An executive order by the Trump administration has briefly delayed the rollout of the bundled payment model for hip and femur fractures, but will not alter cardiac and orthopedic model launches later this year. Regardless, MedBen Analytics is fully prepared to provide hospitals with actionable data reporting for all new models.
The 60-day freeze on federal rulemaking pushed back the effective date of the Surgical Hip and Femur Fracture Treatment (SHFFT) model from February 18 to March 31. However, the July 1 implementation of the Acute Myocardial Infarction (AMI) and Coronary Artery Bypass Graft (CABG) models fall outside the executive order and will not be affected, an HHS spokesman has confirmed.
But whatever the circumstances, MedBen Analytics is ready to move forward. We've taken the advanced reporting portal we created for our Comprehensive Care for Joint Replacement (CJR) clients and expanded it so users of all these bundled payment models can benefit from our useful insights.
If you'd like to see a demonstration of our system or want additional information about MedBen Analytics, please call MedBen President & COO Kurt Harden at 888-633-2364 or email firstname.lastname@example.org.
Heart disease continues to amass physical and financial costs nationwide... a difficult situation that could be greatly alleviated through a collective focus on wellness.
A new American Heart Association report estimates that heart disease-related costs are expected to double from $555 billion in 2016 to $1.1 trillion in 2035. By then, nearly half the U.S. population will have at least one health problem related to heart disease, the report projects.
The difficulty with getting a handle on heart disease is that it's so closely linked to many of our worst habits, such as smoking, poor diet, and lack of exercise. Concerted efforts to address these lifestyle issues could go a long toward reversing the upward trend ‒ and workplace wellness is an obvious place to start.
MedBen WellLiving takes a multi-level approach to heart disease and other chronic conditions. First, our program promotes to your health plan members the importance of preventive care, and building and maintaining a doctor-patient relationship. Second, those members identified at high risk are offered ongoing, individualized counseling from a registered nurse.
The WellLiving approach aids in earlier detection of heart disease that allows for less costly treatment and decreased risk of medical conditions that contribute to the disease. For employers, it translates to lower medical costs and reduced absenteeism.
Get additional information about the benefits of MedBen WellLiving by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
Responsible for pumping more than 2,000 gallons of blood a day throughout the 60,000 miles of blood vessels within your body, the heart requires itself to be in tip-top shape. However, some may not realize the negative impact that every day activities have on our heart... or that they could even lead to heart disease.
Do you watch hours of TV every evening? Snore when you sleep? Skip flossing? Eat a lot of red meats or season food with extra salt? Most of us will answer “yes” to more than one of these.
Watching TV frequently, even if you exercise regularly, can still impair your heart. Snoring can be a sign of obstructive sleep apnea, which, just like eating salty foods, causes a spike in blood pressure. Skipping the floss and eating a lot of red meat have been shown to increase the risk of heart disease.
Though this list may be a short summary of things that can affect the heart, perhaps the most dangerous thing we do is assume that we are not at risk. One in three U.S. adults are diagnosed with a cardiovascular disease that can be considered among the “silent killers.” Seeking guidance from your family physician is one of the only ways to detect early onset and to effectively manage heart conditions.
Even with issues like national security and immigration grabbing the headlines these days, health care costs still rank high on the list of American concerns, a new survey suggests. Likewise, finding ways to control client health care costs continually informs the way the MedBen does business.
The Monmouth University Poll of families nationwide found that about 25% of respondents said the cost of health care was their biggest concern ‒ a 10% jump from a similar poll in 2015. National security and other topical matters ranked comparatively low in the survey.
But the fact that health care costs affect consumers comes as no surprise to MedBen, because we know from first-hand experience how important saving money is to employers who self-fund their health care coverage. Toward that goal, MedBen offers a variety of cost management solutions, including:
Through these and other containment strategies, MedBen works ceaselessly to ensure that clients' coverage costs are kept as low as possible, without sacrificing necessary care. To get a better idea of all the ways we can benefit your business, contact our Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
A new report from the American Cancer Society (ACS) shows encouraging trends on cancer survival ‒ a decline in death rates that coincides with a greater emphasis on preventive care through programs like MedBen WellLiving.
Since the early 1990's, the U.S. death rate from cancer has dropped 25%. This trend can be attributed primarily to large declines in the four major causes of cancer death ‒ lung, colorectal, breast and prostate ‒ which account for almost half of such deaths, noted ACS Director Rebecca Siegel.
"This progress is driven by declines in smoking prevalence beginning in the 1960s, and improvements in the early detection of cancer and cancer treatment," Siegel said.
Still, while mortality rates have fallen overall, some U.S. regions still show much higher numbers ‒ a problem researchers blame, in part, on people not getting regular cancer screenings.
"People show up with a cancer that should have been addressed a long time ago," said Dr. Ethan Basch, Director of the Cancer Outcomes Research Program at the University of North Carolina, Chapel Hill. "If they had a good primary care doctor or good health education they would have noticed it."
MedBen WellLiving stresses the importance of plan members getting regular cancer screenings under the direction of their family doctor. Not only does detecting cancer in its earliest stages greatly improve chances for survival, it significantly reduces the cost of treatment ‒ in some cases, by hundreds of thousands of dollars.
By encouraging preventive care, employers can go a long way toward improving the health of their workforce. Learn how you can make a real difference by contacting MedBen Vice President of Sales & Marketing Brian Fargus at email@example.com.
An important notice for flexible spending account (FSA) members who use MedBen's "Benny" debit card: The e-mail "From" address for Change to Funding Request notifications has changed.
Effective January 30, 2017, daily and weekly funding request e-mail notifications now have the e-mail "from" address "firstname.lastname@example.org." Prior to this change, the "from" address on these notifications was "email@example.com."
Recipients should make sure this new "from" e-mail address is not blocked or marked as spam. For those recipients who have already "white listed" the evolution1.com domain, this change will not impact you.
MedBen FSA debit card users who have any questions about this change are welcome to contact Director of Administrative Services Sharon A. Mills at (800) 423-3151, Ext. 438 or firstname.lastname@example.org.
MedBen President and COO Kurt Harden was one of several local business representatives recently interviewed by Licking County (OH) Chamber of Commerce President Jennifer McDonald for the Chamber's 2017 Economic Forecast video. During the discussion, he shared his thoughts on the future of Obamacare under President Trump as well as doing business in Licking County.
Below are several excerpts from Harden's interview. You can hear his complete comments on YouTube (the MedBen portion begins around the 5:00 mark).
On the survival of Obamacare: "We don't know if everything's going to be repealed or if [Congress] will just repeal the insurance portions of Obamacare and leave other portions in place [...] They will probably repeal large portions of Obamacare and some of the taxes with it, and replace those."
On improving insurance access under Obamacare: "The way I would improve access is, if the goal was to improve access to those most needy, then simply move up the coverage under Medicaid to a higher percentage of the poverty level [...] That way, what you don't do is you don't disrupt an insurance and a health benefits market that was largely working for the vast majority of people who were covered under it."
On the appeal of doing business in Licking County: "First of all, a great quality workforce. We have a great supply of high work ethic employees. Secondly, we like that Licking County is just far enough away from Columbus that we have our own identity [...] but close enough that we can go to Columbus and hire employees there as well. The final thing is really the governments, at both the county, city, village level. They're all very responsive, very pro-business, so when we need something, they're generally there to help out."
Half of health care systems now accept value-based reimbursements, and that number may go even higher in the next few years, a new survey suggests. MedBen has seen firsthand the potential of alternative payments to benefit self-funded employers and providers alike, and is helping clients realize that potential.
According to Modern Healthcare, 36% of respondents to the KPMG survey said they receive some reimbursement from value-based contracts, while 14% said they get most of their payments that way. Another 26% said they are planning to enter value-based payment arrangements in the next one to three years.
These findings indicate that health care systems are responding to the growing popularity of alternative payment methods in the private and public sectors. Last year, an analysis by the National Business Group on Health revealed that nearly half of self-funded employers have incorporated some type of value-based design in their health care plan. Likewise, the Centers for Medicare & Medicaid Services expect that by 2018, half of all provider payments from Medicare will be via “alternative models.”
Through our MedBen Analytics service, which helps hospitals convert raw Medicare data into actionable insights, we've seen how value-based payments enable providers to make informed choices necessary to improve services. This arrangement will also benefit self-funded plans, who will realize lower costs than fee-for-service payments without compromising quality of care.
We are rolling out commercial bundled payment services to clients. As health care systems become more comfortable with the value-based model, MedBen expects it to become the norm for employer claim payments.
With new President Donald Trump and Congress already taking steps to possibly repeal the Affordable Care Act (ACA), the future of health care reform is very much a question mark... and employers are understandably concerned about what will happen next. Several business organization representatives recently shared their thoughts:
Mike Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions: "If anything, we might see ACA repealed with some sort of forward-looking timeframe so they have time to replace it with something. Trump has made a point that he won’t leave people in the lurch in the meantime; frankly, having a time-limited chance to put something in place is an opportunity to take a thoughtful relook at how we do it."
Brian Marcotte, president and CEO at National Business Group on Health: "By selecting [Health & Human Services Secretary Tom] Price, Trump is signaling that he’s really serious about dismantling the ACA and replacing it with a plan that relies more on increased competition among insurers than on government health insurance exchanges [...] We would hope that HHS would continue to transform Medicare away from fee-for-service, which drives unnecessary care and spending toward paying for value, and we’d like to keep our foot on the gas when it comes to transforming the delivery system and not lose momentum there."
Meanwhile, Michael P. Aitken, vice president of government affairs for the Society for Human Resources Management (SHRM), has asked Congress to maintain the employer health care system’s effectiveness while it attempts to repeal. In a letter to the body, Aitken suggested lawmakers “eliminate coverage requirements on employer-sponsored plans to ensure employers have the flexibility to design benefit plans that meet the unique needs of varying workforces” and “allow employers to adopt innovative strategies to improve health benefit offerings to lower overall U.S. health care costs.”
MedBen recently shared its own thoughts on the ACA's future, which you can read elsewhere on this blog.
As we've seen in the headlines repeatedly these days, even high-level government agencies are vulnerable to cyberattacks. For MedBen, it serves as a continual reminder that there is no comfort level when it comes to security ‒ rather, an effective defense requires continual reassessment and revision.
Security experts predict that cyberattacks will increase this year, and the primary target will be health care organizations. “ will take the cybersecurity industry into new territory after 2016’s threat landscape opened doors for cybercriminals to explore a wider range of attacks and attack surfaces,” said Raimund Genes, chief technology officer for Trend Micro, in a recent statement.
For many years ‒ certainly, long before "cybersecurity" became common language ‒ MedBen has taken a variety of measures to protect our clients' personal information. This attention to detail doesn't apply simply to external threats ‒ we also have multiple procedures in place to ensure that only those MedBen employees who need specific information to do their jobs have access to it. Additionally, we use security cameras and numerous physical safeguards to provide an extra layer of protection.
Equally important to our cybersecurity strategy is that we test these protective measures through periodic, unscheduled penetration attempts by IBM and other outside firms. Not only do these tests confirm the reliability of our safeguards, they provide valuable feedback that helps us further strengthen our defenses.
Clients who would like to know more about our security measures are welcome to contact Vice President of Information Systems and Chief Security Officer Rose McEntire at email@example.com.
For most, a new year brings new resolutions. Year after year, weight-related goals are among the top resolutions. Unfortunately, only 8% of all resolutions are achieved. But what if you veer from the traditional route and don’t focus on diet and exercise to improve yourself, but rather simply be optimistic?
Oftentimes, we think of these as two separate subjects: your physical health and your mental attitude. However, studies have shown that poor mental attitude can decrease physical health and vice-versa. Why is that?
One such study found a link between increased levels of optimism and decreased risks of death from cancer, heart disease, stroke, respiratory disease and infections. Another proved that being optimistic lowers stress levels and increases the immune system, thus decreasing the chance of developing negative physical health conditions in the first place. And, you may find it noteworthy that for every 10 positivity points a person had in optimism, their risk of early death decreased by 19%.
While being optimistic is great, MedBen WellLiving suggests that in addition, you seek guidance from your family physician during an annual wellness exam to help ensure your health is on the right track this year.
So as you enter 2017, think about what resolutions you want to set. No matter what you choose (i.e., weight, financial, travel), remember that looking at the glass half-full may help you achieve that goal.
Now going into our 16th year, MedBen University (MBU) continues to offer free educational seminars across the Midwest. Our team of benefits management professionals covers a variety of subjects, from cost-saving strategies to regulatory updates.
This year's MBU season will commence with a pair of roundtables that focus on the distinctive needs of specific industries. In addition to learning about current spending trends, attendees can see first-hand how their plans compare with those of other businesses. Both will be held at the C. Arthur Morrow Conference Center, 1821 W. Main Street, Newark, Ohio (located next to the MedBen home office; times to be determined).
15th Annual Hospital Roundtable
Thursday, March 23
Because of a hospital's position as a care provider, benefit planning poses particular challenges and opportunities for plan administrators. Attendees will learn ways to use this industry advantage to their best benefit, and what performance indicators to watch in order to best manage costs.
11th Annual Municipality Roundtable
Thursday, March 30
City and country governments, school systems and other public sector employers also face unique health care cost control issues. Attendees will learn money-saving strategies that municipalities can apply to their coverage, and ways that they can make more informed planning decisions.
These roundtables are open to their respective industry members, so if you represent a hospital or municipality, whether you are a current client or not, we invite you to join us! Simply contact MedBen Sales Analyst Sally Wood at (800) 423-3151, ext. 502 or emailing firstname.lastname@example.org. Continental breakfast and lunch will be provided.
Keep an eye out for additional information about these seminars and others in both your mailbox and emails!
Because high blood pressure, or hypertension, is closely linked to other chronic conditions, researchers regularly use it as a barometer of health. Likewise, population health programs like MedBen WellLiving stress the role that reducing hypertension plays in improving personal health.
A new University of Washington study determined that worldwide, the rate of systolic blood pressure (or SBP, the pressure while the heart is beating) rose substantially between 1990 and 2015. Preventable deaths from conditions linked to elevated SBP, such as heart disease and stroke, also increased during that period... and perhaps not surprisingly, the U.S. made up a disproportionate number of people whose lives could have been improved or extended by correctly managing their blood pressure.
Considering its significance, it stands to reason that a blood pressure reading is a mainstay of the physician office visit, including the annual wellness exam. Regular readings provide your family doctor with a useful means to track your general health... and multiple bad readings serve notice for the doctor to review lifestyle choices that may be contributing to hypertension.
The good news is that there are multiple ways to control your blood pressure. MedBen WellLiving helps employers to spur plan members into action, by promoting the value of preventive care and the doctor-patient relationship. And those at higher risk for hypertension can complement physician care with individualized nurse coaching.
Learn more about the benefits of MedBen WellLiving offers by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
Hard though it may be to believe, here we are in January 2017... and if you're a self-funded employer plan sponsor, it's time to get serious about preparing your IRS Form 1095s.
As you know, the Affordable Care Act (ACA) and its supporting regulations require that all employers offering health benefits to their employees report certain health coverage information to those employees as well as the Internal Revenue Service (IRS). And just like last year, employers sponsoring health plans must collect, aggregate and distribute this information via Form 1095. These are due to employees no later than March 2, 2017.
Additionally, employers must transmit copies of their employee 1095s to the IRS (via Form 1094) no later than February 28, 2017 (for paper filers) and March 31, 2017 (for electronic filers). Applicable Large Employers (those with 50 or more employees) must report using the IRS’ C-series forms, while small employers offering coverage (those with fewer than 50 employees) must report using the IRS’ B-series forms.
This year, the IRS has put out a good Q&A on how to complete the forms, including answers to coding questions. You can find the Q&A at the IRS website.
Proper use of bundled payments by health care providers can save money while maintaining or even improving quality of care, concludes new research from the Perelman School of Medicine at the University of Pennsylvania.
According to a Penn Medicine news release, the evaluation of costs and care quality for hip and knee replacements performed from 2008-2015 at a Texas-based health system determined that the average cost per patient dropped nearly 21% during that period. The health system began the transition from fee-for-service to bundled payments in 2009.
The study also found a 67% drop in extended hospital stays, while the severity of patient conditions remained unchanged.
As these numbers suggest, the steady growth of alternative payment models carries the potential for significant cost savings in the delivery of health care. MedBen Analytics is working to help hospitals, health systems, and physician groups fulfill that potential.
Through our proprietary reporting platform that converts disparate Medicare data into actionable insights, MedBen Analytics enables providers participating in the Comprehensive Care for Joint Replacement (CJR) and other value based payment initiatives to make informed decisions regarding hospital readmissions, lengths of stay and other cost-oriented variables.
As methods from bundled payments for hip and knee replacements are being applied to cardiac care and other medical procedures, MedBen Analytics continues to broaden its reporting platform. Our goal is to ensure that providers get full advantage of the data transparency now available to them, and use our reports to offer optimal service while saving money ‒ and enhancing their reputations.
Organizations interested in discussing MedBen Analytics' services can call President and COO Kurt Harden at 888-633-2364 or email him at firstname.lastname@example.org.
Over the past few months, MedBen has provided information to our clients about the ramifications and compliance requirements of the Affordable Care Act’s (ACA's) Section 1557 regulations, which prohibits employers and organizations (covered entities) from discriminating on the basis of race, color, national origin, sex (gender), age, or disability, for any health program or activity of which any party receives Health and Human Services (HHS) federal funding or assistance. This includes both patient care and health benefit plans, and applies to health benefit plans effective on the first day of the plan's 2017 plan year.
On December 31, 2016, just one day before the Section 1557 rules took effect for some covered entities, a federal Judge in Texas issued a nationwide injunction halting enforcement of a portion of the Section 1557 rules – specifically, the requirements relating to the provision of health care services for gender transition and termination of pregnancy.
While Section 1557 only applies to a small portion of MedBen clients, it is essential that those covered entities have a clear understanding of how this ruling affects their compliance responsibilities. To that end, the MedBen Compliance team has composed a document summarizing the current status of Section 1557 and what it means for health benefit plans of covered entities. This summary is available for download and printing at MedBen.com.
We'll emphasize here that, due to the federal court’s injunction and as noted in the summary, it appears that you may not have to modify your plan document to cover gender transition services or termination of pregnancy at this time – unless you choose to do so voluntarily.
We encourage MedBen clients who receive HHS federal funding or assistance to read the entire summary. If you have questions, please contact Vice President of Compliance Caroline Fraker at 800-851-0907 or email@example.com.
To our customers, consultants and brokers:
As we come to the close of a rather eventful 2016, we wanted to take a moment to wish you and your employees a Happy New Year on behalf of the entire MedBen staff!
While we've both seen plenty of changes in our time at MedBen, it's safe to say that what we have experienced these past few years have been really unprecedented: A reform of the health care system by one president's administration, followed by a potential overhaul by the next one. Suffice to say, it's been equal parts interesting and challenging so far... and it looks like we're just getting started.
As we turn the calendar, we want to pledge to you that whatever changes to health care that occur in the coming months, MedBen will continue to provide innovative and money-saving benefit solutions and unmatched service. Many of the people working here have been with us for decades, and our trust in their ability to serve you grows with every passing year. Likewise, we will strive to earn your trust in every way possible... and if we should fall down on this pledge, please call either one of us. We will work quickly to fix whatever isn't working for you.
We hope that the coming year finds you happy and healthy, and offer you our very best wishes for a prosperous 2017!
Chairman & CEO
President & COO
A quick reminder: MedBen will be closed on Monday, January 2 and reopen on Tuesday, January 3 at 8:00 a.m. EST. Should you have a claims or benefits question, please visit MedBen Access. Our online customer service center is available 24/7 for your convenience!
The U.S. spends more on diabetes than any other medical condition, according to a new analysis that underscores the impact that a wellness-driven workplace can have on reducing health care costs.
HealthDay reports that in 2013, Americans spent $101 billion on diabetes diagnosis and treatment. Between 1996 and 2013, diabetes spending grew 36 times faster than spending on heart disease, the nation's leading cause of death.
"After adjusting for inflation, we see that every year the U.S. is spending 6% more than we spent the year before on diabetes," said lead researcher Joseph Dieleman of the University of Washington. He added that "spending on diabetes grew twice as fast as all conditions combined" during that 18-year period.
Most diabetics are diagnosed with the type 2 variety, in which the pancreas produces insufficient amounts of insulin to control excess blood glucose. Fortunately, lifestyle changes can significantly reduce the effects of type 2 diabetes ‒ and here, MedBen WellLiving can provide timely assistance.
Through our WellLiving specialty care program, plan members diagnosed with type 2 diabetes will be contacted by an RN Health Consultant to offer customized counseling and confidential disease monitoring. Individuals who aren't at immediate risk will benefit too, as our focus on preventive care encourages regular wellness exams with a family doctor, improving the chances that diabetes symptoms will be detected and addressed in their earliest stages.
Of course, MedBen WellLiving brings population health awareness to other costly conditions as well. Contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org to learn more.
With health care spending expected to reach one-fifth of the U.S. gross domestic product by 2025, it's more important than ever for businesses to have a greater degree of cost control with their health plan. Toward that goal, MedBen continues to help employers make the switch to self-funded coverage.
Self-funding has a number of advantages (i.e., cost savings, regulatory freedom), but we'll single one out here: Flexibility. Specifically, the input the employer has in the creation of their health plan far exceeds that available in traditional insurance coverage. With MedBen’s expertise, employers can rest easy that their customized plan both meet their needs and will be regulatory compliant.
The flexibility doesn't end there. MedBen also offers stop-loss independence, which allows us to shop multiple carriers to find you the best rate. This applies to new groups as well as renewing clients.
MedBen’s risk reduction strategies have been proven to help clients keep their costs in check and beat national cost trends. Also, you can complement your benefits plan with our population health strategies like MedBen WellLiving, resulting in even greater client savings.
Self-funding opens employers to a variety of ways to keep their health care spending to a minimum. Discover how MedBen can help your bottom line by contacting MedBen Vice President of Sales & Marketing Brian Fargus at email@example.com.
With all the talk these days about repealing and replacing the Affordable Care Act (ACA), it's little wonder that its uncertain future troubles many businesses. But as health care reform is potentially "re-reformed," the MedBen Compliance team will be closely monitoring developments and advising clients along the way.
In a new Aon survey of 800 employers, 48% responded that the ACA's employer mandate ranks above prescription drug costs and the "Cadillac tax" as their biggest concern for the incoming Trump administration. "The employer mandate ... has the reporting obligations, the disclosure obligations, 1094 and 1095 forms and the service tracking ... all of that goes into the ACA. The concern is, is it going to be dropped, expanded or modified in some way?” said J.D. Piro, head of the Aon’s law group, to EBN.
While it's fair to say that the ACA has been reliably consistent in its inconsistency, the election of Donald Trump holds the potential for a major overhaul that few could have foreseen. Fortunately, the MedBen Compliance Department has been through health care reform once, and is ready to tackle it again.
Even before the ACA was signed into law in 2010, Compliance management was reviewing its potential provisions and charting a course of action for MedBen clients. And as we collectively learn what's to come, our team will draw upon their experience from the first go-round to help clients understand what the new reforms will mean to their business, and how to best prepare for it.
Of course, any reform will take time to implement... so for 2017 at least, it's business as usual. MedBen Compliance will continue to guide clients, brokers and consultants through the details via phone calls, meetings, webinars, educational materials, newsletters, and this blog. And as always, if you ever have questions about any aspect of the ACA, don’t hesitate to call Vice President of Compliance Caroline Fraker at 800-851-0907 or firstname.lastname@example.org.