MedBen Client Satisfaction Survey


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  05:28:00 pm, by MedBen5   , 360 words,  
Categories: News, Health Plan Management, Health Care Reform, Taxes

Maintaining Grandfathered Plan Status Now May Cost Employer Later

Capitol and Caduceus

More than four years since the signing of the Affordable Care Act, over one-third of businesses still offer a grandfathered plan. But the proportion of these plan structures has dropped dramatically since 2010... and in all likelihood will disappear for good in the next decade, Employee Benefits News reports.

The "grandfather" regulation allows businesses to keep their current plans without having to add such ACA requirements as expanded no-cost preventive care and out-of-pocket limits for in-network care. However, grandfathered plans must still provide certain benefits, including no lifetime coverage maximums and parent coverage of adult dependents until age 26.

According to a Kaiser Family Foundation survey, in 2011 – one year after the health care reform law was passed – 72% of organizations offered at least one grandfathered plan. Today, the number has fallen to 37% – and will continue to decrease, says Beatrice Newbury, senior program manager in the benefits department of the International Brotherhood of Teamsters.

“My view is eventually everyone will lose grandfathered status,” Newbury told attendees at a recent Employee Benefits Conference. “You can only maintain those cost increase limits for so long. Health care will change and plans need to be able to change with it.”

We've noted in multiple blog posts that making plan changes is essential to keeping health care costs in check, regardless of the regulatory environment. The ability to modify deductibles, covered services and employee contributions has a huge effect on an employer's bottom line.

"An employer will spend more time trying to stay grandfathered than just adding the preventive services required under the ACA," says MedBen Vice President of Compliance Caroline Fraker. "And between the wasted man hours and the lost potential to make money-saving plan changes, the math doesn't justify holding on to grandfathered status."

In renewal meetings and employer seminars, MedBen has explained to clients the financial realities of maintaining grandfathered status, and recommended changes that will end the status but prove more cost-effective in the long run. Currently, only a handful of our clients still offer a grandfathered plan.

Looking forward, grandfathered plans that offer benefit-rich coverage will have another reason to consider losing their grandfathered status – a 40% "Cadillac" tax on employers takes effect in 2018.


  09:19:00 pm, by MedBen5   , 99 words,  
Categories: Announcements, Health Plan Management

MedBen Closing Early On October 24

On Friday, October 24, MedBen will be closing at 12:00 p.m. EST for a companywide employee recognition event. We will reopen at 8:00 a.m. EST on Monday, October 27.

Remember that even when live service representatives aren't available, many of your questions (including those pertaining to prescription plans, FSAs and HRAs) can be answered anytime, anywhere through our MedBen Access website.

Also keep in mind that offers resources frequently requested by customers, such as a list of FSA-eligible expenses and instructions for reading EOBs. Just select the "Plan Sponsors" or "Plan Members" button on the home page, depending on your specific needs.


  10:50:00 pm, by MedBen5   , 232 words,  
Categories: News, Prescription

Drug Company Payment Website Adds Simple Search Tool

Open Payments

As promised, the Centers for Medicare and Medicaid Services has made a big improvement to its recently introduced Open Payments website. instead of wading through massive spreadsheets to research drug and medical-device maker payments to doctors, users can now utilize an straightforward search tool.

The Pharmalot blog reports that the tool, currently in beta testing, lets users search by a physician’s name, location or specialty, as well as by the names of teaching hospital and companies. The type of payment is broadly categorized as ownership in companies, research payments and general payments, with the latter further defined through the nature of payment, such as food and beverage, education and consulting.

“CMS is providing a simple-to-use search tool and asking for your feedback on ways to improve it,” CMS says in a brief statement. “Upon performing a search, the returned results will include all three payment types… on one screen.”

Pharmalot notes that the search tool doesn't allow for aggregate payment amounts for each doctor, hospital or company, and the results still contain errors. CMS says that corrections and further improvements (such as displays of summary data, charts and graphs) to the site should be in place before year's end.

The Wall Street Journal has created its own interactive tool based on the data provided through Open Payments. Called "Medical Money," it breaks down aggregate payment amounts by pharmaceutical and medical technology companies.


  11:11:00 pm, by MedBen5   , 304 words,  
Categories: News, Health Plan Management, Consumer-driven Health Plans

CDHPs Key To Employer Plan Changes, Reduced Cost Growth

In several recent blog posts, we touched on the importance of change in keeping employer benefit cost increases down -- not change for the sake of change, but change based on a clear understanding of what changes should be made and how they can benefit plan participation while controlling cost growth.

For employers with an interest in keeping costs down, change via the addition of a consumer-driven health plan continues to be a popular option. By introducing an FSA, HRA or HSA in conjunction with a high-deductible health plan, employers address their need for savings as well as the employee’s desire for choice.

According to Employee Benefit News, an ongoing Mercer survey shows that about half of employers currently offer an CDHP -- a number that is expected to jump to 73% in 2015, as more employers say they will have a CDHP in place within three years. Health care reform is driving much of the accelerated growth.

The survey also finds that the number of employers that offer a CDHP as their only health plan option will also spike in coming years, up to 20% from the current 6%.

Whether you're looking to add a CDHP as an added plan option or -- as the survey refers to it -- a “full replacement CDHP,” MedBen has the tools and the talent to make your benefits package transition a smooth one. Our Specialty Services team has solid experience in administering all types of CDHPs, with seamless plan integration and account coordination. And we back our plan strategies with demonstrated employer savings

If you're seeking a workable solution to controlling rising health care costs, a CDHP may be what you're looking for -- and MedBen can help you put the right plan in place. To learn more about our range of CDHP options, contact Vice President of Sales & Marketing Brian Fargus at


  10:06:00 pm, by MedBen5   , 218 words,  
Categories: Announcements, News, Health Plan Management

MedBen Welcomes Ricketts to Sales & Marketing Team

Brook Ricketts

MedBen is pleased to announce the addition of Brooke Ricketts to the MedBen Sales and Marketing team. In her role as Regional Sales Manager, Ricketts will serve current and prospective MedBen clients in Indiana and Southwestern Ohio.

Ricketts comes to MedBen with first-hand knowledge in the inner workings of benefits management. Her prior position as a claims representative for a national insurer allowed her to work closely with various members of the health care industry, including Medicare and Medicaid as well as other insurance companies.

“As someone who’s had day-to-day dealings with people in multiple areas of the insurance business, Brooke brings a useful background to MedBen,” said Brian Fargus, the company’s Vice President of Sales and Marketing.

Among Ricketts’ primary responsibilities will be to continue the growth of MedBen’s self-funded client base. Fargus said, “Since the Affordable Care Act was signed, we’ve seen a huge jump in the number of fully-insured companies looking at the advantages of self-funding their coverage. Brooke will work directly with employers and their brokers to ensure they have the right health care plan in place for their size and needs.”

Brooke is a graduate of The Ohio State University with a Bachelor of Science degree in Health Sciences and Health Management. She is engaged to Corey Hupp and resides in Newark, Ohio.


  11:26:00 pm, by MedBen5   , 307 words,  
Categories: Wellness

Good Eye Health Starts (Real) Early


Even if your child is less that a year old, it's not too soon to have his or her vision checked. The American Optometric Association recommends that infants get their first eye exam at six months of age.

“The majority of vision problems in children are preventable and treatable,” said Dr. Ida Chung, president of the College of Optometrists in Vision Development. “Eye conditions, whether hereditary or not, can best be managed by having the child receive their first eye examination as early as possible.”

The AOA also notes that children at risk for the development of eye and vision problems may need additional testing or more frequent re-evaluation. Factors include, but are not limited to, prematurity, low birth weight, or a family history of congenital cataracts.

While pediatricians can perform basic vision checks for infants, toddlers and younger children, vision plans typically cover eye exams from optometrists for all covered dependents regardless of their age -- and that includes the MedBen VisionPlus plan.

Being proactive about eye health in a child's developmental years can help to reduce the risk of vision problems. later in life. While certain eye diseases are sometimes hereditary or congenital, some issues are preventable, said Dr. Ron Weber, an Atlanta-based ophthalmologist.

For example, myopia, or nearsightedness, “not only has a genetic component but is also influenced by how kids use their eyes during childhood,” he told Reuters Health by phone. Weber suggests that parents make sure a child’s environment is well-lit while they are doing close work, such as reading or working on the computer.

In addition to regular eye exams, experts recommend the use of sunglasses or hats to shade kids’ eyes. And as for that old advice about eating carrots to see better? “Vitamin deficiencies, particularly vitamin A, can damage vision,” said Weber. “So, yes, carrots are good for your eyes.


  10:43:00 pm, by MedBen5   , 332 words,  
Categories: News, Health Care Reform

CMS Online Portal Now Accepting HPID Applications

CMS website

Several months ago, we noted here that employer-sponsored health plans need to obtain a Health Plan Identifier (HPID) number that will be used in conjunction with electronic transactions related to plan claims and eligibility. Per HIPAA and Affordable Care Act statutes, large health plans (those with more than $5 million in annual receipts) are required to obtain a HPID by November 5, 2014; smaller plans have until November 5, 2015 to do so.

For health care plans to register and apply for an HPID, the Centers for Medicare & Medicaid Services (CMS) has updated its CMS Enterprise Portal. The HPID application feature became active in late September.

MedBen has tested the portal and found it highly intuitive and easy to navigate. And the CMS instruction sheet outlining the registration and application process provides a step-by-step guide for registering and applying for an HPID.

Full story »


  09:25:00 pm, by MedBen5   , 349 words,  
Categories: Wellness, Health Plan Management

Taking the Stress Out of Health Care Costs


For many people, finances and stress go together like peanut butter and jelly. As financial burdens increase, so does the level of stress. And this can be especially true when you add health care into the mix.

While your health plan does its best to keep benefit details clear cut, it’s understandable that all the talk of deductibles and coinsurance can at times feel overwhelming. But at its core, health coverage is pretty simple.

The majority of care is preventive in nature – you see the family doctor for a checkup or to get tests that help you stay healthy. Such care usually comes at no cost to you if you see a doctor in your provider network. Likewise, office visits to treat general ailments typically require only a small copayment – again, so long as the physician is in-network.

Note that we’re emphasizing the importance of in-network care. By seeing doctors who have contractually agreed to treat you for a lower cost, you pay less and you minimize the hassle of added paperwork.

Be aware that not every service you receive from an in-network provider will necessarily be covered, so it’s a good idea to check your plan summary for any limitations or exclusions. And if you have questions about your benefits coverage, speak to your Human Resources Department... or if you're a MedBen client, call our Customer Service Department at (800) 686-8425.

Full story »


  11:27:00 pm, by MedBen5   , 319 words,  
Categories: News, Wellness, Incentives

WellLiving Helps Employers Offer Fair And Achievable Incentives

A recent Wall Street Journal article examines the balancing act undertaken by employers that offer wellness incentives. The author highlights two employers that were sued because of wellness program disputes -- and both suits allege violations of the Americans with Disabilities Act.

Wellness programs have increased in popularity over the past decade, with Affordable Care Act regulations that allow bigger rewards (and conversely, bigger penalties) spurring at least some of the growth. But as often happens, the rise of such programs has led to confusion about the rights of employers to set certain benchmarks.

Offering a "carrot" -- typically, lower premiums for employees who demonstrate a commitment to better health -- can go a long way toward a wellness program's long-term success and promote a more productive team. However, if the needs and limitations of a diverse workforce is not carefully considered, incentives can lead to employee dissatisfaction and possible legal trouble.

Obviously, perspective matters here. You can say that you're rewarding those who meet established wellness guidelines with lower premiums -- but others can just as easily counter that you're punishing those who do not with higher rates. In either case, it's critical that your wellness program give every plan member an equal opportunity to achieve your stated goals, or provide alternative goals for members who have physical disabilities.

MedBen WellLiving understands both the benefits and the potential pitfalls of incentives. We have extensive experience in helping clients design wellness programs that provide support through financial rewards. But our recommendations are always backed by a knowledgeable Compliance Department that can advise on the legalities of the incentives, and offer guidance on ways to ensure that such incentives are equitable for everyone.

MedBen WellLiving can work with you to put together a wellness strategy that motivates every employee fairly. To learn more about how you can make incentives work for your business, contact Vice President of Sales & Marketing Brian Fargus at


  09:35:00 pm, by MedBen5   , 268 words,  
Categories: Health Plan Management, Hospitals

As Hospital Costs Increase, Push Toward Outpatient Care Also Grows

hospital patient

An interesting essay on the state of modern hospitalization and the shift toward outpatient care, by internist Saquib Rahim:

With increasing frequency, the goal of inpatient care has become to address and stabilize a patient's active medical issues so that any remaining care can be conducted in the outpatient setting. This evolution does not mean we should discharge hospital patients before they are clinically ready or when appropriate outpatient services are not available. Providers and hospitals should always ensure patients receive high quality, responsive care for acute medical issues. But in the course of treating patients, especially those with complicated and/or multiple medical issues, there often does come a point when additional care can be safely administered outside of the hospital -- even if the patient is not quite back to his/her baseline health.

In 2012, almost one-third (32 percent) of all health care spending was in hospital-based care, which represented the largest single category of spending and approximately $900 billion. Hospital and physician services together accounted for more than 50 percent of total health care spending. Thus, when looking at areas to increase efficiency and lower expenditures, those two categories stand out. Furthermore, the disparity between the costs of inpatient and outpatient care is striking. According to the Kaiser Family Foundation, the average 2011 hospital expense per inpatient day was almost $2,000 nationally. But according to the Agency for Healthcare Research and Quality, the average national cost per outpatient visit was roughly $200. That means for every extra day in the hospital, a patient could see a physician in the clinic 10 times for the same aggregate cost.

Read more at the HuffPost Healthy Living blog.


  09:38:00 pm, by MedBen5   , 457 words,  
Categories: News, Discounts, Health Plan Management

Advanced Claims Surveillance Helps To Protect Against Questionable Billing

operating room

The New York Times recently profiled the story of Peter Drier, a 37-year-old bank technology manager who underwent neck surgery for herniated disks last December. Mr. Drier had done his homework prior to the procedure, so he had a pretty good idea of the impending medical bills – save for one:

"He was blindsided [...] by a bill of about $117,000 from an 'assistant surgeon,' a Queens-based neurosurgeon whom Mr. Drier did not recall meeting.

“'I thought I understood the risks,' Mr. Drier, who lives in New York City, said later. 'But this was just so wrong – I had no choice and no negotiating power.'”

The article mentions that much Mr. Drier’s insurer had negotiated the primary surgeon's fee to a much lower amount. But the out-of-network assistant surgeon was under no obligation to take a smaller payment. Ultimately, the insurer paid the entire $117,000 – though such costs invariably get filtered down to the customer through higher premiums.

Mr. Drier was a victim of what some medical experts call "drive-by doctoring," a practice in which high-priced assistants and consultants are brought in without the patient’s knowledge, and for questionable reasons. Although such arrangements are uncommon, their occurrences have grown of late – and underscore the need for heightened attention to the content of medical claims.

Full story »


  11:09:00 pm, by MedBen5   , 299 words,  
Categories: News, Wellness

Companies Big & Small Welcoming Wellness

healthy eating

Employers continue to embrace worksite wellness in ever-increasing numbers, according to a recent study by the Kaiser Family Foundation and the Health Research & Educational Trust. Employee Benefits News reports that nearly every large firm (98%) are offering at least one type of wellness program this year, as well as 73% of smaller companies.

“Wellness is a cornerstone to good health and lower cost overall,” says Maulik Joshi, president of the Health Research & Educational Trust and senior vice president of research at the American Hospital Association. “Since 2009, more firms both large and small are offering wellness programs, and more firms are offering incentives to encourage wellness.”

The study defined wellness programs in broad terms, from flu shots (offered by 87% of large firms) to gym membership discounts or on-site exercise facilities (64%). It also found that among employers that offer such programs, over one-third offer incentives to participate in a program.

MedBen's worksite wellness program WellLiving is designed around a simple yet effective premise: that the family doctor should be in charge of the patient's care. Not only does putting the primary care provider first increase awareness of personal health and help prevent complications from unmanaged health conditions, it eliminates the redundancies and logistical headaches of on-site biometric screenings.

The foundation of WellLiving is based on the prevention of cancer and other chronic conditions, and specialty care for plan members at higher disk of disease. However, we also work with the client to customize the plan to their needs. So if an employer wishes to emphasize smoking cessation, we will help it with employee education and incentives designed toward achieving that goal.

For additional information about how MedBen WellLiving can assist you in promoting a healthier and more productive workplace, please contact Vice President of Sales & Marketing Brian Fargus at


  11:36:00 pm, by MedBen5   , 281 words,  
Categories: News, Prescription, Health Care Reform, Online Services

Open Payments Database Provides Glimpse Into Doctor - Drugmaker Relationships


Among the stated goals of the health care reform law was to bring greater transparency to health care costs -- the so-called "Sunshine Act". Toward that goal, the Centers for Medicare & Medicaid Services earlier this week rolled out the Open Payments database on its website.

Right now, the information available from the database is pretty sparse, covering just August through December 2013. And about 40% of the records do not identify the recipient due to CMS's inability to match data. But it does reveal that pharmaceutical and medical technology companies made about $3.5 billion in payments to 546,000 doctors and 1,360 teaching hospitals -- about 4.4 million payments in total during those five months.

A good chunk of the payments go toward drug and medical device research, as well as consulting, speaking fees and travel. Expenditures range from just a few dollars for food and beverages to, in the most extreme instance, $2.3 million in royalty payments to a physician who contributed to the design of endovascular grafts.

While financial relationships between doctors and drug and medical device companies are common, the numbers have gone down a bit. Surveys in 2004 and 2009 found that such relationships dropped from about 94% to 84% during the five-year period.

CMS says it intends to unveil a second, more user-friendly site for consumers sometime this month. In the meantime, a more extensive -- at least in terms of longevity -- and straightforward database is currently available from the non-profit journalism organization ProPublica. Their Dollars for Docs project has collected details about drug company payments to doctors during the past four years, based mainly on information culled from legal settlements.

The New York Times, Kaiser Health News and POLITICO all featured stories this week regarding the Open Payments database.


  11:13:00 pm, by MedBen5   , 312 words,  
Categories: News, Health Plan Management, Health Care Reform

MedBen Helps Employers Make Changes For The Better


In a recent post on health care cost trends, we reported the findings of a Mercer survey which indicated that employer benefit costs are likely to increase between 3.9% and 5.9% in 2015. We also noted that individual results were heavily dependent on whether or not the employer took measures to control growth through strategic plan changes.

With that consideration in mind, it was somewhat surprising to learn that nearly one-third of respondents to the Mercer survey said they had no intention of making changes to their health care plans. Because more often than not, such changes -- be they small (increasing an office visit co-pay) or large (adding a high-deductible option) -- can play an important role in controlling plan costs.

Prior to plan renewal, MedBen meets with the client to review claims activity during the current plan year and suggest ways to reduce medical spending in the coming year. Central to this process is listening to the client and responding with better solutions.

To be sure, change simply for the sake of change is never a good idea. But plan changes based on sound data reporting and professional expertise can help to reduce annual cost increases -- and in certain instances, can even decrease costs from one year to the next.

Moreover, self-funded employers -- and in particular, larger businesses -- need to also be proactive about plan adjustments in anticipation of rule changes under the Affordable Care Act. Again, the MedBen Compliance Team ensures that clients are well aware of the new regulations, and helps them change their plan design accordingly. In this case, change keeps the employer on the right side of the law -- and saves them from costly financial penalties down the road.

Change can be a good thing. To learn how MedBen can make it work for your business, we invite you to contact Vice President of Sales & Marketing Brian Fargus at


  11:54:00 pm, by MedBen5   , 298 words,  
Categories: News, Wellness

Healthy Habits Greatly Reduce Heart Attack Risk, Study Finds

stethoscope and EKG

It's interesting how a few basic changes can make a big difference in one's health. Case in point: A new study suggests that some common-sense lifestyle modifications can prevent 80% of heart attacks in men.

According to HealthDay, researchers found that middle-aged and older men that drank moderately, didn't smoke and made smart diet, exercise and weight decisions were much less likely to have heart attacks over an average of 11 years. And those who strictly adhered at all five recommended health behaviors were 86% less to have heart attacks than those who ate poorly, were overweight, exercised too little, smoked and drank too much alcohol.

But reduced heart risk is only the half of it, said study lead author Agneta Akesson of the Institute of Environmental Medicine at Karolinska Institute in Solna, Sweden. "There is a lot to gain and money to be saved if people had a healthier lifestyle," he noted.

As for women, Akesson is the co-author of a previous study suggesting healthy living has a similar effect on females.

Men and women at increased risk of a heart attack can also improve through lifestyle coaching -- and there, MedBen WellLiving can help. Our wellness program uses a company's claim histories to identify plan members that would benefit from specialized care. Members identified as candidates are contacted by an RN Health Consultant and offered customized counseling on a scheduled basis.

Additionally, plan members receive information through a comprehensive set of resources, including printed materials and websites for education and self-help activities. Those who do not wish to participate may simply inform the nurse when he or she calls.

To learn more about how MedBen WellLiving can contribute to the long-term health of your employees and save you money, contact Vice President of Sales & Marketing Brian Fargus at


  06:05:00 pm, by MedBen5   , 331 words,  
Categories: News, Wellness, Health Plan Management, Health Care Reform, Reporting

Private Exchanges Take Cost Control From Employer’s Hands

dollar and chart

A recent report by the National Business Group on Health concludes that when it comes to private exchanges, self-insured employers are taking a cautious approach – and rightfully so. Because despite their prominence of late, there's no evidence that a private exchange is the money-saving magic elixir that some make them out to be.

According to Employee Benefits News, the survey of 136 employers found that 35% say they are considering moving their active employees to a private exchange in 2016 or beyond. But only 11% think it would control costs better than the employer could themselves.

A private exchange is similar in concept to the state insurance marketplaces offered to people who lack access to group coverage – only in this case, the employee receives an allowance to select an insurance plan from among multiple vendors. And like the public model, it offers the individual a choice of benefit packages and deductible options.

What a private exchange lacks, however, is the flexibility to manage costs – a distinction that lies at the heart of self-funding. An exchange essentially shifts costs from the plan to the employee, and takes from the employer the ability to make real changes when warranted. This stands in stark contrast to self-funding, which offers an unmatched level of plan design control.

By having the ability to make plan changes based on detailed analyses and professional guidance – services available only through a benefits management specialist like MedBen – self-funded employers can make informed decisions that will not only control their costs, but the costs of plan members as well. Moreover, strategic changes can even help to steer employees toward healthier lifestyles, by encouraging preventive care.

For all the talk of private exchanges becoming the next big thing in group health care, MedBen has yet to see exactly how they will control health plan costs over time. And for employers, that's hardly a minor consideration.

To learn more about the savings advantages self-funding offers, contact MedBen Vice President of Sales & Marketing Brian Fargus at


  10:32:00 pm, by MedBen5   , 197 words,  
Categories: News, Wellness

Obesity Has Slowed, But Bellies Keep Getting Bigger: Report

large stomach

Slowly but surely, the U.S. is becoming a big-bellied nation. A report by the Centers for Disease Control and Prevention says that the average adult waist size has expanded over an inch in the past decade.

According to HealthDay, 54% of Americans age 20 and older were abdominally obese in 2012, up from 46% in 1999. In that span (pardon the pun), the average waist circumference swelled from 37.6 inches to 38.8 inches.

The prevalence of obesity has slowed in recent years, so it's a little surprising to learn that waistlines have continued to grow. The researchers speculated that sleep deprivation, certain medications and everyday chemicals known to be endocrine disruptors may possibly play a role. A lack of physical activity is also a likely factor.

Another unexpected finding: Women outgained men nearly twice as much in the period studied – only 0.8 inches for males compared to 1.5 inches for females. The reason for this isn't clear, said study researcher Dr. Earl Ford, a medical officer at the CDC.

Waistlines larger than 35 inches for women and more than 40 inches for men are considered abdominal obesity, a risk factor for heart disease and diabetes. Ford said the best way to reduce waist size is through weight loss.


  09:30:00 pm, by MedBen5   , 267 words,  
Categories: Announcements, News, Prescription, Wellness, Health Plan Management

Painkiller Statistics Underscore Need For Alternate Care Solutions

pill bottle

Two major news organizations have approached a new Centers for Disease Control and Prevention report from differing perspectives. "Prescription painkiller deaths slowing down," says USA Today, while ABC News warns "Prescription drug deaths keep rising."

Actually, both headlines are accurate. The health agency notes that deaths from opioid overdoses rose only 3% annually from 2007 through 2011 still high, but a far cry from the yearly 18% increases between 1999 and 2006. But the actual number of deaths – nearly 17,000 in 2011 compared to 4,263 in 1999 – offers stark evidence to the extent of the problem.

Whether you embrace the "glass half full" or "glass half empty" philosophy, the fact remains that ongoing pain management through prescribed drugs continues to be a critical issue – both in terms of the potential harm to the patient as well as the financial realities that must be taken into account.

Modifications to diet, regular exercise and physical therapy can frequently alleviate pain without the need for drugs. “Opioids are a last resort and should be used when nothing else works,” said Dr. Robert Waldman, an addiction medicine consultant not involved with the research.

While cost considerations are secondary to the well-being of the individual, they can't be ignored in instances of prolonged treatment. MedBen reviews pain management claims and makes recommendations to the client on a case-by-case basis for savings opportunities. At the client's request, we can also require the plan member or provider to request an approved prior authorization before services are rendered.

To learn how MedBen works with clients to control costs while still respecting the doctor-patient relationship, contact Vice President of Sales & Marketing Brian Fargus at


  04:56:00 pm, by MedBen5   , 256 words,  
Categories: News, Wellness, Health Plan Management

Diabetes Problem Continues To Grow; MedBen WellLiving Can Help Control Condition

Some sobering federal health statistics: Nearly half of adults have either pre-diabetes or diabetes, raising their risk of heart attacks, blindness, amputations and cancer.

According to USA Today, 12.3% of Americans 20 and older have diabetes, either diagnosed or undiagnosed. Another 37% have pre-diabetes, a condition marked by higher-than-normal blood sugar. That’s up from 27% a decade ago.

“It’s bad everywhere,” says Philip Kern, director of the Barnstable Brown Diabetes and Obesity Center at the University of Kentucky. “You almost have the perfect storm of an aging population and a population growing more obese, plus fewer reasons to move and be active, and fast food becoming more prevalent.”

Moreover, diabetes has a financial cost in addition to a health one. The American Diabetes Association estimates the disease cost the U.S. $245 billion in 2013.

Fortunately, most people with pre-diabetes can control the condition – or prevent it altogether – through diet and exercise. And bonus: A recent study by the Action for Health in Diabetes found that overweight adults with diabetes who lost weight and kept it off lowered their average annual health care costs by more than $500.

MedBen WellLiving helps plan members diagnosed with type 2 diabetes take the proper steps toward better health. With our Specialty Care program, an RN Health Consultant will contacts patients to offer customized counseling. Members who choose to use the service will get individualized, confidential disease monitoring on a scheduled basis.

To learn more about how MedBen WellLiving can improve employee wellness while reducing health care costs, contact Vice President of Sales & Marketing Brian Fargus at


  11:11:00 am, by MedBen5   , 345 words,  
Categories: News, Health Plan Management, Health Care Reform, Stop-loss

MedBen Savings Solutions Defy Health Care Cost Trends

Another day, another survey…

Hot on the heels of this week’s Kaiser report showing modest health plan premium growth comes a survey from Mercer L.L.C. which suggests that the average rate of increase in health benefit costs has begun to trend back upward.

According to Business Insurance, early findings from Mercer’s National Survey of Employer-Sponsored Benefits indicate that average employer health benefit costs are likely to increase by between 3.9% and 5.9% in 2015, depending on the measures employers take steps to control cost growth. Only through strategic plan changes will benefit costs equal, or come in under, projected growth trends.

But that’s not all. Last week, the Centers for Medicare & Medicaid Services released a report projecting higher health spending increases in the next decade (6.0% per year for 2015 through 2023), though still well under the double-digit jumps in the early 2000’s.

Clearly, there’s a lot of data out there about where health care costs have been, where they’re going and why they’re going there. But at the end of the day, what matters most to employers is what their own costs are, now and in the future.

At MedBen, our mission is to get clients the lowest costs, period – regardless of how high or low current trend may be. To do this, we take claims processing to the next level with advanced surveillance techniques that emphasize savings potential. When we flag a questionable claim, medical specialists and clinicians work directly with the provider to ensure an outcome that’s both cost-effective and patient-sensitive.

MedBen also helps clients to ensure that cost controls are properly in place with their provider network contracts. Doing so reduces the risk of the employer having to cover excess costs in the event of billing issues that cannot be addressed to the satisfaction of the plan’s stop-loss carrier.

There’s much more we could tell you, and we’d welcome the opportunity to discuss the ways we can save your business money on health care costs. Simply contact Vice President of Sales & Marketing Brian Fargus to learn how MedBen defies spending trends with common-sense savings solutions.

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