Tips For CDHP Roll-Outs
A few lessons have emerged for employers that plan to introduce a consumer-driven health plan in the near future. Ann Mond Johnson, president of Submimo, a Chicago-based firm that sells health care decision support systems and hospital evaluation tools, recommends starting employee communications early, understanding your company's goals and garnering support from higher ups.
"Visible executive support cannot be understated," she says. "People will follow those leaders. There seems to be sometimes a disconnect between the executive suite and the HR group." Additionally, she advises, "You need to decrease the noise and increase the value of what you say to employees."
Mistakes to avoid include rushing the implementation, focusing on cost alone and failing to analyze the options and costs to workers with specific examples before implementation, she adds.
Barbara Flitsch, senior consultant at Watson Wyatt, comments, "No amount of communication could fix" a poorly executed launch. Johnson agrees: "When you do it wrong, it can be expensive and difficult to recoup."
As an object lesson, Flitsch recalled one business that experienced problems after it introduced a consumer-driven health plan as the only option for workers, without anticipating employee resistance or using other strategies beyond consumerism to reduce health costs.
"Employees have a hard time assessing the risk and financial exposure" in consumer-driven health plans, Johnson observes, but online tools can help with that calculation.
Article written by BenefitNews - June 20, 2006
New Ranking Allows Doctors (and Brokers) To Measure Payer Performance
A new ranking of how well carriers pay physicians promises to improve the overall efficiency of the health care system while also giving brokers yet another tool to evaluate health offerings and anticipate employee frustrations.
Industry magazine Physicians Practice, and services provider Athena Health have partnered to create the PayerView index, which details how efficiently carriers reimburse physicians for their services.
Humana topped the first ranking of national payers with a score of 93%, followed by Medicare Part B (92.1%), United Health Group (87%), Aetna (86.6%), Cigna (86.5%), Champus/Tricare (86.3%) and Wellpoint (84.5%).
The ranking is comprised of seven data points, including things like first pass pay rate, days in accounts receivable, patient liability and denial rate, among others. Each is weighted according to its importance to the physician community.
For instance, first pass and days in A/R accounted for half of a payer's overall score. First pass pay rate, as described by Physicians Practice, is the ideal situation: physician submits claim, carrier pays claim.
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BenefitNews.com.
Wellness Pays As Health Costs Shift
Pedometers, workouts and wellness points are the topics of casual lunchtime conversations at the DuPage Credit Union in Naperville now that the company offers a consumer-directed health insurance plan that rewards employees for healthy behavior, the company said.
"I'm watching team members come together and really motivate one another to be more healthy individuals," said Lori Mecca McGrath, human resources manager. The wellness focus has been building since October 2004, when the credit union nixed the standard PPO plan it had offered for years in favor of a lesser-known, $1,000-deductible consumer-directed health plan with lower premiums and a health reimbursement arrangement to which the company contributes $600 per employee, she said. If workers don't spend the $600, it is theirs to keep, McGrath said.
"It gives you an impetus to pay a little more attention to your health care," McGrath said.
Article can be viewed in its entirety at
National Healthcare News.
Forever Young: Tips for Preserving Your Health
The numbers are astonishing. More than 60,000 people in the United States are over the age of 100, and there are enough people over the age of 110 for them to have their own term: supercentenariums.
What's the secret of their long lives? And, more importantly, are they exceptions to the rule? Perhaps, but maybe not. The fact is that we are living longer thanks to a combination of factors. According to the US Census, the number of people age 85 and over alone will more than double over the next 25 years. Further, it's estimated that there will be more than 800,000 people 100 and over by 2050.
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CareTalk.
Get Up and Get Moving
Since their bodies don't do it automatically, type 1 diabetics have to carefully control the level of glucose in their blood by watching their diet and taking insulin. Doctors have debated whether to encourage exercise, since physical activity might reduce blood sugar to potentially dangerous levels.
But a new study suggests that regular exercise actually helps kids control their blood sugar levels and doesn't put them at undue risk. The study, which appears in the June issue of Archives of Pediatrics and Adolescent Medicine, found that not only did the people who exercised more often have better control, but the girls also lost weight--important, since being overweight worsens diabetes.
Coauthor Antje Herbst, a pediatrician at the University of Bonn, says that while she would expect adult type 1 diabetics to see the same results, they may have circulatory or other issues that could make exercise harmful. If you're a type 1 diabetic, check with your doctor about how to incorporate exercise into your life.
Article published by U.S. News and World Report 6-19-06.
Companies Save Money With Online Health Tools
What makes some employers better than others at controlling health care costs? Offering their employees online tools to facilitate medical decisions, for one, according to Watson Wyatt and the National Business Group on Health. Companies that excel at reining in medical costs are 108% more likely than others to offer their employees comprehensive online resources, the joint survey of 585 companies finds.
It is not enough to provide tools that allow side-by-side comparisons of health insurance options, the survey shows. While 58% of those polled do supply such tools, the top cost-cutters carry this practice to a new level. They are 36% more likely to offer quality comparison tools and 36% more likely to provide tools that show the tax impact of health care decisions, such as signing up for a flexible spending account.
"Tools that allow employees to consider many facets of their health care can make a significant difference in the health care options employees choose," says Jeri Stepman, national leader for health and welfare administration at Watson Wyatt.
Article provided by BenefitNews, June 1, 2006.
Generic Spending On Rise At Drug Firm
The nation's largest pharmacy benefits manager announced Friday that it was distributing more generic drugs than brand-name counterparts, a sign that costly brand-name prescription medicines may be losing their grip on the market, leading to lower drug costs for consumers.
The trend is significant because even more generic prescription drugs are expected to hit the market in the near future. That could significantly reduce healthcare costs for some people, especially the elderly and those with chronic illnesses.
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Business News to read this article in its entirety.
Health Coaches Help One Employer Cut Medical Bills
Eastman Chemical Company significantly reduced its medical bills through a program that helps newly diagnosed patients weigh treatment options.
Medical decision support, provided by Consumer's Medical Resource, helps patients understand treatment options and choose what's best for them, unlike disease management, which typically helps with follow-ups and treatment compliance after treatment begins.
Eastman, based in Kingsport, Tenn., estimates that it saved $415,000 with the program last year. That means it saved $3.30 for every $1 it spent on the program, according to David Sensibaugh, director of integrated health.
Sensibaugh recalls, for example, one cancer patient who decided on laparoscopic surgery that was less invasive, cost less and provided a quicker return to work, compared to other treatments. Another patient with heart disease opted for a coronary stent insertion rather than open-heart surgery, with similar results.
Health coaching typically leads to 20% to 40% fewer surgeries, 20% to 30% fewer doctor visits and 20% to 30% fewer hospital admissions, according to Mary Jane Favazza, senior vice president of service delivery at Health Dialog. That could represent significant cost savings for employers and patients.
Article can be viewed in its entirety at
BenefitsNews.com.
Fiscal Fitness: Wellness Programs Helping Firms, Workers Shape Up
Juli Gomez always wanted a healthier lifestyle, but had a hard time getting motivated. Now, working out and eating healthier are putting money in her pocket.
Her employer, Sabre Holdings Corp., recently began offering $10 monthly discounts on health insurance premiums to employees who participate in the travel technology firm’s wellness program. There’s an extra $10-a-month discount if employees’ spouses participate.
To read more on Wellness programs, click on
Workers Shaping Up.
More Insurers Reimburse Doctors For Online Care
When Tamara McCartney's chronic sinusitis flared up this year, she knew she needed a prescription antibiotic.
But instead of a long drive to the doctor's office in St. Cloud, missing as much as a half-day of work, she spent less than 15 minutes at home completing an online questionnaire from her doctor. The next day, her Avelox prescription was waiting at a nearby pharmacy.
The online consultation with her physician cost her $40, an out-of-pocket fee she said was well worth it. Her next online consultation will cost far less, however: This month, her insurance company began reimbursing doctors in Florida and California for online consultations with patients.
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Orlando Sentinel.
Close Attention Needed on Rx Administration
It is important for businesses to understand which drugs are best dispensed by retail, mail and specialty pharmacies, according to research from the Scottsdale, Ariz.-based Pharmacy Benefit Management Institute.
Because of pricing discount differences, specialty pharmacy should not be used to dispense drugs that can be dispensed from mail-service pharmacies at a lower price. Drugs formerly dispensed by mail-service pharmacies are being shifted to specialty pharmacies, resulting in higher costs to plan sponsors, PBMI reports.
Article can be viewed it its entirety at
BenefitNews Connect.
Unexpected Benefits
More people will start companies, thanks to health savings accounts.
One of the White House's key health care goals for 2006 is to make health savings accounts more attractive. President Bush has asked Congress to raise the limit on how much money can be contributed to an HSA per year. He would also like to create a tax deduction for all out-of-pocket expenses paid via an HSA that is set up individually rather than through an employer. Furthermore, the Bush plan would let taxpayers write off insurance premiums for high-deductible plans that they obtain outside of a traditional employer-sponsored plan.
I think HSAs are a great innovation, and not simply because they provide employers with a way of buying cheaper coverage for their workers at a time when health care costs continue to rise. No, I like HSAs because I think they provide an aspiring entrepreneur with a health insurance cushion so that he or she feels more comfortable leaving a job that provides coverage in order to start a company.
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Inc. Magazine.
