex topic and we welcome the opportunity to be part of the dialogue.”
A Politico article earlier this week that claimed Congressional leaders were discussing ways to exempt lawmakers and their aides from health insurance exchanges – a requirement under the Affordable Care Act – has put Capital Hill Democrats on the defensive.
According to a follow-up story in Roll Call, talk about possible exemptions arose from concerns by Congressional staff members that the federal government will not be able to contribute money toward their premiums when the exchanges start next year – leaving them to cover 100% of the cost of their health premiums.
“There are not now, have never been, nor will there ever be any discussions about exempting members of Congress or Congressional staff from Affordable Care Act provisions that apply to any employees of any other public or private employer offering health care,” a spokesman for Senate Majority Leader Harry Reid,(D-NV) said in a statement.
Sen. Charles E. Grassley (R-IA), who opposed the health care reform law, added the mandate to the ACA so that Congress would be forced to deal personally with its effects. Now, Republicans are saying that rather than look for a work-around solution, Congressional leaders should just repeal the entire law.
“Obamacare is a train wreck,” Sen. Lindsey Graham, (R-SC) said in a statement. “Congress shouldn’t be able to get out of Obamacare until everyone else does.”
In talking points sent out to counter such charges, House Minority Leader Nancy Pelosi’s communications director Drew Hammill said “Leader Pelosi has suggested as a possible fix to the Grassley language that all Members and all staff (committee, leadership and personal office) be required to choose exchange plans through the Federal Employee Health Benefit Plan. This fix would not require legislation and could be dealt with administratively and would not exempt Members or staff from any part of the ACA.”