An interesting article in the Wall Street Journal that ties (tangentally, anyway) into yesterday’s Patient-Centered Outcomes Research Institute post: Instead of focusing only on blood pressure, cholesterol levels and other indicators of one’s health, health care providers are encouraged to talk with patients about how their health affects their quality of life.
From the article:
“[Health care providers] are pushing for programs where nurses or trained counselors meet with people and ask personal questions like: Is your condition inhibiting your life? Is it making you less happy? Does it make it hard to cope day to day? Then the counselors offer advice about managing those problems and follow up regularly.
“The logic is simple. People are more likely to manage their condition properly when they have more accessible, personal goals, like being able to do more at work or keep up with their kids, instead of focusing only on comparatively abstract targets like blood-sugar levels. And that, in turn, leads to much better health. Numerous studies show that when people have a higher sense of well-being, they have fewer hospitalizations and emergency-room visits, miss fewer days of work and use less medication. They’re also more productive at work and more engaged in the community.”
Nicotine gum and patches may or may not aid cigarette smokers in kicking the habit, but a major study suggests that exercise may be an effective route to quitting once and for all.
According to NPR, researchers in Taiwan tracked the health and habits of 434,190 people in Taiwan from 1996 to 2008. They found that smokers who exercised for as little as 15 minutes a day were 55% more likely to quit than inactive people. And by staying active, ex-smokers were 43% less likely to relapse later.
Not only did a daily workout help smokers give up cigarettes, it also counteracted the negative effects of the habit. Just 30 minutes of exercise a day increased the life of ex-smokers by 5.6 years, while reducing their risk of death by 43%.
And even smokers who haven’t successfully quit benefit from keeping active. The study found that a daily 30-minute walk increased their life expectancy by 3.7 years.
Last week, the Internal Revenue Service released its pre-Federal Register draft of proposed rules on how self-funded plan sponsors and insurance carriers will pay the federal government to support the Patient-Centered Research Outcomes Institute. The Affordable Care Act (ACA) amended the Internal Revenue Code to create the Patient-Centered Outcomes Research Institute Trust Fund and the taxes collected will fund the Trust between 2012 and 2019. The Institute is tasked with conducting research to evaluate the clinical effectiveness of certain medical treatments, services and supplies, as well as reviewing strategies to treat, diagnose and manage illness and injury.
Unlike the discussions during the Supreme Court hearings as to whether the fee charged for not purchasing coverage under the ACA’s Individual Mandate is really a “tax” or a “penalty”, the IRS considers this Trust Fund payment a “tax” and treats it as such under the proposed regulations. You might also have heard this tax called the “Comparative Effectiveness Fee”.
The proposed regulations are based on comments received after the IRS released Notice 2011-35 in June, 2011 regarding implementation of the tax. The Trust Fund tax remains in effect for plan/policy years beginning after September 30, 2012 and continues through the 2018 plan/policy year. The proposed regulations require that the first payments be made in July, 2013 and require submission of IRS Form 720 (Quarterly Federal Excise Tax Return) along with the payment. For the Trust Fund Tax payments only, Form 720 must be filed annually – although Form 720 may need to be filed by a company quarterly for other purposes.
Considering that vision exams can detect diabetes, high blood pressure, high cholesterol, glaucoma, multiple sclerosis and even potential memory loss, it would not be hyperbole to say that our eyes can serve as a treasure trove of medical information. MedPage Today reports on still another condition that a more advanced eye screening may uncover: Parkinson’s disease.
According to a study of 112 Parkinson’s patients, including newly diagnosed cases not yet on medication, all tested showed constant small rhythmic movements of their eyes when attempting to fix their gaze on an object. By comparison, the same instability was seen in just two of 60 age-matched controls.
Co-researcher Mark S. Baron, MD, of the VA Medical Center in Richmond, Va. says that while specialty equipment is needed to measure the eye tremors, the screening could be nearly 100% accurate.
Studies like this demonstrate the usefulness of regular eye checkups. That’s why MedBen VisionPlus promotes regular exams and early detection and treatment of visual impairments. Our group vision plan also provide the highest quality glasses and contact lenses at extremely affordable prices.
To learn more about MedBen’s vision care programs, contact Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
The U.S. Department of Labor (DOL) has released an updated version of its Health Benefits Advisor for Employers. This online resource outlines the federal laws that can affect health benefit coverage provided by group health plans. The Advisor explains the legislation, statutes and regulations in Parts 6 and 7 of Title I of the Employee Retirement Income Security Act of 1974 (ERISA). These laws include:
You may access the updated Health Benefits Advisor for Employers from the DOL web site at http://www.dol.gov/elaws/ebsa/health/employer/.
The Health Benefits Advisor for Employers is one of a series of elaws (Employment Laws Assistance for Workers and Small Businesses) Advisors developed by DOL to help employers and employees understand federal employment laws and resources. To access all of the elaws advisors, visit the elaws Web site at www.dol.gov/elaws.
Carrying around excess weight is a financial burden in addition to a physical one, a new study says.
According to HealthDay News, researchers from Cornell University found that an obese person’s medical costs are $2,741 a year higher (in 2005 dollars) than if they were not obese. That additional money adds up to $190.2 billion a year nationally – nearly 21% of total U.S. health spending.
The study’s numbers far exceed previous estimates that put the cost of obesity at $85.7 billion a year. “Historically, we’ve been underestimating the benefit of preventing and reducing obesity,” study author John Cawley said in a university news release.
“Obesity raises the risk of cancer, stroke, heart attack and diabetes,” Cawley said. “For any type of surgery, there are complications [for the obese] with anesthesia, with healing. Obesity raises the costs of treating almost any medical condition. It adds up very quickly.”
More evidence that irregular sleep habits can adversely affect one’s health: A new study by Brigham and Women’s Hospital in Boston found the fighting the body’s natural sleep patterns can increase the risk of type 2 diabetes.
According to MSNBC, researchers deliberately disrupted the normal sleep patterns of volunteers. Within a few days, their bodies began to respond differently to standard meals – so much so that three of the volunteers became pre-diabetic. Fortunately, symptoms disappeared when regular sleep resumed.
“Glucose levels went much higher and stayed that way for several hours,” said neuroscientist Orfeu Buxton, Ph. D., the study’s lead author. “This was because of decreased insulin released from the pancreas. Together these reflect an increased risk of diabetes.”
More than 21 million Americans who labor evening or nighttime hours have a righer risk of obesity and heart disease, in addtion to diabetes. The advice from the scientists for those who perform “shift work” – either out of necessity or choice:
Public support of the health care reform law has reached a new low, according to the latest ABC News/Washington Post poll.
ABC News reports that 53% now disapprove of the Affordable Care Act, while only 39% support it – the smallest vote of confidence in more than a dozen such polls since August 2009. “Strong” opposition outnumbers strong advocacy by over a 2-to-1 margin.
Moreover, a combined two-thirds of respondents believe that the Supreme Court should strike down the entire law (38%) or at least the individual mandate (29%), the requirement that most Americans carry health insurance or pay a penalty.
As for how people think the high court will vote on the ACA, over half think the justices will allow partisan political views to influence their ruling, while 40% say the decision will be impartial. Along party lines, 41% of Republicans say the vote will be partisan, compared to 55% of Democrats and 52% of independents.
A bit of good news for President Obama, however: 48% of reposdents trust his handling of health care policy, compared to just 38% for presumptive GOP nominee Mitt Romney.
Lots of cancer-related news this week… here’s a sampling:
Every now and then, the scientific community takes a few moments out of their busy schedule to confirm something that we all already know… but hey, a gentle reminder never hurts. In this case, a new study determined that time-tested ways of losing weight – exercise, eating less fatty food and so on – work better than fad diets and “miracle” weight-loss pills.
WebMD reports that researchers analyzed surveys from over 4,000 obese people to determine how those who successfully lost weight did so. They found that those who exercised more and ate less fat lost more weight.
“People actually are losing 5% to 10% of their body weight or more using tried-and-true methods,” says study author Jacinda M. Nicklas, MD, MPH of Beth Israel Deaconess Medical Center in Boston.
The study also showed that people who joined commercial weight loss programs, such as Weight Watchers or Jenny Craig, were more likely to lose 10% or more of their body weight. And while only a small portion of those surveyed used prescription weight loss drugs, most did report some weight loss.
The Department of Health and Human Services (HHS) has announced that an upgrade to the medical-coding standard will be postponed for a year, The Wall Street Journal Health Blog reports.
Originally set for implementation in 2013, the coding set known as will now go into effect on October 1, 2014. In a press release, HHS said the delay will give doctor and health insurers “more time to prepare and fully test their systems to ensure a smooth and coordinated transition to these new code sets.”
When the ICD-10 update is completed, the number of diagnosis and procedure codes used in medical billing will expand greatly, from around 18,000 in the current ICD-9 code set to about 140,000. Not surprisingly, the American Medical Association doesn’t favor the change, saying that the increase in codes will further burden doctors without improving care.
HHS said that the proposed coding changes – which would also establish a unique health plan identifier that could be used in billing – “would save health care providers and health plans up to $4.6 billion over the next ten years.”
To get some idea of the scope of the 120,000+ new codes, take a look at this Wall Street Journal article from September 2011. Suffice it to say, if you’re ever burned by flaming waterskis, there’s a code for that.
Last week, nine medical societies jointly announced “Choosing Wisely” – a doctor-focused campaign to promote more selective use of medical tests. The groups compled a list of 45 tests and procedures they considered to be overused.
On the KevinMD.com blog, two physicians share their opinions of Choosing Wisely – one approving, the other more qualified in his support:
John Mandrola, MD, cardiologist: “Doctors must design and implement healthcare changes and reforms. Call us what you will, but we are the experts in medical diagnosis and treatments. We know what works and what doesn’t. We must be allowed to practice Medicine – not just follow protocols, or test and treat just to cover our butts. The corollary here, of course, is that we must be allowed to be human…
“That our thought leaders are now proclaiming – and social media is amplifying – the values of clinical judgment and targeted thoughtful diagnostic and therapeutic interventions represents a monumental sea change.”
Mike Sevilla, MD, family physician: “With these reports today, patients are challenging me even harder about the testing and treatments that I am recommending. I don’t have a problem with this. However, I do have a problem how this story has been framed in that ‘I’ am the reason why unnecessary tests are done, and my patients are more than happy to remind me of that…”
“Now, don’t get me wrong. I agree with everything that happened today. 30 billion dollars annually of unnecessary tests are a real problem. However, will this effort really change the behavior of physicians? Probably not. Will this effort really try to educate patients not to ask for unnecessary tests? Probably not. Will this campaign hope to score political points with Congress and the White House? Some believe yes…”
The Affordable Care Act will add more that $340 billion to the deficit, according to a new study of the health care reform law by a Republican member of the board that oversees Medicare financing.
The Washington Post reports that conservative policy analyst Charles Blahous predicts that much of the savings and revenue ACA gains – from lower Medicare payments and higher taxes – will be more than offset by additional benefits to individuals already insured, paid through the Medicare hospitalization trust fund. That means those savings would not be available to pay for expanding coverage for the uninsured.
“If one asserts that this law extends the solvency of Medicare, then one is affirming that this law adds to the deficit,” said Blahous, who President Obama approved in 2010 as the GOP trustee for Medicare and Social Security. “Because the expansion of the Medicare trust fund and the creation of the new subsidies together create more spending than existed under prior law.”
The Obama administration countered that Blahous used faulty and selective math to reach his conclusions. “The fact of the matter is, the Congressional Budget Office and independent experts concluded that the health-reform law will reduce the deficit,” a White House budget official said, speaking to the Post on the condition of anonymity because the report was not publicly available.
An oft-cited concern by those in support of reduced mammogramy screening is the greater potential of a “false-positive” – a result that indicates that a cancer is present when it is not. And indeed, 61% of women in the U.S. who do receive annual mammograms have at least one such incorrect result within a ten-year period.
New research suggests, however, that even false-positives may provide some hint for a future risk of breast cancer. Women in a Danish study who had at least one false-positive mammogram had a 67% greater likelihood of eventually being diagnosed with the disease, WebMD reports. The analysis included 58,000 women who had mammograms in Denmark between 1991 and 2005.
Breast cancer specialist Stephanie Bernik, MD doesn’t wholly support the study’s findings. “There has long been a suggestion that women who have more activity in their breasts that lead to false-positive mammograms may also have an increased risk for breast cancer, but I don’t think this study proves this,” she told WebMD.
Bernik (who was not involved in the research) also noted that innovations in mammography screening since 2000 have led to better detection of breast cancer and fewer false-positives, and the analysis reflects the greater test accuracy. “This study could be interpreted as reassuring for women being screened today.”
The more health care changes, the more it stays the same… at least, that’s the conclusion one might reach when reviewing a list of U.S. health care problems from 1933.
C.E.A. Winslow, a Professor of Public Health at Yale University, wrote “A Program of Medical Care for the United States” for the January 27, 1933 edition of Science magazine. His observations about the state of health care back then should strike a familiar chord with you. We’ve highlighted several here – you can read Winslow’s complete list at John Goodman’s Health Policy Blog.
In the leadup to, and aftermath from, Supreme Court hearings over the Affordable Care Act, the Internet has been rife with speculation as to what would happen if the individual mandate, or even the entire health care reform law, was struck down. The New York Times recently focused on how reversing two years of policy would affect a specific industry – health insurers.
Based on the comments of the articles’s interviewees, there’s a fair amount of hand-wringing going on:
And here at MedBen? While we’re certainly keeping an eye on judicial developments, whatever the outcome should be, it’s essentially business as usual. As nothing in the law acts to reduce the cost of care, we continue to do precisely what we’ve always done: Find ways to provide leading-edge administrative services that increase efficiency while reducing client costs.
MedBen has never been a company to take a wait-and-see attitude. So rather than sit idly by, we remain at all times proactive. For instance, in 2010 we developed Partners Community Health Plan – a unique benefits package in which local hospitals and providers play an equal role in its management. Partners is currently available for fully-insured and self-funded businesses in Southeastern Ohio and Southwestern Kentucky, with more regions soon to come.
“Business as usual” really means that MedBen is constantly looking out for your best interests – through varied benefit offerings, innovative cost controls, on-line and in-house technologies, and outstanding customer service – regardless of circumstances.
As more preventive services are covered in full by health insurance, the range of treatment costs from one provider to another has received increased scrunity. USA Today reports that a new study demonstrates just how great the difference can be.
According to research group Change HealthCare, costs for some preventive services can vary as much as 700%. A review of 15,000 consumers found cost differences of hundreds of dollars charged for the same tests. Colonoscopy costs, for example, ranged from $786 to $1,819.
The U.S. Department of Health and Human Services has developed a list of preventive services covered under the Affordable Care Act, and predicts a 1.5% increase in insurance premiums to cover the costs. But whether that’s a conservative estimate or not ultimately depends on the consumer’s choice of medical provider.
Bottom line: Even when you ensue no direct out-of-pocket expenses, it’s a good idea to know how much you’re spending for preventive care, and how it compares to average costs in your area. Such websites as myMedicalCosts.com, Outofpocket.com and Pricedoc.com can help you with your research.
Many of us are so conditioned to getting by with less than seven hours of sleep a night that we ignore the warning signs our body sends when it wants more rest. But failure to take notice can lead to a myriad of health problems, including high blood pressure, obesity, depression, and decreased concentration and reaction times.
Men’s Health highlights six signs that you need to turn in earlier. We summarize them below, but you can check out the complete list at their website.
Avastin users may want to take extra precautions to ensure that their physicians and pharmacists are giving them the proper version. For the second time this year, the Food and Drug Administration has uncovered counterfeits of the injectable cancer drug.
AFP reports that the latest counterfeits are labeled by the name under which Avastin is approved in Turkey, Altuzan, but contain no active ingredient. Genentech, a subsidiary of the Swiss pharmaceutical giant Roche, markets the only FDA-approved version of Avastin in the United States.
The agency “is alerting healthcare professionals that another cancer drug, originating from a foreign source and purchased by US medical practices, has been determined to be counterfeit,” said the FDA in a statement.
In February, the FDA warned that as many as 19 US medical practices had potentially purchased and used counterfeit Avastin from Quality Specialty Products (QSP), a foreign supplier also known as Montana Health Care Solutions.
Avastin is used to treat colorectal, lung, kidney, breast and ovarian cancer.
In an effort to reduce wasteful spending without harming patients, nine medical societies have compiled a list of tests and treatments their members should no longer automatically order. MSNBC reports that the groups, which include the American Academy of Family Physicians, the American Society of Clinical Oncology and the American College of Cardiology, represent nearly 375,000 physicians.
Each of the specialty societies created a list of “Five Things Physicians and Patients Should Question". The 45 tests and procedures considered to be overused include:
Complete lists are available at the “Choosing Wisely” website.