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02/23/11

  10:16:33 pm, by MedBen5   , 223 words,  
Categories: News, Health Plan Management

Third Judge Upholds Constitutionality of Health Reform Law

Another federal judge has weighed in on the constitutionality of the Affordable Care Act, and ruled in the affirmative, The New York Times reports.

Judge Gladys Kessler of Federal District Court for the District of Columbia, an appointee of President Bill Clinton, considered the arguments presented by the conservative Christian legal group American Center for Law and Justice. In addition to challenging the individual mandate – the provision requiring most Americans to get insurance beginning in 2014 – the group also claimed that the law violated the exercise of religious freedom of those who believe in the healing power of faith.

In her 64-page opinion, Judge Kessler wrote that the active choice of not buying insurance affected the marketplace by forcing others to pay higher premiums to cover uninsured care costs. She added: “It is pure semantics to argue that an individual who makes a choice to forgo health insurance is not ‘acting,’ especially given the serious economic and health-related consequences to every individual of that choice. Making a choice is an affirmative action, whether one decides to do something or not do something.”

Five federal judges have thus far handled down rulings on the ACA’s constitutionality. Three judges supported it, while one struck down the individual mandate – and the fifth declared the entire act invalid. All five have ruled along party lines.

  09:30:26 pm, by MedBen5   , 176 words,  
Categories: News, Wellness

Flu Bug Still Out There, And Still Dangerous

If you’ve managed to evade the flu so far this winter, don’t sound the “all-clear” just yet. We’re only just now reaching the peak of the season, and the flu has now got a foothold in all 50 states – and is widespread in 37 – according to the Centers for Disease Control and Prevention (CDC).

USA Today reports that outpatient doctor visits due to flu have risen steadily from January to February. While a bout with the bug is just a temporary inconvenience for most people, it’s an illness that should be taken with the utmost seriousness. About 37,000 people die annually from the flu, and this season’s epidemic has contributed to 8% of adult deaths in 122 cities that report flu stats to the CDC. Moreover, in the past month, pediatric deaths have tripled from 10 in early January to 30 by February 5.

If you haven’t got a flu shot yet, there’s still time. CDC spokesman Tom Skinner cautions, “Flu activity is going to continue into March… There is plenty of vaccine out there, and we encourage vaccination throughout the season.”

02/22/11

  09:46:02 pm, by MedBen5   , 97 words,  
Categories: News, Health Plan Management

Health and Human Services Launches Health Data Warehouse

The Department of Health and Human Services (HHS) has introduced a one-stop shop for web surfers in search of health data, Employee Benefit News reports.

The Health Indicators Warehouse (HIW) contains a wealth of information from 170 data sources, covering such factors as life expectancy, disease incidence and prevalence, health behaviors, health risk factors, and care access, cost, quality and use. The 1,200 downloadable indicators can be searched by topic area, geographic location, and state/federal health initiatives.

According to the HHS, the HIW will serve to “provide a single, user-friendly, source for national, state, and community health indicators.”

  09:07:35 pm, by MedBen5   , 165 words,  
Categories: News, Wellness

Cell Phone Usage Linked to Higher Brain Activity

Sometimes it seems like researchers are working overtime to find a health problem that can be linked to cell phone usage. While a new study doesn’t quite achieve that elusive goal, it does provide fuel for further research and debate.

The New York Times reports on a National Institutes of Health study which demonstrates that cell phone may have an impact on brain activity. Testing both inactive and active (muted) cell phones for extended periods on both sides of participants’ heads, positron emission tomography (PET) scans revealed that metabolism levels in the part of the brain closest to the antenna increased by 7%, whether the phone was on or not.

While the study does suggest that the electromagnetic radiation emitted by cell phones can influence internal chemistry, it fails to answer a much bigger question: Does it in any way affect the user’s health? For that, more research is needed, naturally.

The study will be published this week in The Journal of the American Medical Association.

02/21/11

  09:43:52 pm, by MedBen5   , 203 words,  
Categories: News, Health Plan Management

Major Anti-fraud Sweep Nets 111 Arrests, $226.5 Million in False Claims

Last week, in a massive operation involving more than 700 federal agents from the FBI and the Department of Health and Human Services, the Medicare Fraud Task Force arrested 111 doctors, nurses and health care executives in nine cities across the U.S. The Los Angeles Times reports that the defendants allegedly cheated the government out of more than $225 million in fraudulent claims, kickback operations, identity theft and other false billing schemes.

Since its launch in March 2007, the task force has charged 990 people in offenses totaling over $2.3 billion. Additionally, the joint federal, state and local task force recovered another $4 billion in 2010 from fines and restitution payments for treatments that were medically unnecessary or medically necessary.

At MedBen, we deal with fraud on a much smaller scale than the federal government (thank goodness!), but we’ve no less vigilant when it comes to questionable claims. Our surveillance system thoroughly checks every claim we receive, regardless of size. Any claim that is flagged is then reviewed by physicians to ensure that proper medical protocols have been followed.

System surveillance is just one aspect of MedBen’s Anti-fraud Unit. To learn more about the ways we protect our clients, contact Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

  08:58:11 pm, by MedBen5   , 216 words,  
Categories: News, Wellness

Daily High-fiber Diet Reduces Risk of Premature Death

It’s not like fiber needs any more positive PR – the American public seems to agree that it’s beneficial to you in any number of ways, i.e., lowering cholesterol, aiding with weight loss, and so on. But that won’t stop researchers from seeking out new “fiber good” angles. Hence, another fiber study – and one that may take fiber devotion to even greater heights.

Researchers from such institutes as the National Cancer Institute and Harvard School of Public Health have found that eating lots of fiber every day decreases the risk of dying prematurely from heart disease, cancer, infection and other illnesses.

Using a food survey completed by 400,000 AARP members in 1995-96, the researchers were able to calculate daily fiber consumption for each respondent. Other pertinent information, such as weight, physical activity levels, and smoking habits, was also gathered.

Over the next nine years, the researchers tracked study participant mortality using national databases. They found that participants who ate the most fiber (29 grams per day for men, 26 for women) were 22% less likely to have died of any cause during the study than people who ate the least (13 grams daily for men, 11 for women), taking into account age as well as health and lifestyle factors.

Read the Reuters article about the fiber study (via Yahoo! Health).

02/18/11

  05:34:38 pm, by MedBen5   , 146 words,  
Categories: News, Health Plan Management

House Amendments Block Health Reform Funding

USA Today reports that the Republican-led House of Representatives today voted to defund the Affordable Care Act (ACA), as Majority Leader Eric Cantor said they would do last week.

During debate on a federal spending bill that would pay for government operations through September, House members attached several amendments prohibiting the use of any funds by the IRS to carry out the mandate that Americans buy health insurance. Also adopted was an amendment to prevent the Labor and Health and Human Services Departments from using funds for ACA-related business for the rest of fiscal year 2011, and a provision that would forbid the government from paying the salaries of any federal employees connected with the implementation of health care law.

These amendments can be removed next week if the Democrat-led Senate has enough votes, and President Obama has said he would veto the House bill if necessary.

  11:25:12 am, by MedBen5   , 179 words,  
Categories: News, Wellness

Multiple Studies Find Fast-Food Habits Hard to Break

While the FDA shores up the details of the menu-labeling law, researchers have been busy casting doubt upon its effectiveness. Last month, we summarized a study of Seattle fast food restaurants that posted nutritional information on its menu, only to find that it had minimal impact on customers’ food choices. And now additional research muddies the water even further.

A study of popular fast-food outlets in New York City examined the food choices of teens and parents of small kids before and after a labeling law took effect. The researchers found that while the subjects were aware of the calorie data, it didn’t impact what they ordered.

As The Wall Street Journal Health Blog notes, this was a relatively small study and tracked only low-income areas, so it may not represent the habits of a more diverse population. And as the research was performed only a month after the implementation of the new law, it may take consumers longer to change their buying practices. But there’s a growing pile of evidence that nutitional information alone doesn’t affect eating behavior.

  10:33:20 am, by MedBen5   , 201 words,  
Categories: News, Wellness

Put the Pedal to the... Cubicle?

If your job seems like an uphill climb to begin with, you may as well shed some calories as you ascend. A new study published in the British Journal of Sports Medicine actually analyzed the viability of pedaling your way to better health – at your desk.

According to WebMD, 18 full-time workers were given a bicycle-like exercise machine that fit under their desks to use for four weeks. Most of the volunteers spent an average of 75% of their workday in a seated position. On average, the participants used the pedaling machine 12 out of a possible 20 working days, for 23 minutes a day.

The devices were connected to the users’ computers, which provided real-time feedback on speed, distance and calories burned, and allows the user to adjust resistance on the fly. Participants averaged 187 calories dropped per session.

It sounds like an interesting study, though it didn’t answer the question of whether a person would stick with it once the novelty wore off. And participants did note that pedaling while talking on the phone or using the computer could be a little tricky.

The Wall Street Journal Health Blog also reports on the pedaling machine, which will run you $129, plus $49 for the monitoring software.

02/17/11

  05:25:16 pm, by MedBen5   , 256 words,  
Categories: Prescription

Debating the Merits of "Me-Too" Drugs

Are pharmaceutical companies spending too much time and money making duplicates of their most popular products? NPR reports on the issue of “me-too” medications – drugs that serve similar functions (i.e., reducing cholesterol) as medicines already on the market, but offer a different chemical composition.

On the one hand, some doctors feel there are benefits to having multiple drugs in the same category to choose from. If a patient can’t take a certain medication because of adverse side effects, it’s possible that another option may work better. Or the patient may see more positive results using a different drug.

But an editorial in The Journal of the American Medical Association argues that continually producing new drugs that do essentially the same things as existing medications is a waste of time and resources. Not just for the pharmaceutical companies that spend millions of dollars on research and marketing the drug, but also for the Food and Drug Administration, which uses valuable manpower reviewing variations on already proven products.

Defending me-too medications in a recent editorial, Pfizer CEO Ian Read suggested that new entrants to a drug class in which generic already exist could have to prove that they are superior to alternatives in order to win FDA approval.

If you’re a MedBen client who use PDM for prescription management and would like to do comparative research about drugs in the same category, we suggest you visit the RxEOB website – simply go to the online service site MedBen Access, log in and click on “My Rx”.

  01:21:57 pm, by MedBen5   , 126 words,  
Categories: News, Wellness

Kidney Disease Expenses Top $25 Billion Annually

The ACP Internist website reports that medical spending to treat kidney disease averaged $25.3 billion annually from 2003 to 2007, almost half of which was spent on ambulatory visits. Hospital stays accounted for about 40% of yearly costs, followed by prescription drugs and ER visits.

Citing figures from the Agency for Healthcare Research and Quality, ACP Internist notes that during the four years studied, an average of 3.7 million adults (1.7% of the population) annually reported receiving treatment for kidney disease. On a per person basis, the average annual expenditure was $6,823.

Kidney disease can result from diabetes, high blood pressure and other disorders. If not cared for properly, kidney abnormalities can lead to heart disease and anemia, and ultimately kidney failure and death. For additional information, visit the National Kidney Foundation website.

02/15/11

  06:37:48 pm, by MedBen5   , 184 words,  
Categories: News, Wellness, Health Plan Management

Breast Pumps Can Now Be Bought with FSA Funds

The Associated Press (via The Detroit News) reports that the IRS has ruled that the cost of breast pumps will be treated as a tax-deductible expense. For MedBen Health FSA participants, this means that pumps and related supplies that assist lactation can be purchased with their pre-tax dollars.

Prior to the ruling, the IRS regarded breast pumps as feeding equipment rather than medical devices. Pressure by the American Academy of Pediatrics and members of Congress were apparently among the factors that led to the designation change.

The American Academy of Pediatrics recommends that women breast-feed their babies for at least their first year. Advocates hope that the availability of lower-cost pumps will allow more women to breast-feed longer, and Congressional members said in a statement that breast-feeding reduces the risk of illness in infants and cancer in mothers, which in turn will “save billions in health care costs.”

Breast pumps have been added to MedBen’s list of IRS-eligible Expenses, which is available at MedBen.com. For additional information about MedBen Health FSAs. please contact Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

  01:08:13 pm, by MedBen5   , 193 words,  
Categories: Wellness

Tread Lightly Before Springing Into Activities

The weather is beginning to warm up (finally!), which means that outdoor activities are just around the corner. But before you get off the couch and get into motion, help your body make the proper transition from inactivity to action.

HealthDay News (via Yahoo! Health) offers advice from Dr. Anders Cohen, chief of neurosurgery and spine surgery at The Brooklyn Hospital Center, about the steps a sedentary person should take to enter safely into spring activities. He suggests starting with your annual physical, including weight and cardio fitness, to get a good assessment of your condition.

Once your doctor has given you the once-over, Cohen recommends spending three weeks focusing on strength and flexibility – through gym workouts, exercise videos, and so forth – before taking part in new sports or activities. Along the same lines, take protective measures to avoid chronic injuries: “Once you have an injury, that part of your body is always more susceptible. Pay attention to preexisting conditions and work on strengthening those areas.”

The doctor also recommends 10 minutes of warm-up and cool-down before and after any physical activity, and monitoring your progress in order to improve your performance.

02/14/11

  06:23:07 pm, by MedBen5   , 281 words,  
Categories: Health Plan Management

Confronting High Medical Costs

As we noted on this blog last week, pivotal to making health coverage available to all – be it through insurance plans, government programs, or a blend of the two – is reducing medical costs. And by ignoring this major issue in favor of passing numerous laws aimed almost entirely at insurance plans, the Affordable Care Act undermines the very goal stated in its title.

The Everything Health blog, authored by Toni Brayer, MD, recently featured an entry entitled “Health Care Costs Too Much”. In the post, Dr. Brayer relates a personal anecdote in which an upset sales clerk bemoans a recent physician visit that resulted in an $850 chest X-ray:

“She wishes she would have known the cost and said, ‘I would have thought twice about getting it. I had a cold that lasted several weeks and the doctor just wanted to make sure it wasn’t pneumonia.’”

As Brayer notes, $850 is definitely on the high end of a simple chest X-ray, and it doesn’t include the additional cost of a radiologist to analyze it. And while this is just an isolated example, it does illustrate the problem of high medical costs – costs that are invariably reflected in insurance premiums. Understandably, it’s a difficult situation to remedy, but insurance reforms alone aren’t the solution.

At MedBen, we rely on a variety of containment tools to ensure that clients’ medical costs are kept at their lowest. One of the most powerful is our leading edge claims surveillance system, which uses over 80,000 physician-developed algorithms to locate additional savings opportunities. To learn more about how this system can benefit your business, please call Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

  12:35:10 pm, by MedBen5   , 261 words,  
Categories: Wellness

Heart Not-What-To-Do's

Seeing that today is Valentine’s Day, it seems the perfect time to speak about affairs of the heart. Not the lovey-dovey, arrow-through-it variety, mind you – we’re referring to the fist-sized organ that pumps blood around the body. (Sorry if you’re the romantic type.)

WebMD is looking out for your heart – it’s assembled a list of “what not to do’s” if you’re interested in keeping your ticker ticking as long as possible. We’ll give you an overview of the first four items below… you can read the entire list of ten “what not’s” here.

  1. Keep smoking. Cigarettes and hearts don’t mix. Smoking is linked to high blood pressure and causes blood clots. The American Heart Association says it’s “the number one preventable cause of premature death in the U.S.”
  2. Ignore that chest pain. While heartache and Valentine’s Day frequently go hand-in-hand, literal heartache is nothing to trifle with. If you feel chest pain while exercising, get it checked out. And “if you feel like an elephant is sitting on your chest,” call 911, stat.
  3. Just accept that it’s in your genes. Having a family history of heart disease doesn’t mean that you’re destined to suffer the same fate. There are a number of things you can do to reduce your risk, such as lowering your LDL (bad cholesterol) by 50%.
  4. Skip your checkup. Heart disease can be pretty quiet as it goes about its business of inflicting damage on you. Seeing your family doctor on a regular basis gives you a better-than-fighting chance against high cholesteral and high blood pressure.

02/11/11

  05:38:59 pm, by MedBen5   , 176 words,  
Categories: News, Wellness

Employee Wellness Incentives on the Rise

Gift cards and contributions to consumer-driven health plans are among the incentives employers are increasingly using to encourage participation in worksite wellness programs, The Wall Street Journal reports.

According to a recent Fidelity Investments survey, the percentage of employers offering health improvement incentives grew in the past year, from 57% in 2009 to 62% in 2010. Average employee incentives also rose 65% last year to $430, from $260 in 2009. And positive perks appear to be the favored kind, as only 12% of employers offer negative incentives aimed at employees who don’t participate.

At MedBen, we encourage better health by making contributions to our employees’ HRAs for meeting weekly cardio and resistance workout goals, working in partnership with neighboring fitness center The Advantage Club. For MedBen clients, our worksite wellness program offers a foundation for self-improvement through personal coaching for chronic conditions and preventive care. And we will be happy to work with you to discuss incentives your company can use to promote wellness from within.

For additional information about MedBen Worksite Wellness, please contact Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

  03:26:20 pm, by MedBen5   , 159 words,  
Categories: News, Health Plan Management

High-Risk Pool Enrollments Up, But Not By Much

Enrollments in high-risk health pools picked up during the past three months but still lag far behind initial projections, The Washington Post reports.

The pools were created last year as a temporary insurance option for individuals with pre-existing conditions until state-run health insurance exchanges become available in 2014 (assuming such exchanges are actually in operation by then). The Medicare program’s chief actuary estimated that 375,000 Americans would enroll in the pools by the end of 2010, but only 12,500 have done so as of February 1. On the plus side, that’s about a 50% jump from early November, when fewer than 8,000 had joined nationwide.

Administration officials still hold out hope that the pools will catch fire as more people became aware of their existence. But critics say the cost is too high for the most likely candidates.

Twenty-seven states have started their own high-risk pools, while the balance offer the federal plan. Pennsylvania has the greatest number of enrollments – 2,050, roughly one-sixth of overall participants.

  02:10:10 pm, by MedBen5   , 349 words,  
Categories: News, Wellness

Stroke Studies Find Rises, Risks and Potential Prevention

For some unknown reason, there’s been a lot of news items about strokes over the past few days. (A stroke occurs when a blood clot blocks a vessel leading to the brain.) Here’s a roundup of some of the articles we’ve run across:

New data shows that from 1994 to 2007, stroke hospitalizations increased sharply among men and women ages 15 to 44, The New York Times reports. Among that rise was a 51% jump among 15- to 34-year old men. While the research didn’t analyze the reasons for the increase, the study authors speculate that better awareness about strokes risk in young people could be a factor, as could the rising obesity problem in this country. It’s also worth noting that stokes among men and women 45 and older fell 25% and 29%, respectively, during the period examined.

According to WebMD, drinking diet soda may increase the risk of stroke and heart attack. A nine-year study of 2,500-plus people who drank diet soda daily had a 48% higher chance of being stricken by these events, compared with those who drank soda infrequently or not at all. Interestingly, people who drank regular soda suffered no increased risk of cardiovascular disorders.

WebMD also reports on research that found consuming more than 4,000 milligrams of salt daily – less that two teaspoons – may raise your stroke risk. People in the study who got over 4,000 mg of sodium a day were about two-and-a-half times more likely to suffer a stroke that those who got less than 1,500 mg a day. And the results were the same regardless of whether a person had high blood pressure.

Clot-busting drugs could potentially prevent disability in people who suffer mild strokes. WebMD (apparently, the go-to source for stroke news) reports that people with mild strokes are usually denied tissue plasminogen activator (tPA), a drug that dissolves clots and restores blood flow, because prior studies analyzing its effectiveness felt the benefits of administering to mild cases outweighed the risks. But as one in three people who suffer a mild stroke become disabled within three months, researchers say that using the drug would help over 2,000 people each year.

02/10/11

  10:24:46 pm, by MedBen5   , 176 words,  
Categories: News, Wellness, Health Plan Management

Breast Cancer Study May Reduce Need for Lymph Node Removal

A recent study is having a major impact on an established medical practice, allowing some women with early breast cancers to forgo a potentially painful procedure, USA Today reports.

Frequently in breast cancer cases, doctors will remove cancerous lymph nodes under the arm to prevent the spread of tumors through the lymph system. But the surgery can be painful and may result in lymphedema, a swelling of the arm.

The 900 women involved in the study were in the early stages of breast cancer and had undergone lumpectomies and radiation. Researchers analyzed data from half of the women who had their lymph nodes removed, and the other half, who did not. They found that after five years, 92% of women in both groups were still alive regardless of whether or not nodes were removed.

The study results were presented at a medical meeting last year, prompting some surgeons to modify their approach to the disease.

Additional information about this study can be found at The Washington Post; a Q&A is available at The New York Times.

  05:08:35 pm, by MedBen5   , 180 words,  
Categories: News, Health Plan Management

GOP Letter Demands Big Changes to Insurance Exchanges

Yesterday we touched on a letter sent earlier this week by 21 Republican governors to Health and Human Services Secretary Kathleen Sebelius, in which they warned that they would not get involved with the creation of state-run insurance exchanges unless specific changes are made to the Affordable Care Act. The AHIP Hi-Wire website provides additional details about the correspondence.

One of the governors’ requests is that states be allowed to set their own benefit mandates, which goes against the current ACA provision that states offer a standardized package of essential benefits and foot the bill for any additional benefits they want. The governors also requested that HHS “provide states with complete flexibility on operating the exchange, most importantly the freedom to decide which licensed insurers are permitted to offer their products” – again challenging an ACA rule that the state exchanges adhere to specified federal standards.

Other changes sought by the governors include a standardized tool for verifying the income of people eligible for government subsidies, and the authority to move non-disabled Medicaid beneficiaries into state exchanges without requesting HHS approval.

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