As part of an effort to encourage more small businesses to provide health care coverage, the Obama administration has expanded the Affordable Care Act’s healthcare tax credit to $14 billion in its proposed fiscal 2013 budget.
According to Modern Healthcare, the proposal would raise the size of small businesses allowed to claim tax credits from the existing 25 or fewer workers to 50. Additionally, the tax credits themselves will cover up to 50% of employee premiums beginning in 2014, a 15% increase from the current standard.
“We need to make it easier for small-business owners to provide insurance to their employees right now,” said Karen Mills, the administrator of the Small Business Administration, in a conference call with reporters Thursday.
The administration also said it would promote greater interest in the healthcare tax credit plan by better publicizing the incentives and simplifying the application process.
It’s Friday, and therefore, the perfect time to talk sweat.
It’s one of life’s little injustices that some people just tend to perspire more than others. Occasionally, heavy sweating may be caused by a medical condition or medication, in which case your doctor may be able to help.
Most of the time, however, it’s the simple combination of genes and environment that determine our level of perspiration. Fortunately, there are ways to keep sweat to a minimum, regardless of circumstances. WebMD has put together a list of helpful hints on its website – we’ll highlight a few here.
Most older members of the U.S. workforce have vision care coverage, but not all of them take full advantage of their benefits, Employee Benefit News reports.
A recent Transitions Optical survey found that 79% of baby boomers have enrolled in a group vision plan. However, one-third of them say that don’t bother to schedule regular eye exams – leaving them at a higher risk for age-related vision problems and chronic conditions that affect eye health and compromise productivity.
“A quality vision benefit is important for everyone, but especially for employees ages 45 and older, who are more likely to experience vision problems that hurt job performance. This age group also has a higher risk for developing costly eye diseases and whole body conditions such as diabetes and hypertension, all of which can be detected through comprehensive eye care,” says Pat Huot, director of managed vision care at Transitions Optical.
MedBen encourages its customers to get their eyes checked regularly. Our VisionPlus plan promotes early detection and treatment of vision abnormalities by covering exams, basic lenses and selected extras in full when using a network provider. In addition, the program also provides the highest quality ophthalmic materials at extremely affordable prices.
To learn more about MedBen VisionPlus, contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.
The birth control compromise offered by the Obama administration quelled – momentarily, at least – a growing political headache. But, as the New York Times notes, it ignored one conspicuous point.
To appease religiously-affiliated employers that oppose contraceptive usage, the administration announced last week that insurers, rather than the organizations, would be required to cover women’s birth control costs in full. Trouble is, many of these organizations self-fund their employee health care benefits – which means that they serve as their own insurers, and therefore, are still responsible for covering the costs.
So far, the administration has only said that the details will be worked out with religious leaders in the coming weeks. But some aren’t confident that a suitable solution can be reached.
“Putting the obligation on the insurer and not the employer doesn’t help much if they are the same person,” said Richard M. Doerflinger of the United States Conference of Catholic Bishops. Ironically, several Catholic organizations went the self-insurance route in order to avoid similar birth control mandates already present in certain states.
Often, making just a small change to your diet can make a big difference if you’re trying to shed a few pounds. Case in point: A new clinical trial found that participants who replaced sugar-sweetened soda with water (or a diet beverage) nearly doubled their likelihood of meaningful weight loss.
According to Reuters, researchers divided 300 overweight adults into three groups. The first and second groups substituted sugary soda for, respectively, water and diet drinks, while the third was given weight-loss advice but could make their own beverage choices.
After six months, all three groups lost an average of four or five pounds. But 20% of the first two groups dropped at least 5% of their starting weight, compared to only 11% of the third group. And while that may not seem like much, it’s enough for the body to realize such healthful benefits as a reduction in blood pressure.
Lead researcher Deborah F. Tate, of the University of North Carolina at Chapel Hill, advised that people who have a hard time with a major diet overhaul can start with sugar-free drinks before making changes to eating habits. “This is a simple thing you can do consistently each day,” she said.
In an effort to reduce excessive medical testing, the American College of Physicians (ACP) is releasing guidelines to aid physicians in determining whether or not patients should screen for specific disesases.
“Excessive testing costs $200 billion to $250 billion (per year),” Dr. Steven Weinberger, CEO of ACP said in an interview to Reuters. “There’s an overuse of imaging studies, CT scans for lung disease, overuse of routine electrocardiograms and other cardiac tests such as stress testing.”
Ordering unneeded tests while health care costs continue to escalate constitutes “medical gluttony,” said Dr. Otis Brawley, chief medical officer of the American Cancer Society. “We have got to think about the rational use of medicine in order to avoid rationing medicine.”
By handling the situation in-house, as it were, the ACP is hoping to avoid further government intervention. But MIT healthcare economist Dr. Jonathan Gruber believes that’s precisely what is needed.
“I don’t trust professional societies to do it because that’s how they make money – by doing tests and procedures,” Gruber said.
An interesting article in today’s New York Times: Pediatricians are increasingly “firing” families whose parents refuse to allow their children to be vaccinated.
Medical associations don’t recommend such patient bans. But a 2011 study of Connecticut pediatricians found that 30% of 133 doctors said they had asked a family to leave their practice for refusing vaccines, and a recent survey of 909 Midwestern pediatricians found that 21% reported discharging families for the same reason.
While rates for several key innoculations in young children rose between 2009 and 2010, lower overall immunization rates have been blamed as a factor in U.S. outbreaks of whooping cough and measles in recent years. And some pediatricians are concerned that unimmunized patients may pose a danger in the waiting room to infants or sick children who haven’t yet been fully vaccinated.
Parents who refuse vaccinations often voice concerns that the innoculations increase the risk of autism or may overwhelm their child’s immune system. But recent studies have dispelled these concerns among scientists.
As we noted here last week, President Obama has proposed a compromise regarding the mandate that religiously-affliated businesses cover contraceptive services. But even if the Catholic Church accepts the work-around, questions and controversy remain.
From Insureblog, third party administrator Nate Ogden points out that “free” contraceptives are anything but:
“When employers pay claims under a self funded plan, the majority of the time that is coming right out of the employer’s general account. So while it may seem like it’s ‘free’ to the employees (just like it seems like it’s ‘free’ to folks on fully insured plans), it’s really coming out of their raises, bonuses, even salary.
“Which brings up the first big question, one that hasn’t seen much (if any) press: What birth control is provided for free? Can we cover the generic 100%, or if their doctor prescribes something new at $500 per month are we stuck covering that 100% as well? Remember, it’s not the insurance company getting stuck with the bill here.”
And at Slate, Matthew Yglesias offers the counterpoint:
“While birth control costs more than nothing, it costs less than an abortion and much less than having a baby. From a social point of view, unless we’re not going to subsidize consumption of health care services at all (which would be a really drastic change from the status quo) then it makes a ton of sense to heavily subsidize contraceptives… The unfortunate thing is that under the American setup the subsidies tend to be passed through the employer, which has set the stage for this controversy.”
Physicians are prescribing more than ever these days – and drugs have nothing to do with it. A new report from the Centers for Disease Contral and Prevention says that one-third of adults who saw a doctor or other health care professionals in 2010 were advised to exercise more.
According to WebMD, the number of patients being told to increase their physical activity as a way to maintain or improve their health has jumped significantly since 2000, when less than a quarter of consulations included such advice.
“Trends over the past 10 years suggest that the medical community is increasing its efforts to recommend participation in exercise and other physical activity that research has shown to be associated with substantial health benefits,” states the report, from the CDC’s National Center for Health Statistics.
Doctors most typically prescribe exercise to their overweight and obese patients. The report indicates that this increased emphasis is an important development, as patients tend to follow their doctor’s counsel – especially if the doctor follows up after the initial prescription.
On Thursday, the Department of Labor released the Final Regulations describing a plan sponsor’s responsibilities for preparing and distributing the 4-Page Summary of Benefits and Coverage (SBC). The template for the 4-Page (double-sided) Summary has not changed significantly from the earlier proposed regulations and the Final Regulations require compliance for plan years on or after September 23, 2012.
MedBen is in the process of reviewing the Final Regulations and will provide for its clients a summary of the requirements, but in the meantime, additional information can be found on the Department of Labor’s Employee Benefits Security Administration website:
Summary of Benefits and Coverage and Uniform Glossary
MedBen clients who have any immediate questions may contact MedBen Vice President of Compliance Caroline Fraker at (800) 851-0907.
In response to escalating criticism from political opponents and members of his own party, today President Obama has reversed the requirement that religiously-affilated employers provide birth control coverage to women.
The Washington Post reports that women who work for affliated non-profit schools, charities, universities, and hospitals will still be guaranteed free coverage for contraceptive services, but must get such coverage directly from their insurance companies. Churches remain exempt from the requirement, which means that their female employes cannot obtain separate contraceptive coverage.
“After many genuine concerns were raised over the last few weeks – and the more cynical desire to make this into political football – it became clear that spending months hammering out a solution was not an option; we had to move this faster,” Obama said during a conference earlier today.
A senior White House official, speaking to reporters about the revised rule, said that the change would have no cost impact on insurers, and could potentially save money by reducing unwanted pregnancies and other conditions that could be avoided by birth control.
The National Journal reports that health care spending increased just 4.4% from 2010 to 2011, among the slowest rate of growth in the past 50 years.
According to a report by the nonprofit Altarum Institute, the $2.70 trillion spending rise “represents an increase over the government’s official estimate of spending growth in 2010 (3.9%) that was released last month.”
As health spending makes up nearly one-fifth of the gross domestic product, any sign that growth is health spending is slowing is a positive development, Altrarum noted. The group also reported that this ranks as the third slowest rate of growth since national health expenditures have been tracked.
“The health spending share of gross domestic product was 18.1% in December 2011, up from 16.4% at the start of the recession (December 2007), but down slightly from the all-time high of 18.2% in June 2011,” the report reads. “Altarum’s data indicate that health care price inflation was only 2.1% for all of 2011, the lowest annual figure since 1998, when it stood at 2%.”
Remember all that talk a few years back about how bad trans fats are for you, and that food makers should cut back on them? Apparently, someone took it to heart (so to speak).
According to the New York Times, a new National Institutes of Health report says the level of trans fatty acids in white Americans’ bloodstreams decreased 58% from 2000 to 2009. Additionally, levels of LDL, or “bad” cholesterol, fell almost 10 units on average, while levels of HDL, or “good” cholesterol, rose over 6 units.
Trans fats have been linked to an elevelated risk of heart disease. The drop in their levels coincides with a concerted effort to remove them from fried, baked and packaged foods. Some major cities, including New York and Philadeplia, have also banned their use in restaurants.
In the study, researchers obtaimed blood samples from 521 Americans with an average age of 47. Participants were tested in 2000 and again in 2009.
A new study of physician honesty finds that doctors aren’t above the occasional fib, if they feel it serves the best interest of their patients – or themselves.
The Wall Street Journal Health Blog reports that the Health Affairs survey of 1,891 doctors nationwide revealed that more than half of respondents sugar-coated a patient’s prognosis at least once in the past year. And about 11% admitted that they told an outright lie to an adult patient or child’s guardian.
Respondents also fessed up about other medical transgressions. Over one-quarter said that they’d shared confidential patient information with an unauthorized persion, while nearly 20% reported not fully disclosing an error to a patient because they feared a lawsuit.
The study didn’t delve into specifics about why respondents lied, so it’s possible that there may be a good reason behind their actions. But “at the end of the day, patients need accurate information about their health” in order to make the best decisions about their care, says Lisa Iezzoni, an author of the study and director of the Mongan Institute for Health Policy at Massachusetts General Hospital.
Members of the MedBen Information Systems team worked diligently throughout 2011 to see that new Centers for Medicare & Medicaid Services guidelines for electronic transmission of administrative transactions were in place by the original December 31 deadline. And while the CMS deadline has been extended until March 30, we already have completed the computer coding necessary for seamless interactions with physicians, hospitals and other medical facilities.
HIPAA 5010 guidelines were created to ensure that health benefits administrators and providers use a common set of standards for the transmission of claims submissions, explanations of benefits (EOBs) and related transactions. By doing so, we make certain these processes maintain security and uniformity. Once final testing is completed, MedBen will be in full compliance with HIPAA 5010.
MedBen has made multiple system changes so electronic EOBs remain HIPAA-compliant – and these changes have the added benefit of providing greater accuracy and processing speed. For instance, a new “Primary Carrier” entry screen allows for more detailed coordination of benefits information on transmitted EOBs, which reduces the need for follow-up calls and letters. And “Splitting/Bundling” screens can automatically separate or combine treatment information when appropriate, so our providers receive a precise breakdown of how their claims were processed.
The Obama administration may attempt to find middle ground with Catholic universities and hospitals in regard to the controversial rule that health insurance plans must cover birth control, Reuters reports.
Speaking on MSNBC, presidental adviser David Axelrod said that religious institutions can use the 12-month grace period to find a solution that doesn’t violate Catholic Church doctrine. “We certainly don’t want to abridge anyone’s religious freedom so we’re going to look for a way to move forward that both guarantees women that basic preventive care that they need and respects the prerogatives of religious institutions,” Axelrod said.
The Catholic Church has expressed outrage against the rule, which was implemented to reduce unwanted pregnancies by giving more women access to birth control. Church officials say affiliated institutions will be forced to go against Church teachings.
And the backlash over the rule has extended beyond church members, The Hill reports. Presidential candidate Mitt Romney has launched a petition against the mandate, and conservative leaders have attacked the administration for the decision.
Even some Obama supporters have questioned the political wisdom of the birth control requirement. Left-leaning Washington Post columnist E.J. Dionne wrote that the administration “utterly botched” the issue and “threw his progressive Catholic allies under the bus.”
Overall drug costs in the U.S. will go up from 3% to 5% in 2012, according to the annual report from The American Journal of Health-System Pharmacy.
Entitled “Projecting Future Drug Expenditures,” the report analyzes trends for total drug expenditures as well as hospital an clinic sectors. Expenditures on clinic-administered drugs will increase by 5-7%, while hospital drug expenses are expected to rise no more than 2%.
The report notes that widely used drugs have experienced only moderate cost growth over the past several years, due in large part “to the ongoing introduction and wide use of generic versions of high-cost, frequently used medications.” Generic drugs currently account for over 3 out of 4 of all retail prescriptions dispensed.
Conversely, expenditures for specialized medicines have greatly increased as of late, especially for clinic-administered drugs.
Among the factors that will shape costs this year are drugs in development, distribution of new drugs, ongoing drug shortages, increased use of generics, and uncertainty about biosimilars (drugs that are copies of biological agents).
(Thanks to Drug Topics for the link.)
Apparently, Americans are just head over heels in love with salt. A new report from the Centers for Disease Contral and Prevention found that 90% of people ages 2 and older eat more than the recommended amount of sodium each day.
Of course, many of us don’t realize just how much salt we consume. That’s because most of our sodium intake doesn’t come from a salt shaker, or potato chips or popcorn. The biggest offender is white bread, which can contain as many as 230 milligrams of salt per slice.
According to MSNBC, the average American takes in about 3,300 milligrams of sodium per day, in addition to the salt you may shake on your food. The 2010 U.S. Dietary Guidelines recommend people limit the salt in their daily diet to 2,300 milligrams.
“Too much sodium raises blood pressure, which is a major risk factor for heart disease and stroke,” Dr. Thomas Frieden, director of the CDC, said in a statement. “These diseases kill more than 800,000 Americans each year, and contribute an estimated $273 billion in health care costs.”
The Obama administration had its say about the Affordable Care Act, and now the opposition has chimed in as well.
Reuters reports that 26 states and the National Federation of Independent Business have presented separate written briefs to the Supreme Court. They argue that “Congress overstepped its authority under the Constitution to regulate interstate commerce” by requiring most Americans to purchase health care coverage by 2014 or pay a penality.
“Forcing people into commerce does not regulate commerce. Otherwise, Congress could compel the purchase of any product,” attorneys for the independent business group said in the written brief.
Nor are the states aren’t buying the administration’s claim that health care reform will work acceptably without the individual mandate – if the requirement goes, they say, the entire law should be declared null and void.
Last month, the Obama administration filed its own brief with the high court. In it, Solicitor General Donald Verrilli defended the individual mandate as a necessary response to a national health care crisis.
Still on the fence about whether to switch from Lipitor to a new generic alternative? Here’s some thoughts from Anthony Komaroff, M.D., the Editor in Chief of Harvard Health Publications – a doctor who puts his medication money where his mouth is:
“[T]he generic version of Lipitor, called atorvastatin, is highly likely to be just as safe and effective as Lipitor, but also cheaper. And under most health insurance plans, that means cheaper for you, because of lower co-pays, not just for the insurance company.
generic drug contains the same chemical as the corresponding brand-name drug. The FDA is legally required to determine that generics are ‘bioequivalent’ to brand-name drugs, which means they produce similar blood concentrations of the same chemical…“So I can’t give you an absolute guarantee that generic atorvastatin will be equal to brand-name Lipitor. But I can tell you this: I take Lipitor, and I’ll be switching to generic atorvastatin, so I will be following my own advice (something my wife has suggested that I should do more often).”
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".