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03/27/12

  05:42:06 pm, by MedBen5   , 243 words,  
Categories: News, Health Plan Management

Questions & Opinions Fill Day Two Of Reform Hearings

“Can you create commerce in order to regulate it?” Justice Anthony M. Kennedy asked the question to Solicitor General Donald B. Verrilli Jr. in the early moments of today’s Supreme Court hearings. Verrilli, lawyer for the Obama administration, was defending the constitutionality of the individual mandate – the provision in the Affordable Care Act that would require most Americans to purchase health insurance coverage.

According to The New York Times, almost all the nine justices had questions and comments about the mandate during the two-hour session. Only Clarence Thomas refrained from making inquiries.

“May failure to purchase something subject me to regulation?” asked Justice Antonin Scalia. Chief Justice John Roberts Jr. and Justice Samuel Alito Jr. wondered if the government could force people to buy cellphones and burial plots, respectively.

Justice Kennedy also asserted the need for such intense scrutiny, saying that as the requirement to obtain insurance was unprecedented, it required “a heavy burden of justification.” To this Verilli responded that as most Americans would almost certainly need health care services in their lifetime, the federal government was well within their constititutional authority.

Other members of the court joined the administration in supporting the law. Justice Ruth Bader Ginsburg said the individual mandate was necessary to ensure that all individuals paid their fair share for health care. And Justice Sotomayor noted that Americans would not stand for a system in which children in danger of dying were turned away from emergency rooms.

  05:03:36 pm, by MedBen5   , 245 words,  
Categories: News, Prescription, Wellness

Weight-Loss Surgery May Successfully Treat Diabetes

New research promises to spur a lot of dialogue about the benefits of weight reduction surgery. The Wall Street Journal reports that studies in the U.S. and Italy found that surgical procedures to reduce the size of the stomach in obese patients proved more effective in treating Type 2 diabetes than medication and weight-loss counseling.

Using randomized studies, researchers compared the results of weight loss through gastric bypass surgery with a regimen of drugs and diet and exercise coaching. The studies showed that surgery patients lost five times as much weight on average than those in the medical-therapy group. Surgery patients also showed much lower blood sugar levels – so much so, in fact, that many of them went off at least some of their medications even before leaving the hospital.

The findings “open the door for surgery to be considered as a more standard therapy for diabetes, particularly in the obese diabetic who isn’t well controlled with medical therapy,” said Philip Schauer, director of the bariatric and metabolic institute at the Cleveland Clinic and lead author of one of the studies.

Other doctors said further study of long-term risks and benefits was necessary before taking such a drastic step. “This is a very expensive and invasive way to control the disease,” said W. Douglas Weaver, head of cardiology at Henry Ford Health System in Detroit. “Having your blood sugar look better isn’t the same as not losing your eyes or having a heart attack.”

03/26/12

  05:02:10 pm, by MedBen5   , 212 words,  
Categories: Wellness, Health Plan Management

Three Tips To Save On Hospital Stays

Should you require a hospital stay, MedBen offers a variety of tools to keep your hospital costs down – from comprehensive medical management services to a specialized surveillance system that thoroughly reviews your claims for potential savings. But there are also a few fairly simple steps you take to to reduce your hospital bill.

John Santa, MD, a medical expert with Consumer Reports, offers these useful suggestions (courtesy of WebMD):

Insist on efficiency. If you’re having surgery, ask to be admitted to the hospital the morning of your procedure rather than the night before. Also ask to be discharged as early as is safe and reasonable.

Demand focus. Be clear that you want your care to focus on the particular procedure for which you were hospitalized. “Let them know, I don’t want anybody ordering another X-ray or set of blood tests. My doctor will take care of that when I’m discharged,” Santa says.

Don’t pay for mistakes. Billing errors are common. Insist on an itemized bill and a copy of your medical record after treatment, and make sure they’re consistent. Don’t pay for any service, device, or drug you didn’t use. If hospitalization led to an infection, demand that any extra hospital days needed to treat it be removed from your bill.

  12:37:00 pm, by MedBen5   , 229 words,  
Categories: News, Health Plan Management

Tax Question Argued During Day One Of Reform Law Hearings

The first day of Supreme Court health care reform hearings kicked off with an interesting twist – the plantiff and defendent agreed on the issue being argued.

According to The Washington Post, private attorney Robert A. Long stressed that because of the the Anti-Injunction Act, the Supreme Court cannot pass judgment on the Affordable Care Act until the individual mandate does into effect in 2014. Long was appointed by the court to argue in favor of the delay.

Both the Obama administration lawyers and those representing the 26 states challenging the law argue that the justices should should decide the question of the mandate’s constitutionality now. But the Anti-Injunction Act, a 19th-century law that prohibits legal challenges to a tax before it is collected, must first be weighed before the justices can consider whether or not the federal government has the right to require most Americans to buy health insurance or pay a penalty.

Long said the penalty, which is estimated to raise up to $6 billion a year by the end of the decade and would be collected by the IRS, looks like a tax. But Justice Stephen G. Breyer challenged that premise: Just because the penalty is “being collected in the same manner of a tax doesn’t automatically mean it’s a tax, particularly since the purpose of the Anti-Injunction Act is to prevent interference with the revenue stream.”

  11:58:26 am, by MedBen5   , 208 words,  
Categories: News, Wellness

Popcorn Beats Fruits & Vegetables In Antioxidant Content

Finally, popcorn gets a little love!

Well, that’s not entirely correct. Popcorn has long been considered one of the healthier snack foods, so long as it’s air-popped and not slathered in butter. But now scientists report that it also contains more healthy antioxidants, called polyphenols, than some fruits or vegetables.

Medical News Today reports that polyphenols are more concentrated in popcorn, which averages only about 4% water, while polyphenols are diluted in the 90% water that makes up many fruits and vegetables.

And the hulls that get stuck between your teeth? They contain an even higher concentration of polyphenols and fiber. “They are nutritional gold nuggets,” said study co-author Joe Vinson, Ph.D. University of Scranton in Pennsylvania.

“Popcorn may be the perfect snack food. It’s the only snack that is 100% unprocessed whole grain,” Vinson noted. “One serving of popcorn will provide more than 70% of the daily intake of whole grain. The average person only gets about half a serving of whole grains a day, and popcorn could fill that gap in a very pleasant way.”

Of course, Vinson also cautioned that oil and butter can quickly negate popcorn’s benefits. And don’t drop fruits and vegetables from your diet – they contain vitamins and other vital nutrients lacking in popcorn.

03/23/12

  04:44:55 pm, by MedBen5   , 119 words,  
Categories: Health Plan Management

Deadline For 2011 FSA/HRA Submissions Fast Approaching

A reminder to MedBen FSA and HRA clients: For most groups, the week of March 25th is the last week to turn in expenses for the 2011 FSA and/or HRA plan year.

If you have any outstanding 2011 expenses that you would like to get reimbursed for from your Health FSA, Dependent Care and/or HRA plan, those expenses must be submitted on or before the close of business on Friday, March 30. FSA and HRA reimbursement forms are available at the MedBen website.

Please note that some FSA/HRA groups have different year-end deadlines to submit expenses. If you’re unsure as to your final submission date, please speak to your plan administrator or contact MedBen Customer Service at 800-297-1829.

  02:43:38 pm, by MedBen5   , 351 words,  
Categories: News, Health Plan Management

A Health Care Reform FAQ

On this, the second anniverary of the passage of the Affordable Care Act, it’s an appropriate time to to look at the impact of health care reform so far, as well as what’s coming down the road. Fortunately, Kaiser Health News has done the heavy lifting for us.

A Consumer Guide To Health Reform Law” offers a wide-ranging FAQ about ACA provisions past, present and future. We’ll highlight a couple questions here pertaining to employer-based health plans, but check out the complete article for additional information about other aspects of the law.

I get my health coverage at work and I’d like to keep my current plan. Will I be able to do that? How will my plan be affected by the health law? If you get insurance through your job, it is likely to stay that way. But, just as before the law was passed, your employer is not obligated to keep the current plan and may change premiums, deductibles, co-pays and network coverage.

You may have seen some law-related changes already. For example, most plans now ban lifetime coverage limits and include a guarantee that an adult child up to age 26 who can’t get health insurance at a job can stay on her parents’ health plan.

I own a small business. Will I have to buy health insurance for my workers? No employer is required to provide insurance. But starting in 2014, businesses with 50 or more employees that don’t provide health care coverage and have at least one full-time worker who receives subsidized coverage in the health insurance exchange will have to pay a fee of up to $2,000 per full-time employee. The firm’s first 30 workers would be excluded from the fee.

However, if you have a firm with 50 or fewer people you won’t face any penalties.

In addition, if you own a small business, the health law offers a tax credit to help cover the cost. Employers with 25 or fewer full-time workers who earn an average yearly salary of $50,000 or less today can get tax credits of up 35 percent of the cost of premiums. The credit increases to 50 percent in 2014.

  11:45:50 am, by MedBen5   , 142 words,  
Categories: News, Prescription

FDA Considers Expanding Over-the-Counter Drug Options

The Food and Drug Administration is currently conducting a two-day hearing to discuss the possibility of allowing more drugs to be purchased without a prescription, Bloomberg Businessweek reports.

At a meeting yesterday, the FDA discussed whether cholesterol, asthma, migraine and blood-pressure medications should be sold over-the-counter. By allowing this regulatory change, the agnecy hopes to lower costs and ease access to drugs for people with chronic conditions.

And today, the question of contraceptive care will enter the debate. Reproductive-rights advocates are urging that any expansion of nonprescription drugs include birth control. Last year, the Obama administration overrode the FDA’s support for selling “morning-after” pills over-the-counter to girls 16 and younger – a move that upset women’s health advocates.

Over-the-counter medicines save the U.S. health-care system $102 billion a year, according to the Consumer Healthcare Products Association, the nonprescription drugmakers’ lobbying group in Washington.

  10:56:46 am, by MedBen5   , 171 words,  
Categories: News, Health Plan Management

House Votes To Eliminate Independent Medicare Panel

By a vote of 223 to 181, the House of Representatives yesterday approved a bill to abolish the Independent Payment Advisory Board created by the Affordable Care Act. The purpose of the 15-member board is to recommend Medicare spending cuts, which would automatically take effect unless Congress voted to block or change them.

According to the New York Times, the House vote fell largely along party lines. Seven Democrats voted for the bill, and 10 Republicans voted against it.

“The Independent Payment Advisory Board encompasses all that is wrong with the Affordable Care Act,” said Representative Michael C. Burgess, Republican of Texas. “It is not accountable to any constituency, and it exists only to cut provider payments to fit a mathematically created target.”

Democrats who also voted against the bill say they fear it will usurp the power of Congress to set Medicare policy. But most party members objected to the bill’s inclusion of tort reform proposals that could limit patients’ ability to recover damages for injuries suffered as a result of medical malpractice.

03/22/12

  04:59:40 pm, by MedBen5   , 237 words,  
Categories: News, Wellness, Health Plan Management

Test To Predict Heart Attacks May Become A Reality

A simple test could predict whether a heart attack is looming, the Los Angeles Times reports. Using a blood sample, doctors may be able to determine circulating cells that have broken off damaged blood vessel walls – which in turn can form a blood clot that blocks flow to the heart, leading to an attack.

While physicians can easily determine if a heart attack is underway, anticipating one that’s still some time away is much more difficult. But new research offers hope that the test could potentially address “the greatest unmet need” facing cardiologists, said lead author Dr. Eric Topol, a cardiologist at the Scripps Translational Science Institute in San Diego.

“When someone is having the real deal, we know that,” Topol said. “The real question is, is something percolating in their artery? We’d like to prevent the heart attack from happening,” or mitigate its effects with drugs.

Of course, a better strategy than hoping this heart attack test works is to minimize your risk of developing heart disease in the first place. With MedBen Worksite Wellness, plan members with certain specific diseases or risk factors will be identified for intervention and management. Our Specialty Care Program provides individualized disease monitoring and nurse coaching for members with heart disease as well as diabetes, asthma, hypertension and high cholesterol.

For more information about MedBen Worksite Wellness, please call Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

  03:06:46 pm, by MedBen5   , 233 words,  
Categories: News, Wellness

FDA Wins Latest Round In Cigarette Label War

The battle to visually upset smokers is getting as convoluted as the battle to strike down health care reform. Just weeks after a U.S. District Judge found the federal requirement to place graphic images on cigarette labels to be unconstitutional, a federal appeals court has ruled the law doesn’t violate the free speech rights of tobacco companies.

According to Reuters, Cincinnati-based U.S. Court of Appeals for the 6th Circuit upheld Food and Drug Administration regulations, which include a requirement that cigarette makers incorporate pictures depicting the hazards of smoking on their packaging. Tobacco companies argued that the rules violated their First Amendment right to communicate with adult tobacco consumers.

“There can be no doubt that the government has a significant interest in preventing juvenile smoking and in warning the general public about the harms associated with the use of tobacco products,” Judge Eric Clay wrote for the three-judge 6th Circuit panel.

The FDA has approved nine images to go on cigarette packs, including graphic pictures of dead bodies, diseased lungs and rotting teeth. Warning-label regulations, passed by Congress into 2009, specify that the labels must be in color, must cover the top 50% of a cigarette pack’s front and back panels, and must cover the top 20% of print advertisements.

Floyd Abrams, a lawyer for Lorillard Tobacco Company, predicted that the 6th Circuit case would likely end up in the U.S. Supreme Court.

  01:27:19 pm, by MedBen5   , 275 words,  
Categories: Wellness

When Researching Health Advice Online, Tread Cautiously

The Internet can be a great source of medical knowledge. But knowing where to look, and who you can trust, is critical when trying to diagnose symptoms or learn more about a disease. Former law professor Toni Bernhard offers some tips for your online health information search (read her complete comments on theKevinMD.com blog):

  • When researching your condition, look for .org or .edu as opposed to .com at the end of a Web address. Web addresses ending in .org take you to non-profit associations whose mission is to educate the public about your particular condition, while .edu addresses take you to medical sites that are maintained by universities.
  • Be wary of websites that claim to cure your chronic pain or illness if you’ll just fork over your money. If there were a “cure” for your condition, the odds are high that those .org or .edu. websites would be recommending it or at least discussing it.
  • If you find an article on your condition, check out who authored it. Make sure it’s not someone who gets paid money to get your attention.
  • Be cautious before relying on other people’s experiences with various treatments. Feedback can vary widely in chat rooms and message boards, so don’t take every negative comment about side effects to heart.
  • Find community and support on the Internet. Facebook and Twitter, blogs and online communities all offer opportunities to talk with people who understand your medical struggles.
  • And, finally … enter the doctor. Make your doctor feel that you’re sharing information because the two of you are partners in your health care, not that you’re challenging him or her.
  11:42:17 am, by MedBen5   , 321 words,  
Categories: News, Health Plan Management

Legal Experts Predict Health Reform Law Will Stand

We’re just a few days from the battle of the century – President Obama vs. 26 states challenging his Affordable Care Act, going mano a mano in the Supreme Court, with the future of healh care reform hanging in the balance.

The outcome of the three-day hearing likely won’t be known until summer, but that hasn’t stopped HealthDay News from asking legal experts to predict the outcome. And just about everyone is giving the President a win by technical knockout:

Gregory Magarian, professor at Washington University Law School: “The folks [26 states] who are challenging the act have somewhat of an uphill battle. It’s been some time since the court has struck down a major piece of federal legislation on the theory that it exceeds Congress’ constitutional authority.”

Neil Siegel, professor of law and political science at Duke University School of Law: “The court has held that in issues of economic activity, Congress can act as if we have an integrated national economy. Here you have economic conduct [health care] with massive interstate effects.”

Robert Field, professor of law at Drexel University’s School of Public Health: “I think it’s unlikely the court wants to create a major public or policy upheaval, which is what it would be doing if it overturned the law.”

Stephen Presser, professor of legal history at Northwestern University School of Law: “I think [Justices] Scalia, Thomas, Alito and Roberts will all have to view this as Congress going much too far and virtually ignoring the 10th Amendment. Justices Breyer and Ginsburg have always been strong voices for expanded Congressional power, and Justices Kagan and Sotomayor are not going to embarrass the man [Obama] who appointed them, so there are four sure votes to uphold the legislation as well. That leaves only Kennedy as the swing vote, as most commentators, I think, understand.” Presser believes Kennedy will vote with the conservative justices, which means the ACA will be ruled unconstitutional.

03/21/12

  04:55:42 pm, by MedBen5   , 231 words,  
Categories: News, Health Plan Management

Partners Plan Offers High-Quality, Low-Cost Regional Care

Sometimes, expensive health care is just that – expensive health care, no matter where you get it. And lower-cost caregivers can deliver high quality regardless of geography.

According to Medical Xpress, a new study conducted by physicians in San Francisco found no solid evidence to support the theory that regions of the United States that spend more on health care and have higher rates of health care use deliver more unnecessary care to patients. Conversely, low-cost areas don’t necessarily deliver more efficient care – they simply don’t charge as much for care that’s just as good.

MedBen’s own experience has demonstrated degrees of cost-effective care at hospitals of all sizes, in regions large, small and in-between. But one important lesson we’ve learned is that many smaller facilities do indeed offer care that’s of comparable quality to their larger colleagues, and frequently charge less for it.

Partners Community Health Plan, now available in multiple Southeast Ohio and Southwest Kentucky regions, rewards members who choose local hospitals and doctors. Under the plan – a partnership between MedBen and leading area providers – members can obtain lower-cost care from smaller regional hospitals, at the same outcome levels found at facilities in major metropolitan areas.

Partners plans are available to both fully-insured and self-funded groups. To learn more, visit the Partners website or contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

  10:30:18 am, by MedBen5   , 186 words,  
Categories: News, Wellness

Aspirin May Reduce Short-Term Cancer Risk

Not only is aspirin lauded for its ability to limit heart attack damage, it is believed that the painkiller can reduce the long-term risk of dying from cancer. Now, new research shows that there may be a short-term advantage as well.

Bloomberg reports that men and women who took a daily dose of aspirin had a 24% lower rate of developing cancer after three years and were 37% less likely to die from the disease after five years than those who didn’t, according to a study in The Lancet medical journal. Previous research had concluded that it took at least eight years to realize the benefits.

Based on the research findings, it’s also possible that the faster-acting qualities of aspirin may help to prevent tumors from spreading.

“We still need to do trials of aspirin in treatment of cancer to show that the benefit is definitely there if you start taking it after the cancer’s been diagnosed,” said Peter Rothwell, a professor at the University of Oxford who led the research. “But potentially it would be a highly cost-effective way of preventing the spread of cancers.”

03/20/12

  03:27:48 pm, by MedBen5   , 204 words,  
Categories: News, Prescription

Generic Versions Of Boniva, Lexapro Now Available

As we noted on this blog last July, 2012 looks to be a big year for generic rollouts of popular brand name drugs. WebMD recently reported on two such introductions:

A reminder to MedBen plan members who get pharmacy benefits management services through Pharmacy Data Management (PDMI): You can get information about generic alternatives and compare prices through MedBen Access. By clicking on your name under “My Rx Claims” in the sidebar menu, you will be taken directly to the RxEOB service.

To access MedBen Access, simply go to MedBen.com, select “Online Client Services", and click on “MedBen Access".

  02:56:09 pm, by MedBen5   , 331 words,  
Categories: News, Health Plan Management

Health Care Reform Enters The "Terrible Two's"

The Affordable Care Act turns two years old on March 23, and to mark the occasion, Politico has compiled a list of five things to watch for in year three. Below we offer a “teaser” – you can find the complete answers at Politico website.

1) How many states won’t set up their own exchanges? So far[…] a lot of states are not moving ahead. The federal exchange could end up covering as many as 15 to 25 states[.]

2) What’s next on essential benefits? So far, [Health and Human Services] has put out a “bulletin” – less formal than an actual rule – that said states will be able to choose from a selection of benchmark plans. But who in the states, exactly, gets to make that call? And how can states fill in the gaps for benefits not typically offered by their insurers?

3) Who’s forming accountable care organizations? [July 1 is] the deadline for providers to apply to become accountable care organizations – the new networks of hospitals and physicians that will work together to deliver medical care more efficiently under new payment rules, incentives and quality measures. It’ll be too soon to tell whether these ACOs can actually save money without skimping on patients’ care, which is the point of the program. But the sign-up deadline will give everyone a better read on whether providers believe the model is viable in the long run.

4) Will there be more scares about the costs? Each study of how employers may react to the health care law invites potentially damaging answers that speak to people’s worst fears about employers dropping coverage. The studies get widely quoted, and new ones could make the public sour on the law even more.

5) Will there be a replacement plan? Congressional Republicans insist the Affordable Care Act is not the only way to fix the health care system — but they haven’t yet delivered the promised plan to “replace” the law with a more market-driven, state-centered alternative.

  10:41:49 am, by MedBen5   , 179 words,  
Categories: News, Wellness

Just 1% Of People Meet Recommended Heart Health Goals

Only about 1 in 100 Americans meets seven heart-healthy targets recommended by the American Heart Association. according to WebMD.

The seven behaviors include:

  • Not smoking
  • Being physically active
  • Having normal blood pressure (under 120/80)
  • Healthy fasting blood-glucose levels (below 100)
  • Total cholesterol levels below 200
  • Maintaining a healthy weight
  • Eating a healthy diet

A study conducted in 2005-2010 found that just 1.2% of Americans followed all the heart health habits, a drop from 2% in 1988-1994. Researchers noted that the number of people eating a healthy diet has declined, while the prevalence of obesity and abnormal fasting blood-glucose levels has risen.

There is some positive news, though. Smoking is down from from 28% to 23%, and more people met the ideal heart-healthy level of physical activity (45%, up from 41%). But the percentage of people classified as inactive doubled from 16% to 32%.

The study also demonstrated that heart disease and death risk decreases as more heart-healthy goals are met. People who met six of the seven goals had a 76% lower risk of heart-related death and a 51% lower risk of death from any cause, compared with those who met one or fewer.

03/19/12

  05:00:02 pm, by MedBen5   , 187 words,  
Categories: News, Wellness, Health Plan Management

Eye Checkups Can Detect Potential Memory Loss

More proof that we can learn a lot just by looking in someone’s eyes – especially if you look really close. WebMD reports people who have eye damage involving the blood vessels of the retina have a higher risk for memory decline, according to a new study.

Researchers say that retinopathy – damage to blood vessels in the eyes, caused by vascular disease – may indicate that blood vessels in the brain are likewise not operating properly. Retinopathy is also a common complication of diabetes and uncontrolled high blood pressure, which have also been linked to a higher risk for memory and thinking declines.

If the study is correct, it demonstrates how regular eye exams can identify problems that go well beyond impaired vision – in this case, potentially helping identify people at risk for dementia.

MedBen VisionPlus is a perfect match to your health care plan. Detecting eye disease and other potential ailments early reduces the risk of major medical costs down the road. To learn more about the benefits of group vision coverage, contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

  04:03:18 pm, by MedBen5   , 282 words,  
Categories: News

The Truth Behind Popular Health Care Myths

From John Goodman’s Health Policy Blog: In his new book American Health Economy Illustrated, Christopher Conover of the American Enterprise Institute debunks some widely-held health care myths.

Myth: Relative to other countries, the U.S. spends “too much” on health care.
Differences in income explain 85% of variations in health spending. The U.S. is spending what it should in GDP per capita, while France spends 1/5 too much, and Canada and the U.K. spend too little. Blue states are spending too much due to overregulation (Massachusetts, New York, New Jersey). After RomneyCare, Massachusetts has the highest level of health care spending.

Myth: The U.S. has an abysmal infant mortality rate.
It does rate 43rd, but there is no standard for reporting infant mortality. The U.S. is one of eight countries that count extremely premature infants as live births despite low chances of survival. If we categorize births by length of gestations the U.S. ranks 2nd, 3rd, or 4th (depending on type of rank) to European countries.

Myth: The U.S. lags behind its competitors in life expectancy.
The U.S. ranks 39th, but this is misleading. This distortion is due to a high rate of deaths resulting from violence. When adjusted for deaths related to violence and suicide the U.S. ranks first in OECD countries.

Myth: The U.S. has worse health outcomes than its peers.
Cancer is the second leading cause of death in the U.S., but cancer patients live longer in the U.S.; cancer survival rates are better. The U.S. has far higher screening rates.

Conclusion: The U.S. health system has many problems, but other countries do not offer a magic bullet.

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