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02/08/12

  01:06:25 pm, by MedBen5   , 207 words,  
Categories: News, Wellness, Health Plan Management

Birth Control Mandate Spawns Backlash, Potential Compromise

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.”

  11:36:27 am, by MedBen5   , 171 words,  
Categories: News, Prescription

Pharmacy Group Predicts 3-5% Drug Cost Increase In 2012

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.)

  10:20:42 am, by MedBen5   , 173 words,  
Categories: News, Wellness

Most Americans Enjoy Salt Too Much

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.”

02/07/12

  05:02:16 pm, by MedBen5   , 165 words,  
Categories: News, Health Plan Management

Individual Mandate Foes Say Congress Overstepped Bounds

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.

  03:37:36 pm, by MedBen5   , 246 words,  
Categories: Prescription, Health Plan Management

Doctor Offers Personal Take On Lipitor Vs. Generic Question

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".

  03:17:24 pm, by MedBen5   , 200 words,  
Categories: News, Wellness

Studies Find Differences In How Doctors Follow Cancer Guidelines

Two new studies reveal serious inconsistencies in how doctors interpret cancer guidelines:

  • The Wall Street Journal Health Blog reports that, in a study of over 1,000 primary care doctors, 28.5% surveyed said that they “sometimes” or “almost always” offered or ordered ovarian cancer screenings for low-risk women. Such actions go against the advice of professional groups, which do not recommend routine screening of women with no symptoms.

    The United States Preventive Services Task Force and the American Congress of Obstetricians and Gynecologists have both concluded that the risks of ovarian cancer screenings (such as complications from unnecessary surgery) outweight the benefits, even for women with a high risk of the disease.

  • Guidelines for breast cancer surgeries also can vary widely by doctor, according to The New York Times. A study of women who received lumpectomies found that almost half had second operations that may not have been needed. Conversely, the data suggests that some women who might benefit from the surgey aren’t getting it.

    Additional lumpectomies are performed when pathology reports suggest that the initial operation failed to locate all cancer cells. But doctors interpret these reports differently – evidence of uncertainty that study author Dr. Laurence E. McCahill called “a shame.”

02/06/12

  05:07:59 pm, by MedBen5   , 257 words,  
Categories: Announcements, Health Plan Management

Partners Expands Community Health Network

As part of an ongoing effort to promote better health, Partners Community Health Plan is currently expanding its community health network. Local businesses, sharing a common dedication to consumer wellness, have generously agreed to provide discounts to Partners members.

Community health network merchants offer a variety of health-oriented products and services. Health clubs, nutritionists, masseuses, sporting goods stores, and even golf courses are among the area businesses that presently participate.

To receive the Partners discount from a participating business, members simply need to show their ID card at the time of purchase. In addition, the community health network is not exclusive to a particular area. Plan members are welcome to take advantage of discounts available in other areas that offer Partners.

MedBen, in conjunction with area hospitals, introduced Partners in 2010. The innovative plan design encourages members to visit local providers in order to receive the best benefits. In addition to the community health network, groups can realize further savings through such features as a worksite wellness program, free dental and vision screenings, and the best pharmacy discounts available.

Partners is currently offered in both fully-insured and self-funded versions, and is available in the following Ohio cities and surrounding areas: Cambridge, Coshocton, Marietta and Zanesville. The plan is also available in Murray, Kentucky and surrounding areas.

For additional information about Partners, contact a MedBen broker or call Vice President of Sales and Marketing Brian Fargus at (888) 627-8683. To see a list of participating community health network merchants in your area, visit the Partners website at www.partnerschp.com.

  04:10:54 pm, by MedBen5   , 207 words,  
Categories: News, Health Plan Management

House Votes To Repeal Long-Term Care Program

Last week, the House of Representatives voted 267-159 to repeal the Community Living Assistance Services and Support program, the Associated Press reports.

A provision of the Affordable Care Act, the program – known as the CLASS Act – was designed to provide affordable and voluntary long-term care insurance. However, in October, the Obama administration admitted that the program was financially unviable.

Individuals covered under CLASS would receive benefits of at least $50 a day should they require home health services or nursing home care. But government actuaries determined that the program would require a large number of healthy people to sign up in order to sustain it.

All 239 House Republicans present voted to remove the CLASS Act from the health care reform, in addition to 28 Democrats. The bill’s sponsor, Rep. Charles Boustany, R-La., said the administration finally has come to the conclusion “that we knew even before the bill passed, that this was unsustainable, it was unworkable, it was fatally flawed.”

But Rep. Henry Waxman, D-Calif., said the Republican goal was to “tear down and dismantle programs that provide health care in the United States.” He said “the solution is to amend the program to make it work, not just repeal it and leave nothing in its place.”

  03:16:54 pm, by MedBen5   , 249 words,  
Categories: News, Wellness

Adult Vaccines Up, But Numbers Still Lag

Many people have a serious aversion to getting a shot in the arm – or any other body part, for that matter. But a new report from the U.S. Centers for Disease Control and Prevention drives home the point (sorry) that other considerations should outweight the fear factor.

According to HealthDay News (via MedicineNet.com), the CDC found that about 45,000 Americans die from disease that could have been prevented by vaccine. And while the number of people getting some vaccines has risen slightly, overall numbers remain low.

In 2010, the usage rate of three vaccines – tetanus, diphtheria, and Tdap (to guard against whooping cough) – went up 1.6%, to 8.2%. Increases were also seen in the use of the shingles vaccine among whites aged 60 and older, and in the cervical cancer vaccine human papillomavirus (HPV) among women aged 19-26.

In contrast, among high-risk adults aged 19 to 64, just 18.5% received a vaccine that safeguards against pneumonia. And the adult vaccination rates for hepatitis A and B remained more or less unchanged from 2009.

Vaccine rates likely remain low because awareness is low as well, noted Dr. Carolyn B. Bridges, associate director of adult immunization at the CDC and co-author of the report: “There is not enough information about which vaccines are needed for adults and unlike children, who have regularly scheduled doctors’ visits for vaccines, this is not the case for adults.” She adds that vaccine schedules for adults are based on not just age, but on personal risk and occupation as well.

02/03/12

  04:26:18 pm, by MedBen5   , 230 words,  
Categories: News, Wellness

Scientists Sour On Sugar-Sweetened Foods

Does sugar need to come with a warning label, just like cigarettes? Well, maybe things aren’t that drastic, but a new commentary published in Nature calls for much greater regulation of sugar-sweetened foods.

According to The Wall Street Journal Health Blog, the authors of the piece – all scientists at the University of California – say that taxes, zoning ordinances and even age limits for buying sugary sodas should receive serious consideration by the federal government. Such measures, they stress, would not apply to fruit or other foods with naturally occurring fructose.

While sugar doesn’t receive the same level of disapproval as saturated fat or salt, the authors argue that it’s more than just empty calories, Overconsumption of fructose contributes to hypertension and diabetes, and is a leading factor in the rise in obesity over the past several decades.

Naturally, the Sugar Association begs to differ. In a response on its website, the industry group calls the authors arguments “flawed", noting that while people consume more calories per day than we did 40 years ago, caloric sweeters account for only a small fraction of those extra calories.

“We consider it irresponsible when health professionals use their platforms to instill fear by using words like ‘diabetes,’ ‘cancer,’ and even ‘death,’ without so much as one disclaimer about the fact that the incomplete science being referenced is inconclusive at best,” the association says.

02/01/12

  05:11:22 pm, by MedBen5   , 229 words,  
Categories: News, Wellness

Obese Doctors Less Likely To Talk Weight With Obese Patients

Do you need professional help with your weight problem? Well, if your family doctor also happens to be battling the bulge, you may want to consider getting your counseling elsewhere. WebMD reports doctors of normal weight are more likely to offer advice on diet and exercise that one who is overweight or obese.

A survey of 500 primary care physicians found that doctors who have a normal body mass index were more likely to discuss weight loss issues, compared to overweight and obese physicians (30% to 18%, respectively). Additionally, doctors of normal weight were much more likely to diagnose someone as obese if they thought a person’s BMI equalled or exceeded their own, and were more confident that patients would follow their advice.

Exactly why heavier doctors may be reluctant to discuss weight issues is not fully understood. One possibility is that an overweight doctor won’t recommend eating less and exercise more when that same approach didn’t work for him or her. “They may not want to give advice that is not effective in their own minds,” says researcher Sara Bleich, PhD of the Johns Hopkins Bloomberg School. She adds that heavyset doctors are more likely to suggest weight loss pills.

Another possible explanation: “They are used to seeing overweight and obese patients who look like they do and doctors may think, ‘I am OK and so are they,’” Bleich says.

  11:56:55 am, by MedBen5   , 195 words,  
Categories: Health Plan Management

High-Risk Pools Not Affected By Unlimited Coverage Rule

The Affordable Care Act no longer allows health insurers to set lifetime maximums on coverage. But the change doesn’t apply to people in high-risk insurance pools – sicker individuals who would benefit most from unlimited access to medical funds.

NPR reports that unlike commercial health plans, most state high-risk pools for people with pre-existing conditions aren’t licensed as insurance issuers, and therefore the provision eliminating lifetime limits doesn’t apply to them. About 45,000 people are currently enrolled in the pools, in addition to more than 200,000 who joined state pools that were in place prior to the enactment of the health care reform legislation in 2010.

The article notes that some state plans – specifically, the 23 run by the federal government – do not cap their high-risk plans, even though they’re under no obligation to offer unlimited coverage. And other states have kept the coverage limits, but bumped up the maximum amount.

Preexisting-condition insurance plans serve as a stopgap until 2014, when insurers must charge all consumers the same cost for coverage regardless of their condition. However, if the Supreme Court strikes the individual mandate from the ACA, the same-premium provision likely would also be dropped from the law.

01/31/12

  11:54:03 am, by MedBen5   , 269 words,  
Categories: Prescription

The Fine Art Of Pharmaceutical "Disease Mongering"

Since the Food and Drug Adminstration approved direct-to-consumer pharmaceutical advertising in 1997, drug manufacturers have worked overtime to promote name recognition to potential customers. One proven strategy used in this pursuit: the checklist.

The New York Times recently examined the phenomenon of “disease mongering", in which a marketing team devises a list of symptoms that a specific medication can treat – symptoms defined broadly enough to make consumers think they may suffer from the condition. The checklists are then placed on websites, on downloadable apps and in pamphlets in doctors’ offices. And patients who diagnose their ailments in this manner associate the drug as an effective cure.

From the Well Blog:

“The makers of Yaz, a birth control pill, for example, used a checklist to help promote the use of their drug as a treatment for premenstrual dysphoric disorder, a controversial diagnosis said to affect up to 10 percent of women. Alongside links to articles on fashion, makeup, hair and celebrity news, Yaz’s Web site offered a ‘Body Diary’ checklist to help patients determine whether they suffer from the disorder.

“Taking its cues from the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., which mental health professionals use to diagnose disease, the checklist offered watered-down and potentially more inclusive descriptions. A symptom described in the D.S.M. as “persistent and marked anger or irritability or increased interpersonal conflicts” appeared in the Yaz questionnaire as “Felt angry, or irritable.” … The printable results that patients could then take to their doctors (the site has since been taken down) were on a form emblazoned with the birth control brand.”

  10:48:22 am, by MedBen5   , 219 words,  
Categories: News, Health Plan Management

People Divided On Reform Legislation, But Like Key Elements

A new Harris Interactive/HealthDay survey reveals that key provisions of the Affordable Care Act are increasingly finding favor with most Americans.

HealthDay News (via MedicineNet.com) reports that people remain sharply divided over the overall legislation, mainly along partisan lines – most Democrats support it, while most Republicans want it repealed. But major elements of the bill have gained in popularity, including:

  • allowing children to stay on their parents’ insurance plans until they turn 26 – 57% in January 2012 vs. 55% in November 2010.
  • preventing insurance companies from denying coverage to those already sick – 71% vs. 64%.
  • creating insurance exchanges where people can shop for insurance – 59% vs. 51%.
  • providing tax credits to small businesses to help pay for their employees’ insurance – 70% vs. 60%.
  • requiring all employers with 50 or more employees to offer insurance to their employees or pay a penalty – 53% vs. 48%.
  • requiring research to measure the effectiveness of different treatments – 53% vs. 44%.
  • creating a new Independent Payment Advisory Board to limit the growth of Medicare spending – 38% vs. 32%.

One provision that has the masses have definitely not embraced is the individual mandate – only 19% of those polled support requiring most Americans to buy health insurance or pay a tax penalty.

The poll also found that 55% of respondents believe that health care reform should be addressed at the state level, rather than federally.

  10:04:00 am, by MedBen5   , 186 words,  
Categories: News, Wellness

Calories Trump Fat, Carbs And Protein, Diet Study Suggests

Dieting need not come down to how much fat, carbs or protein you consume – calories are what counts, says a new scientific study.

According to Reuters, researchers randomly assigned several hundred overweight or obese people to one of four diets: average protein, low fat and higher carbs; high protein, low fat, and higher carbs; average protein, high fat and lower carbs; or high protein, high fat and lower carbs. Each of the diets was designed to eliminate 750 calories a day from the people’s energy needs.

After six months, researchers found that participants had lost over nine pounds of fat and nearly five pounds of lean mass. A two-year follow-up revealed that, on average, people maintained a weight loss of eight pounds. But across-the-board losses were similar regardless of what diet was assigned.

“If you’re happier doing it low fat, or happier doing it low carb, this paper says it’s OK to do it either way. They were equally successful,” said Christopher Gardner, a Stanford University professor who was not involved in the study. Finding a diet you can stick with is more important, he added.

01/30/12

  05:39:02 pm, by MedBen5   , 190 words,  
Categories: News, Wellness, Health Plan Management

U.S. Cancer Screenings Remain Below Target Levels

If you’ve put off a cancer screening, you’re not only doing yourself a disservice – you’re also disappointing your friends in the federal government.

According to WebMD, a new Centers for Disease Control and Prevention report says that screening rates for breast, cervical, and colorectal cancer remain below target levels set by federal officials in the Healthy People 2020 initiative:

  • About 75% of eligible women received mammograms over the past decade. The Healthy People target rate is 81%.
  • Cervical cancer screenings have remained consistent of late, with about 80% of women having Pap tests – but still below the 93% goal.
  • While colorectal cancer screenings are up from previous studies, only 59% of men and women got tested in 2010. That’s well short of the 70% target screening rate for both sexes.

The federal government doesn’t set target numbers for prostate cancer, so those sceening rates weren’t included.

At MedBen, we encourage all adults to get their age-appropriate cancer tests. A reminder for our Worksite Wellness members: you can monitor you compliance critical wellness examinations, including all four cancer screenings mentioned above, by visiting the MedBen Access website and clicking on the Wellness Plan link under “My Plan”.

  04:45:42 pm, by MedBen5   , 257 words,  
Categories: News, Health Plan Management

President -- And A Candidate -- Weigh In On Individual Mandate

Two health care reform news notes to begin the week:

  • Reuters reports that the Obama administration has presented a written brief to the Supreme Court, which argues that even if the individual mandate is found unconstitutional, almost all the rest of the Affordable Care Act can still function properly.

    “Many provisions of the act, focused on controlling costs, improving public health and other objectives, have no connection to insurance coverage at all,” Solicitor General Donald Verrilli wrote in the brief. Only the provisions that bar insurers from rejecting an applicant because of pre-existing conditions, and from charging higher premiums based on a person’s medical history, would have to be removed from the law.

  • If the administration’s attorneys hadn’t already thought up a valid justification for the individual mandate, they got one this weekend from a surprising source: Republican presidential nominee Mitt Romney.

    NPR reports that at a GOP debate in Jacksonville, Florida, Romney defended the introduction of a 2006 Massachusetts law which required most state residents to buy health insurance or pay a tax penality. Romney was governor at the time the law was passed.

    “If you don’t want to buy insurance, then you have to help pay for the cost of the state picking up your bill, because under federal law if someone doesn’t have insurance, then we have to care for them in the hospitals, give them free care,” said Romney. “So we said, no more, no more free riders. We are insisting on personal responsibility. Either get the insurance or help pay for your care.”

  12:19:17 pm, by MedBen5   , 134 words,  
Categories: News, Prescription, Wellness

FDA Approves First Once-Weekly Diabetes Drug

The third time’s the charm for the diabetes drug Bydureon. MedPage Today reports that the Food and Drug Administation has approved the once-weekly injection for type 2 diabetes – the first such treatment to get the green light.

Drugmakers Amylin and Alkermes submitted Bydureon (exenatide extended-release) for FDA review in 2009, but approval was twice delayed due to questons about the manufacturing process and a possible cardiovascular side effect. The agency did make approval contingent upon the drugmakers putting together a strategy to address concerns over acute pancreatitis and potential risk of thyroid cancer.

Common side effects of Bydureon include nausea, diarrhea, upper respiratory tract infection, and injection site nodules. But earlier trials showed that the drug promotes weight loss rather than gain, and shows better glycemic control than with the once-daily version of exenatide (Byetta).

  11:14:31 am, by MedBen5   , 159 words,  
Categories: News, Health Plan Management

Referrals To Specialists Almost Doubled In Last Decade

Specialists lately have experienced a boom in referral business. The New York Times reports that doctors decided to send their patients to specialists and other doctors 9.3% of the time, compared with 4.8% a decade earlier, according to a new Harvard Medical School study.

“This evolution in care patterns may be playing a role in the rising trajectory of health care spending in the U.S., as referrals to specialists may lead to increased use of higher-cost services,” the researchers said. They add that while sometimes the referrals lead to necessary treatments, in other cases the additional tests and procedures do little to benefit patients.

How to explain this trend? “Medicine is becoming increasingly technologically sophisticated,” as the number of specialists and subspecialists has risen, said study co-author Dr. Bruce E. Landon. But he also atrributes it to the “tyranny of the 15-minute visit,” as primary care physicians have less time and resources to delve into any potentially complicated medical condition.

01/27/12

  05:41:01 pm, by MedBen5   , 278 words,  
Categories: Wellness, Health Plan Management

Cost, Complexity Among Reasons For Cancer Care Need

MedBen recently introduced comprehensive care management through Accountable Care Solutions (ACS). These programs were designed by medical professionals to control expenses for three costly and pervasive chronic conditions: Cardiovascular, Kidney Care and Oncology, or cancer care.

In a recent e-newsletter, inVentiv Medical Management, MedBen’s ACS partner, highlighted three reasons why cancer care management is so important:

  • Rising Costs: Double what it was 20 years ago, the cost of treating cancer is expected to rise by at least 27% in the next 10 years. With an estimated 1.5 million+ new cancer cases diagnosed last year (NiH 2010 study) and with costs for cancer care nearing $367 billion, competent and appropriate cancer care management has never been more vital.
  • Innovations Fuel Complexity: Cancer care is evolving thanks to research and development, and patients and providers want access to the best care. Yet the complexity of the more than 300 cancer types and frequent innovations in treatment require continuous education and understanding of the risks and benefits of care decisions. Therefore, cancer treatment benefits from expert, balanced medical management to promote cost effective, safe, and integrated care to patients.
  • Lack of Evidence Based Care: Depending on the type of cancer, initial diagnoses are incorrect up to 70% of the time. Further, up to 36% of care is not evidence-based. As such, outcomes are historically inconsistent and include issues of safety, such as adverse events that trigger hospitalizations and ER visits.

Comprehensive Oncology Care Management begins at the time of diagnosis and prior to therapy. ACS provides care resources during therapy to empower patients and caregivers, and provides claims surveillance to realize cost savings after therapy.

To learn more, contact MedBen Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

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