Ask An Expert: All About Group Health Insurance Plans

Posted by:  :  Category: Medicare

Insurance Plan of the City of Portage La Prairie, Man. June 1959, 56 (1959)  by Manitoba Historical MapsTony was here in February discussing individual health insurance plans. Today (with help from his colleague Ken Whitley), he’ll be offering his expertise on employer-group insurance plans, including how the Affordable Care Act ("ObamaCare") will affect your company’s plan and possibly even your organization itself. Ken has been marketing group health insurance plans exclusively for over 30 years, and is one of the most knowledgable group health insurance brokers in the U.S. Have questions for them? They’re here for the next hour—ask away!
Source: lifehacker.com

Video: Know the different types of LIfe Insurance policies before you buy!

Coverage Problems Could Still Remain For Young Adults

Despite such requirements, some coverage isn’t assured. For example, employers in the large-group market don’t have to cover the essential health benefits. Young women enrolled in such plans might find themselves without maternity coverage if they become pregnant. The Pregnancy Discrimination Act of 1978 requires employers with 15 or more workers that offer insurance to cover maternity care. But the law doesn’t cover dependent children. Dan Priga, who heads the performance audit group at human resources consultant Mercer, estimated that roughly 70 percent of self-funded employers who pay their workers’ claims directly don’t offer maternity coverage for dependent children. 
Source: kaiserhealthnews.org

StudentSecure, International Student Health Insurance Plans Revamped for 2013

The StudentSecure plan, underwritten by Lloyds of London, provides comprehensive inpatient and outpatient medical coverage up to $ 200,000 (Smart plan), $ 250,000 (Budget plan) or $ 300,000 (Select plan), in addition to maternity coverage, prescription drug coverage, repatriation, and emergency evacuation and reunion. With an A (Excellent) rating by AM Best and an A+ (Strong) rating by Standard and Poors, students can rest assured that they have a financially stable, high quality plan that both meets and exceeds all insurance requirements laid out by the US State Department and most colleges and universities.
Source: nicaraguastudyabroad.org

Explaining Health Care Reform: Questions About Health Insurance Exchanges

The Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, made broad changes to the way health insurance will be provided and paid for in the United States. PPACA created a new mechanism for purchasing coverage called Exchanges, which are entities that will be set up in states to create a more organized and competitive market for health insurance by offering a choice of health plans, establishing common rules regarding the offering and pricing of insurance, and providing information to help consumers better understand the options available to them. Initially Exchanges will serve primarily individuals purchasing insurance on their own and smaller employers; states will have the option of opening Exchanges to larger employers a few years after implementation.
Source: kff.org

Oregon gets first peek at health insurance market

The oregonhealthrates.org website provides the filings by the individual carriers and a comparison of certain requested rates in the individual and small business market, broken down by region. The rate comparison shows identical standard-benefit plans rated bronze, silver or gold for their level of benefits for small businesses, as well as individual non-smokers aged 21, 40 and 60.
Source: spokesman.com

OPINION: industry pushes high

Even in 2008, the last year I worked for an insurance company, my colleagues in the sales division were encouraging employers to go “total replacement,” which means eliminating all choices except high-deductible plans. Insurers have long used proprietary “studies” supposedly proving that making people pay more out of pocket for medical care will “incentivize” them to lead healthier lives.
Source: publicintegrity.org

New website can help citizens learn more about the Kentucky Health Benefit Exchange

“Starting today, we are undertaking a major education and awareness campaign to ensure that all uninsured Kentuckians understand how kynect can help them and their families find affordable health coverage,” said CHFS Secretary Audrey Tayse Haynes. “In the coming months, kynect staff will be attending community events, adding more information to our website, and opening up a toll-free hotline. We want everyone to know a healthier future for Kentucky is on the way and where to go to apply when open enrollment arrives.”  
Source: kyforward.com

Insurance Plan Options for ASC Staff: 3 Plans to Consider

“Most ASCs offer at least two options for their employees,” says John Merski Jr., executive director of human resources at MedHQ. “If a company is offering just a single healthcare option, they are limiting options for their employees. The two options at minimum should be the low- and high-deductible plans. That will help their employees be more informed consumers in the future.” Here are the pros and cons of each option, and what employees should consider when they are deciding on each. 1. Low deductible PPO plans. The more traditional low deductible PPO plans are ideal for employees who may have large medical expenses and need a high amount of coverage throughout the year. “Those that have children, families or who are sickly tend to take the PPO offerings because they have a lower deductible,” says Mr. Merski. “It costs more in the premium, but the deductible is lower and they can plan accordingly. However, if the employer pays the same amount for both plans and the out-of-pocket payroll deduction is the same, everyone will take the low-deductible plan.” Those with modest to few health issues who are just looking to cover annual check-ups will likely benefit more from high-deductible plans. 2. High deductible health savings accounts. The more common high deductible plan today is health savings accounts, which allow the employee to set money aside in their own account and withdraw funds when necessary. Usually, these accounts are closer to $1,500 to $5,000 individual deductible level plans. “If you have young healthy employees, a lot of the groups will choose HSA plans because they don’t visit the doctor as much,” says Mr. Merski. “They can stockpile money for the time when they do get ill. These plans also keep costs under control to some extent.” HSAs transfer savings from year to year as the funds accumulate. The high deductible plans have lower rates because the employer takes on more risk. 3. Self-insured plans. Most ambulatory surgery centers will not have self-insured plans because they don’t have the volume of employees necessary to mitigate risk. A self-insured plan is usually for companies with populations in excess of 75 or more employees. “If you have a very high risk employee population that has a considerable amount of healthcare issues, going to a self-insured plan generally don’t make it,” says Mr. Merski. “The expense would be enormous and the resource limitations would place considerable burden on the  ASC. They should consider the fully insured plans instead because they are mixing with larger groups and the insurance company is taking some of the risk.” Self-insured plans are usually cheaper than fully-insured plans because the employer doesn’t have to share risk with insurance companies; on the other hand, the liability does pose other risks for their employees under the self insured plans and most ASCs choose not to use resources in this way. More Articles on Surgery Centers: 61 ASC Management & Development Company CEOs to Know 7 Ways ASCs Can Increase Profits Quickly Without Additional Overhead 7 Steps for a Smoothly-Run Multispecialty ASC
Source: beckersasc.com

Japan’s Largest Life Insurance Plans And Other Flows

Japanese investors have been persistent sellers of foreign bonds this year, according to the weekly MOF data. They have been net sellers in all but three weeks this year. The most recent selling streak is for five weeks through April 12, during which they have sold JPY2.56 trillion (~$25.6 bln). Unlike their foreign counterparts, Japanese currency trading on margin (similar to futures) have been reducing their short yen wagers (from about JPY7.6 trillion in March to about JPY3.3 trillion more recently.
Source: seekingalpha.com

Telemedicine gets increasingly popular with insurance plans

Cigna joins other big name insurers such as United Healthcare, WellPoint, and Aetna in offering telehealth amenities to their customers, even as thousands of Medicare beneficiaries cope with losing access to the budding service. “Congress has long overlooked the need for telemedicine services for residents of urban counties, despite the fact that they often suffer similar problems accessing healthcare. Now, because of a statistical quirk, even more people will lose coverage of these services, reducing access and care,” said Jonathan Linkous, CEO of the American Telemedicine Association in response to the redrawing of county maps that changed the definition of rural and urban areas. “Medicare should cover remote health services for all beneficiaries, regardless of location,” Linkour urged. “We call on Congress to ensure that existing beneficiaries will not lose coverage for these services.”
Source: premlo.com

Report: Private Medicare Advantage Plans Make Progress in Combating Chronic Disease

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524Since its start in 2003, Medicare Advantage has gained popularity because of its high quality, coordinated benefits and patient-centeredness.  Its central role for private health plans makes MA extremely popular with seniors.  The best practices of these plans should be integrated into conventional Medicare.  That’s the only hope if Medicare is to contain its costs without sacrificing quality and care in the process.
Source: hlc.org

Video: What Is Medicare Advantage?

What is Medicare Advantage (Part C)?

Health Maintenance Organizations (HMO): Provide access to a range of doctors and hospital insurance through a flat monthly rate with no deductibles. HMO plans have the strictest network guidelines, meaning all visits and prescriptions are subject to the plan’s approval. Going outside the established network of doctors, labs, hospitals, and pharmacies will result in a higher cost to the beneficiary. When enrolling in an HMO, the beneficiary must select a primary care physician who must approve all referrals to specialists.
Source: ehealthmedicare.com

UnitedHealth Issues Warning Over Medicare Advantage Cuts

Kaiser Health News: Capsules: Despite Win, UnitedHealth Criticizes Medicare Rates, Eyes Pruning Business If the Obama administration expected the biggest health insurance company to give thanks for this month’s decision to reverse cuts to private Medicare plans, it was wrong. UnitedHealth Group CEO Stephen Hemsley said Thursday that Medicare Advantage rates are still far too low and that the company may shrink its business of managing care for seniors. … But in Thursday’s call to discuss the company’s quarterly profits of $2.1 billion on revenue of $30.3 billion, Hemsley said other changes — including the Affordable Care Act’s long-term reduction in Medicare Advantage payments – would still lead to a net reduction next year of more than 4 percent. That’s inadequate when medical costs are rising in the 3 percent neighborhood, he said” (Hancock, 4/19).
Source: kaiserhealthnews.org

Population Health Management In Medicare Advantage

Wellnesss promotion.  A key component of PHM is the ability to promote health and wellness among all individuals, and MAOs reported extensive activities directly for members, including smoking cessation, wellness discounts, and the promotion of healthy lifestyles (exercise and nutrition).  In addition to promoting wellness, PHM requires monitoring of population risk and designing and implementing programs that manage sub-populations based on their risk.  Health risk assessments used universally by MAOs serve to segment populations at risk for disease.  For patients identified as being at risk for chronic conditions, common interventions include targeted health education or outreach to engage members in activities intended to reduce risk factors, enrollment in care management programs, and working with nurses in health education.
Source: healthaffairs.org

Medicare advantage costs often exceed traditional Medicare costs

Using newly available government data, Marsha Gold, a senior fellow with Mathematica Policy Research, found that risk-adjusted MA plan costs in 2009 were, on average, 4 percent higher than those for traditional Medicare. Among plan types, only health maintenance organizations (HMOs) had lower average costs, while costs for more than 75 percent of local preferred provider organizations (PPOs) and private fee-for service plans exceeded traditional Medicare’s. According to Gold, the wide variation in MA plan costs relative to traditional Medicare suggests there is room for many of these plans to deliver care more efficiently and keeps costs down.
Source: wordpress.com

Medicare Advantage: Providing Quality Care to More than 14 Million Beneficiaries

Medicare Advantage plans are a valuable resource in protecting beneficiaries from unpredictable out-of-pocket costs. In 2012, all Medicare Advantage plans offered an out-of-pocket maximum limit for beneficiary costs, and about 78 percent of Medicare Advantage enrollees are in plans that have annual out-of-pocket maximums of $5,000 or less. These out-of-pocket maximums – which are not offered by the Medicare FFS program – help protect Medicare beneficiaries from catastrophic health care expenses that otherwise might pose a serious threat to their financial security.  Medicare Advantage plans also help reduce out-of-pocket costs for enrollees by reducing premiums for Part B and Part D, and by limiting cost-sharing for Medicare-covered services, including primary care physician visits and inpatient hospital stays.
Source: ahipcoverage.com

Medicare Advantage – or DISAdvantage?

During the debate on health care reform, the Congressional Budget Office estimated those overpayments would cost the government $157 billion over the coming decade. As a consequence of these overpayments, according to CMS, premiums for all Medicare beneficiaries, including those enrolled in traditional Medicare, are higher than they otherwise would be. That’s more than just an annoyance: the Medicare Hospital Insurance Trust Fund will become insolvent 18 months earlier than it would otherwise because of those overpayments, according to Congressional testimony by CMS’ chief actuary. That’s why, despite intense lobbying by the insurance industry, Congress inserted a provision in the Affordable Care Act to eventually phase out those overpayments.
Source: wendellpotter.com

The Medicare Advantage Disenrollment Period Explained

It’s important to note that this time is not an additional enrollment period, which means that you cannot enroll in Medicare Advantage or switch between Medicare Advantage options. However, if you are planning to disenroll from Medicare Advantage, you may use this opportunity to enroll in a Medicare Supplement policy upon returning to Original Medicare. Any other changes to your Medicare plans must wait until the next valid Part D election period
Source: bradeninsurance.com

Seniors should tell Obama to prevent Medicare Advantage cuts

When President Obama signed the Affordable Care Act into law, he simultaneously authorized $200 billion in cuts to the Medicare Advantage program. At the time, the Congressional Budget Office projected that the health care reform law’s cuts would result in three million fewer Medicare Advantage enrollees. Moreover, actuaries at Oliver Wyman predicted that the cost of the health insurance tax would mean an additional $3,500 in out-of-pocket expenses for seniors over the next 10 years.
Source: dailycaller.com

Financial Success: Medigap & Medicare Advantage Plans

All Things Human by Patrice Passidomo, M.D. Amateur Palate Restaurant Reviews Animal Ark Rescue Arts and Entertainmet Arts Calendar by Carol Kantor Arts on the Lake Bits of Inspiration Brewster Theater Company Delaney’s Dugout Financial Success by Kurt Schlesinger Happy Reading by Christine O’Neill Heart of the Matter: Pawling Real Estate by Todd Kesseman Intern and Student Contributors In The Shade by Thomas D Kersting Kitty Korner Living Landscape Journal by Pete Muroski Local Business Local Interest Meteorologist Mike Shustak’s Forecast Mizzentop Music Reviews by Zach Silva Our Town by Susan Stone Pawling Fire Department Pawling Garden Club Pawling Parents Pawling Public Library Pawling Public Radio Pawling School Sports Peace of Mind by Dr. Jeremy Stone Reflections on a Silver Screen by Ben Rendich Sherman Chamber Ensemble Spice: The Final Frontier by Lisa Kelsey The Art of the Brew by Mark Klinger The Computer Guy by Mike Pepper The Five Facets of Mom by Stephanie Nevins The Pawling High School Insider The Pet Professor by Mary Jean Calvi, LVT The Puppy Pad The Whole Tooth and Nothing But The Tooth by Dr. Thomas Bloom This Side of the Law Towne Crier Trinity Pawling Uncategorized Vegan Delights by Carole Baral What’s New by Susan Stone
Source: wpengine.com

When it’s Time to Drop Your Medicare Advantage Plan

Currently, Medicare Advantage sellers are engaged in heavy marketing due to the MA open enrollment period that ends on December 7th. The ads don’t say much but give enough clues to tip you off that you must ask lots of questions and dig deep to find out what you’re getting. A solicitation I received from UnitedHealthcare touted the plan’s zero monthly premium, zero copay for a primary care doctor’s visit, zero medical deductible and zero prescription drug deductible. A closer look revealed that the copays for expensive drugs were steep—$95 for non-preferred brand drugs and 33 percent of the cost for a specialty drug. Then came the fine print warning: “Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co/insurance may change on January 1 of each year.”
Source: openplacement.com

Insurers: Cuts to Medicare Advantage will hit poor, minorities

“Medicare Advantage is a lifeline for millions of low-income and minority Medicare beneficiaries who rely on the high-quality coverage and innovative programs and services these plans provide,” AHIP President and CEO Karen Ignagni said in a statement.
Source: thehill.com

Texans rally to expand Medicaid

Posted by:  :  Category: Medicare

Beneath Highway 90 bridge, Richmond, Texas 1018091117BW by Patrick FellerAccording to Bob Kafka, of Adapt Texas, the action demonstrated the importance of Medicaid for millions of people living in the state. Participants aimed to send two huge messages to lawmakers, he said:  First, current Medicaid programs desperately need additional funding, and second, future programs need expansion in order to offer more opportunities to individuals who don’t make the cut to be eligible for Medicaid but still can’t afford private healthcare.
Source: peoplesworld.org

Video: Texas Rejects Obamacare’s Medicaid Expansion, Won’t Set Up Own Exchange

Texas and Medicaid Hypocrisy

Kolkhorst also touts Texas’ plan to use a Medicaid “waiver” to provide Federally Qualified Health Clinics (FQHCs) around the state. A Medicaid waiver is essentially a grant to implement some temporary health program for the Medicaid population in lieu of regular Medicaid. Not only are those clinics literally socialized medicine, but after the federal deficit spending glut is over, Texans will be left to pay the bill.
Source: freedomworks.org

Expanding Medicaid in Texas is good for business. Here’s why.

As board chair of the Oak Cliff Chamber of Commerce, I know that my fellow business owners believe that healthy workers are necessary for sustained economic development, not only in Oak Cliff but in the entire state. Sustainable economic development will create more health care jobs and resources into our health care system, which means fewer uninsured workers that burden employers and taxpayers alike.
Source: dallasnews.com

Renegade nuns join activists for Medicaid rally at Texas capitol

The Nuns on the Bus, a touring group of activist Catholic nuns, arrived at the Texas state capitol in Austin, Texas on Wednesday, to demonstrate alongside more than 400 others who support the expansion of Medicaid in that state to help the poor. According to the Associated Press, the purpose of the rally was to urge lawmakers to pass a state law that would add more than 1 million working poor people to the Medicaid rolls.
Source: rawstory.com

Bill on Texas Solution to Medicaid Expansion Moves Forward

“Private insurance is more expensive than Medicaid, so if you have your entire Medicaid expansion population on private insurance and you’re also paying for wrap-around Medicaid benefits, you’re going to end up with a much larger state share once the federal dollars begin to drop off,” Davidson said.
Source: kutnews.org

Tell Texas to Expand Medicaid to Millions

I’ve always been proud to be a native Texan; I spent my formative years in the sunny suburbs of Houston, cheering on the greatest second baseman of all time, and trying not to run my bike into the bayous. I spent my college years in booming Austin, where I swam in Barton Springs, and saw more live shows than some people do in a lifetime. It’s easy to see why Texas is the greatest state in the nation. We gave you Willie Nelson, Tex-Mex, and Beyoncé.
Source: younginvincibles.org

Texas almost opens the door to Obamacare Medicaid exchanges

The amendment said that if the state were to negotiate with the Obama administration to expand eligibility, it must reach a deal that reduces uncompensated care costs, promotes the use of private insurance plans and health savings accounts, and establishes wellness, cost-sharing and pay-for-performance initiatives. It also called for creating customized benefit plans for different Medicaid populations. The Legislative Budget Board would have been charged with determining whether such a deal addresses those reforms.
Source: teapartypatriots.org

Rick Perry: White House holding states ‘hostage’ with Medicaid expansion

Perry’s comments are a direct rejection of a recent movement among Republican governors in support of Medicaid expansion. Those governors have argued that expansion would provide an economic windfall for their states, offer basic health coverage to the most vulnerable and prop up struggling hospitals.
Source: politico.com

As Texas starts to pivot on Medicaid expansion, “no” looks more like “maybe”

The downside is higher prices for providers, but the feds are paying all the costs for the first three years. There’s still much negotiating to do, and one analyst said that Wall Street is assuming that Texas won’t reverse course. If Texas were to opt in, wrote Sheryl Skolnick of CRT Capital Group, there’s a powerful upside for four publicly traded hospital companies, including Dallas-based Tenet Healthcare Corp.
Source: dallasnews.com

Explaining Health Care Reform: Questions About Health Insurance Exchanges

Posted by:  :  Category: Medicare

Maryland Health Insurance Plan Federal Press Announcement by MDGovpicsThe Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, made broad changes to the way health insurance will be provided and paid for in the United States. PPACA created a new mechanism for purchasing coverage called Exchanges, which are entities that will be set up in states to create a more organized and competitive market for health insurance by offering a choice of health plans, establishing common rules regarding the offering and pricing of insurance, and providing information to help consumers better understand the options available to them. Initially Exchanges will serve primarily individuals purchasing insurance on their own and smaller employers; states will have the option of opening Exchanges to larger employers a few years after implementation.
Source: kff.org

Video: Obama’s Health Plan In 4 Minutes

Ask An Expert: All About Group Health Insurance Plans

Tony was here in February discussing individual health insurance plans. Today (with help from his colleague Ken Whitley), he’ll be offering his expertise on employer-group insurance plans, including how the Affordable Care Act ("ObamaCare") will affect your company’s plan and possibly even your organization itself. Ken has been marketing group health insurance plans exclusively for over 30 years, and is one of the most knowledgable group health insurance brokers in the U.S. Have questions for them? They’re here for the next hour—ask away!
Source: lifehacker.com

Coverage Problems Could Still Remain For Young Adults

Despite such requirements, some coverage isn’t assured. For example, employers in the large-group market don’t have to cover the essential health benefits. Young women enrolled in such plans might find themselves without maternity coverage if they become pregnant. The Pregnancy Discrimination Act of 1978 requires employers with 15 or more workers that offer insurance to cover maternity care. But the law doesn’t cover dependent children. Dan Priga, who heads the performance audit group at human resources consultant Mercer, estimated that roughly 70 percent of self-funded employers who pay their workers’ claims directly don’t offer maternity coverage for dependent children. 
Source: kaiserhealthnews.org

Changes in Health Care Moms Need to Know About (VIDEO)

I am happy about the age change to keep your child on the plan. But most happy about the unlimited lifetime amounts. I have previously worked for an insurance company and I have seen too many people max out their lifetime benefits in one bad accident. Or in the tragic case of a baby born with major medical issues and transplants were needed. The 2 million max the policy had was gone before the childs 1st birthday. 
Source: cafemom.com

With a Mother’s Day peg, Obama defends health care law against ‘misinformation’

Distorted Keynesian theory??? Keynes was pretty much right on on everything that’s happened to the world since 2009 (minus the lack of observable deflation); it’s those stupid supply-siders, monetarists, and “free market” thinkers who’ve been dead wrong. But that’s for another time; austerity isn’t measured by amounts; it’s measured by policy. You cut spending: you’re engaging in austerity. The main reason we had an economic boom in that period was because of the dramatic increase in economic production and employment necessitated by the United States’ involvement in World War I; in 1920, the boom fell apart after wartime inflation forced us back to the gold standard. And the period that followed (1923-1929) was not a “major economic boom”; it was a bubble, pure and simple. The stock market expanded rapidly as demand increased due to expansions in credit among America’s working classes, who purchased cars, radios, and telephones at rates that dazzled contemporaries. Problem was, this “boom” led to a dramatic increase in production that eventually surpassed demand (a situation known as “overproduction”). This, and the combination of an unregulated stock market unprepared for a worldwide depression (most previous depressions had been regional) led to a dramatic crash in late 1929 and a surge in deflation, hurting borrowers and thus depressing demand. Production became unprofitable, businesses laid off workers in droves, and unemployment across the industrialized world touched 25%. This malaise almost destroyed the entire concept of capitalism; the 1930s was replete with authoritarian leaders seizing power in the name of restoring prosperity and left-wing socialists campaigning for an end to the dictatorship of the bourgeois and demanding global revolution. Had the United States not turned to Keynesian stimulus via the New Deal to turn the tide of the Depression, our political system could have fared the way of factional France or Nazi Germany. The New Deal, while insufficient to eliminate the depression entirely, led to a recovery that salvaged American pride and faith in their civic institutions and paved the way for the robust recovery during World War II (another example of Keynesian stimulus). The period between 1919 and 1929 was an unsustainable bubble that almost destroyed the very fabric of modern society; how any modern person can reject the lessons of the Great Depression and hail the “Roaring Twenties” as a Golden Age lost to the ideals of the statist devil himself (Keynes, who ironically considered himself a moderate conservative) is beyond my limited understand. Those people (and not us lefties) are a threat to the gene pool, to paraphrase your beloved Tea Party advocate Allen West.
Source: nbcnews.com

StudentSecure, International Student Health Insurance Plans Revamped for 2013

The StudentSecure plan, underwritten by Lloyds of London, provides comprehensive inpatient and outpatient medical coverage up to $ 200,000 (Smart plan), $ 250,000 (Budget plan) or $ 300,000 (Select plan), in addition to maternity coverage, prescription drug coverage, repatriation, and emergency evacuation and reunion. With an A (Excellent) rating by AM Best and an A+ (Strong) rating by Standard and Poors, students can rest assured that they have a financially stable, high quality plan that both meets and exceeds all insurance requirements laid out by the US State Department and most colleges and universities.
Source: nicaraguastudyabroad.org

Expert: Premiums for Individual Health Plans in Exchange Will Be High

The President and Democrats made it clear that their preference is single payer, govt. run healthcare. No surprise there, because that further binds people to government dependency, and the govt. can abuse funds as they do with those of medicare, medicaid and social security. The ACA mandates penalize employers and insurance companies, forcing them to accept unsound business models and restrict employment. This will drive more and more people towards the exchanges. The govt. is spending millions drawing people into the exchanges, most of whom will be subsidizing, and has developed a taxpayer-backed “public option” to compete with private insurers. It doesn’t take a conspiracy theorist to work out what’s happning here. The Administration is out to destroy private health insurance companies and undermine employer provided insurance benefits, which will leave only the government to pick up the pieces. Unchecked, this country will have European style national health within 10 years
Source: californiahealthline.org

Health Insurance Exchanges Will Make Medical Coverage Easier to Find and Afford

"AARP fought to ensure the new health law would prevent insurance companies from pricing older Americans out of affordable coverage and denying people because of preexisting conditions," says Ariel Gonzalez, AARP’s director of health and family advocacy. "Now we’re working to ensure the new health marketplace is transparent and provides older Americans quality and affordable choices."
Source: aarp.org

Healthcare Solutions Team – The Health Insurance Agency You Can Trust

Healthcare Solutions Team also ensures you will not get rejected, so that regardless of your social condition you will get the insurance you need. Whether you are on a tight budget or not, you will be accepted and there will be no medical questions asked. With their help you can get benefits like accidental medical insurance and prescription among many others. In addition to this, the company provides you with hospital negotiation services, and with their help, you’re sure to get discounts in the event that you are hospitalized.
Source: blogowpis.pl

Does health insurance pay for a gym membership?

Aetna offers gym membership discounts with most of its plans, says Ethan Slavin, a communications officer at Aetna. This year, Aetna also launched a fitness reimbursement program, which is open to a number of employer-sponsored health care plans. In addition to gym memberships, plan members can receive reimbursement for purchasing at-home exercise equipment, group classes and wellness counseling. Employers are able to customize the program and decide how much money their employees are eligible to be reimbursed for their fitness-related expenses.
Source: insurancequotes.com

Chancellor announces return to Berkeley

Student leaders from the Associated Students of the University of California (ASUC), the Graduate Assembly, the campus Committee on Student Fees and the Student Health Advisory Committee felt strongly that it was in the best interests of UC Berkeley students to leave UC SHIP and return to a Berkeley-based plan. Although there are many possible advantages in a system-wide plan, there also are features in our health coverage which are best optimized campus by campus. The advantages of having a Berkeley-specific student health-insurance plan have been made to me very forcefully in a letter (PDF) from the ASUC and Graduate Assembly, and this letter helped me reach this decision.
Source: berkeley.edu

Obamacare’s Health Insurance Premium Nightmare

Posted by:  :  Category: Medicare

House Republican Press Conference on Health Care Reform by House GOP LeaderObamacare limits variation in premium costs to a ratio of 3 to 1 based on age. But as Heritage research shows, “The natural variation by age in medical costs is about 5 to 1—meaning that the oldest group of (non-Medicare) adults normally consumes about five times as much medical care as the youngest group.” This means that under Obamacare, young adults will pay significantly higher premiums than they would have prior to Obamacare, and older adults will pay only slightly lower premiums.
Source: heritageaction.com

Video: How to Take Health Insurance Premiums Off Taxes : All About Taxes

Schumer: Yeah, health insurance premiums are going up partially because of ObamaCare; Update: Er, that’s not what I meant…

While the debate over Obama’s health care law isn’t a life-or-death battle, health care affects voter livelihood (and their voting decisions) like few other issues do. And there are clear signs that if premiums go up, businesses are forced to change how they insure their employees, and implementation of the law is uneven, the potential for political consequences are significant. In the 2010 midterms, Democrats suffered a historic landslide when the debate over health care was abstract. The stakes could be even higher when voters have first-hand experience with its effects.
Source: hotair.com

Don't Get Sick: Obama's Health Insurance Premiums are Going Through the Roof

Perhaps the severest impact will be among employers who can’t afford Obama’s higher health insurance prices. Last year, a Congressional Budget Office and the Joint Committee on Taxation report suggested that about three to five million fewer people each year will be able to obtain employer-provided health insurance in the years to come.
Source: townhall.com

Health Insurance Premium Subsidies: How Far Will They Go?

3rd Party Studies ACOs Admin Costs affordability Age Rating Cadillac Tax Delivery System Reform Employers Essential Benefits Exchanges GRP Health Insurance Tax Health Plan Innovations Health Plan Satisfaction House hearings House legislation KI MA Medical Prices Medical Tests medicare medigap MLR Morning Headlines Patient Safety premiums Profits Provider Consolidation Quality Rate Review Reform RZ Senate hearings Senate legislation Small Business The Link Vilification Waste Fraud and Abuse
Source: ahipcoverage.com

Expert: Premiums for Individual Health Plans in Exchange Will Be High

The President and Democrats made it clear that their preference is single payer, govt. run healthcare. No surprise there, because that further binds people to government dependency, and the govt. can abuse funds as they do with those of medicare, medicaid and social security. The ACA mandates penalize employers and insurance companies, forcing them to accept unsound business models and restrict employment. This will drive more and more people towards the exchanges. The govt. is spending millions drawing people into the exchanges, most of whom will be subsidizing, and has developed a taxpayer-backed “public option” to compete with private insurers. It doesn’t take a conspiracy theorist to work out what’s happning here. The Administration is out to destroy private health insurance companies and undermine employer provided insurance benefits, which will leave only the government to pick up the pieces. Unchecked, this country will have European style national health within 10 years
Source: californiahealthline.org

Bill would let Oregon bargain for better health insurance premiums

Oregon’s health insurance exchange is being set up in response to federal health reforms. Called Cover Oregon, it will allow consumers and small businesses to shop between plans and qualify for tax credits. Currently, to sell on the exchange, insurers must submit plans to the Oregon Insurance Division to be reviewed for compliance with state and federal law.
Source: oregonlive.com

Will my health care costs go up under Obamacare?

In the past, buying an individual health plan has been costly, sometimes costing more than a thousand dollars per month. Women and anyone with a preexisting medical condition often end up paying the highest premiums. Starting on Oct. 1, 2013, Americans can shop for coverage on a health insurance exchange and compare prices. The exchanges will monitor premium increases and can exclude an insurer if its annual premium increase is too high (each state decides what increases it will permit). Starting on Jan. 1, 2014, insurers won’t be allowed to deny coverage or charge someone a higher rate because of gender or preexisting conditions.
Source: insurancequotes.com

Insurance Quotes: A Explanation of Medicare Part A

Posted by:  :  Category: Medicare

CorettaScottKing_WinonaBartonBallentine3 by Mark TribePart A of Medicare covers qualified inpatient care that is received in a hospital. Medicare Part A will also pay for limited skilled nursing facility care, as well as for some types of home health care and hospice services. The coverage provided through Medicare Part A provides the following: Hospital – Coverage includes the fees of a semi-private room as an inpatient at a hospital, nursing services, and certain other medical supplies and equipment and hospital services. All services are paid for 100% after the insured has paid a out of pocket deductible of $1,184. Blood – Part A of Medicare covers 100% of the cost of blood transfusions after the first three pints are paid for by the insured. Skilled Nursing Facility Care – The Skilled nursing facility benefits are provided by Part A includes the cost of a room (semi-private), and the meals for the insured. Medicare Part A also provides coverage of skilled nursing and rehabilitative services, and many other medically necessary skilled nursing facility services and supplies. Medicare doesn’t cover long term nursing facility stays, and coverage ceases after a 20 day limit. Home Health Care Services – Home health services are totally covered by Medicare Part A and/or Medicare part B but are limited to reasonable and medically required part-time or intermittent home health aide services, physical therapy, occupational therapy, and speech-language pathology that is ordered by a physician and is provided by a Medicare approved home health agency. Medicare will fund up to 100% of all medically required home healthcare costs Hospice Care – Part A of Medicare will cover many medications that are used for symptom control and relief of pain in a hospice care situations. It may cover most medical and support services from a Medicare certified hospice agency. Medicare will cover up to 95% of the cost of hospice care services. What is not covered by Medicare Part A Coverage? Even though Medicare Part A covers numerous health care expenses, there are still many holes in the coverage. For example, Part A does not offer coverage for private duty nursing. Also, Medicare Part A does not provide coverage for inpatient mental health care in a psychiatric hospital for more than 190 days in an insured’s lifetime. Medicare Part A will also not cover long-term care that is considered to be “custodial” or basic in nature, meaning that assistance with basic daily living activities such as dressing and bathing are not covered unless they are part of skilled care services. While Medicare may not cover all of your needs completely, Medicare supplement plans are available for purchase to help cover the cost of other health care services you might require. Are Medicare Part A Benefits Calculated? Medicare Part A tabulates its coverage in terms of benefit periods and reserve days. A benefit period is considered beginning on the day that a Medicare Part A insured enters the hospital. The insured’s benefit period will cease when the enrolled has been released from the hospital for at least 60 consecutive days. Other than hospice care benefits, a Medicare Part A provides unlimited benefit periods. How do I Qualify for Medicare Part A? An individual who is suffering from end state renal disease and who requires kidney dialysis or a kidney transplant will also be considered as eligible to enroll in Medicare Part A. How to Enroll in Part A of Medicare If a person is not all ready enrolled, they can enroll in Medicare Part A through their local Social Security office. All other Medicare Part A enrollees must submit an application of enrollment during an “open enrollment” period. Can You Enroll in Medicare Part A If You Have Other Health Insurance Coverage? If a person has other health insurance, they can also receive Medicare Part A. The primary insurance provider will usually pay the claim up to its coverage limits. Then, the secondary insurance provider will make a payment on the amount that the primary insurer did not pay, if any. An example, if a insured filed a claim through their primary health insurance carrier and the claim is not paid in a timely manner, the provider may bill Medicare. What is the cost for Medicare Part A? Most people enrolling in Medicare Part A do not pay a monthly premium. This is the situation if an individual and/or their spouse paid Medicare taxes while they were working. However, if, an individual is not eligible for zero premium Medicare Part A, they may be able to buy this coverage if they meet one of the following conditions: They are over age 65, are entitled to or are enrolling in Medicare Part B, and they meet United States residency or citizenship requirements They are under the age of 65 and disabled and their no premium Medicare Part A coverage ended because the individual has returned to their job. If a person plans to buy Medicare Part B, they must also be enrolled in Medicare Part A.
Source: blogspot.com

Video: Medicare Quotes

Advantages of Medicare Supplement Quotes

Medicare supplement insurance will be highly expensive to get. This insurance is very essential and is mandatory for all. People will have to spend a lot to obtain this supplement insurance as most of them do not have a complete understanding about the supplements. Getting a Medicare supplement quote is very simple but analyzing the same is a very difficult task.
Source: scriptitcs.com

Study: Cuts to Medicare trim costs to insurers

Chapin White, a senior health researcher at the Center for Studying Health System Change, analyzed data on payment rates from 1995-2009 and found a widening gap between Medicare rates and private rates. Medicare had an average annual growth rate of 3 percent while private insurance grew more quickly — at 3.56 percent — he found.
Source: politico.com

Medicare Supplement Quote

Medicare coverage is a great option for seniors looking for good healthcare options. The problem is that there are sometimes gaps that need filling. That is where Medicare Supplement plans, or Medigap plans, come into play. Offered by private insurance agencies for the purpose of filling inevitable gaps in Medicare, this kind of policy is needed to pay the share of healthcare costs that are not covered by Medicare Advantage alone. Having a combination of these two plans is perfect for getting the best coverage. Of course, there are different Supplement plans, so you must obtain more than one Medicare Supplement quote to get the best deal possible.
Source: allabout101.com

Medicare ‘Doc Fix’ Hostage To Fiscal Cliff Negotiations

Posted by:  :  Category: Medicare

Medscape: Obama’s Fiscal-Cliff Plan Said To Repeal SGR President Barack Obama’s latest plan to save the nation from the fiscal cliff includes a repeal of Medicare’s sustainable growth rate (SGR) formula that otherwise will trigger a 26.5% cut in physician reimbursement on January 1, according to a source familiar with negotiations between Congress and the White House. The Medicare rate reduction is part of the automatic spending cuts and tax increases dubbed the “fiscal cliff” that take effect in January. … The SGR crisis, a yearly event for physicians over the past decade, is a fiscal-cliff sideshow. Most of the jawboning between Obama, Senate Democrats who rule that chamber, and House Speaker John Boehner (R-OH), has been over the expiration of the Bush-era tax cuts, which will raise everyone’s rates (Lowes, 12/19).
Source: kaiserhealthnews.org

Video: Fiscal Cliff: What Is At Stake For Medicare And Medicaid?

Congress passes on chance to fix Medicare doctor pay

4. My girlfriend is in med school and I can attest to how much work goes into it. Four years of med school, three years of residency (4 for surgery) and then 3-5 for a fellowship if the person so chooses to subspecialize. They take 3 board exams, 1 after 2nd year, 1 during 4th year and 1 during residency. They also recertify every 10 years for their specialty. However, their testing is no more comprehensive than a lawyers (believe me, I’ve watched and listened to my girlfriend study). They merely get tested on a set number of things for their boards that don’t encompass all of medicine for each exam. These are also only like 4 hour exams. To clue you into what a NY attorney must do I’ll explain: (1) We must take the MPRE which is an ethics exam which is 60 multiple choice questions (not really difficult but the questions are intentionally tricky and often not straight forward) within 3 years of taking the bar exam; (2) The bar exam consists of approximately 2 days made up of four three and a half hour parts (That’s 14 hours total). These parts are 50 multiple choice and 6 essays based on 27 different areas of NY State law. The second day is 200 multiple choice questions based on Federal and Common law. See, I had to memorize 3 entirely separate systems of law and be able to regurgitate that knowledge on command. Doctors do not do anything near that. My girlfriend (who is at the top of her class and has scored in the top 3% of the nation on her boards) has never written an essay. Doctor’s strictly memorize and get tested by answering multiple choice questions. There’s very little “analysis.” In fact, I’m often shocked by how little they teach doctors to analyze issues. They seldom teach doctors basic medical things, mostly concentrating on obscure diseases that one hundredth of one percent of people would ever get. In terms of training, yeah the residency is “training” just like when someone gets hired for a job, they get “on the job training.” In fact, after the 1 year internship, a doctor can open their own practice.
Source: nbcnews.com

Congress Passes Bill to Avoid “Fiscal Cliff,” With Medicare Doc Fix, Other Medicare/Medicaid Extensions

The legislation requires CMS, for services furnished on or after January 1, 2014, to adjust payments relating to the end stage renal disease (ESRD) bundled payment rate to reflect changes in utilization of certain drugs and biologicals. In making reductions, CMS must take into account the most recently available data on average sales prices and changes in prices for drugs and biological reflected in the ESRD market basket percentage increase factor. The legislation also delays until January 1, 2016, implementation of oral-only ESRD-related drugs in the ESRD prospective payment system. HHS also must conduct an analysis by January 1, 2016, of the case mix payment adjustments relating to ESRD bundled payments, and make appropriate revisions to such case mix payment adjustments. The Government Accountability Office (GAO), no later than December 31, 2015, must prepare a report to Congress on how HHS has addressed implementation of payments for oral-only ESRD-related drugs in the bundled ESRD prospective payment system.
Source: wolterskluwerlb.com

Will House Republicans Successfully Repeal the Medicare “Doc Fix” Law?

The 16-year-old “sustainable growth rate” (SGR) provision calls for reductions in doctor pay as a way to control spending by Medicare. Congress has prevented the SGR from taking effect through temporary measures, but that has run up the fiscal and political costs of finding a permanent solution.
Source: medicarewire.com

Happy Anniversary, Health Care Reform 

Posted by:  :  Category: Medicare

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[1]  Health Care Reform consists of two separate laws, the Patient Protection and Affordability Care Act of 2010 (PPACA), Pub.L. 111-148  (March 23, 2010),  and the Health Care and Education Reconciliation Act of 2010 (HCERA), Pub. L. 111-152 (March 30, 2010).  The laws often are collectively referred to as the Affordable Care Act (ACA). [2] "The Employment Situation." Economic News Release. U.S. Bureau of Labor Statistics, http://www.bls.gov/news.release/empsit.nr0.htm. [3] For a comparison of the various deficit reduction proposals, see, Kaiser Family Foundation, Comparison of Medicare Provisions in Deficit Reduction Proposals  (January 2011), http://www.kff.org/medicare/upload/8124.pdf. [4] "Preliminary Analysis of the President’s Budget for 2012," March 18, 2011, http://www.cbo.gov/doc.cfm?index=12103. [5] Even before enactment of health care reform, experts argued that lowering spending growth in Medicare is only possible if lower spending growth is reflected in the private sector. Gail Wilensky, "The Challenge of Medicare," in Restoring Fiscal Sanity 2007: The Health Spending Challenge, Brookings Institution Press, 2007. [6] Congressional Budget Office, H.R. 2, Repealing the Job-Killing Health Care Law Act. Feb 18, 2011, available at: http://www.cbo.gov/doc.cfm?index=12069 [7] "2010 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds," August 5, 2010, https://www.cms.gov/ReportsTrustFunds/downloads/tr2010.pdf. [8] PPACA §§ 3601, 3602. [9] Douglas W. Elmendorf, Director, Congressional Budget Office, Letter to the Honorable Paul D. Ryan, November 17, 2010, http://www.cbo.gov/ftpdocs/119xx/doc11966/11-17-Rivlin-Ryan_Preliminary_Analysis.pdf; Paul N. Van de Water, Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs To States And Beneficiaries(Center on Budget and Policy Priorities, March 17, 2011), http://www.cbpp.org/cms/index.cfm?fa=view&id=3429. [10] Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs to States and Beneficiaries, supra. [11] Ibid. [12] PPACA §§ 3203,3301, 3315 4103, 4104, HCERA § 1101,amending 42 U.S.C. §§1395l(a)(1),  1395w-22(a)(1)(B); and adding  42 U.S.C. §1395w-114A. [13] Alice Rivlin and Paul Ryan, A Long-Term Plan for Medicare and Medicaid, November 17, 2010, available at http://paulryan.house.gov/UploadedFiles/rivlinryan.pdf [14] Medicare Payment Advisory Committee, Report to the Congress:  Medicare Payment Policy, Chapter 8 (March 2011) http://www.medpac.gov/documents/Mar11_EntireReport.pdf. [15] Report of the National Commission on Fiscal Responsibility and Reform, The Moment of Truth, December 2010. [16] Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs to States and Beneficiaries, supra. [17] PPACA §§ 3308, 3402, amending 42 U.S.C. §§ 1395r(i), 1395w-113(a). [18] Center for American Progress, "Higher Tolls on the Roadmap", February 15, 2011, available at http://www.americanprogress.org/issues/2011/02/ryan_roadmap.html. [19] HCERA §§ 1102, amending 42 U.S.C. §1395w-23. [20] PPACA, §§ 6401-6411, HCERA § 1304. [21] Congressional Budget Office, H.R. 2, Repealing the Job-Killing Health Care Law Act, supra. [22] PPACA §§ 3001-3015. [23] PPACA §§ 3021, 3022, adding 42 U.S.C §§ 1315a, 1395jjj. [24] PPACA § 2602, adding 42 U.S.C. § 1315b. [25]  PPACA §§ 3302, 3303,amending 42 U.S.C. §§ 1395w-114(a),(b). [26] Edwin Park, Matt Broaddus, Medicaid Block Grant Would Shift Financial Risks and Costs to States, (Center for Budget and Policy Priorities, February 23, 2011) http://www.cbpp.org/cms/index.cfm?fa=view&id=3409.
Source: medicareadvocacy.org

Video: Understanding Healthcare Costs: Medicare Advantage

Why is Medicare shutting down one of the most effective health

We think of the hospital as a place people go to get better. At Health Quality Partners, the view is that a hospital is a place where seniors get worse. “Being in the hospital for three days or five days sets them back to a point where they'll never regain what they were,” says Sherry Marcantonio, chief program architect of HQP. “That's where the scales tip. That's where people end up needing a nursing home.” Keeping seniors out of the hospital, which is a core focus of its program, cuts costs and saves lives, but it also preserves quality of life — a measure often ignored in these discussions. There's a good argument to be made that if a program like HQP cost slightly more than traditional Medicare but cut hospitalizations by a third, it would still be worth it. The point of health care, after all, is to keep people healthy. But HQP saves money — and lots of it.
Source: bangordailynews.com

Boehner, McConnell block their own Medicare goals

In terms of fiscal goals, both parties want roughly the same thing: a more stable fiscal future for health care costs, especially for seniors. Democrats see value in IPAB, and there's ample reason to believe this is a responsible approach. Republicans, meanwhile, argue that Medicare should be eliminated, and replaced with a voucher program in which seniors effectively bring a coupon to the private insurance marketplace. This, too, would lower costs by shifting the financial burden from Medicare to financially vulnerable families.
Source: msnbc.com

HEALTHCARE: Medicare Provider Charge Data

The data provided here include hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for the top 100 most frequently billed discharges, paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG) for Fiscal Year (FY) 2011. These DRGs represent almost 7 million discharges or 60 percent of total Medicare IPPS discharges.
Source: wordpress.com

Fact Check:Will Increased Longevity Bring Down Medicare?

The customary formulation of this myth is that Medicare is doomed by its own success in keeping its beneficiaries alive. Not only will the ranks of the program's beneficiaries increase as the vaunted baby boom generation reaches the statutory age of eligibility, but because people are staying alive longer, Medicare's costs will explode. The first part of this contention is indisputably true: entitlement to Medicare occurs when a person reaches age sixty-five, and the baby boom generation that is generally calibrated as starting in 1946 has arrived at that threshold. As a result, additional Medicare beneficiaries enter that program every day, and because the baby boom generation dwarfs any preceding age cohort, it is highly likely that more beneficiaries will be added to the program than are lost as older beneficiaries pass away. Consequently, the number of Medicare beneficiaries will inexorably increase over the next decade or so. Ceteris paribus, more beneficiaries mean higher aggregate costs.
Source: thehealthcareblog.com

More Home Health Care Medicare Fraud Convictions Reported by The Washington Examiner

* A health care clinic director and psychologist pled guilty Tuesday to charges of Medicare fraud for submitting claims as a personal provider while the clinic she worked for billed Medicare for the same expenses, the Department of Justice said. Alina Feas was aware that the health provider she worked for, the now-defunct Health Care Solutions Network, paid illegal kickbacks in exchange for patient information used to submit false Medicare claims. Feas even signed therapy notes and medical records for services she and HCSN never provided. Of the fifteen people charged with participating in the scheme, 13 have pled guilty.
Source: homecaredaily.com

Jury Finds Tuomey Healthcare Submitted $39M in Illegal Medicare Kickbacks

A jury has ruled that Sumter, S.C.-based Tuomey Healthcare System submitted $39 million worth of illegal bills to Medicare through kickbacks to 19 specialists, according to a Thomson Reuters report. The decision stems from a whistleblower lawsuit, which alleged that from 2005 through 2006, Tuomey improperly compensated 19 specialists to discourage them from referring lucrative patients to competing hospitals or physicians, according to the report. The health system's contracts with physicians included non-compete clauses that prevented referring physicians from competing with the hospital for 12 years and established the hospital would be responsible for billing all third-party players, including Medicare and Medicaid, the court found. Tuomey had argued that when creating contracts with its physicians, it relied on guidance from CMS, according to the report. The 10-person jury sided with the government last week, finding Tuomey submitted a total of 21,730 Medicare claims that were illegal due to the compensation arrangements. Tuomey has 28 days to file an appeal in the case.
Source: beckershospitalreview.com

The Federales' Open Data Policy and the Medicare Hospital Chargemaster Data Dump

The data on hospital charges for the one hundred most common codes on the Medicare hospital claims database released to great fanfare this week is just that -- data. Since neither Medicare nor any other payor actually pays hospitals based on those charges, the many many news stories (here's one or two f''rinstance) about the differences in charges from one hospital to another (the hospital responses to the accusatory questions about high charges are all of the Lake Wobegone variety ... their patients are all, well, above average) gloss over the fact that what we have here is data, but no useful information. Payment amounts are included as well, but Medicare fee schedules with local modifiers are published annually, so this is new presentation of data that's already out there.
Source: healthworkscollective.com

The Real Cost of Health Care for Patients and Physicians

To dig further into CodeView data, let's compare rates for a cardiology imaging procedure known as a Myocardial Perfusion SPECT. (Note: If you'd like to follow along using CodeView, you will have to change the specialty you're viewing to ‘Cardiology,' or use this direct link. According to our data, Medicare says a doctor is typically owed between $489 and $531 for this procedure, depending on the region of the country where it was performed. Medicaid rates vary by state, but we typically see that they are 50-90% of Medicare rates; this particular procedure falls on the lower end of that range, as Medicaid payers typically allow between $206 and $294 for this procedure.
Source: athenahealth.com

Medicare Advantage Fact Sheet

Posted by:  :  Category: Medicare

Since 2006, Medicare has paid plans under a bidding process.  Plans submit “bids” based on estimated costs per enrollee for services covered under Medicare Parts A and B; all bids that meet the necessary requirements are accepted.  The bids are compared to benchmark amounts that are set by a formula established in statute and vary by county (or region in the case of regional PPOs).  The benchmarks are the maximum amount Medicare will pay a plan in a given area. If a plan’s bid is higher than the benchmark, enrollees pay the difference between the benchmark and the bid in the form of a monthly premium, in addition to the Medicare Part B premium.  If the bid is lower than the benchmark, the plan and Medicare split the difference between the bid and the benchmark; the plan’s share is known as a “rebate,” which must be used to provide supplemental benefits to enrollees.  Medicare payments to plans are then adjusted based on enrollees’ risk profiles.
Source: kff.org

Video: Part D Medicare by 1-800-MEDIGAP

Financial Success: Medigap & Medicare Advantage Plans

All Things Human by Patrice Passidomo, M.D. Amateur Palate Restaurant Reviews Animal Ark Rescue Arts and Entertainmet Arts Calendar by Carol Kantor Arts on the Lake Bits of Inspiration Brewster Theater Company Delaney’s Dugout Financial Success by Kurt Schlesinger Happy Reading by Christine O’Neill Heart of the Matter: Pawling Real Estate by Todd Kesseman Intern and Student Contributors In The Shade by Thomas D Kersting Kitty Korner Living Landscape Journal by Pete Muroski Local Business Local Interest Meteorologist Mike Shustak’s Forecast Mizzentop Music Reviews by Zach Silva Our Town by Susan Stone Pawling Fire Department Pawling Garden Club Pawling Parents Pawling Public Library Pawling Public Radio Pawling School Sports Peace of Mind by Dr. Jeremy Stone Reflections on a Silver Screen by Ben Rendich Sherman Chamber Ensemble Spice: The Final Frontier by Lisa Kelsey The Art of the Brew by Mark Klinger The Computer Guy by Mike Pepper The Five Facets of Mom by Stephanie Nevins The Pawling High School Insider The Pet Professor by Mary Jean Calvi, LVT The Puppy Pad The Whole Tooth and Nothing But The Tooth by Dr. Thomas Bloom This Side of the Law Towne Crier Trinity Pawling Uncategorized Vegan Delights by Carole Baral What’s New by Susan Stone
Source: wpengine.com

2013 Tax Changes for Individuals: A Checklist

Child and Dependent Care Credit The child and dependent care tax credit was permanently extended for taxable years beginning in 2013. If you pay someone to take care of your dependent (defined as being under the age of 13 at the end of the tax year or incapable of self-care) in order to work or look for work, you may qualify for a credit of up to $1,050 or 35 percent of $3,000 of eligible expenses. For two or more qualifying dependents, you can claim up to 35 percent of $6,000 (or $2,100) of eligible expenses. For higher income earners the credit percentage is reduced, but not below 20 percent, regardless of the amount of adjusted gross income.
Source: lvbwcpa.com

Medicare Part C: Medicare Advantage Plans

Alzheimer’s Alzheimer’s Disease antianxiety antidepressant antipsychotic anxiety anxiety disorder asthma treatment Bad cholesterol bipolar disorder cholesterol chronic lower back pain dementia depression depression medication depression treatment depressive disorder diabetes fibromyalgia HDL health insurance high blood pressure inhaler insulin dependent diabetes LDL LDL cholesterol low blood sugar lower blood pressure lower cholesterol major depressive disorder medicare medicare coverage medicare information medicare part b memory loss narcotic pain reliever non-insulin dependent diabetes oral diabetes medication prescription prescription drug prescription medication schizophrenia stroke type 1 diabetes type 2 diabetes
Source: odsmedical.com

Is HSA health insurance a good option for me?

Yes! Monies that aren’t used remain in your account and are carried forward. Interest and other earnings on funds in your HSA account are tax-free. Distributions from these accounts are also tax-free if used to pay for qualified medical expenses. In addition, an HSA account is “portable,” staying with you if you leave your employer or cease working.
Source: healthinsuranceproviders.com

IRS Reminds HSA Trustees About Filing Dates

Trustees of health savings accounts, as well as participants, have some time left for reporting on 2012 accounts. And now they can begin preparing for 2013 reporting. The IRS has issued a reminder concerning the Form 5498-SA, “HSA, Archer MSA, or Medicare Advantage MSA Information,” for 2012 and 2013.
Source: thompson.com

Top 10 Health & Medical Information Websites

Posted by:  :  Category: Medicare

MEDFLAG 2010, Kinshasa, Democratic Republic of Congo, September 2010 by US Army AfricaNote: The Experian Hitwise data featured is based on US market share of visits as defined by the IAB, which is the percentage of online traffic to the domain or category, from the Experian Hitwise sample of 10 million US internet users. Experian Hitwise measures more than 1 million unique websites on a daily basis, including sub-domains of larger websites. Experian Hitwise categorizes websites into industries on the basis of subject matter and content, as well as market orientation and competitive context. The market share of visits percentage does not include traffic for all sub-domains of certain websites that could be reported on separately.
Source: marketingcharts.com

Video: Medical Information : Causes of Numbness in Fingers

A Note from Dr. Bill Feaster, CHOC Children’s Chief Medical Information Officer

Healthcare’s future will alter in a number of ways.  For example, payment reforms will require us to audit and improve the quality and detail of our clinical documentation.  Of course, this is something we should be focusing on anyway to best communicate to our colleagues about the care we’re providing.  APR-DRGs are coming to children’s hospitals this July as California’s MediCal program is changing over from per diem reimbursement to this detailed DRG-based payment mechanism.  The more complete the information about a patient’s care is documented in the chart, the more accurate an APR-DRG can be assigned to each case.  In addition, by next fall we will be shifting from ICD-9CM to ICD-10 diagnostic coding.  ICD-10 is comprised of over 155,000 codes, up from the current 24,000 and will affect all specialty areas.  To help us transition to these new coding systems, we will be starting a Clinical Documentation Improvement (CDI) program at CHOC.  Stay tuned for more information on this important new program.
Source: chocchildrens.org

Career of the Week in Health Care Management: Chief Medical Information Officer

JOB DESCRIPTION The Chief Medical Information Officer (CMIO) is a new position in hospitals. The goal of the CMIO is to help facilitate and accelerate the clinical use of IT throughout the organization and serve as the bridge between the clinical staff and IT department. The CMIO directs the effective use and implementation of IT, particularly as it applies to physicians, nurses, and other clinical staff.
Source: springerpub.com

New Caregiver Resource: Personalized Medical Information

While the internet is an amazing tool and has vast amounts of information, the whole process of finding the right trustworthy information suitable for the specific loved one is still ineffective and inefficient. When searching for the person’s medical condition or symptoms, one ends up with thousands or even millions of results, most of which are not relevant to the specific case. The results are not clear what is most current and trustworthy. Much of the material is in language beyond the reach of a typical reader. None of it is personalized to a caregiver’s specific situation. It is nearly impossible to continue to stay abreast of the latest developments over time.
Source: robcares.com

Medivizor: personalized medical information at your fingertips : Caregiving Cafe Blog

One of the most important steps that anyone can take to become an empowered patient or an effective family caregiver is to learn about the condition one is dealing with.  Books and online resources abound, but investing time and effort to finding and filtering this wealth of information can be all-consuming.  Where do you look for reliable information?  Once you find it, can you understand it?  Does it apply to your condition?  Most of us are not well-versed in the scientific or medical terminology that makes up most of the research papers one comes across on the internet.  Would we be able to discuss these reports with our doctors?
Source: caregivingcafe.com

5 Tips for Organizing Your Medical Information

Keep in mind that organizing your medical information and the information for your family does not fall entirely on you. Each person should work to understand the family’s medical status so that multiple people can help out should medical issues arise. In particular, you can get support from your family by bringing a relative (or a trusted friend) with you to a medical appointment. This can be especially important at major medical examinations, because a lot of information can be communicated during such checkups. If the issue is serious, you may wind up having lots of questions and getting lots of answers from your doctor. Having someone there to support you can help you ask all of the questions that need asking and keep track of the doctor’s answers.
Source: newlywedsurvival.com

'Donor information goes far beyond access to medical records'

Thousands of children conceived using donated sperm want to know about their parental history but currently lack the legal rights to do so. However this could soon change, with two state inquiries calling for a central register of information that could be accessed by sperm donors and their children under consensual agreement.  Deakin University Professor of Law Sonia Allan, who has completed a PhD on the issue, talks to 6minutes about why the release of this information is critical. 1. Why should donor information be released?  From a donor-conceived person’s perspective, it’s often about a sense of identity. They want to know their donor’s name and a bit more about them.  A number of the donor-conceived people I’ve spoken to have also expressed…
Source: com.au