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06/27/12

  12:10:04 pm, by MedBen5   , 304 words,  
Categories: News, Health Plan Management

Employers Face More Changes If Health Care Law Falls

Based on just about everything we’ve read of late – including the opinions of legal experts – the smart money is on the Supreme Court striking down the individual mandate of the Affordable Care Act while leaving the rest of it intact. That said, we’ve still got at least one day to speculate on other possible outcomes, so why not seize the opportunity?

The likelihood that the justices could invalidate the entire health care reform law isn’t too high… but as Kaiser Health News notes, if it did happen, the effect on employers would differ depending on their size.

As the ACA stands now, businesses with more than 50 workers will have to provide health care coverage or pay a penalty beginning in 2014. If the law is struck down, however, that rules comes off the books.

On the other side of the coin, small employers are not required to provide coverage, but those who do are currently eligible for tax credits to offset the costs. Again, that goes away if the law falls.

It’s also possible that small businesses would lose access to state-run health insurance exchanges designed to offer lower-cost coverage. Most states would probably abandon these marketplaces if they were no longer required to offer them, but the states that have already put time and effort into creating them could decide to make them available no matter the outcome.

Chances are we’ll know tomorrow if these circumstances change or stay the same. But regardless of the court’s ruling, one thing we can say with absolute certainty will not change: MedBen will continue to help employers make smart benefit plan choices that save both them and their employees money. If you’re interested in learning how we can accomplish this for your business, contact Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

  11:15:13 am, by MedBen5   , 187 words,  
Categories: News, Prescription, Wellness

Pharmacists Stepping Up To Serve Patients Better

As primary care doctors expand the number of patients they accept, and the number of those patients taking medications rises, pharmacists have taken on an increasingly important role. And some drugstore chains, as well as independent pharmacies, are hoping to foster customer loyalty by making their pharmacists even more accessible:

“They are counseling patients face-to-face and on the phone, contacting patients who don’t refill prescriptions and checking for potential interactions between drugs prescribed by different doctors. Pharmacists can’t actually prescribe drugs, but with a patient’s permission they can call the physician to discuss recommended medications that may have been overlooked and ask whether the doctor wants to prescribe them.

“Many patients, especially those with chronic conditions like diabetes and heart disease, don’t adhere to medication regimens. Studies show only 25% to 30% of medications are taken properly, and only 15% to 20% are refilled as prescribed.

“Pharmacy groups and drugstore chains say an enhanced role for the pharmacist makes it easier for patients to stay on the wagon and significantly reduces unnecessary hospitalizations and emergency-room visits that can occur when patients skip their meds.”

Read more at The Wall Street Journal.

  10:39:34 am, by MedBen5   , 236 words,  
Categories: News, Wellness

Type Of Calories Count When Keeping Weight Off, Study Suggests

Ask someone who’s battled a weight problem about the toughest part of dieting, there’s a pretty good chance they’ll say it’s not losing the weight, but keeping it off. For that reason, a new study examined how different types of diets help or hinder weight maintentance.

According to the Los Angeles Times, the seven-month experiment closely controlled the diets of 21 overweight men and women. The study began with a 12-week weight-loss regimen that help participants shed 10-15% of their body weight, followed by a four-week weight stabilization phase.

Next, participants followed three different diets for four weeks at a time: a traditional low-fat diet (with 60% carbohydrates, 20% fat and 20% protein), a low glycemic index diet 40% carbs, 40% fat and 20% protein) and a very low-carbohydrate diet a la Atkins (10% carbohydrates, 60% fat and 30% protein).

At the start of the study and every four weeks thereafter, participants were hospitalized and tested over a three-day period. Researchers measured resting energy as well as energy burned in a day.

And the findings? Participants burned more than 300 more calories per day on the very low-carbohydrate diet compared with the low-fat diet – “roughly equal to an hour of moderate physical activiety,” noted study senior author Dr. David Ludwig. However, he added that low-carb diets could be risky for the heart, so didn’t recommend it as a long-term solition.

As for the low glycemic index diet, participants burned 200 additional calories compared to the low-fat diet.

06/26/12

  05:01:47 pm, by MedBen5   , 176 words,  
Categories: News, Health Plan Management

Days Before Decision, Health Care Reform Law Gets Tepid Support

NBC News and The Wall Street Journal have managed to sneak in one final poll about the health care reform law before The Supreme Court puts the matter to rest (for the time being, anyway) later this week.

According to MSNBC, the survey shows that 37% of respondents would be pleased if the justices find that the Affordable Care Act is unconstitutional, compared with 22% who would be disappointed with the decision.

Asked the question from the opposite perspective, 28% say they would be pleased if the court rules the law is constitutional, versus 35% who would be disappointed.

As for the individual mandate – the provision that requires most Americans to buy health insurance or pay a penalty, and the most controversial aspect of the law – 25% say it would hurt them and their families if it were deemed unconstitutional; 18% say it would help; and 55% say it wouldn’t make a difference.

Lastly, 35% think the law is a good idea, compared to 41% who feel otherwise – numbers that have remained pretty much constant since the ACA was passed in March 2010.

  04:35:27 pm, by MedBen5   , 161 words,  
Categories: News, Wellness

Test All Adults For Obesity, Task Force Advises

The U.S. Preventive Services Task Force (USPSTF) has recommended that doctors screen all adults for obesity, WebMD reports.

Actually, this is not the first time USPSTF has advised this – it made a similar suggestion back in 2003. But the independent panel now also recommends that doctors should refer obese patients to intensive counseling for weight loss.

“The prevalence of obesity in the United States is high, exceeding 30% in adult men and women,” the statement says. “Obesity is associated with such health problems as an increased risk for coronary heart disease, type 2 diabetes mellitus, various types of cancer, gallstones, and disability. These comorbid medical conditions are associated with higher use of health care services and costs among obese patients.”

The task force also notes that for adults younger than 65 years, obesity increases their risk of death.

As for patients who aren’t obese but are at risk for developing weight issues, USPSTF advises that doctors counsel them to make smarter lifestyle choices.

06/25/12

  02:02:05 pm, by MedBen5   , 244 words,  
Categories: News, Health Plan Management

Supreme Court Will Rule On ACA This Thursday

Say what you will about the Supreme Court, but the justices know a thing or two about heightening the drama.

The Court had two high-profile cases to rule on this week: The constitutionality of the Affordable Care Act as well as Arizona’s anti-immigration law. Ultimately, the justices opted to settle the immigration controversy and hold health care reform as the headliner until Thursday, the last day of its 2011-12 term.

As USA Today aptly observes, the three extra days until the decision gives Monday morning quarterbacks in the media an additional 72 hours to second-guess an outcome that still isn’t known:

Washington Post: “Some prominent legal scholars say a series of tactical decisions by President Obama’s legal team may have hurt the chances of saving his landmark health-care legislation from being gutted by Supreme Court conservatives.”

The New York Times: The White House team once “assumed any (legal) challenge” to the law would fail, but officials now fear “that a centerpiece of Mr. Obama’s presidency may be partly or completely overturned on a theory that it gave little credence. The miscalculation left the administration on the defensive as its legal strategy evolved over the last two years.”

At MedBen, we’ve also got a few thoughts on the decision… but we’ll wait to share them until we actually hear what that decision is. The justices are expected to make their ruling at about 10 a.m. on June 28, so be sure to check in here then!

06/22/12

  01:26:26 pm, by MedBen5   , 198 words,  
Categories: News, Wellness, Health Plan Management

Money Talks, But Other Wellness Incentives Work, Too

Money makes the world go round, they say… and if used right, it makes people get healthy, suggests new research.

WebMD reports that the study encouraged adults aged 21 to 60 – all of whom ate poorly and exercised little – to practice healthier habits. And to provide an extra push, participants who reached set goals (i.e., eat more fruits and vegetables, work out more, reduce couch time) after three weeks received $175.

Once completed, the participants no longer had to meet wellness goals, but still got $30 to $80 for reporting activities to their coach. And after six months, the researchers found that 88% of participants tried to maintain healthy changes once they had made them.

At MedBen, our own experience with worksite wellness has shown that offering even modest incentives can indeed have a major impact on program participation. However, we have also learned that rewards don’t necessarily have to be monetary – sponsoring a team competition, giving recognition through the company newsletter, or sharing member success stories can be equally valuable, so long as management shows a shared wellness commitment.

To learn more about MedBen Worksite Wellness, please contact Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

  12:50:52 pm, by MedBen5   , 200 words,  
Categories: News, Health Plan Management

If Justices Remove Individual Mandate, Don't Stop There

Business columnist David Lazarus anticipates the fallout if Supreme Court strikes down the individual mandate of the Affordable Care Act but keeps other provisions intact:

“Put simply, by eliminating the individual mandate but leaving in place what’s known as ‘guaranteed issue’ of coverage, the Supreme Court would be giving Americans a green light to wait until they get sick before seeking health coverage.

“Why spend thousands of dollars on insurance when you’re young and healthy? Without a mandate but with guaranteed issue, you could just put off paying annual premiums until you actually need medical care. It would be almost foolish to do otherwise.

“This would have enormous ramifications for the insurance industry. It would essentially mean that insurers would be covering only sick people, rather than spreading their risk among the entire population, healthy and unhealthy.

“If insurers are covering only sick people, they’ll have no choice but to jack up their rates to reflect the higher risk they face.

“And if rates go significantly higher, fewer people will be able to afford insurance, even with government subsidies.

“The upshot: higher insurance costs and millions more people without access to affordable healthcare.”

Read more at the Los Angeles Times.

  12:22:14 pm, by MedBen5   , 169 words,  
Categories: News, Prescription

Rx Companies May Back Off On Internet Advertising

Rx Online Ad Spending

The Pharmalot blog reports that drugmakers may spend about $1.58 billion on online advertising this year, nearly a 25% leap from 2011, according to a market research analysis from eMarketer. But while dollars-and-cents spending will continue to go up over the next few years, actual spending growth is expected to drop dramatically during this period (see chart).

Does this mean pharmaceutical companies are backing off on their advertising efforts and putting more money into other areas, such as research and development? Not exactly. “Drugmakers have been slow to shift to online tactics. Without definitive online marketing guidelines from the FDA for direct-to-consumer advertising, many marketers prioritize spending in print and broadcast media, for which there is a clearer road map. The shift to digital is under way, but has not progressed as quickly as it has in less-regulated industries,” the firm writes.

eMarketer also notes that the growing emphasis on newer drugs that target more specific patient populations have led drugmakers to refocus their marketing efforts at patients and health care providers.

  11:29:29 am, by MedBen5   , 169 words,  
Categories: News, Wellness

More Young People Developing High Blood Pressure

On the heels of news that childhood obesity has resulted in an increase in diabetes comes a study showing that the number of young people sent to the hospital for high blood pressure that nearly doubled during a recent 10-year period.

WebMD reports that hospital stays for Americans 18 and under due to high blood pressure spiked from 12,661 in 1997 to 24, 602 in 2006. And though hospital records usually don’t make a reference to the patient’s obesity, the researchers believe that the ongoing weight crisis is a key reason for this growth trend.

In an editorial published along with the study, Joshua Samuels, MD, of the University of Texas, noted that high blood pressure affects more children than higher-profile conditions like autism or epilepsy. The “significant increases in blood pressure are likely riding the wave of pediatric obesity that is spreading across America,” he wrote.

Samuels added that blood pressure in kids can cause damage to the heart and put them at higher risk for heart disease and stroke in their adult years.

06/21/12

  11:55:10 am, by MedBen5   , 193 words,  
Categories: News, Wellness, Health Plan Management

Partners Plan: Community Involvement Means Better Care, Better Cost

Real health care reform can only be accomplished by primary care providers and the local community. That’s the message from the new policy paper “Communities of Solution: The Folsom Report Revisited.”

According to Medical Xpress, the paper is a follow-up to the 1967 Folsom Report, which argued for a closer alliance between public health and primary care. “Now, nearly 50 years later, we’re calling for the same thing,” says Kim S. Griswold, MD, MPH, an author of the new report. “We need to inject – and maintain – the public ingredient in medical care.”

MedBen has worked with local communities, primary care providers and hospitals in the creation of Partners Community Health Plan. The plan allows providers to play an equal and integral role in the management of group health benefits, working with employers to control costs both today and in the long term.

Partners offers the full scope of services available from community providers, and combines high-quality, lower-cost health care with wellness discounts from local merchants and the cost containment expertise of MedBen.

For additional information, visit the Partners website or contact MedBen Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

  11:26:53 am, by MedBen5   , 186 words,  
Categories: News, Prescription

Movie Tie-In To Children's Drug Raises Concerns

A bit of Marketing 101: Proceed extra-cautiously when promoting children’s medicines.

According to The New York Times, the drug company Merck is catching flack because of a marketing campaign for Children’s Claritin using animated characters from the movie “Madagascar 3: Europe’s Most Wanted.” The Public Health Advocacy Institute and 10 other groups have filed a complaint with the Federal Trade Commission, calling the promotion for the allergy drug dangerous and deceptive.

Among the campaign components the group objected to: character stickers included in some boxes; activity books that parents can download for their children; and the enlistment of a team of mothers who blog to hold Claritin-themed “Madagascar” viewing parties for their children and friends.

The group also expressed concern that children could confuse the grape-flavored Claritin tablets and syrup for candy, as the same character are used to promote other children’s products, such as candy and gummy snacks.

Kelley Dougherty, a Merck spokeswoman, said the company was reviewing the matter, but added, “We advertised in appropriate venues to reach those parents of children who may benefit from the use of Claritin, and not to the children themselves.”

  10:55:47 am, by MedBen5   , 149 words,  
Categories: Announcements

Court Will Overturn Individual Mandate, Legal Insiders Say

The Supreme Court will strike down the individual mandate provision of the Affordable Care Act, says a survey of legal experts.

USA Today reports that research group Purple Insights asked 56 insiders – 38 former clerks of current Supreme Court justices and 18 attorneys who have argued before the Court – how the Court would vote on the requirement that most Americans purchase health insurance or pay a penalty. The survey found that oral arguments persuaded the majority of respondents that the justices will kill the mandate.

“In March, our experts believed that likelihood (of an overturn) stood at 35%,” said a memo from Doug Usher of Purple Insights. “After hearing the oral arguments and the justices’ questioning, our experts now place that probability at 57%.”

The survey conclusions also note that “[i]f the mandate is struck down, respondents are more likely to believe other parts of the law will go with it.”

  10:32:36 am, by MedBen5   , 166 words,  
Categories: News, Wellness

AMA Says Soda Tax Would Help Reduce Obesity

Reuters reports that the American Medical Association has recommended that government on local, state or federal levels consider imposing a soda tax to aid in the fight against obesity. The physician’s group stopped short of an outright endorsement of such a tax, however.

The AMA stated that sugar-sweetened drinks account for almost half of Americans’ added sugar intake, and reducing their consumption would go a long way in lowering the intake of sugar and empty calories.

While recognizing that obesity is caused by many factors, the AMA noted that several studies have demonstrated a link to increased body weight, as well as a rise in type 2 diabetes and other health conditions. A tax on sugary beverages, the group said, would help pay for education campaigns and other obesity-related programs.

Raising taxes on sugar-sweetened drinks to a penny per ounce could potentially lower obesity rates by 5% and cut medical costs by $157 billion within a decade, the AMA Council on Science and Public Health said in its report.

06/20/12

  02:30:31 pm, by MedBen5   , 235 words,  
Categories: News, Health Plan Management

MedBen Claims Accuracy Exceeds The Norm

Medical claims payment accuracy by U.S health insurers has improved in 2012 compared to last year, according to the American Medical Association.

The AMA’s National Health Insurer Report Card, which uses data from several larger insurers, says that 9.5% of claims were incorrectly processed in the beginning of this year, compared to 19% in 2012. That improvement represents about $8 billion in savings from additional administrative work to correct errors, the report adds.

The Chicago Sun-Times notes that the AMA considers a claim inaccurate based on whether the physician got paid what they were expected to, so its criteria for accuracy differs somewhat from insurers. Still, insurers have take measures to boost effectiveness, says Robert Zirkelbach, a spokesman for America’s Health Insurance Plans.

At MedBen, we’re all about exceeding expectations. That’s why every aspect of our claims processing operations, from transmission to payment, strictly follows established company standards to ensure efficiency, accuracy and security.

Independent CPAs review every procedure related to MedBen’s claims operating system, and have repeatedly reported no findings in annual SAS 70 audits. In addition, internal staff members review 5% of each examiner’s claims every day – a level unmatched by other health benefit managers.

The results of this attention to detail? Procedural accuracy of 97% in claims processing last year – and financial accuracy of 99%.

For additional information about MedBen’s claims accuracy measures, contact Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

  01:04:17 pm, by MedBen5   , 227 words,  
Categories: News, Prescription

Prescriptions For Young People Decline, Though Some Drugs Go Up

The number of prescriptions dispensed for children and teenagers fell from 2002 to 2010 – but prescriptions for some individual medications saw big increases, WebMD reports.

Overall, doctors wrote 7% fewer prescriptions for children and teens during that period, based on the results of a new study from the U.S. Public Health Service. Among the larger decreases were allergy medicines (a 61% decline in 2010 compared to 2002) and cough and cold medicines without expectorant (down 42%). Both antibiotic and pain medicine prescription both dropped 14%.

Conversely, some prescriptions for younger people went way up, such as contraceptives (a 93% spike), ADHD drugs (up 46%) and asthma drugs (up 14%).

The executive vice president of the Institute for Safe Medication Practices is pleased by the falling rate of antibiotic prescriptions. “For the last decade, the pediatric professional societies and infection control groups have been pushing to say, ‘Every time you have the sniffles or a cold, you don’t need an antibiotic,’” Allen Vaida, PharmD told WebMD. He was not involved in the study.

As for the rise in ADHD prescriptions, Donna Halloran, MD, MSPH, of St. Louis University noted that it could be good news – “there are so many kids who respond so beautifully to the medicines,” she said to WebMD – or bad, “because there is plenty of evidence out there that there are plenty of kids labeled as ADHD and it’s not accurate.”

  10:53:00 am, by MedBen5   , 297 words,  
Categories: News, Health Plan Management

With Decision Days Away, Health Reform Chatter Grows

With the Supreme Court decision on the fate of the Affordable Care Act expected in just a few days, speculation and commentary is currently running rampant on Internet news sights. Here’s a quick sampling:

Self-Interest Meets Mandate (New York Times): “Advocates of health care reform argue that eliminating the [individual] mandate could gut the president’s plan. Most health economists would probably agree.

“But this consensus is based on a fairly optimistic view that the individual mandate and accompanying fines for failing to comply will be highly effective at persuading Americans to buy health insurance that they would otherwise forgo. On that score, the mandate might matter less than its advocates believe.”

Getting past healthcare’s individual mandate (Los Angeles Times): “[W]hat many Americans don’t realize is that the individual mandate would affect fewer than 2 of every 100 people, according to the best estimates. When all is said and done, a few Americans might still refuse to buy insurance – and nothing much will happen to them […] The mandate brouhaha is truly much ado about almost nothing.”

Regardless Of High Court, No Return To Old Days For Parts Of Health System (NPR): “Efforts to stop paying doctors for procedures and start rewarding them for keeping people healthy began even before the 2010 law. The act’s so-called accountable care organizations of Medicare providers, designed to deliver better health for less money, inspired similar attempts involving commercial insurers and hospitals. Such enterprises will continue even if the court whacks the entire ACA, many argue.”

Poll: Vast support for new health care effort (Associated Press): “Americans overwhelmingly want the president and Congress to get to work on a new bill to change the health care system if the Supreme Court strikes down President Barack Obama’s 2010 overhaul as unconstitutional, a new poll finds.”

  10:11:14 am, by MedBen5   , 145 words,  
Categories: Wellness

Stay Sun-Safe This Summer

Happy first day of summer! Here in the Midwest, the season has come in full force, with temperatures expect to exceed 90 degrees.

Chances are, you’ll want to spend some time outside enjoying the warm weather. But when you do, remember to apply sunscreen in order to avoid the harmful effects of the sun’s ultraviolet rays.

The U.S. Centers for Disease Control and Prevention offers these guidelines (via HealthDay News):

  • Lather your skin with sunscreen about 30 minutes before you go outside, and always reapply after you swim or sweat heavily.
  • If you spend a lot of time outdoors, reapply sunscreen several times throughout the day.
  • Thoroughly shake the bottle before applying.
  • Apply a thick, thorough layer of sunscreen, and don’t scrimp.
  • Don’t forget to use sunscreen on your ears, shoulders, back and the backs of your knees and legs.
  • Don’t get sunscreen in your eyes.

06/19/12

  01:07:41 pm, by MedBen5   , 184 words,  
Categories: News, Prescription, Wellness

Painkiller Restrictions Dropped From Congressional Bill

The New York Times reports that pharmacy and drugstore representatives have successfully lobbied against efforts to impose stricter controls on painkillers and other commonly abused prescription drugs.

The new restrictions, had they been passed by Congress, would have required patients to seek new prescriptions for refills of Vicodin and other hydrocone products, required a higher level of security for the storage and transportation of the drugs, and increased penalties for misuse.

Though the Senate approved the controls as part of a bill reauthorizing user fees for the Food and Drug Administration, the House of Representatives didn’t include a similar provision in their legislation. Negotiators from both houses reached a bipartisian agreement on the overall bill, omitting the restrictions.

Senator Joe Manchin III (D.-WV), who led the push for new controls, said in an interview that chain pharmacies and drugstores should rethink their business model in regard to painkillers. “These are legal drugs needed by some people. But they can also be addictive. They are so readily accessible, so easy to obtain, that they are ravaging society and ending many young lives,” he said.

  12:18:42 pm, by MedBen5   , 178 words,  
Categories: News, Wellness

Obesity Exhausting Global Resources, Researchers Caution

Here’s a rather unsettling fact: Scientists have deduced that that global effect of overweight and obese people is like adding half a billion to the 7 billion humans on the Earth.

Using data from the United Nations (UN) and the World Health Organization (WHO), British researchers estimated that the cumulative weight of every adult human on this planet is 287 million tons – 15 million of which is due to overweight, and 3.5 million to obesity.

A Medical News Today article on the study notes that “[a]round half the food a human being eats is burned up in physical activity. But the more mass a person has, the more energy he or she needs for the same amount of physical activity, because it takes more energy to move a heavier body. Even when not moving, a heavier body burns more energy.”

The additional resources required to generate this additional energy threatens food security and ecological sustainability, the researchers warned.

The study also determined that North America is responsible for 34% of global obesity, even though it holds only 6% of the world’s population.

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