Health care spending has slowed in recent years, but is still growing faster than the nation’s GDP, and amounts to nearly 1/5 of the total US economy. Carrington College (via MedCity News) identifies seven significant factors that contribute to health care spending growth – and if not kept in check, higher insurance costs:
At MedBen, we strive to find clients solutions to minimize the impact of rising health care spending. Our advanced surveillance system finds potential for large loss, inappropriate billing, and cost reduction opportunities. Our worksite wellness program promotes the use of your primary care doctor and personal coaching to members with chronic illness. And our fraud detection unit reviews questionable claims and other related information to help conserve plan assets.
Cutting back from a full pack to cigarettes a day to just half may help your pocketbook, but will do little to extend your lifespan, a new Scottish study suggests.
According to HealthDay News, the study, which tracked individuals’ smoking habits from the 1970 to 2010, concluded that only kicking by the habit altogether can a person hope to gain extra years. The researchers found no difference overall in death rates between those who smoked and those who only cut down.
“These inconclusive results support the view that reducing cigarette consumption should not be promoted as a means of reducing mortality, although it may have a valuable role as a step toward smoking cessation,” the researchers wrote.
Another tobacco-use researcher questioned the accuracy of the findings. “It is not possible to know the detailed smoking history of every subject, and there’s a myriad of subtle differences in consumption. There is little doubt that there is a difference in risk between one cigarette per day and 20, but it is not possible to measure all gradations in between,” said Brad Rodu, a professor of medicine at the University of Louisville. He added that participants who smoked fewer cigarettes may have underreported their habit, or compensated by “smoking more intensely.”
Writing for the Los Angeles Times, Tracy Weber and Charles Ornstein explain their concern about little patients know in regard to how their doctors determine what medications to prescribe:
“For most of us, evaluating a doctor’s prescribing habits is just about impossible. Even doctors themselves have little way of knowing whether their drug choices fall in line with those of their peers.
“Once they graduate from medical school, physicians often have a tough time keeping up with the latest clinical trials and sorting through the hype on new drugs. Seldom are they monitored to see whether they are prescribing appropriately, and there isn’t even universal agreement on what good prescribing is.
“This dearth of knowledge and insight matters for both patients and doctors. Drugs are complicated. Most come with side effects and risk-benefit calculations. What may work for one person may be absolutely inappropriate, or even harmful, for someone else.”
To give consumers greater inside into physician prescriving habits, the authors requested, and were given, a list of the drugs prescribed by every health professional to enrollees in Medicare’s prescription drug program, known as Part D. That information has been put into an online database that allows anyone to look up a doctor’s prescribing patterns and see how they compare with those of other doctors.
To learn more about Weber and Ornstein’s findings, visit latimes.com.
More employees prefer a lower-cost, high-deductible employer health insurance plan to traditional coverage, a new study reveals.
According to USA Today, data from 2,503 employees in New York and New Jersey showed that given a choice between a tradtional no-deductible plan, a higher-deductible health plan (HDHP) in conjunction with a health savings account (HSA), and a plan built around one primary care doctor or a limited network (also knows as an accountable care organization), 80% chose the non-traditional offerings. Benefits were the same regardless of the plan design; just the payment structure differed.
The number of people enrolled in HSAs has more than tripled in the last six years, from 4.5 million people in January 2007 to 15.5 million in January 2013, according to trade association America’s Health Insurance Plans. “HSA plans encourage individuals to take an active role in their health care decisions while stretching their health care dollars,” said Karen Ignagni, AHIP president.
MedBen offers consumer-driven health plans (CDHPs) across all group sizes. In addition to the administration of a HDHP tied to an HSA, we offer HRAs and flexible spending accounts (FSAs). These plans can be offered on a stand-alone basis or in a variety of combinations.
To learn more about CHDP options available to your group, contact MedBen Vice President of Sales and Marketing Brian Fargus at firstname.lastname@example.org.
The Internet has become the go-to place for all manner of personal inquiries, including medical research: A recent survey found that 6 in 10 adults have gone online in the past year to diagnosis health issues. But how accurate is the information we find?
On KevinMD.com, family physician Kenneth Lin warns than many health websites contain “flawed, inaccurate, or biased” information. Sometimes, the group running the site may have a hidden agenda, such as a drug company that promotes awareness of a previously unrecognized to spur consumer demand for its new product – a practice known as “disease mongering". Or an organization may willfully disregard scientific evidence to promote certain health beliefs.
For his patients who need trustworthy health information, Lin recommends several websites that have received a high quality rating from independent medical associations, such as Healthfinder.gov and FamilyDoctor.org. The latter site offers a variety of handouts about preventive test basics or newly diagnosed health conditions, including one that advises patients to ask themselves three questions about every health-related website they visit:
While Lin warns patients not to use online information to self-diagnose or treat a medical problem, he does believe that visitng a high-quality health website can help them make better-informed choices – so long as its in conjunction with a doctor’s care.
The U.S. Food and Drug Administration has approved a new drug to treat advanced lung cancer, HealthDay News reports. Gilotrif (afatinib) will be available to patients with a specific subtype of non-small cell lung cancer (NSCLC).
The agency approved the drug to treat tumors that carry key deletions on the epidermal growth factor receptor (EGFR) gene, long a target for lung cancer therapeutics. Mutations in the EGFR gene – thought to occur in about 10% of NSCLCs – are targeted by Gilotrif.
“This drug represents a new important alternative to standard chemotherapy in the 10-15% of lung cancer patients who have EGFR mutations,” said Dr. Jorge Gomez, medical director of the thoracic oncology program at Mount Sinai Medical Center in New York City.
Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, added that new drugs such as Gilotrif “complement standard chemotherapy [and] give hope of increased survival even in late stage lung cancer.”
Along with common side effects such as itching, bladder inflammation, low blood potassium levels, fever, and eye inflammation, serious side effects associated with Gilotrif include diarrhea that can result in kidney failure and severe dehydration, severe rash, lung inflammation and liver toxicity, the FDA said.
Spurred by last week’s postponed enforcement of the Affordable Care Act’s employer mandate by the White House, House Speaker John Boehner (R-Oh.) has announced that the House will vote next week to similarly delay the individual mandate until 2015, ABC News reports.
in his announcement, Boehner said it’s “indefensible” that financially burdened individuals would have to struggle to meet the mandate, which would require them to buy coverage beginning in 2014 or pay a fine. “Is it fair for the president to give American businesses an exemption from the health law’s mandates without giving the same break to individuals and families across the country? Hell, no, it isn’t!”
House Minority Leader Nancy Pelosi refuted Boehner’s comments, explaining that while a “certain reporting” requirement by businesses was indeed delayed for a year, the Obama administration still hoped that employers would still maintain or enact coverage during the 2014 transition period.
Consumers apparently agree that the individual mandate should go on the back burner, at least for the time being (see chart). A survey by HealthPocket found that 41% of respondents believe the mandate waiver should apply equally to individuals and businesses, compared to 12% who said the mandate should remain and 47% who weren’t sure.
Just because the Food and Drug Administration approves a medication doesn’t mean that the manufacturer is free to relax and reap the rewards – often the agency will require more research be done even after the product hits the market. But not every drugmaker is quick to act on such requests, NPR reports.
Post-approval research used to be conducted more or less at the discretion of the manufacturer before the FDA was given the power to enforce the request in 2007. Curious to see if the mandate had improved compliance, Kevin Fain and some colleagues took a look at the five-year period ending in 2011.
Fain’s team found that prior to the FDA’s new powers, over half of the of the 2,000+ studies the agency expected to be performed hadn’t been started by drugmakers. That number fell to 775 studies, or about 44%, in 2011. Progress. But that’s “still a fairly large number,” said Fain, a research fellow at Johns Hopkins Bloomberg School of Public Health.
The proportion of tardy starts to studies ordered by FDA since the agency got mandatory powers has increased steadily and stood at 271, or about 15%, in 2011. More of the old studies got finished, though none of the newly mandatory ones had been.
The NPR article notes that failure to comply with agreed deadlines can land the drugmaker in hot water, though so far the FDA’s enforcement has been limited to warning letters.
An increase in the amount of time Americans spend exercising hasn’t slowed the rise in obesity, the Los Angeles Times reports.
Data published in the online journal Population Health Metrics revealed that while individuals in two-thirds of the nation’s counties have stepped up their physical activity in the past decade, national obesity rates have also climbed. On the positive side, some recent evidence suggests the rates may be leveling off.
“There has been a lot of progress on physical activity,” said Christopher Murray, lead author of the research. “But we probably also need to do more. There are still more calories coming in … than calories going out in physical activity.”
Indeed, bad diet choices are the single leading cause of America’s poor health compared to other countries, said Robert Lustig, a neuroendocrinologist and clinical professor at UCSF School of Medicine. While physical activity is a critical component of well-being, “[t]here is not one study anywhere in the world that shows that exercise [alone] causes weight loss.”
Lustig noted that poor diet also reduces the will to exercise, and advised that people reduce their insulin levels by drinking less alcohol and eating less sugar, trans fats and corn-fed beef and chicken.
Despite last year’s recommendation by the U.S. Preventive Services Task Force that older men shouldn’t get a prostate cancer screening, most still plan to do so, HealthDay News reports.
A survey of over 1,000 men aged 40 to 74 with no history of prostate cancer found that only 13% of respondents plan to follow the USPSTF recommendation and not get tested, compared to 54% who said they’d ignore it and 33% who were undecided. Blacks, wealthier men, those who’d had a recent PSA test, and those who were at least somewhat worried about prostate cancer were more likely to plan to get a test.
Overall, the survey shows that “we need to do a better job of presenting both the benefits and harms of screening to all patients,” said Linda Squiers, lead author of a report on the survey. “We also should explain the science behind the recommendation in plain language so everyone can understand it.”
The USPSTF website states that “current methods of PSA screening and treatment of screen-detected cancer are not the answer", and critics of the test believe it can lead to unnecessary and harmful treatment. Nevertheless, many physicians say the test serves a useful purpose.
MedBen follows American Cancer Society screening guidelines, which recommend that men at age 50 who are at average risk of the disease and are expected to live at least 10 more years consult with their primary care physician about getting tested.
And the saga continues…
According to The Hill, House Rep. Scott Garrett (R-N.J.) has introduced a resolution charging that President Obama violated the Constitution by delaying enforcement of the employer mandate provision of the Affordable Care Act.
“President Obama is in violation of Section 3 of Article II of the Constitution by refusing to enforce the employer mandate provisions of ObamaCare,” Garrett said. “The executive branch, which has no constitutional authority to write or rewrite law at whim, has usurped the exclusive legislative power of Congress.”
The resolution reads, in part: “[T]he executive branch’s unilateral decision to delay the implementation of a law sets a dangerous precedent under which legislation that is enacted through the passage of that legislation by the democratically elected Members of Congress and the signing of that legislation into law by the President will no longer have the force of law and will instead be relegated to having the status of a mere recommendation, which the President may choose to ignore.”
The Obama administration announced last week that it would delay enforcement of the mandate, which requires employers with more than 50 full-time workers to provide health insurance or pay a penalty, until 2015. In defending the move, the White House said it was necessary to allow businesses time to comply with the new law and that other provisions will be implemented as scheduled.
While MedBen recommends that health plan members see their family doctor regularly, it’s also a good idea to rely on your pharmacist for guidance, as a new study of hypertension treatment demonstrates.
According to HealthDay News, researchers found that 72% of individuals who self-monitored their blood pressure with home kits for six months and partnered with a pharmacist for medication guidance kept their high blood pressure under control, compared to 45% whose care was limited to scheduled physician checkups. And six months following the study, 72% of the home monitoring group still controlled their high blood pressure compared to 57% of the usual care group.
“The reason that only about half of people with [high] blood pressure have it under control is that usual care isn’t working. We combined two interventions that we thought would be very powerful together – home monitoring and pharmacist managements – and this is one system that we’ve shown works very well for blood pressure control,” said senior investigator Dr. Karen Margolis, from the HealthPartners Institute for Education and Research in Minneapolis.
This is not to suggest, however, that the family doctor doesn’t play an important role in helping to control high blood pressure, in addition to managing a patient’s care in general. But it does show how taking on greater responsibility for one’s health, and taking advantage of every available resource, can make a positive difference.
An extensive new study of U.S. health trends from 1990 to 2010 revealed some positive developments, according to the Health Hub:
Still, not all the news was good. The study, conducted by the Cleveland Clinic, found that while the U.S. is spending more, our health is only gradually improving compared to other countries. Additionally, the gap between life expectancy and the expected number of healthy years that an American loses to disability increased from 9.4 to 10.1 years.
The study also determined that disease and long-term disability account for nearly half of the U.S. health burden. The researchers suggested that by stressing education and preventive medicine to limit chronic conditions, our country could reduce that number.
MedBen Worksite Wellness adheres to that philosophy. By promoting prevention of chronic diseases through physician office testing that uses the plan member’s primary care provider, we eliminate the logistical headaches and potential redundancy of on-site screenings. And our program uses customized education and counseling to help high-risk plan members reduce their odds of developing diseases in the first place.
For additional information about worksite wellness, contact MedBen Vice President of Sales and Marketing Brian Fargus at email@example.com.
The employer mandate may be off the table for a year, but other provisions of the Affordable Care Act will arrive on schedule, whether businesses understand them or not. And one particular industry is pressing the federal government for greater clarity, Modern Healthcare reports.
The American Hospital Association and Catholic Health Association, in letters filed with the Internal Revenue Service, called for regulators to define and offer examples of “egregious” violations that could threaten tax exemption for about not-for-profit hospitals. The facilities, which make up about 60% of U.S. hospitals, have been under increased scrutiny to prove whether they provide sufficient community benefit in order to retain their tax-exempt status.
The health care reform law restricts the use of aggressive bill collection practices; requires not-for-profit hospitals to promote financial aid; and mandates an assessment of community need every three years. While hospitals that fix small mistakes won’t lose their tax breaks, those that commit “willful or egregious” violations will face potential loss of tax exemption, the IRS says.
The Catholic Health Association commented that such violations should be limited to those “of the utmost seriousness,” and asked for examples to what constitutes a major violation. The AHA called on the IRS to define or clarify “egregious” as well as “willful” violations that will trigger loss of tax exemption.
So many studies have lauded the benefits of aspirin, it’s easy to conclude that a daily dose doesn’t hurt and may even help. But such thinking is unwise, the Cleveland Clinic’s Health Hub reports.
While it’s true many doctors prescribe aspirin therapy for patients with heart disease, self-prescribing to stay heart healthy carries serious risks, says Steven Nissen, MD, Chairman of the Department of Cardiovascular Medicine at Cleveland Clinic – and some, such as gastrointestinal bleeding or hemorrhagic stroke, can be potentially fatal.
“Only those individuals who are at high risk for a heart attack benefit from taking aspirin as a preventive measure,” says Dr. Nissen. “Before taking a daily dose, you need to have a dialog with your physician about the benefits and risks of aspirin therapy.”
Dr. Nissen acknowledges that for patients who have had a heart attack, bypass surgery or a history of coronary artery disease, the benefits of daily aspirin outweigh the risks. But for others, only people with a cluster of risk factors – say, having diabetes, being a smoker, having high cholesterol and high blood pressure – should consider a daily aspirin, and even then only under a doctor’s counsel.
Not every scientific endeavor aims for the fences. Sometimes, as NPR reports, researchers have more modest goals in mind – such as a simple explanation as to why more people don’t favor lower-cost generic pills:
“Matthew Gentzkow, an economist at the University of Chicago’s Booth school, recently tried to answer this question. Along with a few colleagues, Gentzkow set out to test a hypothesis: Maybe people buy the brand-name pills because they just don’t know that the generic version is basically the same thing.”
Gentzkow and his colleagues discovered that people who know that generics contain the same active ingredient as brand-name pills do indeed tend to go for the cheaper alternative. Pharmacists, for example, bought generics 90% of the time, compared with about 70% of the time for the overall population.
Care to learn more about the saving potential of generics? MedBen plan members who get pharmacy benefits management services through Pharmacy Data Management (PDMI) can find information about generic alternatives and compare prices through MedBen Access. By clicking on your name under “My Rx Claims” in the sidebar menu, you will be taken directly to our medication database.
To access the site, simply go to the MedBen.com home page and select “MedBen Access".
Last week’s announcement that the Obama administration that would delay until 2015 the Affordable Care Act provision requiring businesses with 50 or more employees to provide health insurance or pay a penality has generated a variety of reactions:
Delay For Insurance Mandate Pleases Businesses (NPR): “It is welcome relief that the Administration took this step, particularly in light of the numerous questions that remained in terms of how companies were supposed to comply with the employer mandate provisions that were originally set to take effect next year,” said Gretchen Young of the ERISA Industry Committee. “We do appreciate the sensitivity of the Administration to our concerns and hope that it will carry forward into other difficult issues as well.”
Hospitals to Obama: Spare us, too (Healthwatch): “The goal of the [Affordable Care Act] was to extend coverage to the uninsured, which required a shared responsibility from all stakeholders,” [American Hospital Association President Rich] Umbdenstock said in a statement.
“We are concerned that the delay further erodes the coverage that was envisioned as part of the ACA.”
House Republican leaders slam ObamaCare business mandate delay (Healthwatch): In a joint statement Wednesday, Speaker John Boehner (R-Ohio), House Majority Leader Eric Cantor (R-Va.) and their deputies suggested that if employers deserve relief from a requirement to offer health insurance, individuals should not be made to carry coverage.
“The president owes the American people an answer: why does he think businesses deserve a one year delay from the mandates in ObamaCare, but middle class families and hardworking Americans don’t?” the leaders said.
Right on the heels of a recent study that found smoking and surgery don’t mix comes a analysis that suggests heavy drinking also hinders recovery.
Reuters Health reports that a review of 55 past studies concluded that people who have more that a couple of alcholic drinks every day tend to have more complications after surgery than teetotalers or light drinkers. Infections and slow wound healing were the most common complications associated with heavy drinking.
Patients who drank heavily leading up to surgery were also more than twice as likely to die in the month after their procedures than abstainers, according to lead author Marie Eliasen of the National Institute of Public Health at the University of Southern Denmark in Copenhagen.
While the analysis confirms that “alcohol and surgery are a bad combination,” it’s not clear what effect stopping drinking before surgery would have on complications, Bolette Pedersen of the Clinical Health Promotion Center of Bispebjerg told Reuters by email. Pedersen was not involved in the review.
A recent New York Times article highlights America’s growing use of narcotic painkillers in the past decade. Once prescribed primarily for short-term discomforts, OxyContin and other popular opiods now provide relief from such chronic conditions as back injuries, headaches and arthritis – though questions have arisen about the long-term effectiveness of such drugs.
The growing reliance on painkillers has led to an increase in usage beyond what is required for treatment. In addition to the risk of addiction, side effects can include psychological dependence, reduced drive, extreme lethargy and sleep apnea.
Deaths from opoid overdoses have also risen in the past decade, especially among females. According to the Centers for Disease Control and Prevention, prescription pain pills were involved in 6,631 overdose deaths, intentional and unintentional, among women in 2010, a 415% increase from the 1,287 such deaths in 1999.
In spite of the known risks, narcotic painkillers are now the most widely prescribed class of medications in the United States. But depending on a patient’s overall health, many ailments for which opoids provide temporary comfort may realize more lasting relief through physical therapy.
(Thanks to John Goodman’s Health Policy Blog for the link.)
While the health care community was still abuzz about the announcement that the federal government would postpone the employer mandate until 2015, the Obama administration quietly communicated on Friday that it would also reduce the onus on state exchanges to verify consumers’ income and health insurance status.
The Washington Post reports that in 2014, the insurance marketplaces could rely more heavily on consumers’ self-reported information, in the hopes that stronger verification systems would be in place the following year.
Under the Affordable Care Act, Americans who earn less than 400% of the proverty line – roughly $45,000 for an individual – can use tax subsidies to offset the cost of buying health insurance, provided they don’t already receive affordable health insurance from their company. The new regulations put prospective exchange customers on the honor system in regard to meeting this criteria.
“The exchange may accept the applicant’s attestation regarding enrollment in eligible employer-sponsored plan… without further verification,” according to the final rule, which also scaled back states’ responsibilities to double-check the income levels that consumers report.