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02/10/16

  05:25:00 pm, by MedBen5   , 203 words,  
Categories: News, Wellness, Cancer, Research

Urologists More Likely than Primary Care Doctors to Recommend PSA Testing

doctor

Prostate-specific antigen (PSA) testing has declined as a standard wellness screening in recent years... but the likelihood of a recommendation depends largely on whether your doctor is a primary or specialty care provider.

In 2011, the U.S. Preventive Services Task Force advised against routine screenings for all men over 50, instead suggesting that men discuss options with their family doctor and make an educated decision about testing based on family history, lifestyle and symptoms. The American Cancer Society (ACS) and MedBen WellLiving also support this recommendation.

HealthDays News reports that, according to new research, PSA testing by primary care physicians decreased from 36% to 16% between 2010 and 2012, but testing by urologists fell only from 39% to 34% during the same period. The study authors suggest this discrepancy may be due to different perceptions of the benefits of the test among doctors, conflicting prostate cancer screening guidelines, and differences in patients' demographics or expectations.

"Moving forward, this finding emphasizes the need to continue interdisciplinary dialogue to achieve a broader consensus on prostate cancer screening," the researchers from Brigham and Women's Hospital in Boston concluded.

To reduce the risk of prostate cancer, the ACS recommends eating a diet rich in vegetables and fruits, staying physically active, and maintaining a healthy weight.

02/05/16

  10:38:00 pm, by MedBen5   , 340 words,  
Categories: News, Health Care Reform, Taxes

Obama Administration Proposes Change to Cadillac Tax Threshold

White House

In hopes of salvaging the Affordable Care Act's unpopular "Cadillac" tax, President Obama has proposed tweaking it as part of the 2017 federal budget, using individual health insurance marketplace plans as a new threshold yardstick.

According to Business Insurance, administration officials revealed that the proposal would change the threshold for the 40% employer excise tax from an across-the-board amount to one that would vary based on regional individual health care costs. In any state where the average marketplace premium for "gold" coverage exceeds the current threshold, the tax trigger would be set at the level of that average gold premium.

“This policy prevents the tax from creating unintended burdens for firms located in areas where health care is particularly expensive, while ensuring that the policy remains targeted at overly generous plans over the long term if health costs rise faster than the tax thresholds,” Jason Furman, chairman of the administration's Council of Economic Advisers, and Matt Fiedler, the council's chief economist, wrote in a New England Journal of Medicine article.

The threshold value is currently set at $10,200 for individuals or $27,500 for families, based on the tax's original 2018 start date. With implementation now pushed back two years, these amounts will likely increase before the tax takes effect.

Employer groups say that the change is appreciated but insufficient. “Its impact in high-cost areas is just one of its many problems,” James Klein, president of the nonprofit American Benefits Council, said in a statement. “It also unfairly hits health plans that cover large numbers of women, older workers and families suffering catastrophic health events. In short, the Cadillac tax cannot be fixed. It must be repealed.”

Bloomberg View columnist Megan McArdle adds that applying a different criteria to the tax will ultimately prove self-defeating: "If you want to control costs, the areas you want to target are the ones with higher average costs. Instead, the administration is perversely giving those areas a special exemption from the tax."

The White House released the federal budget on February 9.

(Post updated February 10 to confirm proposal's inclusion in budget.)

02/04/16

  10:41:00 pm, by MedBen5   , 327 words,  
Categories: News, Prescription, Cost savings

Drug Price Hikes Another Reason to Have a Smart Rx Strategy

pills

High brand-name drug prices are a frequent topic of discussion, but recently a different wrinkle on pharmacy pricing has joined the conversation: huge increases in individual drug costs. And it's another reason that MedBen makes controlling drug spending a priority.

Turing Pharmaceuticals made headlines last year when it raised the price of its anti-parasitic drug Daraprim more than 5000%, from $13.50 a pill to $750. But while that's an extreme example of spiking drug costs, it's hardly the only one. According to Bloomberg Business, a new survey of about 3,000 brand-name prescription drugs found that prices more than doubled for 60 and at least quadrupled for 20 since December 2014. Overall, the cost of many drugs has continued to rise at annual rates of more than 10%.

As the U.S. winds its way to choosing a new president, the question of how to best control drug prices will undoubtedly pop up in many a debate and campaign ad in 2016. But rather than hold out for a government solution, MedBen is doing its part right now to help clients keep prescription drug costs in check.

Because MedBen believes a high dispense rate for generic drugs is key to controlling spending, our average discount on generics regularly exceeds 77%. Generics are available in nearly every drug class, and each increase in the generic dispense rate results in a 2% decrease in cost.

To further promote the use of generics, MedBen advises clients to exclude high-cost specialty drugs from coverage altogether if a less expensive equivalent is available. Alternately, the pharmacy plan can require members to pay the difference whenever a generic alternative to a brand medicine is available and a brand is dispensed. Through these strategies and others, our clients save an additional 9.3% from pharmacy benefits management compared to national Rx programs.

MedBen finds intelligent ways to reduce drug spending while ensuring that patients have access to the medications they need. Learn more about our Rx advantage by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

02/02/16

  09:11:00 pm, by MedBen5   , 219 words,  
Categories: News, Wellness, Children's Health, Immunizations

Flu Shots for Babies Falling Short, Study Suggests

baby

The percentage of U.S. babies that get flu shots has risen dramatically in the past decade... but the numbers still come in well short of expectations, according to a new study.

HealthDay reports that about 45% of babies aged 6 months to 23 months got vaccinated against the flu during the 2011-12 flu season. While that's a vast improvement over the 2002-03 rate of just 5%, that U.S. Centers for Disease Control and Prevention recommends that most children 6 months and older get a flu shot every year. (MedBen WellLiving guidelines advise clients to consult their pediatrician or family physician regarding childhood influenza immunizations.)

"While flu vaccination for children has gone up, there is still a long way to go to protect every child," said study lead researcher Tammy Santibanez, an epidemiologist with CDC's National Immunization Program. She added that special emphasis should be placed on encouraging black and Hispanic parents to get their children a flu shot, as their vaccination numbers are typically lower than those of white children.

On average, 20,000 children under 5 years of age are annually hospitalized because of complications from the flu. During last year's flu season, more than 140 children died from flu, the CDC said.

"Both parents and doctors can work together to do a better job at ensuring that children are fully vaccinated and protected against the flu," Santibanez said.

01/29/16

  09:21:00 pm, by MedBen5   , 427 words,  
Categories: Announcements, News, Health Plan Management, Health Care Reform, Client Services

MedBen University Schedule for Spring 2016

MedBen University

The 2016 season of MedBen University will soon be in session! For the 15th straight year, MedBen will be offering a variety of events that provide attendees with information they can use to be smarter consumers of health care.

If you’ve never had the opportunity to attend a MBU, we encourage you to join us at an upcoming session. Not only will you receive practical guidance about health care planning and timely updates about regulatory developments, you’ll have the opportunity to pose questions to a team of benefit management professionals and discuss coverage concepts with other self-funded employers. And you're welcome to attend even if you're not a current MedBen client!

The following sessions will be held at the C. Arthur Morrow Conference Center, 1821 W. Main St., Newark, Ohio (located next to the MedBen home office):

Navigating the Health Care Reform Storm
Thursday, February 25

The delay of the "Cadillac" tax and other recent changes to the Affordable Care Act have further complicated an already confusing law. We'll bring you up to date on the current state of health care reform and explore what's to come in 2016 as another presidential election nears. In addition, we'll share important cautionary information regarding the growing use of ACA scare tactics on self-funded employers.

MedBen Broker Roundtable
Thursday, March 10

At this unique session designed specifically for MedBen brokers, we'll discuss the current health benefits management landscape and how it impacts broker sales efforts. By reviewing recent trends in regional sales, group plan design and benefits usage, and learning how regulatory matters affect employer purchasing decisions, attendees will be better equipped to gain and maintain new clients.

Hospital Roundtable
Thursday, March 24
Municipality Roundtable
Thursday, April 7

These industry-specific events offer employers a unique opportunity to learn how health care spending trends affect their bottom line, and get strategies they can use to keep medical and pharmacy costs in check. Plus, attendees can see first-hand how their plans compare with those of other businesses.

And we're just getting started! Once again, we'll take MBU on the road to conduct sessions throughout the Midwest. We’re currently planning additional events in multiple states for the first half of 2016. If you're a MedBen client and we’re coming to your area, we’ll be sure to see that you get an invitation to attend.

To register for one or more of the MBUs listed above, or to receive additional information about upcoming events (whether you're a MedBen client or not), please contact MedBen Sales Analyst Sally Wood at (800) 423-3151, Ext. 502 or swood@medben.com. We look forward to seeing you at a future MBU!

01/27/16

  10:30:00 pm, by MedBen5   , 529 words,  
Categories: News, Reporting, Hospitals, Cost savings, MedBen Analytics, Bundled Payments

Data Transparency Leads to Success in Bundled Payments, Harden Says at Conference

"Data transparency will help drive success in the new world of value-based and bundled payments." That's the message MedBen President and COO Kurt Harden shared with hospital, health system, and provider group representatives at the 2nd Annual Bundled Payment Implementation Forum on January 25.

“The old world of health payments has been about delayed, withheld, filtered, and segmented information,” Harden told conference attendees. "The new world will need more on-demand, widely dispersed, useful, and comprehensive data use."

Kurt Harden

Bundled Payments
Harden was among the featured speakers at the conference, which offered professional perspectives on bundled payments, an increasingly common form of provider compensation.

As the Centers for Medicare and Medicaid Services (CMS) move away from a fee-for-service reimbursement model, a variety of alternative reimbursement models are being implemented. CMS Director, Sylvia Burwell says that 90% of the CMS payments will be in the form of alternate payments by 2018 – among them, bundled payments.

In a bundled payments model, hospitals, health systems, and providers are incentivized to meet payment targets for entire episodes of care. For example, the payment for a hip or knee replacement would cover all elements of the procedure, including the hospital stay, replacement joint, physician charges, anesthesia, most medications, and care for up to 90 days following discharge from the hospital.

Early indications from a variety of nationwide tests on this approach have shown success in controlling costs and improving outcomes for patients. As a result of those successes, CMS announced a mandatory lower joint replacement bundle to be implemented in 67 markets across the U.S. This mandatory bundle, known as the Comprehensive Care for Joint Replacement model, or CJR, will affect over 800 hospitals nationwide who perform lower joint replacements on Medicare recipients.

Full story »

01/26/16

  05:13:00 pm, by MedBen5   , 290 words,  
Categories: News, Wellness, Online Services

Simple Online Test Can Determine Diabetes Risk

diabetes

The U.S. Centers for Disease Control (CDC), in association with the American Diabetes Association and the American Medical Association, has launched a campaign to raise awareness about prediabetes, a serious health condition that affects more than one in three American adults.

HealthDay News reports that most people who have the condition, which is characterized by higher-than-normal blood sugar (but lower than full-blown diabetes), aren't aware of it. Gone untreated, prediabetes can lead to Type 2 diabetes within five years, as well as heart attack and stroke.

To determine your risk of prediabetes, the CDC has created a quick and easy online test at DoIHavePrediabetes.org.

"One of the problems with prediabetes and diabetes is that people sometimes don't feel sick until it's too late" said Dr. Mary Vouyiouklis Kellis, an endocrinologist at Cleveland Clinic. "If they are at higher risk, this [test] will hopefully prompt them to seek medical attention sooner."

If you are determined to be at risk for diabetes, simple changes in activity and diet can make a big difference.

"Losing 5 to 7% of body weight can significantly reduce your risk as well as making lifestyle changes, which include portion control, reducing foods with refined sugars and exercising regularly," Kellis added. "Exercising just 30 minutes a day, five days a week, can also help reduce this risk."

It also benefits to have a family doctor who serves as a lifestyle mentor. The MedBen WellLiving Primary Prevention program encourages regular checkups and recommended care, thereby improving the chances of catching diabetes and other chronic conditions in their earliest stages. Moreover, seeing a physician regularly provides an added incentive to maintain healthy habits.

Got more information about Primary Prevention through MedBen WellLiving by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

01/25/16

  05:38:00 pm, by MedBen5   , 328 words,  
Categories: News, Health Plan Management, Health Care Reform

Freeman, Harden Interviewed for Newark Advocate

The January 23 edition of the Newark Advocate features a "Q&A" interview with MedBen Chairman & CEO Doug Freeman and President & COO Kurt Harden. Speaking to reporter Kent Mallett, Freeman and Harden discuss changes to the health benefits management company over the past three decades and the challenges moving forward.

Kurt Harden and Dog Freeman

Asked about what they're most proud of about MedBen, Freeman answered, "We’re still here, and we’re growing and have great people that have stayed. Most of the senior staff has been here 20 years.” The biggest challenge, Freeman said, is "being relevant in a market that changes practically daily."

Other interview excerpts:

Q. What would you like people to know about this company they may not know?

Doug: “We’re not a household name, except for people that sell us or companies that hire us. But for general public, we’d like to be known for what we do in the community.”

Kurt: “Last year, employees raised $9,500 for Operation Feed, and MedBen added $15,000 to that. Our employees are people we’re very proud of and are very involved in the community.”

Q. How have things changed since the Affordable Care Act became law?


Doug: “It has completely changed the way we do business in so many ways, it’s hard to even fathom it. We discovered along the way, in complying with all the requirements, that we have a very good IT department. The MedBen I inherited when I came here in 1983 doesn’t exist anymore. What we were doing then, we’re not doing any of it now.”

The article also highlights the two men's activities outside MedBen, such as Freeman's work with the Community Health Clinic of Newark and Licking County, and Harden serving on the Newark School Board and City Council. Additionally, Freeman and Harden are asked several "lighter side" questions, such as their favorite TV shows and books, and which person they most admire in their lives (both wisely replied, "My wife").

Read the entire interview at the Newark Advocate website.

01/22/16

  05:10:00 pm, by MedBen5   , 224 words,  
Categories: Announcements, News, Wellness

MedBen-sponsored Fun Run Sets New Donation Record

GTT turkey

For the third consecutive year, MedBen was pleased to serve as a premier sponsor for the Granville Turkey Trot (GTT). The 5K fun run/walk, held on November 26, 2015, raised $110,000 for the Food Pantry Network of Licking County – $10,000 more than the previous year.

Over 2,500 participants got up early on Thanksgiving morning to support the Food Pantry’s mission of ensuring that area families have nutritious food available to them during the holidays and in other times of need. Thanks to their efforts as well as those who donated online as “virtual runners,” the Food Pantry can continue to supply more than 3,600 meals each day in Licking County.

In addition to MedBen's role as a premier sponsor, company Chairman & CEO Doug Freeman serves on the GTT committee.

St. Luke’s Church in Granville has spearheaded GTT since its 2006 inception. Overall, the event has raised $422,500 for the Food Pantry Network. The 5K is truly a community event, as the participants' efforts are supported by hundreds of supportive spectators and helpful volunteers, all who give generously of their time.

MedBen would once again like to thank everyone who made the Turkey Trot such a success – in particular, the MedBen employees who contributed a portion of their Thanksgiving to help those less fortunate by volunteering or participating in the event. We look forward to seeing you all again this coming November!

01/21/16

  06:13:00 pm, by MedBen5   , 335 words,  
Categories: News, Wellness, Cancer, Hospitals

End-of-Life Care More Costly in U.S., but Hospital Stays Lower

hospital bed

A new study of end-of-life practices in the United States and other industrialized nations suggests that while American doctors are more aggressive in their treatment of terminally ill cancer patients, most patients do spend their final days in places other than hospitals.

According the online site Stat, an analysis of health records from 2010 to 2012 of more than 389,000 cancer patients in the United States, Canada, Belgium, the Netherlands, England, Germany, and Norway over the last six months of their lives found that American cancer patients were more than twice as likely than those in other countries to end up in the intensive care unit, and American patients were more likely to receive chemotherapy.

“We’re still overusing the high-tech aspects of medical care,” said Dr. Ezekiel J. Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania and the study’s senior author. “The ICU, the chemotherapy, it seems like we can’t fully control ourselves when it comes to those high-tech elements.”

The United States spent at least $18,500 per patient in their final months, roughly the same amount spent by Canada and Norway, but about twice as much as England.

The finding that American cancer patients are the least likely to pass away in a hospital (only 22% compared to Canada's 52%) comes as something of a surprise, going against long-held conceits. But as more terminally ill patients express a wish to die at home, the U.S. health system is becoming more responsive to such requests.

The study does comes with several large caveats, however. While all individuals in the study were cancer patients, some ultimately died from other diseases. Also, unlike the other countries analyzed, the U.S. doesn't include physician costs in its hospital cost data -- a discrepancy that could add another 11.5% to total expenditures, potentially bringing U.S. costs to at or near the highest in the study. As such, Emanuel said he considers the study “hypothesis-generating and not definitive.”

Emanuel has also co-written a New York Times op-ed piece about the study.

01/20/16

  03:53:00 pm, by MedBen5   , 285 words,  
Categories: News, Wellness, Cancer

Raising Awareness for Cervical Cancer

doctor consultation

January is Cervical Cancer Awareness month and we did not want to miss this opportunity to remind women ages 21 and older how important it is to get a Pap test every three years, in addition to other wellness exams and screenings.

It is estimated that nearly 13,000 new cases of cervical cancer arise each year and that approximately 30% of those cases are terminal. Though it is unclear about what causes cancer, it is certain that HPV (human papilloma virus) does play a role when on the topic of cervical cancer. Due to this, The American Cancer Society recommends females between the ages of 11 and 12 get the HPV vaccination.

MedBen WellLiving understands that developing an ongoing professional doctor-patient relationship is critical to better health. By developing this relationship and visiting your doctor at least once a year (for your annual wellness visit, if nothing else) you’re educating yourself on risks you may not have even known existed for yourself.

For more information on what steps are specifically best for you when preventing and testing for cervical cancer and other chronic diseases throughout the year, schedule a trip to your family physician’s office.

Full story »

01/19/16

  07:08:00 pm, by MedBen5   , 355 words,  
Categories: Wellness

Wellness Exam More than Just Disease Detection

weigh-in

Every few months, it seems another article comes out that questions the value of the annual wellness exam. At MedBen, we're convinced of their usefulness – and for reasons that go beyond early detection of chronic conditions.

In the latest contribution to the ongoing debate, The Wall Street Journal approaches the issue from both sides. On the one hand, some members of the medical community consider regular physicals "a waste of health-care resources" that doesn't reduce incidences of illness. Conversely, others find the yearly checkup to be "an important part of building a physician-patient relationship" that can lead to unexpected diagnoses.

Regardless of where one stands on the question of annual wellness exam in regard to detecting disease – and MedBen has seen first-hand how they can benefit the long-term health of a patient – there are other benefits that justify its time and cost:

Building a comfort zone. By developing and maintaining a doctor-patient relationship through a yearly checkup, both parties tend to feel more comfortable about talking openly regarding areas of concern.

Getting the big picture. Regular visits with the same doctor raises the likelihood of detecting crucial health changes – not just physical, but emotional and mental as well.

Greater accountability. If you've gotten into some unhealthy habits, the wellness visit is the perfect opportunity to redirect your efforts. Moreover, the simple knowledge that your doctor expects you to be accountable for your lifestyle choices can serve as a motivation to improve.

Focused testing, focused dialogue. Doctors use evidence-based guidelines for age and gender, so the wellness visit focuses on the tests that are of greatest use to the patient. And the concurrent conversation serves an equally valuable purpose – namely, to determine through testing and dialogue where the patient may be at risk.

MedBen WellLiving emphasizes doctor office testing over health risk assessments and on-site screenings. Annual wellness visits give the patient a true incentive to make positive changes – a key to continued good health and lower care costs.

Learn more about the MedBen WellLiving approach to your employees' better health by visiting MedBen.com or contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

01/15/16

  11:45:00 pm, by MedBen5   , 370 words,  
Categories: News, Health Care Reform

Marketplace Enrollments Up, But Not All News Good

Capitol-Caduceus-bills

The latest open enrollment period for individuals who wish to enroll in the federal health insurance marketplace ends on January 31. According to federal officials, over 11 million people have enrolled, surpassing last year's mark as well as the 10.5 million goal that the Obama administration set for the year.

However, while the number of people getting private health insurance under the Affordable Care Act looks impressive, it fails to take into account the trouble that's brewing underneath the surface:

Younger, healthier adults have been slow to sign up for coverage. The Wall Street Journal reports that only 26% of people who have enrolled in the federal marketplace are ages 18 to 34 -- well short of the 40% goal set by actuaries when the marketplaces were rolled out in 2013.

Many people who have coverage through the marketplace spend a substantial portion of their income on health expenses. According to a new study, even individuals with subsidies to make coverage more affordable are paying more on premiums, deductibles and other out-of-pocket payments than was originally predicted -- anywhere from 10% of their income to upwards of 25% for those with significant medical needs.

More insurers may leave the marketplace soon. One of the nation's major health insurers recently threatened to drop out of the federal and state marketplaces in 2017, citing lower-than-promised enrollment and high usage. Several smaller insurers already have dropped out or announced their intentions to leave if the financial situation doesn't improve.

On the Health Care Policy and Marketplace Review blog, health policy consultant Bob Laszewski recently offered his two cents on the 2016 outlook for Obamacare... and he says it's not just young people who need to enroll in the marketplaces to help them succeed:

"I worry more about the really poor take-up rates for the healthy people who have not signed up in the 200% of federal poverty level and above brackets than I worry about the percentage of the young who have signed up. Way too much emphasis is put on this age 18-to-35 statistic. Yes, they are more often healthy but under Obamacare the youngest pay one-third the premium of the oldest. We really need the healthy to sign up in much bigger numbers, that have so far been holding out, more than we need the young."

01/14/16

  08:56:00 pm, by MedBen5   , 575 words,  
Categories: News, Wellness, Health Plan Management, Cancer

Task Force Raises Recommended Mammography Age; MedBen Continues with Current Recommendations

pink ribbon

In spite of the latest change in the U.S. Preventive Services Task Force guidelines for mammography screenings, MedBen is keeping its current screening recommendations in place.

On January 11, the USPSTF released final guidelines regarding the age range and frequency of breast cancer screenings. Affirming a draft circulated last year -- and echoing preliminary guidelines offered back in 2009 -- the panel advised that screening mammograms are most effective for women ages 50 to 74, performed every two years.

Under the Affordable Care Act, the USPSTF language becomes a "B" preventive care recommendation, which means that group health plans must cover mammograms at full cost in accordance with the new guidelines. Additionally, Congress last month extended a law requiring health insurance companies to pay for annual mammograms for women in their 40s if their doctor recommends earlier screenings.

As concerns about false positives and unnecessary biopsies have arisen in the past few years, questions about the ideal age to start getting mammograms have increased accordingly. Last October, the American Cancer Society (ACS) revised its own guidelines, raising the minimum starting age from 40 to 45 and recommending annual mammograms from ages 45 to 54, and then every other year from age 55 until an age where life expectancy is ten more years.

At MedBen, our WellLiving program recommends that women start getting mammograms at age 40 every two years until their physician decides not to order the screening -- and we are continuing that recommendation. Further, we recommend that clients continue paying 100% of the cost of these screening mammograms as part of the WellLiving benefit, even in light of the USPSTF's final guidelines.

Full story »

01/11/16

  10:44:00 pm, by MedBen5   , 346 words,  
Categories: News, Wellness, Incentives

Employers More Invested in Wellness Incentives

blood pressure

"In it to win it"... it's a phrase frequently uttered by everyone from pro athletes to reality show contestants. And increasingly, the same philosophy applies to employers that offer wellness programs as well.

According to BenefitsPro, a recent survey of human resources professionals found that from 2010 to 2015, the median financial incentive for participation in certain health programs nearly tripled, from $150 to $400. The largest incentives are tied to getting annual wellness exams and screenings and tracking physical activity, both of which paid plan members a median of $100 – typically through reductions in premiums and contributions to member health accounts.

More employers tie incentives to participation (47%) than health outcomes (34%), while 18% use a combined criteria. As for how employers measure the success of their wellness program, 35% base it solely on member participation (down from 55% in 2010) and 17% consider "employees’ attitudes toward health and recognition of the importance of healthy living."

It's probably not a coincidence that wellness incentives have risen since the 2010 passing of the Affordable Care Act, which allows employers to offer bigger rewards. But it's obviously important to use the incentives wisely, to realize the maximum return on investment, in terms of employee satisfaction in addition to long-term monetary savings.

Through its WellLiving offering, MedBen has extensive experience in helping clients design wellness programs that provide support through financial rewards. We can help your business develop an incentive program appropriate to plan member needs – complemented by actionable reporting that not only demonstrates the overall progress of your program, but shows in pure dollars-and-cents whether or not the plan is benefiting you financially as well.

Moreover, our incentive recommendations are backed by a knowledgeable Compliance team that can advise on the legalities of the incentives, and offer guidance on ways to ensure that such incentives are equitable for everyone.

A strategic and educated approach to incentives can elevate a wellness program from a simple "perk" to a force for real and lasting change. To learn more abour how MedBen WellLiving can benefit both employee health and the bottom line, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

01/08/16

  10:15:00 pm, by MedBen5   , 304 words,  
Categories: News, Health Care Reform

President Obama Vetoes Bill to Repeal ACA

White House

It's official: The president has shot down an attempt to scrap the Affordable Care Act.

To the surprise of absolutely no one, on January 8 President Obama vetoed a bill to repeal the health care reform law, saying that it "would reverse the significant progress we have made in improving health care in America."

The legislation, and Obama's anticipated response, was largely a symbolic action in a presidential election year. Unlike earlier repeal efforts that passed in the Republican-led House but stalled in the Senate (also with more GOP members, but lacking a sufficient majority to pass such bills through regular votes), this time Republicans pushed legislation through both Houses by using the process of budget reconciliation that prevented a filibuster by Senate Democrats. The process demonstrated that with a Republican president in office, a repeal of the ACA is possible.

Obama's veto was only the eighth of his presidency, and Congressional Republicans don't have enough votes to override the president. Still, GOP members consider it a victory.

“This vote sends the signal to the president and the American people there are changes that need to be made in this law.” said Bill Hoagland, senior vice president of the Bipartisan Policy Center in Washington and a former longtime Republican staff member on the Senate Budget Committee. He did also note, however, that among Republicans “there is a recognition that you may not do away with a number of the provisions that are popular.”

Sylvia Mathews Burwell, the Secretary of Health and Human Services, expressed incredulity at the Republicans' actions. “We are in the final weeks of Open Enrollment for 2016 under the Affordable Care Act and saw unprecedented demand for January 2016 coverage. Yet at the same time, we continue to see efforts to repeal the ACA and turn back the clock,” she said in a statement.

01/07/16

  10:37:00 pm, by MedBen5   , 224 words,  
Categories: MedBen Analytics, Bundled Payments

MedBen Analytics Bundled Payment Webinars Offer Final Rule Analysis, Practical Advice

Last month, MedBen Analytics offered several bundled payment webinars to hospital administrators whose facilities will soon take part in a mandatory Comprehensive Care for Joint Replacement (CJR) program. The presentation from December 17 is now available for viewing below, and also at the new MedBen Analytics YouTube page.

Entitled "Understanding the Final Rules: Comprehensive Care for Joint Replacement," the webinar offers attendees an overview of value-based payments and a professional analysis of the CJR rules. The Centers for Medicare and Medicaid Services (CMS) will start the mandatory CJR program for selected health systems in April 2016.

Additionally, webinar co-presenters Kurt Harden, President and COO of MedBen Analytics, and Kimberly Hartsfield, Vice President of GE Healthcare Camden Group discuss practical next steps for best ensuring success in the CJR and insights for key savings opportunities. Attendees also are given an opportunity to assess hospital-specific historic performance.

MedBen Analytics will be conducting additional bundled payment webinars throughout 2016. Hospital, health system and physician group administrators who would like to be added to the webinar invite list are welcome to contact MedBen Sales Analyst Sally Wood at swood@medben.com.

Administrators that are interested in an analysis based on the lower joint replacement services using the Medicare Limited Data Sets for 2014 are welcome to contact Harden at 888-633-2364 or kharden@medben.com. We also invite you to visit the MedBen Analytics website for additional information.

01/06/16

  09:24:00 pm, by MedBen5   , 293 words,  
Categories: News, Health Care Reform, Reporting, IRS

Affordable Coverage Threshold for ALEs Higher in 2016

A reminder for the 2016 plan year: The threshold for Applicable Large Employers (ALEs) – that is, those with 50 or more full-time employees – to determine whether or not the contributions they charge their employees for health coverage is affordable under Affordable Care Act rules has been raised to 9.66% of an employee's household income. This is a slight increase from last year's 9.56% threshold.

IRS Form 1095-C

As ALEs likely wouldn’t have access to employee household incomes, they can instead use any of three government-approved affordability "safe harbors":

  • 9.66% of the employee’s W-2 wages;
  • 9.66% of the employee’s rate of pay; or
  • 9.66% of the federal poverty line.

Once an employer determines that the contribution for coverage is affordable, that information must be noted on Line 16 of IRS Form 1095-C to avoid a financial penalty. You can learn more about applicable safe harbor codes by watching this segment from MedBen's recent ACA Reporting Workshop

Again, providing this information applies only to businesses with 50 or more full-time employees, so it's important to have an accurate employee count – particularly if you're on the under-50 "bubble." Accurately counting both your full-time and part-time employees will make a difference in which parts of health care reform apply to you and your health care plan. And, making this determination is required each calendar year using the prior calendar year’s employee information.

Rather than relying on outdated information, MedBen encourages clients to perform a new employee count every plan year. To assist with this task, we recently prepared a Determination of ALE document, which is available for download at MedBen.com.

Clients who have questions regarding their full-time and full-time equivalent employee count, or who would like to inquire about IRS Form 1095 reporting services available through MedBen, are welcome to contact Vice President of Compliance Caroline Fraker at 800-851-0907 or cfraker@medben.com.

01/05/16

  09:18:00 pm, by MedBen5   , 252 words,  
Categories: News, Prescription, Cost savings

While U.S. Drug Spending Jumps, MedBen Rx Controls Costs

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Government numbers indicate that prescription drug spending in the U.S. will likely continue to spike in the coming years... but MedBen is helping its clients to buck the trend.

According to a recent analysis by the Centers for Medicare and Medicaid Services, Americans spent $297.7 billion on prescription drugs in 2014. That marks a 12% jump from the prior year, the largest annual increase in more than a decade. Moreover, federal officials estimate that yearly spending on medications will grow 6.3% on average through 2024.

The growing popularity of expensive specialty drugs, and rising medication costs in general, have contributed to the spurt in spending. But there is a silver lining: An analysis by the prescription drug price comparison site GoodRx revealed that in 2015, many of the most popular generic drugs went down in price, continuing a decade-long trend.

In 2014, MedBen clients saw their pharmacy plan spending rise just an average of 0.5%. A large part of the savings comes from simply returning to groups what is rightfully theirs – 100% of pharmacy rebates go back to the client.

Further, MedBen has for many years encouraged the use of generic drugs to save pharmacy plans money – on average, clients receive a 77.4% discount on retail generics. And we help to keep specialty drug costs manageable by working with groups to balance plan member needs with bottom line considerations.

Even in a climate of soaring prescription drug costs, the MedBen Rx Advantage works. To learn how we can benefit your business, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

12/31/15

  03:49:00 pm, by MedBen5   , 287 words,  
Categories: Announcements

A Note from Our Chairman

To our customers, consultants and brokers:

Hard though it may be to believe, yet another year has seemingly flown by. And before we close the book on 2015, we wanted to take a moment to wish you a Happy Holiday season on behalf of the entire MedBen staff!

Much like every year since the passage of the Affordable Care Act, 2015 has brought with it its own set of unique challenges, which will impact all of us in the months and years to come. But as often happens, these challenges have spurred MedBen into finding better ways of serving you – with improved technologies, more detailed reporting, and most importantly, new (or improved) ways of helping clients to save money.

Additionally, while we focus most of our energies on serving our self-funded employer block, MedBen continues to expand its service offerings. This year we formally introduced MedBen Analytics, LLC, which provides bundled payment solutions to health care systems. While this new service is designed specifically for hospitals and physician groups, some of the innovations we've developed in its conception will likely find applications in other areas of our business as well.

Once again, MedBen extends its warmest wishes for the holidays and sincere hopes for a prosperous new year. And remember, if you ever have anything on your mind – be it a question, comment or suggestion – we encourage you to call either of us anytime. We'll be happy to talk with you.

Sincerely,

Doug Freeman

Chairman & CEO

Kurt Harden
President & COO

A quick reminder: MedBen will be closed on Friday, January 1 and reopen on Monday, January 4. Should you have a claims or benefits question, please visit MedBen Access. Our online customer service center is available 24/7 for your convenience!

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