U.S. health care spending growth has been relatively moderate this decade, but some recent numbers suggest that costs could soon see an upswing. For employers, it's an ideal time to review their current health plan administrator and ensure that measures are in place to control potential spending spikes.
According to the Los Angeles Times, the U.S. Labor Department says that health care spending rose 1% in August ‒ the largest single-month increase in more than three decades. While that may not seem like much, similar increases over a year's time could lead to a double-digit spending jump.
Among the factors accounting for the monthly growth increases in hospital services costs and prescription drug pricing. Overall, average drug prices have climbed 6.3% in the past 12 months... and the likelihood is that future years will bring similar increases. Fortunately, MedBen can assist employers in beating these trends.
If you received our new Client Report, you know that we've highlighted some of the ways we help groups control their health plan costs, from our provider-driven claims surveillance system to our advanced reporting platform. And for pharmacy plans, we offer total price transparency, with 100% of pharmacy rebates and discounts returned to the client.
One of our most effective savings tools, plan design, draws upon our years of expertise in third party administration. Our goal is to regularly meet with clients and consultants to review plan activity and discuss ways to further improve care while reducing medical spending.
If you're not a current client, we'd be happy to talk about your current health benefits package and how we can help you defy health care spending trends. Contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org to learn more.
At an employee appreciation luncheon on Friday, September 9, MedBen honored employees who have reached anniversary benchmarks in 2016. The recognition presentation was co-hosted by MedBen President & COO Kurt Harden and Vice President of Compliance Caroline Fraker. Harden is also among the employees who are celebrating their 25th year with the company.
Harden joined MedBen as Director of Public Affairs in 1991, when the company was primarily a mutual life insurer with a small workforce and an up-and-coming third party administration division. At the luncheon, he thanked everyone for their continued service and singled out those employees also celebrating benchmark anniversaries. "Your loyalty and good work motivate me, and together we all make MedBen a success," he said.
Also receiving special congratulations at the luncheon on their 25th Anniversary were: Sheri Gutridge, Senior Accountant; Monica Jackson, Claims Examiner III; and Cathy Valentine, Data Prep and Data Entry Manager.
Sheri Gutridge has been a member of the MedBen Accounting Department from her very first day, starting as a Staff Accountant following a short stint as a temp. "I have never considered going to another department," she said after the event.
A regular at the lunchtime exercise classes offered by MedBen, Gutridge said that she appreciates how the company "strives to promote wellness." As for what she enjoys most about being an employee, she replied, "It's a wonderful working environment. I hope to be here until my retirement."
Monica Jackson has also worked for just one department (Claims) in her 25 years at MedBen, and in a single capacity, as a Claims Examiner. But as she's gained valuable experience, her responsibilities have grown accordingly. In addition to her own examiner duties, she also trains new examiners and reviews their claims for accuracy.
Jackson cites her co-workers as the best part about working at MedBen. "All the people I work with are great," she said.
Cathy Valentine first joined MedBen as a Submission Control Clerk in the Claims Department, and held various Claims positions before becoming a member of the Data Services team. "After 25 years, I still enjoy coming to work every day," she said.
Valentine added that she is amazed by how much data storage has changed from 1991, when claims were saved to microfiche, then later to disks and now digitally. Likewise, MedBen itself has changed, always with an eye toward improving the client experience. "All of the many employee benefits and products that have been introduced over the years continue to inspire me," she said.
Other MedBen employees honored at the event include:
Not too long ago, it seemed that most people got their flu shot at just about the same time every year. But now that many pharmacies offer walk-in vaccinations ‒ with one major chain even going so far as to offer shopping discounts with your shot ‒ the flu shot season has practically become a year-round event. But is that a sensible approach to protecting against a serious condition like influenza?
The length of a vaccine's effectiveness can vary from person to person, so getting a shot too early could make you vulnerable during the peak months of flu activity (roughly November through March). Moreover, health plans typically pay for just one flu shot per year, and cover additional shots only in cases of medical necessity.
Therefore, when you get the immunization matters. For most people, the best time to get immunized is just prior to the start of flu season ‒ mid- to late October is a good rule of thumb. Keep in mind that the vaccine can take several weeks to become effective, so procrastinating isn't a good idea, either.
Employees covered under a MedBen-administered health plan who have questions about their flu shot benefits are welcome to contact our Customer Service Department at 800-686-8425.
Group health care plans can take up a sizable chunk of employer budgets, but MedBen offers a variety of ways to free up a portion of those funds for other business matters. In our new MedBen Client Report, we highlight some of the methods we use to save clients money.
According to Benefits Pro, a new report from the Society of Human Resource Management says the cost of providing health coverage to the average U.S. employee rose nearly $500 over the past year. That means employers are now spending an average of $8,669 annually for each worker they cover, or about 7.6% of their budget. Fortunately, MedBen has multiple solutions to keep your coverage costs in check.
This year's Client Report explains how saving employers money is a companywide effort. Our solutions range from a doctor-driven system for comprehensive claim review, to a transparent pharmacy plan that returns 100% of prescription rebates and discounts to the client. The report also shows the actual savings clients are seeing from these and other cost containment services.
We recently sent the Client Report to our self-funded group contacts and brokers. If you have not yet received one or would like to request additional copies, please contact Sales Analyst Sally Wood at email@example.com. Or, if you're an employer interested in knowing more about the ways that MedBen's self-funded savings solutions can benefit your bottom line, you're welcome to contact our Sales and Marketing Department at 888-627-8683.
Pharmaceutical company Mylan finds itself in a firestorm of controversy regarding its EpiPen auto-injector, the price of which has skyrocketed from just $100 in 2007 to over $600 today. While its convenience has made it a must-have for certain allergy sufferers, its high cost has upset consumers and health plans alike and opened the market for less expensive options.
An EpiPen injects a dose of epinephrine (adrenaline) into individuals who experience a serious allergic reaction known as anaphylaxis. The key to the EpiPen is not the epinephrine itself, which can be purchased for as little as $15.00, but a dispensing unit that offers easier injections. This patented feature is a major reason that the EpiPen has a virtual monopoly as an anaphylaxis treatment.
Several cheaper alternatives are available, though all lack the EpiPen's ease of use and reliability. Because of the lack of practical substitutes, health plans will typically cover a portion of the EpiPen's cost and require the plan member to pay either a percentage of the remaining charge or a flat copay.
In the wake of the controversy, Mylan is now offering coupons that lower the patient's out-of-pocket cost to no more than $300. Additionally, the company will soon offer a generic EpiPen, also retailing for $300. Meanwhile, competing drugmakers have stepped up their efforts to provide alternative auto-injector options.
MedBen clients who have a question about EpiPen coverage or any aspect of their prescription plan are welcome to contact their Group Service Representative. Additional information about EpiPens and available alternatives can be found at the MedBen Access website.
Although they may not cure mental health diseases, certain foods have been shown to help improve and protect the brain and its functions. A study from the journal Neurological showed that adding servings of fruit to your diet (1–2 cups daily depending on your age and gender, per USDA recommendations) decreases the risk of stroke by 11%.
But why does fruit play such a vital role in brain health? The study suggests that fruit has a positive effect on blood pressure and high cholesterol. Potassium-rich fruits such as avocados help to reduce the risk of hypertension, which has been linked directly to increased risk of stroke. It should be noted, however, that avocados are fatty fruits and consumption should be kept to one-quarter or one-half of an avocado once a day.
Blueberries are also a good example of brain-healthy fruit, packed full of antioxidants which help to protect the brain from oxidative stress and may reduce the effects of age-related conditions such as Alzheimer’s disease or dementia. Citrus fruits, such as lemons and pomegranate juice, provide antioxidant properties as well. But again, be conscious of the amount consumed. Because pomegranates are fairly high in sugar, limit your intake to no more than two ounces a day, diluted with spring water or seltzer.
If you have questions about how much fruit you should include in your diet, or to gain more information on how to keep your brain healthy, MedBen WellLiving suggests consulting your family doctor.
Here's a good reason to promote the value of exercise to your employees: It could save them $2,500 a year.
According to a new study published in the Journal of the American Heart Association, an analysis of 26,239 men and women found that just 30 minutes of walking five days a week can result in a substantial reduction in medical costs.
Researchers from Yale, Johns Hopkins, and other universities and hospitals reviewed data from a 2012 health and lifestyle survey and determined that individuals who exercise regularly realize greater financial savings than those who don't engage in regular physical activity. People with a history of cardiovascular disease who worked out regularly saved up to $2,500 annually, including $400 on prescription drugs, than those who did not. Even people with less serious health issues can cut their medical bills by an average of $500 just by exercising.
At MedBen, we incentivize our employees for staying active: Those who work out three or more times a week will have additional money contributed to their HRAs. If you're a MedBen WellLiving client and would to discuss ways to incentivize your work force to exercise, just contact your Group Service Representative.
While precision medicine is in its relative infancy, its implications for our future health is significant. Tapping into that which makes us unique as individuals ‒ genetics, lifestyle, and environment ‒ improves the chances of better treatment outcomes and faster recoveries.
MedBen recently took its first step into this intriguing medical model through the introduction of a pharmacogenetics test that determines personal compatibility with hundreds of commonly prescribed drugs. By eschewing the "one-size-fits-all" approach that once was common to prescribing, the physician is better able to choose the drug and dose that's best for the patient.
Pharmacogenetics encompasses such common therapeutic categories as cardiovascular (heart), oncology (cancer) and pain management. It also extends into such sciences as psychiatry and neurology, thereby offering potential benefits for mind and body alike.
Besides reducing the trial-and-error common to prescribing, there's another important consideration for using pharmacogenetics testing: It also reduces the risk adverse drug reactions that can lead to unwanted side effects, be they minor or something much more serious. Plus, additional drugs may be required to treat those side effects, resulting in extra costs.
There's a good likelihood that MedBen will be exploring other forms of personalized medicine down the road. In the meantime, we invite you to learn more about pharmacogenetics testing and the positive impact it can have on your plan members. Contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
Heart disease and cancer rank as the number one and two causes of death in the United States, according to new data from the Centers for Disease Control and Prevention. The two diseases are trending in opposite directions ‒ but in both cases, early detection through preventive care can help to bring the overall mortality numbers down.
By encouraging preventive care through a wellness program like MedBen WellLiving, employers can help their employees to reduce the risk of developing a fatal disease such as heart disease, detect cancer in its earliest stages, or realize a higher quality of life in general. Additionally, the financial savings from early detection can be significant.
MedBen WellLiving takes a two-pronged approach to worksite wellness: Primary Prevention, which advocates annual wellness exams and cancer screenings for the entire workplace; and Specialty Care, which connects plan members at higher disease risk with registered nurses for personalized counseling. Together, these programs can aid your business greatly in reducing illness while improving productivity.
Worksite wellness works best when it focuses on preventing major diseases through timely intervention and promoting the doctor-patient relationship, and MedBen WellLiving can help you do that. Get more information by visiting MedBen.com or contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
The staff of MedBen want to wish you and your family a safe and relaxing Labor Day!
Our home office will be closed on Monday, September 5 in observance of the holiday. We will reopen at 8:00 a.m. EST Tuesday, September 6.
Additionally, MedBen will be closing at 12:00 p.m. EST on Friday, September 9 for a companywide employee recognition event. We will reopen at 8:00 a.m. EST on Monday, September 12.
During these times, please remember that clients can use the 24/7 online services of MedBen Access to check on benefit coverage and the status of any pending claims. Simply go to MedBen.com and select "MedBen Access". For those who use Pharmacy Data Management (PDM) as their pharmacy benefits manager, you can check on prescription claims and find lower cost drug options through MedBen Access by clicking on the "Rx" button located in the "My Claims" section of this website.
If you're a MedBen Flexible Spending Account (FSA) or Health Reimbursement Arrangement (HRA) participant in addition to having other coverage, you also can use MedBen Access to see your FSA/HRA balances, claims submissions and payments. When you log in to MedBen Access, you'll find an "FSA/HRA Online Inquiry" option (visible only to groups offering MedBen FSAs/HRAs) under the "My Plan" section located on the left sidebar. By selecting this option, users are automatically taken to the MedBen FSA/HRA Online System.
Once again, have a good holiday!
A new benefits survey indicates that the trend of switching from fully insured to self-insured is expected to grow by 35% in the next two years. This is to no surprise since fully-insured groups continue to see high premium cost growth.
According to Employee Benefits News, the changeover can be attributed to the “explosion in healthcare costs," with inflation rates for insurance carriers hovering around 8% and prescription drug costs running closer to 12-15%. At the same time, an onslaught of new regulations under the Affordable Care Act have reduced those carriers' ability to control costs.
Self-funding offers a greater degree of freedom from state and federal regulations compared to traditional insurance. Moreover, stop-loss carriers offer added financial protections to make self-funding even more appealing to employers looking to save money.
Once exclusive to larger companies, self-funding has evolved so that even businesses with as few as 25 covered lives can benefit from its cost-saving potential. And for those employers who already self-fund, they can add worksite wellness and other services to their plans, which can help to reduce their coverage costs even further.
Self-funding your health care coverage through MedBen offers all these advantages, plus others ‒ stop-loss independence to find you the best rates, advanced claims surveillance using board-certified medical specialists, and interactive reporting that allows clients to see spending trends. And one more: We listen to your concerns and respond with better solutions.
Whether you're already self-funding or considering the switch, MedBen can help your group get the most out of your health care coverage. Get more information by contacting Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
The U.S. Preventive Services Task Force (USPSTF) recommendation against routine screenings of prostate cancer has resulted in fewer diagnoses for the disease, new research finds. But the question remains as to whether more men will ultimately develop late-stage cancer that may have been detected earlier through such screenings.
Citing a large number of false positives, in 2012 the task force formally changed its guidelines for prostate-specific antigen (PSA) testing. Since then, diagnoses of early prostate cancer in American men aged 50 and older dropped by 19% between 2011 and 2012 and by another 6% the following year, HealthDay reports.
Less frequent screening may have a downside, however."Some men who should be treated are either losing the chance for cure or presenting later and needing to undergo more treatment and more side effects for a possible cure," said Dr. Anthony D'Amico, chief of genitourinary radiation oncology at Brigham and Women's Hospital.
"The answer to this dilemma will come with personalized medicine based on risk-based screening ‒ screening men preferentially in good health and at high risk," D'Amico added.
MedBen WellLiving currently follows the USPSTF recommendation that men should discuss PSA testing options with their family doctor and make an educated decision about testing based on family history, lifestyle and symptoms.
MedBen clients who have any questions about USPSTF preventive care requirements under the Affordable Care Act are welcome to contact Compliance Supervisor Erin Kelly at email@example.com.
A recent Harvard Medical School study of how prescription drug prices are set suggests that, despite presidential campaign promises of reduced costs through government intervention, current conditions make it difficult for them to make significant changes. So controlling drug costs will continue to require private sector solutions ‒ and MedBen is perfectly positioned to help employers make informed pharmacy plan choices that can save them money.
Ironically, Congress' ability to control drug cost is hindered by its own actions. The Harvard researchers cite the existence of government-protected “monopoly” rights for drug manufacturers as the “most important factor” that drives prescription drug prices higher in the United States than anywhere else in the world.
With no government fix likely, it falls to health plans to find ways to keep their prescription drug costs in check. MedBen clients are aided greatly in this task through the availability of a pharmacy benefits consulting group that provides employer-specific financial and plan management consultation.
Developments in genetic technology are also aiding self-funded groups in pharmacy management. MedBen recently introduced an innovative service that determines personal compatibility with over 300 commonly prescribed drugs. Plan participants receive reports that aid the provider in avoiding medications that would ineffective or harmful to the patient, thereby reducing wasteful spending.
MedBen offers these and other pharmacy savings solutions so you may better manage your plan's prescription drug costs. We invite you to contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org to learn more.
As more hospitals gravitate away from traditional fee-for-service to alternative payments methods, self-funded groups are making changes to their health care plans to capitalize on the potential savings. According to an analysis by the National Business Group on Health (NBGH), nearly half of employers have incorporated some type of value-based design in their plan.
In a recent article about alternative payment methods, MedBen Vice President of Compliance Caroline Fraker observed that "large employers in your communities are already experimenting with some form of bundled payment models." Likewise, employers have introduced various wellness-based measures that allow them to benefit from the lower costs these payment structures offer — among them, participation in a disease management program and adherence to chronic medications and screenings for chronic conditions.
The NBGH analysis found that, while the transition from fee-for-service medicine has been slow, many employers already have put in place a foundation for the future. Current value-based designs include offers to lower worker premiums and reduce out-of-pocket costs if they “take steps to manage chronic conditions, obtain higher quality care or more efficient care,” the analysis says.
Worksite wellness and disease management programs like MedBen WellLiving are a way to promote better health. But the cost savings from these programs matter, too... and as payment models change, the potential exists for even greater savings. As we continue to roll out our commercial bundled payment services, we'll help to instruct clients on plan design changes that will benefit employer and employee alike.
There's been a lot of hype lately about how private health insurance exchanges — a system in which employees receive a set allowance to select an insurance plan from multiple vendors — are the next big thing in group coverage. But as is often the case, "hype" doesn't always translate to "interest."
A recent Mercer survey found that only 6% of large employers have a private exchange in place or say they will implement one this year. Additionally, 71% of employers surveyed said they had either no plans to consider adopting an exchange platform or had already looked into exchange options and decided not to pursue them.
As to why employers haven't made the switch to private exchanges, 65% said they had seen no evidence that such a system will save them any money. Even a cursory glance at how an exchange works bears this out: They offer no real means for the employer to control costs, instead depending solely on the insurer to handle plan benefits. The only real savings comes from shifting costs to employees through defined contributions.
Self-funding has succeeded largely because employers have the final say about the specific aspects of their health care plan. Working with an experienced benefits manager like MedBen, they can minimize rising health care costs through a variety of money-saving tools, and design a plan that directly addresses employee needs. Any money that doesn't go toward paying claims stays with the employer.
Moreover, because they are not as heavily regulated as traditional insurance coverage, self-funded plans offer a higher degree of legislative freedom, in addition to greater plan design flexibility.
To learn more about self-funded saving solutions available through MedBen, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
Let’s do some math. Subtract your age from the number 220 (the answer is your maximum heart rate). Now multiply that number by 0.6. Got it? Repeat the steps, only this time, multiply by 0.8. You now know your targeted pulse range when performing cardiovascular fitness activities. (By the way, a healthy resting heart rage is between 60 and 100 BPM).
Cardio is any activity that makes the heart beat faster and harder for a period of time. This causes the blood flow to your muscles and your lungs to increase. You’ll begin to breathe faster and deeper, maximizing the amount of oxygen in your blood. Your small blood vessels will then widen to deliver the oxygen to your muscles and carry away waste, such as carbon dioxide and lactic acid. Your body even releases endorphins that increase your sense of well-being.
The Centers for Disease Control and Prevention recommends 150 minutes a week of moderate-intensity aerobic activity, but not everyone has that kind of time to burn. Recent studies show that HIIT (High Intensity Interval Training) makes it possible to reap all the benefits of cardio simply by doing short bursts of intense exercise, from 30 seconds to 3 minutes, with short recovery breaks in between (and yes, chasing Pokémon on the new app counts – just stay safe!).
Getting or staying fit in the world of cardiovascular is extremely important. We know too, that staying fit helps to ward off a list of other conditions. However, certain activities are not meant for everyone. Always seek guidance from your family doctor before performing high intensity workouts.
From BenefitsPRO: "[Health reimbursement arrangements (HRAs)] are making a comeback, most notably among smaller employers (2 to 100), large employers (5,000+), and any size groups with historically low utilization. Their appeal may also increase as they as they appear to have the least impact on the Cadillac Tax thresholds since actual claims versus potential claims paid from the HRA are expected to be used in the calculations, assuming the Cadillac Tax survives."
In spite of an ever-changing health care landscape ‒ or, as BenefitsPRO notes above, sometimes because of it ‒ HRAs and other types of consumer-driven health plans (CDHPs) continue to thrive and save employers money. MedBen Specialty Services has the experience to match the right CHDP with the needs of the employer.
Going back to the earliest days of HRAs as well as flexible spending accounts (FSAs) and health savings accounts (HSAs), MedBen has provided expert support to employers and plan members. We review your group’s goals to help ensure that you achieve the savings you desire, and set the proper course for your health plan.
Once your CDHP is in place, our service team will give you the tools you need to promote it. Plus, we complement our services with online account management tools and debit cards that give plan members an easy way to pay for qualified expenses.
Regardless of how the landscape shifts, MedBen Specialty Services has the CDHP expertise to keep your plan on a firm foundation. Contact your MedBen broker Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org to learn more.
While average costs for employer-based health plans nationwide have risen at a fairly moderate pace this decade (though, it should be noted, not as low as MedBen's 5-year trend), specialty drug price spikes continue to concern employers. To reduce the financial impact of these expensive medications, MedBen works with clients to find group-specific solutions.
A new report from the National Business Group on Health estimates that the average cost of an employer-based health plan will increase about 6% in 2017. But specialty drug costs are expected to jump 17% next year, following a similarly high increase in 2016.
MedBen offers a variety of ways to keep specialty drug costs manageable, and offers the services of an experienced pharmaceutical consultant to provide clients with timely advice. Particular strategies can vary from group to group, but they all have a common aim: Giving plan members access to appropriate medications while remaining mindful of bottom line considerations.
Key to saving money on high-end medications is having an awareness of generic equivalents and alternative therapies. In certain cases, so-called "specialty" drugs are nothing more than two or more existing products combined into a single medication that may be more user-friendly, but come at a greatly inflated price tag. MedBen ensures that employers don't get stuck paying for these high-cost medications when far less expensive options are available.
Keeping specialty drug spending in check is critical to controlling costs, and MedBen is dedicated to helping you achieve that goal. Find out more by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
Sitting on the sofa all day may be relaxing, but it's costing our country a lot of money. According to Benefits Pro, a new study finds that physical inactivity costs the U.S. $27.8 billion annually, an amount researchers label a conservative estimate. But promoting wellness in the workplace can go a long way toward lowering the bill.
The researchers estimated the costs by looking at expenses, productivity losses, and disability-adjusted life-years for five major diseases related to inactivity — coronary heart disease, stroke, breast cancer, colon cancer, and type 2 diabetes (which alone accounts for 70% of all direct health costs).
MedBen WellLiving focuses on all five of the diseases examined in the study, as well as other chronic conditions like asthma and bad cholesterol. By promoting preventive care and identifying high risks at earlier disease stages, we can greatly reduce potential health care costs as well as improve overall health, on both an individual basis and on a larger scale.
Closely tied to preventive medical care is fostering a workplace philosophy of healthier lifestyles. Simple things, like making fruit available for purchase in the lunchroom or sponsoring a companywide fitness event with appropriate incentives for participants, can make a big difference where costs are concerned.
MedBen WellLiving will work with your group to offer wellness services that encourage healthier lifestyles while improving your bottom line. Contact Vice President of Sales & Marketing Brian Fargus to learn more.
High cost claimants are among the leading contributors to health care spending, topping even medical inflation, pharmaceuticals, and specific diseases. A study from the American Health Policy Institute and Leavitt Partners found that claimants who cost $50,000 or more in a year are the top cost driver for 43% of large employers, and comprise 31% of total spending among employers’ health plans. On average, a high cost claimant costs an employer about $122,000 annually.
Recognizing that plan members sometimes require high-priced treatment, MedBen has multiple means to keep claim costs in check. Key to our claims management approach is a panel of over 125 board-certified medical specialists. Reviewing claims flagged for potential clinical problems, they work with the provider to reach a proper resolution — all before the plan pays the provider, so you don’t have to recoup expenses later.
Going hand in hand with controlling costs is early detection of chronic conditions through MedBen WellLiving. This program utilizes customized education and nurse coaching to help plan members who are at greater risk of developing conditions that could prove physically and financially costly in the long run.
MedBen offers a variety of ways to keep high claimant costs in check as well as helping employers to promote healthier plan members. To hear more about how we can assist your business, contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.