Flying to Centers of Excellence

CNBC recently featured a story about Walmart and their history of not only suggesting that employees visit Centers of Excellence for surgeries and second opinions but flying them all expenses paid. The case study revealed that between 2015 and 2018, more than half of their employees suffering from spine pain were able to avoid surgery by seeking treatment at Mayo Clinic.

Shorter hospital stays, lower readmission rates, fewer episodes of postsurgical care and a faster return to work were other benefits gained when results were compared to patients who chose other hospitals for treatment. Walmart reported that even though they spent more per surgery at Mayo Clinic than what other hospitals were charging, they saved money because of better outcomes and surgeries that were avoided.

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Is Your Plan Examining the Value of Investment?

While many employemedical-moneyrs use health screenings and health risk assessments to detect medical conditions early on, some have a difficult time determining the value of these wellness-related measures. Some compare the costs of testing to an estimated cost of medical claims, but in an effort to determine a more accurate return on investment, others are taking factors such as reduced absenteeism and increased overall productivity into consideration. It makes sense since improving overall health and productivity really is the objective of wellness programs.

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Federal Judge Derails New Association Health Plans

As reported by The Phia Group on March 29, 2019, a federal judge in Washington, D.C. ruled that the new Department of Labor rules expanding the marketing of Association Health Plans (AHPs) violate existing law. TPAs, brokers and employers see this as a significant blow to AHPs, especially new self-funded AHPs that have been preparing to launch on April 1, 2019.

Federal Judge John Bates sided with several states that took issue with the DOL’s final rules several months ago, arguing that a broad availability of AHPs is not within the scope of ERISA, which defines an employer as having at least two or more employees. The final rules were going to allow small employers, including working business owners (employers of one), to join with others based on either common geography or industry affiliation to form an AHP. It appears that the Judge’s ruling means that both criteria, geography and industry affiliation, must be met and that qualifying employers must have a minimum of two employees.

Thus far, we are not aware of any response filed by the DOL. We will continue to monitor reactions to the ruling and other developments regarding Association Health Plans.

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First Step to Price Transparency a Confusing One

medical-moneyThe rule requiring hospitals to post their prices online, which became effective on January 1, 2019, really hasn’t done much to promote cost transparency. The problem is that the price lists, which payers refer to as chargemasters, break common procedures into complex, coded retail-priced components that mean little to the average consumer.

As an example, determining the cost of an ER visit would require knowing the codes and locating costs for all parts involved in the visit. Few people, if any, are familiar with these complex details. While giving consumers price information in an easy-to-understand format would be a big help, it appears that CMS Administrator Seema Verma was accurate when she described this as little more than a “critical first step”.

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Are You Washing Your Water Bottle?

Water may be the beverage of choice for health and wellness lovers, but using your reusable water bottle multiple days in a row without washing it and allowing it to dry completely can lead to bacterial growth and sickness. Infectious disease specialists recommend that, at a minimum, pouring water out of your reusable bottle at the end of each day will eliminate some germs. Getting rid of the bulk of bacteria and decreasing the likelihood of a stomach bug requires scrubbing the entire bottle, including the lid and straw and letting it air dry completely after each use. A bottle brush is good for tall bottles with thin necks and dish soap or a bleach-based cleanser labeled safe for drinkware is best.

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More Choose Veganuary

veganuaryWorldwide, 226,000 people have signed up with the British charity Veganuary, agreeing to try a vegan diet free of all animal products. While some try vegan for one or two meals per day, others have gone full scale. Some are doing it for environmental reasons while others are concerned about animal welfare and, of course, their health.

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Flexibility Means Retention

employer-planResearch reported by the Execu Search Group shows that flexibility may very well be the key to keeping millennials engaged. Allowing more vacation time, better training and a more flexible work schedule, including the ability to work at home when needed, are keys that will make young people happier and more productive. The SHRM says that more companies are offering these benefits in order to retain young workers in today’s competitive labor market.

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Group Exercise is Big

health-planThe College of Sports Medicine, in ranking fitness trends for 2019, concluded that millennials enjoy being part of a community that will cheer them on when they do a good job and perhaps push them a bit harder when they don’t. Other popular fitness trends include wearable technology, high intensity interval training (HIIT), yoga and more personalized exercise programs designed specifically for members of the baby boomer generation.

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More Value-Based Payments

stethescope for healthcareAccording to a public-private partnership launched by HHS, the percentage of U.S. healthcare payments tied to value-based care rose to 34% in 2017, a 23% increase since 2015. Fee-for-service Medicare data and data from 61 health plans and 3 fee-for-service Medicaid states with spending tied to shared savings, shared risk, population-based payments and bundled payments were examined in the analysis.

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Winning Against Pollen

It’s spring and with it comes the sneezing, itchy eyes and congestion that allergies can cause. Here are a few tips that can help you keep pollen from winning in and around your home.

Wash Away the Pollen – If you’ve been outside doing yard work, walking or doing most anything, take a shower as soon as possible when you come in for the day. If that timing doesn’t work for you, make sure you wash your hands immediately.

Remove Your Shoes – It might sound silly, but your shoes will carry all kinds of irritants from your trees, grass, weeds and dirt right into your home. Take them off as soon as you enter your house.

Close Your Windows and Doors – We all love to air out the house after a long winter but keeping windows and doors open is just the invitation pollen is waiting for. If you can’t resist fresh air, be especially careful from early to midmorning, at dusk and, of course, when it’s windy.

Don’t Hang Laundry Outdoors – You can bet that pollen will stick to sheets, pillow cases and towels, so it’s important that you wash your bedding every week and avoid outdoor drying.

Use HEPA Filters – High efficiency particulate air filters (HEPA) help trap allergens and other irritants before they flow throughout your home’s interior. While some can be effective for up to 2 years, the Institute of Environmental Science and Technology recommends changing HEPA filters every 6 months.

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