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06/20/13

  04:25:22 pm, by MedBen5   , 194 words,  
Categories: News, Prescription

Nearly 70% Of Americans Take A Prescription Drug

If you don’t take a prescription drug, chances are you know one or two people who do… or three, or four, or more, Drug Store News reports.

According to a new study by the Mayo Clinich, nearly 70% of Americans use at least one prescription drug, and more than half are taking two. Most of the drugs are antibiotics, antidepressants and opioid painkillers, followed by medications to control blood pressure and vaccines.

“Often, when people talk about health conditions, they’re talking about chronic conditions, such as heart disease or diabetes,” study author Jennifer St. Sauver said. “However, the second most common prescription was for antidepressants; that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a big concerning considering their addicting nature.”

The study also found that women receive more prescriptions, and nearly 25% of women aged 50 to 64 are on an antidepressant. Older adults also account for a large number of prescriptions overall, escpecially cardiovascular drugs. Antibiotics and asthma drugs were most commonly prescribed to those younger than 19 years, while antidepressants and opioids were most common among young and middle-aged adults.

  04:00:07 pm, by MedBen5   , 183 words,  
Categories: News, Health Plan Management

Proposed Bill Would Increase Hours Under Employer Mandate

According to The Hill’s Healthwatch blog, legislation has been introduced in the Senate to modify the employer mandate in the Affordable Care Act.

The mandate, which will take effect in 2014, requires businesses to offer health insurance to their employees who work 30 hours or more. The bipartisan bill would move the working hours from 30 to 40 hours to match the traditional definition of a full-time worker.

Critics of the current mandate believe it will hurt small businesses, as employers will be forced to reduce workers’ hours. Proponents of the bill say that changing working hours to 40 per week ensures that all people have access to affordable health care.

“Businesses are baffled by the definition of 30 hours,” said Susan Collins (R-Maine), a co-sponsor of the bill. She noted that other federal laws generally define a full-time employee as someone who works at least 40 hours per week.

Some liberal Democrats say that they will not consider the change, as setting the employer mandate at 30 hours per week was the best way to ensure that people who work 30 to 40 hours per week have access to health care.

06/19/13

  05:04:10 pm, by MedBen5   , 200 words,  
Categories: News, Prescription

Avoidable Rx Costs Add Up To $200 Billion Last Year

Smarter use of prescription medications could have saved Americans $200 billion in 2012, according to a new study from the IMS Institute for Healthcare Informatics. These “avoidable costs", as the study calls them, lead to millions of unnecessary hospital admissions, outpatient and emergency room visits and prescriptions.

“Access to medications is a very important priority,” Murray Aitken, executive director of the IMS Institute for Healthcare Informatics, said during a call with reporters. “We believe that the responsible use of those medications is equally important.”

Modern Healthcare reports that the single biggest avoidable cost was medical nonadherence – not following a doctor’s instructions for taking drugs properly cost Americans an estimated $105 billion last year. Cost, a patient’s lack of information about long-term effects of certain diseases and fear of a drug’s side effects all contributed to nonadherence.

Misuse of antibiotics, medication errors and suboptimal use of generic drugs were among the other avoidable cost addressed by the study.

The study did note that improvements have been made that address some of these problems. Generic drug usage, for instance, is on the rise and the percentage of patients who are inappropriately prescribed antibiotics for the cold or flu dropped to 6% in 2012, compared with 20% in 2007.

  04:16:24 pm, by MedBen5   , 215 words,  
Categories: News, Wellness

Less Than 1 In 5 Americans Now Smoke, Study Finds

A recent government study conducted by the Centers for Disease Control (CDC) has found that the proportion of U.S. adult smoking has dropped to 18% within the last two years, the Associated Press reports. Overall smoking rates have fallen over the past seven years, but this marks the first time the habit has dipped under 20%.

The study analyzed surveys taken from 35,000 US adults. Smokers were identified by how many cigarettes they smoke in their lifetime and how often. The rate was only 9% for people of age 65 and older, but 20% for younger adults. The study also determined that about 16% of high school students smoke.

Patrick Reynolds, executive director of the Foundation for a Smoke Free America,
said he felt that many factors have contributed to the decline in adult smoking, such as the federal tobacco taxes, a campaign launched by the CDC to strike against smoking and more laws banning smoking in public.

Smoking is the leading cause of preventable illness and death in the United States. A major contributor to lung cancer, smoking kills 440,000 people each year.

A January 2013 study in the New England Journal of Medicine found people who quit smoking before age 40 lived as long as people who never smoked. Research also supports that smoking can cut 10 years off a person’s life.

  04:03:35 pm, by MedBen5   , 182 words,  
Categories: News, Health Plan Management

GAO: Government In Danger Of Missing Exchange Deadline

The federal government could miss the October 1 deadline to enroll in health insurance exchanges, a report by the non-partisan Government Accountability Office (GAO) released today said.

According to Reuters, the report noted that the key parts of the framework of the online marketplaces, including those that addressed consumers’ eligibility for federal subsidies, management and monitoring of insurance plans and consumer assistance, had not been completed. Additionally, many states have not completed many of the tasks assigned for implementation.

“Additional missed deadlines closer to the start of enrollment could (affect implementation),” the report concluded. “Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined.”

Despite the concerns raised by the GAO, the Department of Health and Human Services is confident the exchanges will be ready on time. “We are working every day to establish individual and small business marketplaces, where many Americans will have access to quality, affordable coverage for the first time. We have already met key milestones and are on track to open the marketplace on time,” HHS spokeswoman Joanne Peters said.

06/18/13

  12:56:49 pm, by MedBen5   , 228 words,  
Categories: News, Health Plan Management

Slow Health Care Cost Growth In 2014, Report Says

Health care costs will see slow growth next year, according to a new report by the accounting and consulting firm PwC.

The Associated Press reports that the recend trend of lower cost increases will continue, in spite of an improving economy and the prospect of millions of additional Americans receving coverage under the Affordable Care Act, Any cost spikes, the report says, should be contained within a relatively narrow market segment.

“There are some underlying changes to the system that are having an impact, and we can expect lower increases as we come out of the recession,” said Mike Thompson of PwC’s Health Research Institute, which produced the study. Cost “is still going up, but not as much as it used to.”

The report pointed to several specific factors influencing downward costs, including increased use of clinics in retail stores and higher employee deductibles. Conversely, the high cost of specialty drugs to treat chronic illnesses will keep cost increases from going even lower.

Regardless of national trends, MedBen can work with you to develop a health care plan that keeps cost increases low without sacrificing desired benefits. And our compliance team will help to keep you informed of regulatory developments that may affect your plan design, as well as your bottom line. To learn more, call Vice President of Sales and Marketing Brian Fargus at bfargus@medben.com.

  10:11:09 am, by MedBen5   , 196 words,  
Categories: News, Prescription

Court Ruling Give FTC Greater Scrutiny Over "Pay-for-Delay" Deals

In a 5-3 ruling, the Supreme Court ruled yesterday that the Federal Trade Commission can give additional scrutiny to so-called “pay-for-delay” arrangements between generic and brand-name drug companies, The New York Times reports. Justice Samuel Alito recused himself for the decision.

Brand name drug manufacturers sometimes pay competitors to keep generic versions of their products off the market. While the court did not address the legality of such agreements, it did effectively overturn a lower-court ruling that said they were lawful, so long as a deal did not keep a generic drug off the market beyond the term of the brand-name drug’s patent.

The FTC, which has fought pay-for-delay for over a decade, had hoped the court would find that the practice violated antitruat laws. But the ruling did give the agency – as well as consumer groups, drug retailers, wholesalers and insurance companies – the ability to challenge any deals it deemed questionable.

Justice Stephen G. Breyer, writing for the majority, said that “a court, by examining the size of the payment, may well be able to assess its likely anticompetitive effects along with its potential justifications without litigating the validity of the patent.”

06/17/13

  05:03:19 pm, by MedBen5   , 231 words,  
Categories: News, Health Plan Management

Best Medical Outcomes At A Lower Cost? MedBen Has The Solution

In order to hold down health care plan costs, employers are considering new approaches to promoting plan member use of providers with the best medical outcomes, Business Insurance reports.

According to an Aon Hewitt survey of about 800 large and midsize employers, 59% of respondents said they intend to direct members, through plan design or lower costs, to hospitals or physicians with demonstrated high quality for specific procedures or conditions. “Employers want to drive employees to providers with the best outcomes,” Jim Winkler, chief innovation officer for health in Aon Hewitt’s Norwalk, Connecticut, office.

Partners Community Health Plan is the perfect solution for employers who value high quality at lower costs. MedBen has partnered with community hospitals throughout Ohio and Kentucky to provide a level of care comparable to that found in major metropolitan areas, often at a fraction of the price.

In addition to the most comprehensive provider network available, Partners offers a worksite wellness program and the best pharmacy plan discounts you can find. Members also have access to a community wellness network that offers discounts from neighboring businesses on a variety of products and services. In short, it’s better care at a better cost.

Partners Community Health Plan is available to both fully- and self-insured groups. To learn more, e-mail MedBen Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com or contact a participating Partners agent.

  03:45:17 pm, by MedBen5   , 273 words,  
Categories: News, Wellness, Health Plan Management

AMA Recognizes Obesity As A Disease (UPDATED)

With two-thirds of US adults defined as overweight or obese, The American Medical Association is considering whether to recognize obesity as a disease, Forbes reports.

The potential classification has already created debate. “More widespread recognition of obesity as a disease could result in greater investment by government and the private sector to develop and reimburse obesity treatment,” states the AMA’s Council on Science and Public Health.

Opponents counter that obesity results from personal choices and is not an illness. “We understand obesity as a condition and a risk factor for other diseases,” said Susan Pisano, spokeswoman for American’s Health Insurance Plans. “The important thing is to get programs and supports in place to address it, as health plans have done and are doing,”

The debate will continue during the AMA’s House of Delegates meeting, which will conclude on June 19. While the group does not have any legal authority, its delegates do have standing with many policymakers in Washington.

UPDATE (6/18/13): At the AMA’s annual meeting on Monday, the Council on Science and Public Health said that partly because obesity is hard to define, it cannot be classified as a disease. To do so could undermine prevention efforts and will do little to impact its treatment, according to a report issued by the council.

Read more at MedPage Today.

UPDATE 2 (6/19/13): Despite the Council’s recommendation, the AMA voted Tuesday to classify obesity as a disease, HealthDay News reports. “Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,” AMA board member Dr. Patrice Harris said in a statement Tuesday.

  10:32:44 am, by MedBen5   , 189 words,  
Categories: News, Health Plan Management

More Employers Expect Higher Costs Under Reform Law

Employers aren’t overly optomistic that the Affordable Care Act will help their bottom line, finds a new survey by benefits consultant Mercer.

According to The Wall Street Journal, just 9% of the 881companies surveyed feel the health care reform law will add less than 1% to their costs next year. That represents a significant drop from 2012, when 20% felt they would see little impact come 2014 – which in itself marked a decline from 25% in 2011.

Conversely, an increasing number of employers expect costs to go up by 5% or more – 19%, compared to 15% in 2011.

About a third of the companies Mercer surveyed currently don’t provide coverage. But with the upcoming ACA rule requiring all employees working 30 hours or more a week to be eligible for insurance, almost 60% of those who don’t say they intend to, and 30% expect to add a new, lower-cost plan.

Nearly 80% of employers also expressed concerns about communicating the law to their employees, while 70% said the requirements to educate their employees on plan changes and to help them make informed decisions are a “significant concern.”

Mercer surveyed 281 companies with fewer than 500 employees, 418 with 500 to 5,000 employees and 182 who have more than 5,000 employees.

06/14/13

  05:33:55 pm, by MedBen5   , 240 words,  
Categories: News, Wellness, Health Plan Management

Oncology Care Management Promotes Effective Cancer Treatment

A recent Reuters article notes that at the annual meeting of the American Society of Clinical Oncology earlier this month, doctors “heard groundbreaking data on a new class of immune system boosters” that shrank tumors in patients with advanced melanoma and lung cancer. Such drugs could potentially become the main treatment for more than half of all cancers in the next 10 years.

Naturally, such innovations don’t come cheap: Citigroup analysts expect the drug treatment to cost around $110,000 for a year’s worth of treatment. And while those costs will be somewhat offset by reduced hospitalization fees, the National Cancer Institute estimates that the total cost of caring for U.S. cancer patients will rise to $174 billion in 2020 from $125 billion in 2010.

So how will group health plans balance these cost increases for cancer treatment while allowing proper care for the patient AND respecting the physician’s right to direct care? MedBen already has a proven solution.

Comprehensive Oncology Care Management offers cancer patients an additional advocate to provide professional guidance and counseling for their condition. The service ensures that patients receive appropriate cancer treatment that is in accordance with current standards of care and backed by reliable evidence.

Care management works with physicians to make sure that care is appropriate and eligible for coverage, while always giving them the final say as to the course of care. To learn more, contact MedBen Sales & Marketing Vice President Brian Fargus at bfargus@medben.com.

  04:39:29 pm, by MedBen5   , 199 words,  
Categories: Announcements

Thran Joins MedBen Sales & Marketing As Project Coordinator

Kelly Thran

The MedBen Sales & Marketing Department is pleased to announce the recent addition of Kelly Thran to its team. A seasoned veteran of the benefits management company, Thran will serve as the department’s Marketing Project Coordinator.

In her new position, Thran will work with other members of the Sales & Marketing staff in the creation of client reports and analyses, sales proposals, marketing flyers and other materials. She will also contribute daily content to the MedBen Blog, which offers company news, regulatory updates and other information of interest to customers.

“I’m very pleased that Kelly has chosen to join our team,” said Brian Fargus, MedBen Vice President of Sales & Marketing. “She brings a tremendous amount of experience and knowledge to the job, and I look forward to working with her.”

Thran joined MedBen in 2000 as a member of the Underwriting Department, for which she performed such duties as generating proposals for fully-insured employer groups and assisting with sold group write-ups. Prior to joining Sales & Marketing, she served as the company’s Network Coordinator, acting as a liaison between current and prospective clients and provider network partners.

A graduate of Salve Regina University, Kelly currently resides in Newark, Ohio.

  04:26:48 pm, by MedBen5   , 272 words,  
Categories: Health Plan Management

Marketplace Creates Hospital Cost Differences, Says AHA

The fact that surgical costs differ from one hospital to another may not come a total surprise. But the recent introduction of a Medicare Provider Charge database by Health and Human Services, containing prices charged by more than 3,000 hospitals, has brought such cost variances under closer scrutiny.

WebMD recently compiled an FAQ examining hospital costs. Among the questions asked: Why is there such a big cost difference for the same services?

Hospital rates are based on a number of factors, according to the American Hospital Association, including:

  • Scope of services provided
  • Whether the hospital serves a large portion of poorer and sicker patients
  • Community reputation of the hospital

The difference in costs between one hospital and another is a “byproduct” of the marketplace, says the AHA.

Caroline Steinberg, the AHA’s vice president of trends analysis, believes the focus should shift from pricing to what hospitals actually collect for their services. Medicare and private insurer payments to hospitals are typically far lower than the stated cost. Medicare sets the rate of reimbursement, even though it adjusts the rates according to factors like the number of poorer people the hospital serves, Steinberg says.

But economist William Custer, PhD, director of health services research at the Institute of Health Administration at Georgia State University, says these factors can’t explain the cost variations.

“Hospitals have historically set prices based on their own methodology. One hospital can set prices three times greater than another; there’s no real pattern,” says Custer. “If we had a healthy health services market, you would expect those prices to be much closer aligned.”

Read more of the FAQ at the WebMD site.

06/13/13

  05:33:23 pm, by MedBen5   , 215 words,  
Categories: News, Wellness

Worksite Wellness Factors Into Employment Decisions, Survey Finds

Prospective employee consider a company’s apporach to health and wellness when making a job decisions, a new survey reveals.

According to Small Biz Advisor, the survey of approximately 1,300 businesses and 10,000 employees found that 87% claim that health and wellness programs play a role in determining their employer of choice. Most of the business surveyed – 4 out of 5 – said they offer some level of wellness benefits.

In regard to wellness and working conditions, 70% of employees surveyed say that such programs positively influence the culture at work. Also, providing a little additional encouragement helps: 61% of employees say incentives are a key reason they participate, while 78% claim they are interested in participating in incentive-based programs while at work.

MedBen Worksite Wellness can provide employers of all sizes a program designed to address specific employee needs. We focus on the promotion of early detection testing for chronic conditions, while emphasizing the importance of annual member wellness exams. And our disease- and prevention-based approach encourages healthier lifestyles and provides customized coaching.

Our worksite wellness program also features extensive employer reporting, showing ongoing compliance rates for early detection testing, the clinical progress of members enrolled in health coaching, and your financial return on the program. To learn more, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

  04:59:56 pm, by MedBen5   , 200 words,  
Categories: News, Health Plan Management

Individual Health Plan Premiums Will Nearly Double, Says Ohio Dept. Of Insurance

Avik Roy warns Ohioans covered under individual health plans to prepare for some serious sticker shock next year:

“Democrats continue to try to dismiss the evidence that Obamacare will dramatically increase the cost of insurance for people who buy it on their own. But on [June 6], the Ohio Department of Insurance announced that, based on the rates submitted by insurers to date, the average individual-market health insurance premium in 2014 will come in around $420, ‘representing an increase of 88 percent” relative to 2013. ‘We have warned of these increases,’ said Lt. Gov. Mary Taylor in a statement. ‘Consumers will have fewer choices and pay much higher premiums for their health insurance starting in 2014.’

“It’s called ‘rate shock,’ but it’s not shocking to people who understand the economics of health insurance. In August 2011, Milliman, one of the nation’s leading actuarial firms, predicted that Obamacare would increase individual-market premiums in Ohio by 55 to 85 percent. This past March, the Society of Actuaries projected that the law would increase premiums in that market by 81 percent. Like good players on ‘The Price is Right,’ they both came in just under the Dept. of Insurance’s figure.”

Read more at Forbes.com.

  04:40:20 pm, by MedBen5   , 248 words,  
Categories: News, Prescription, Wellness

Birth Control Pills Linked To Lower Ovarian Cancer Risk

A recent study by Duke University School of Medicine supports findings that women who use oral contraceptives are less likely to develop ovarian cancer later in life, Reuters reports. Dr. Laura Havrilesky, who led the study, said, “It reinforces that there is a positive relationship between the use of oral contraceptives and ovarian cancer prevention in the general public.”

Havrilesky and her colleagues researched data from 24 previous studies that compared thousands of women who took the pill, varying at different lengths of time, as well as those women who did not take the pill. They concluded that women who took the pill had a 27% lower risk of developing ovarian cancer. A longer use of the contraceptive was linked to more protection.

The study cannot prove that oral contraceptives alone can prevent ovarian cancer because there could have been other unmeasured factors in the study group, such as genetics. Although there is no known cure for ovarian cancer, eating a healthy diet and maintaining a normal weight may help the risk.

“What we’ve got right now may be the best evidence that we ever are able to have. I don’t necessarily think that it is enough to tell a physician to have their patients use oral contraceptives solely for the purpose of preventing ovarian cancer. But I think it’s enough to say this is a possible advantage in women who are considering use of oral contraceptives for birth control or other medical reasons,” Havrilesky told Reuters.

  05:12:45 am, by MedBen5   , 248 words,  
Categories: News, Health Plan Management

Health Care Fraud Can Be Costly To Employers

Taken together, the leading causes of medical fraud cost employers $4.93 per member per year in unnecessary payments, according to a new study by Truven Health Analytics. Employee Benefit News listed the six most common factors that drive fraud in American health care:

  1. Schedule II drugs without physician care. ($84.3 million) Truven says more than 20% of patients that received drugs such as Morphine, Ritalin or Oxycodone had no medical visit within 90 days of the receipt of prescription.
  2. Multiple patient visits. ($18.5 million) Some 1.4% of “new patient visits” broke American Medical Association guidelines that they occur only once every three years.
  3. Improper use of diabetic supplies. ($8 million) While only $3.9 million in 2010, the cost of diabetic supplies for non-diabetic patients has more than doubled in two years.
  4. Unbundled psychotherapy/drug management services. ($5.3 million) The two are supposed to be billed together using a code that includes both.
  5. Refills on schedule II drugs. ($5.2 million) Although refills are prohibited by law, nearly 1% of patients on schedule II drugs got one.
  6. Wasteful medical transportation. ($1.3 million) More than 5% of patients and 4.6% of medical transport costs had no associated medical visit.

At MedBen, we combat these and other practices through our Anti-fraud Unit, which reviews questionable claims and other related information. This team works in tandem with an advanced surveillance system that thoroughly reviews every claim for fraud potential.

If you’d like to learn more about the measure we take to protect our clients, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

06/12/13

  05:05:38 pm, by MedBen5   , 154 words,  
Categories: News, Wellness

Study Links Mother's Obesity To Higher Premature Birth Risk

A new Swedish study suggests overweight and obese women are more likely to give birth prematurely, Reuters reports.

The study, conducted by Dr. Sven Cnattingius of the Karolinska Institute in Stockholm, analyzed 1.6 million pregnant women and their babies between 1992 and 2010. The data collected a woman’s weight and body mass index (BMI) at her first prenatal visit and followed the progression throughout her pregnancy.

Research determined that a higher body BMI was linked to babies being born between 22 and 27 weeks. Overweight women are also more likely to develop high blood pressure, the study noted.

Only 17% of women with an average weight delivered an extremely premature baby. Overweight women (with a BMI of 40 or greater) had the greatest risk for delivering a premature baby – 52%.

The researchers concluded that women should maintain a healthy lifestyle and weight before and after pregnancy. This will not only help the mother, but raises the odds for a safe delivery.

06/11/13

  05:20:16 pm, by MedBen5   , 127 words,  
Categories: Announcements

MedBen Releases ICD-10 Readiness Statement

In anticipation of the national changeover from current ICD-9 medical diagnosis and inpatient procedure codes to ICD-10 in 2014, MedBen has released this Readiness Statement:

“MedBen will be fully compliant with the upcoming ICD-10 mandate by the deadline of October 1, 2014. We are diligently working to ensure that all of our system components are able to accept and process ICD-10 codes without interruption to our day-to-day processes.

“Our current implementation timeline will allow us to begin internal system testing of the ICD-10 modifications early in 2014. This will enable us to begin testing with vendor partners several months prior to the October 2014 deadline.”

The statement is posted on MedBen.com.

MedBen clients with questions regarding ICD-10 readiness may contact Vice President of Information Systems Rose McEntire at rmcentire@medben.com.

  05:11:50 pm, by MedBen5   , 207 words,  
Categories: News, Wellness

One Dental Checkup A Year Enough For Some, Study Suggests

Two dental cleanings a year may be overkill for some people – though most patients do benefit from semi-annual checkups, a new University of Michigan study suggests.

According to HealthDay News (via WebMD), study author William Giannobile and colleagues reviewed data from more than 5,100 adults who visited the dentist regularly for 16 straight years to examine the link between the frequency of teeth cleanings and long-term tooth loss in the participants. They also reviewed three key risk factors for gum disease: smoking, diabetes and genetics.

The research team found that two dental cleanings a year provided significant benefits to people with one or more of the three risk factors, while people with two or three of the risk factors may require more than two cleanings a year. One cleaning per year appears sufficient for people with none of the risk factors, according to the study… but Giannobile noted in university news release that “over half the population” have at least one risk factor.

MedBen Dental encourages multiple checkups every year as well as good oral hygiene. Our plan incorporates affordable coverage, sound dental principles and responsiveness to the needs of your employees. To learn more, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

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