While precision medicine is in its relative infancy, its implications for our future health is significant. Tapping into that which makes us unique as individuals ‒ genetics, lifestyle, and environment ‒ improves the chances of better treatment outcomes and faster recoveries.
MedBen recently took its first step into this intriguing medical model through the introduction of a pharmacogenetics test that determines personal compatibility with hundreds of commonly prescribed drugs. By eschewing the "one-size-fits-all" approach that once was common to prescribing, the physician is better able to choose the drug and dose that's best for the patient.
Pharmacogenetics encompasses such common therapeutic categories as cardiovascular (heart), oncology (cancer) and pain management. It also extends into such sciences as psychiatry and neurology, thereby offering potential benefits for mind and body alike.
Besides reducing the trial-and-error common to prescribing, there's another important consideration for using pharmacogenetics testing: It also reduces the risk adverse drug reactions that can lead to unwanted side effects, be they minor or something much more serious. Plus, additional drugs may be required to treat those side effects, resulting in extra costs.
There's a good likelihood that MedBen will be exploring other forms of personalized medicine down the road. In the meantime, we invite you to learn more about pharmacogenetics testing and the positive impact it can have on your plan members. Contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
Heart disease and cancer rank as the number one and two causes of death in the United States, according to new data from the Centers for Disease Control and Prevention. The two diseases are trending in opposite directions ‒ but in both cases, early detection through preventive care can help to bring the overall mortality numbers down.
By encouraging preventive care through a wellness program like MedBen WellLiving, employers can help their employees to reduce the risk of developing a fatal disease such as heart disease, detect cancer in its earliest stages, or realize a higher quality of life in general. Additionally, the financial savings from early detection can be significant.
MedBen WellLiving takes a two-pronged approach to worksite wellness: Primary Prevention, which advocates annual wellness exams and cancer screenings for the entire workplace; and Specialty Care, which connects plan members at higher disease risk with registered nurses for personalized counseling. Together, these programs can aid your business greatly in reducing illness while improving productivity.
Worksite wellness works best when it focuses on preventing major diseases through timely intervention and promoting the doctor-patient relationship, and MedBen WellLiving can help you do that. Get more information by visiting MedBen.com or contacting Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
The staff of MedBen want to wish you and your family a safe and relaxing Labor Day!
Our home office will be closed on Monday, September 5 in observance of the holiday. We will reopen at 8:00 a.m. EST Tuesday, September 6.
Additionally, MedBen will be closing at 12:00 p.m. EST on Friday, September 9 for a companywide employee recognition event. We will reopen at 8:00 a.m. EST on Monday, September 12.
During these times, please remember that clients can use the 24/7 online services of MedBen Access to check on benefit coverage and the status of any pending claims. Simply go to MedBen.com and select "MedBen Access". For those who use Pharmacy Data Management (PDM) as their pharmacy benefits manager, you can check on prescription claims and find lower cost drug options through MedBen Access by clicking on the "Rx" button located in the "My Claims" section of this website.
If you're a MedBen Flexible Spending Account (FSA) or Health Reimbursement Arrangement (HRA) participant in addition to having other coverage, you also can use MedBen Access to see your FSA/HRA balances, claims submissions and payments. When you log in to MedBen Access, you'll find an "FSA/HRA Online Inquiry" option (visible only to groups offering MedBen FSAs/HRAs) under the "My Plan" section located on the left sidebar. By selecting this option, users are automatically taken to the MedBen FSA/HRA Online System.
Once again, have a good holiday!
A new benefits survey indicates that the trend of switching from fully insured to self-insured is expected to grow by 35% in the next two years. This is to no surprise since fully-insured groups continue to see high premium cost growth.
According to Employee Benefits News, the changeover can be attributed to the “explosion in healthcare costs," with inflation rates for insurance carriers hovering around 8% and prescription drug costs running closer to 12-15%. At the same time, an onslaught of new regulations under the Affordable Care Act have reduced those carriers' ability to control costs.
Self-funding offers a greater degree of freedom from state and federal regulations compared to traditional insurance. Moreover, stop-loss carriers offer added financial protections to make self-funding even more appealing to employers looking to save money.
Once exclusive to larger companies, self-funding has evolved so that even businesses with as few as 25 covered lives can benefit from its cost-saving potential. And for those employers who already self-fund, they can add worksite wellness and other services to their plans, which can help to reduce their coverage costs even further.
Self-funding your health care coverage through MedBen offers all these advantages, plus others ‒ stop-loss independence to find you the best rates, advanced claims surveillance using board-certified medical specialists, and interactive reporting that allows clients to see spending trends. And one more: We listen to your concerns and respond with better solutions.
Whether you're already self-funding or considering the switch, MedBen can help your group get the most out of your health care coverage. Get more information by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
The U.S. Preventive Services Task Force (USPSTF) recommendation against routine screenings of prostate cancer has resulted in fewer diagnoses for the disease, new research finds. But the question remains as to whether more men will ultimately develop late-stage cancer that may have been detected earlier through such screenings.
Citing a large number of false positives, in 2012 the task force formally changed its guidelines for prostate-specific antigen (PSA) testing. Since then, diagnoses of early prostate cancer in American men aged 50 and older dropped by 19% between 2011 and 2012 and by another 6% the following year, HealthDay reports.
Less frequent screening may have a downside, however."Some men who should be treated are either losing the chance for cure or presenting later and needing to undergo more treatment and more side effects for a possible cure," said Dr. Anthony D'Amico, chief of genitourinary radiation oncology at Brigham and Women's Hospital.
"The answer to this dilemma will come with personalized medicine based on risk-based screening ‒ screening men preferentially in good health and at high risk," D'Amico added.
MedBen WellLiving currently follows the USPSTF recommendation that men should discuss PSA testing options with their family doctor and make an educated decision about testing based on family history, lifestyle and symptoms.
MedBen clients who have any questions about USPSTF preventive care requirements under the Affordable Care Act are welcome to contact Compliance Supervisor Erin Kelly at firstname.lastname@example.org.
A recent Harvard Medical School study of how prescription drug prices are set suggests that, despite presidential campaign promises of reduced costs through government intervention, current conditions make it difficult for them to make significant changes. So controlling drug costs will continue to require private sector solutions ‒ and MedBen is perfectly positioned to help employers make informed pharmacy plan choices that can save them money.
Ironically, Congress' ability to control drug cost is hindered by its own actions. The Harvard researchers cite the existence of government-protected “monopoly” rights for drug manufacturers as the “most important factor” that drives prescription drug prices higher in the United States than anywhere else in the world.
With no government fix likely, it falls to health plans to find ways to keep their prescription drug costs in check. MedBen clients are aided greatly in this task through the availability of a pharmacy benefits consulting group that provides employer-specific financial and plan management consultation.
Developments in genetic technology are also aiding self-funded groups in pharmacy management. MedBen recently introduced an innovative service that determines personal compatibility with over 300 commonly prescribed drugs. Plan participants receive reports that aid the provider in avoiding medications that would ineffective or harmful to the patient, thereby reducing wasteful spending.
MedBen offers these and other pharmacy savings solutions so you may better manage your plan's prescription drug costs. We invite you to contact Vice President of Sales & Marketing Brian Fargus at email@example.com to learn more.
As more hospitals gravitate away from traditional fee-for-service to alternative payments methods, self-funded groups are making changes to their health care plans to capitalize on the potential savings. According to an analysis by the National Business Group on Health (NBGH), nearly half of employers have incorporated some type of value-based design in their plan.
In a recent article about alternative payment methods, MedBen Vice President of Compliance Caroline Fraker observed that "large employers in your communities are already experimenting with some form of bundled payment models." Likewise, employers have introduced various wellness-based measures that allow them to benefit from the lower costs these payment structures offer — among them, participation in a disease management program and adherence to chronic medications and screenings for chronic conditions.
The NBGH analysis found that, while the transition from fee-for-service medicine has been slow, many employers already have put in place a foundation for the future. Current value-based designs include offers to lower worker premiums and reduce out-of-pocket costs if they “take steps to manage chronic conditions, obtain higher quality care or more efficient care,” the analysis says.
Worksite wellness and disease management programs like MedBen WellLiving are a way to promote better health. But the cost savings from these programs matter, too... and as payment models change, the potential exists for even greater savings. As we continue to roll out our commercial bundled payment services, we'll help to instruct clients on plan design changes that will benefit employer and employee alike.
There's been a lot of hype lately about how private health insurance exchanges — a system in which employees receive a set allowance to select an insurance plan from multiple vendors — are the next big thing in group coverage. But as is often the case, "hype" doesn't always translate to "interest."
A recent Mercer survey found that only 6% of large employers have a private exchange in place or say they will implement one this year. Additionally, 71% of employers surveyed said they had either no plans to consider adopting an exchange platform or had already looked into exchange options and decided not to pursue them.
As to why employers haven't made the switch to private exchanges, 65% said they had seen no evidence that such a system will save them any money. Even a cursory glance at how an exchange works bears this out: They offer no real means for the employer to control costs, instead depending solely on the insurer to handle plan benefits. The only real savings comes from shifting costs to employees through defined contributions.
Self-funding has succeeded largely because employers have the final say about the specific aspects of their health care plan. Working with an experienced benefits manager like MedBen, they can minimize rising health care costs through a variety of money-saving tools, and design a plan that directly addresses employee needs. Any money that doesn't go toward paying claims stays with the employer.
Moreover, because they are not as heavily regulated as traditional insurance coverage, self-funded plans offer a higher degree of legislative freedom, in addition to greater plan design flexibility.
To learn more about self-funded saving solutions available through MedBen, contact Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
Let’s do some math. Subtract your age from the number 220 (the answer is your maximum heart rate). Now multiply that number by 0.6. Got it? Repeat the steps, only this time, multiply by 0.8. You now know your targeted pulse range when performing cardiovascular fitness activities. (By the way, a healthy resting heart rage is between 60 and 100 BPM).
Cardio is any activity that makes the heart beat faster and harder for a period of time. This causes the blood flow to your muscles and your lungs to increase. You’ll begin to breathe faster and deeper, maximizing the amount of oxygen in your blood. Your small blood vessels will then widen to deliver the oxygen to your muscles and carry away waste, such as carbon dioxide and lactic acid. Your body even releases endorphins that increase your sense of well-being.
The Centers for Disease Control and Prevention recommends 150 minutes a week of moderate-intensity aerobic activity, but not everyone has that kind of time to burn. Recent studies show that HIIT (High Intensity Interval Training) makes it possible to reap all the benefits of cardio simply by doing short bursts of intense exercise, from 30 seconds to 3 minutes, with short recovery breaks in between (and yes, chasing Pokémon on the new app counts – just stay safe!).
Getting or staying fit in the world of cardiovascular is extremely important. We know too, that staying fit helps to ward off a list of other conditions. However, certain activities are not meant for everyone. Always seek guidance from your family doctor before performing high intensity workouts.
From BenefitsPRO: "[Health reimbursement arrangements (HRAs)] are making a comeback, most notably among smaller employers (2 to 100), large employers (5,000+), and any size groups with historically low utilization. Their appeal may also increase as they as they appear to have the least impact on the Cadillac Tax thresholds since actual claims versus potential claims paid from the HRA are expected to be used in the calculations, assuming the Cadillac Tax survives."
In spite of an ever-changing health care landscape ‒ or, as BenefitsPRO notes above, sometimes because of it ‒ HRAs and other types of consumer-driven health plans (CDHPs) continue to thrive and save employers money. MedBen Specialty Services has the experience to match the right CHDP with the needs of the employer.
Going back to the earliest days of HRAs as well as flexible spending accounts (FSAs) and health savings accounts (HSAs), MedBen has provided expert support to employers and plan members. We review your group’s goals to help ensure that you achieve the savings you desire, and set the proper course for your health plan.
Once your CDHP is in place, our service team will give you the tools you need to promote it. Plus, we complement our services with online account management tools and debit cards that give plan members an easy way to pay for qualified expenses.
Regardless of how the landscape shifts, MedBen Specialty Services has the CDHP expertise to keep your plan on a firm foundation. Contact your MedBen broker Vice President of Sales & Marketing Brian Fargus at email@example.com to learn more.
While average costs for employer-based health plans nationwide have risen at a fairly moderate pace this decade (though, it should be noted, not as low as MedBen's 5-year trend), specialty drug price spikes continue to concern employers. To reduce the financial impact of these expensive medications, MedBen works with clients to find group-specific solutions.
A new report from the National Business Group on Health estimates that the average cost of an employer-based health plan will increase about 6% in 2017. But specialty drug costs are expected to jump 17% next year, following a similarly high increase in 2016.
MedBen offers a variety of ways to keep specialty drug costs manageable, and offers the services of an experienced pharmaceutical consultant to provide clients with timely advice. Particular strategies can vary from group to group, but they all have a common aim: Giving plan members access to appropriate medications while remaining mindful of bottom line considerations.
Key to saving money on high-end medications is having an awareness of generic equivalents and alternative therapies. In certain cases, so-called "specialty" drugs are nothing more than two or more existing products combined into a single medication that may be more user-friendly, but come at a greatly inflated price tag. MedBen ensures that employers don't get stuck paying for these high-cost medications when far less expensive options are available.
Keeping specialty drug spending in check is critical to controlling costs, and MedBen is dedicated to helping you achieve that goal. Find out more by contacting Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
Sitting on the sofa all day may be relaxing, but it's costing our country a lot of money. According to Benefits Pro, a new study finds that physical inactivity costs the U.S. $27.8 billion annually, an amount researchers label a conservative estimate. But promoting wellness in the workplace can go a long way toward lowering the bill.
The researchers estimated the costs by looking at expenses, productivity losses, and disability-adjusted life-years for five major diseases related to inactivity — coronary heart disease, stroke, breast cancer, colon cancer, and type 2 diabetes (which alone accounts for 70% of all direct health costs).
MedBen WellLiving focuses on all five of the diseases examined in the study, as well as other chronic conditions like asthma and bad cholesterol. By promoting preventive care and identifying high risks at earlier disease stages, we can greatly reduce potential health care costs as well as improve overall health, on both an individual basis and on a larger scale.
Closely tied to preventive medical care is fostering a workplace philosophy of healthier lifestyles. Simple things, like making fruit available for purchase in the lunchroom or sponsoring a companywide fitness event with appropriate incentives for participants, can make a big difference where costs are concerned.
MedBen WellLiving will work with your group to offer wellness services that encourage healthier lifestyles while improving your bottom line. Contact Vice President of Sales & Marketing Brian Fargus to learn more.
High cost claimants are among the leading contributors to health care spending, topping even medical inflation, pharmaceuticals, and specific diseases. A study from the American Health Policy Institute and Leavitt Partners found that claimants who cost $50,000 or more in a year are the top cost driver for 43% of large employers, and comprise 31% of total spending among employers’ health plans. On average, a high cost claimant costs an employer about $122,000 annually.
Recognizing that plan members sometimes require high-priced treatment, MedBen has multiple means to keep claim costs in check. Key to our claims management approach is a panel of over 125 board-certified medical specialists. Reviewing claims flagged for potential clinical problems, they work with the provider to reach a proper resolution — all before the plan pays the provider, so you don’t have to recoup expenses later.
Going hand in hand with controlling costs is early detection of chronic conditions through MedBen WellLiving. This program utilizes customized education and nurse coaching to help plan members who are at greater risk of developing conditions that could prove physically and financially costly in the long run.
MedBen offers a variety of ways to keep high claimant costs in check as well as helping employers to promote healthier plan members. To hear more about how we can assist your business, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
When it comes to matters of personal security, sometimes common-sense solutions are the most effective — which is why MedBen performs full backups of electronic client data and stores it offsite at a secure location. Recent ransomware outbreaks have only reinforced the importance of having such a system in place.
According to the CSOonline.com news site, new research has determined that health care organizations' computer networks are 114 times more likely to suffer ransomware attacks than those at financial institutions. This is due to the inherent value of their data as well as the (false) perception that such businesses are often technologically lacking.
Threat intelligence analyst Terrance DeJesus of the security firm Solutionary says that off-site backups are critical for health care data as well as the systems used to access it. Going a step further, MedBen also has a high availability disaster recovery solution in place along with our secure backup solution.
Long before the term "ransomware" entered the vernacular, MedBen has been proactive in taking appropriate steps to minimize threats. Of course, backups and recovery are just starting points... we have in place a wide variety of tools to maximize data security and guarantee client privacy.
The growth of cyberattacks has called for an unprecedented level of vigilance, but MedBen is up to the challenge. 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 firstname.lastname@example.org.
It should come as little surprise that a proven wellness program like MedBen WellLiving can help to reduce the risk of serious health conditions. But a new study shows just how much of an impact regular preventive care can make.
According to HealthDay News, researchers determined that 90% of all strokes worldwide are preventable — and the biggest risk factor is hypertension. Eliminating high blood pressure was estimated to reduce risk by nearly 48%, the findings showed.
Other risk factors include: physical inactivity (36% potential stroke reduction if eliminated): bad cholesterol (27%); poor diet (23%); obesity (19%); smoking (12%); heart causes (9%); and diabetes (4%).
Early detection of hypertension and other chronic conditions can mean the difference between a treatable health issue and a major (and costly) problem. Toward that goal, MedBen WellLiving performs an electronic claims data analysis of the employer's total employee population, using company claims history to identify individual health patterns that would benefit from specialized nurse coaching.
Plan members with better health records benefit from WellLiving, too. Our focus on primary prevention puts the physician first, promoting an ongoing doctor-patient relationship that spots potential conditions before they have a chance to worsen.
Wellness works best by reducing risk that leads to preventable diseases. Learn more about how MedBen WellLiving can work for your group by contacting Vice President of Sales & marketing Brian Fargus at email@example.com.
As in years past, all self-funded employer health plan sponsors are required to file and pay their Patient-Centered Outcomes Research Institute (PCORI) fee no later than July 31, 2016. All self-funded plan sponsors are required to pay a fee based on the average number of covered lives under their eligible plans — including employees, retirees, spouses and dependents. Self-funded plans subject to the requirements include self-funded medical benefit plans, including most non-ERISA self-funded plans and retiree-only plans. Other self-funded plans subject to the fee include self-funded HRAs and FSAs which are not integrated with a plan sponsor’s self-funded major medical plan. Dental-only, vision-only, EAP, disease management, and wellness plans are exempt.
All plan sponsors must use the IRS Form 720 dated April, 2016 to record and remit the amount due. This year, the IRS Form 720 has been modified to include the payment amounts due under the schedule shown below. Make sure to complete the correct section of Part II for “Applicable self-insured health plans” and that you select the correct payment amount based on your plan’s year end date. The form is available on the IRS website, or simply perform a search for "IRS Form 720."
This year’s payment schedule is as follows. If your plan year ended on October 31, 2015, November 30, 2015 or December 31, 2015 you will owe $2.17 per covered life. All other plans years owe $2.08 per covered life.
MedBen clients who need more information about how to count covered lives under their plan or how to prepare and remit their payment are welcome to contact Vice President of Compliance Caroline Fraker at 800-851-0907 or firstname.lastname@example.org.
Over half of all stop-loss reimbursements can be traced to a mere ten ailments, finds a new study that highlights the importance of stop-loss coverage for self-funded employers. MedBen is here to help groups with stop-loss carrier advice and cost control strategies.
Benefits Pro reports that, between 2012 and 2015, self-insured employers covered by Sun Life stop-loss insurance paid out 53% of stop-loss claims reimbursements for just ten catastrophic claim conditions. Of these, various forms of cancer made up 26.6% of reimbursements, due in part to new treatments and high-cost medications.
For self-funded employers, numbers like these serve as a stark reminder to have a stop-loss carrier that not only serves as a safety net for catastrophic claims, but balances quality coverage with cost considerations. Toward this goal, MedBen shops multiple carriers to ensure that clients retain the desired level of specific and aggregate protection, and negotiates the best possible rates.
Moreover, while stop-loss insurance helps to limit potential losses, MedBen reduces client risk even further. Our cost containment solutions range from advanced claims management to plan language expertise for specific catastrophic conditions, including chronic renal disease (ranked #3 in the Top Ten) and transplants (#6).
Learn more about MedBen stop-loss services and savings solutions by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
The complete Top Ten:
Vision care is typically described as an ancillary benefit, but its advantages make it more than just an add-on. MedBen VisionPlus offers a great complement to your group medical and pharmacy coverage.
HealthDay News reports that, according to a new study, after receiving routine eye exams more than half of people with no new symptoms or vision problems receive new prescriptions or treatment changes. Meanwhile, 16% were diagnosed with a new eye condition and 31% had a change in their ongoing care.
Furthermore, regular vision checkups do more than correct eyesight and reduce the risk of eye diseases — they also can potentially detect such chronic conditions as diabetes, hypertension and high cholesterol. Conversely, people with these conditions are more prone to losing their eyesight. So the benefits of vision care extend well beyond simply getting a fashionable pair of eyeglasses.
MedBen VisionPlus puts your employees’ eyes first. By emphasizing regular exams and early detection and treatment of visual impairments, our group vision product enhances your overall health care plan. It's an affordable benefit that pays for itself in multiple ways.
Learn more about the advantages of quality vision care through MedBen VisionPlus by contacting Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org.
The Centers for Medicare and Medicaid Services recently projected that U.S. health care spending trend will continue to outpace the economy over the next decade. But MedBen uses its proven saving strategies to keep client cost trend as low as possible.
From 2011-2015, MedBen's five-year average claims cost trend for its overall block of business was only 4.9%. That compares to a 9.5% trend nationally during the same period.
MedBen uses a variety of claims management tools to help clients realize long-term savings — chief among them, a surveillance systems that calls on the expertise of over 125 medical specialists. When the system flags a claim, panel members quickly review it to determine potential clinical problems and work with the provider to reach a proper resolution. All of this is taken care of before the plan pays money out, so clients don’t have to recoup expenses later.
In 2015, MedBen's claim surveillance measures saved an average of $13.61 per employee per month. And the savings hardly stop there — our plan design and plan language solutions, network discounts, medical management and other cost controls all benefit the bottom line.
MedBen is committed to beating national cost trends today and in the future. Learn more about the ways we save our clients money by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
"Pharmacogenetics" — it's a big word that could make a huge difference in how doctors prescribe drugs, while helping self-funded employers see long-term savings on pharmacy costs. And MedBen is rolling out a new service that will allow clients to take advantage of this important new form of personalized medicine.
MedBen now offers an innovative pharmacogenetics test that determines personal compatibility with over 300 commonly prescribed drugs in a variety of therapeutic categories. Plan participants receive reports that provide clear, concise guidance on which medications will work and which ones to avoid, greatly reducing the "trial and error" approach common to prescribing.
So what is pharmacogenetics? Simply put, it concerns how a person responds to a drug based on inherited characteristics. Because every individual is unique, the ways our bodies react to a medication can vary greatly. What works well for one person may be less effective for another, or may not work at all.
Studies show that the average efficacy rate for drugs treating the most prevalent diseases is estimated to be only 50%. But regardless of whether a medication works or not, the pharmacy bill is the same to the health plan. So having a way to know in advance if a drug is right for a patient reduces wasteful spending.
MedBen works with a state-of-the-art laboratory that studies DNA variants to determine if and how well an individual's body will metabolize various medications, and makes its report based on scientific evidence. In this way, the patient gets better quicker, the physician saves time, and the employer saves money.
MedBen is now in the process of contacting clients about the benefits of personalized medicine through drug compatibility testing, but if you'd like to get additional information about the technology today, just contact your Group Service Representative. And if you're not a current client but want to learn more, contact our Vice President of Sales & Marketing Brian Fargus at firstname.lastname@example.org (888 623-2364).