New data from Mercer shows that employers say they will be forced yet again to offset their rising premiums on the wallets of their employees:
Well over half (59 percent) of employers taking action to reduce their 2009 cost increase will raise deductibles, copayments, coinsurance or employee out-of-pocket spending limits. Employee cost-sharing has risen sharply over the past five years: Between 2003 and 2007, the median family deductible for in-network services in a PPO (the type of plan offered by the most employers) rose from $1,000 to $1,500.
How much more can employers take or employees endure?
Harvard Men’s Health Watch says a quickie power nap in the afternoon at work is very good for alertness, performance and mood.
Those wiley researchers don’t recommend a two-hour nap, of course. A simple 20 to 40 minute nap sometime between noon and 4 p.m. should suffice. And make sure to give yourself 10 to 15 minutes to wake up fully before you resume a demanding task, Harvard pros say.
And just to shore up your argument when your boss asks where the heck you are, Harvard says this:
Voluntary napping … is not a sign of sleep deprivation, illness, or aging. In fact, a “power nap” can be helpful as well as enjoyable. Many studies of shift workers and other volunteers have reported that a nap as brief as 20 minutes can improve alertness, psychomotor performance, and mood.
Policy wonk John Goodman raised an interesting question in his health policy blog: who’s at fault for the problems in our health care system? Is it doctors or the payment structure under which they operate?
Goodman, president of the National Center for Policy Analysis, a nonprofit group that bills itself as a nonpartisan public policy research organization, says he believes the payment system needs to be revamped in order to affect better, more efficient care.
He writes:
Our view is that doctors are just like other professionals. They respond to economic incentives. The policy problem: how to change the incentives in the perverse way doctors are paid.
Those who believe doctors are at fault, Goodman says, think doctors are just too stuck in their “imperfect” habits and are unwilling to go the extra mile to achieve better results and lower costs. If you believe that, Goodman says, you believe the public policy problem boils down to “how to get doctors to adopt the best practices, learn to use computers, work in teams, adopt safety protocols, etc. in the face of psychological resistance.”
Food for thought. What do you think? Are insurance providers — from private companies such as Blue Cross Blue Shield to government payers such as Medicare — to blame for our cost and quality issues, not to mention our rampant uninsured?
Despite projections for a weak 2007, Moody’s Investors Service conceded that nonprofit hospitals were fairly stable last year, despite the subprime mortgage-fueled financial markets meltdown, ongoing problems in the U.S. economy and continuous pressure on margins, Fierce HealthFinace reports.
But gone are the ubiquitous 5 percent to 6 percent margins. As Via Christi Health System can attest, just staying near the 2 percent mark is a coup these days.
Wesley Medical Center just went mostly private. Via Christi Regional Medical Center is adding more private rooms when feasible (that’s the plan so far with its planned west side hospital). Galichia Heart Hospital is doing it. And now a paper in the Aug. 27 issue of the Journal of the American Medical Association is arguing that all hospitals should move toward single, private patient rooms.
Besides the obvious patient satisfaction component, supporters say private patient rooms reduce infections, enhance the privacy of patient information, and promote better sleep and healing.
Say the JAMA authors:
Most modernhospitals have public value statements regarding safety, dignity,privacy, and patient-centered care. A tangible way to show commitmentto these values would be to give patients their bed with theirown bathroom in a single-patient room.
Yes, it’s more expensive for hospitals, at least at first (One North American analysis found that the cost of a new ward with exclusive single-patient rooms was $182 to $400 per patient, whereas a ward with exclusive double rooms cost $122 to $550 per patient, according to JAMA), but do you think it’s worth it?
Are patients willing to pay the difference in exchange for the value? By the same token, is it cost-effective for mega community hospitals such as Via Christi to convert to all private rooms (something it cannot feasibly do) when it is essentially the safety net hospital that sees a good chunk of this region’s uninsured patients?
The national commission that accredits hospitals — and makes hospital managers shake in their shoes every three years when it comes time for re-accreditation and the accompanying hospital inspection surveys — is developing a new set of standards which hospitals must strive to meet.
Armed with a grant from The Commonwealth Fund, the Joint Commission this month began developing “accreditation standards for hospitals that will promote, facilitate and advance the provision of culturally competent patient-centered care.”
The Joint Commission is essentially trying to figure out how hospitals can competently treat patients who have cultural differences that are important to them (Muslim women, for example?), language and literacy issues (Spanish speaking populations, for example?).
The group, which is seeking panel members to help define these standards, has set a target date of 2011 for hospitals to begin complying with the new rules.
I wonder how important this might be in Wichita? Should hospitals take on cultural issues for better patient satisfaction and — as the commission suggests — care? My guess is is the better people communicate with one another, the more successful the outcomes.
The State Employees’ Insurance Board this week approved a plan to charge state workers starting in January 2010 if they don’t have free health screenings.
If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program, or take steps on their own to improve their health. If they show progress in a follow-up screening, they won’t be charged. But if they don’t, they must pay starting in January 2011.
Here’s the threshold:
The board will apply the obesity charge to anyone with a body mass index of 35 or higher who is not making progress. A person 5 feet 6 inches tall weighing 220 pounds, for example, would have a BMI of 35.5. A BMI of 30 is considered the threshold for obesity.
Employers charging employees who smoke has become somewhat commonplace, but charging workers who are overweight is a fairly unique stance. Think these “incentives” will induce better health? Is it better to reward employees who engage in healthy behaviors or penalize those who don’t?
The $100,000 fine to a Seattle-based home health agency last month should cause health care providers and related industries charged with protecting private patient information to take note, experts say. The government’s cracking down on HIPAA — the patient privacy act — violations.
The U.S. Department of Health and Human Resources said it created a “robust” corrective action plan that requires the company to:
Revise its security policies and procedures
Train its workforce members
Conduct regular audits and site visits
Submit compliance reports to HHS for the next three years
All this happened after HHS received more than 30 complaints against Providence Health & Services for losing unencrypted laptop computers and backup data more than two years ago. AIS Health.com, in a report on patient privacy, wrote that the punitive measures are a signal that the government is taking a tougher stance on HIPAA compliance. Two experts weighed in:
“This is a significant warning sign for covered entities, mainly a heads up that the government is getting more aggressive and [the CAP provides] a checklist of items that companies should be paying particular attention to in their security efforts,” says Kirk Nahra, a partner with Washington, D.C.-based law firm Wiley Rein, LLP.
Adds Chris Apgar, a health care privacy and security consultant, “covered entities need to prepare for the potential that a privacy complaint could lead to financial costs associated with a corrective action plan and the imposition of a ‘fine.’”
Physician Benjamin Brewer in the Wall Street Journal today advocates using the Internet as a safe, efficient way to cover about 20 percent of his routine, in-person office visits, thus eliminating the hassle and inconvenience of visiting a doctor’s office for something relatively minor.
He writes:
I think 20% of my routine office visits could be handled safely and less expensively over the Internet. There is nothing magical about the four office walls that make face-to-face visits superior. Demanding an in-person visit for every little thing is based on tradition and consensus opinion — not science.
How likely are you, as a physician, to try this kind of patient interaction? Do you feel it’s safe and reliable? What about patients? Are they willing to seek routine, simple help through the Internet? I certainly would! The question remains, however, is if insurance companies and the government are willing to reimburse for it.
The iconic TV couple largely credited with defeating Clinton’s proposed health care plan back in 1993 are being brought back to life today in new television ads that promote health care reform as the top domestic priority for the next Administration.
Harry and Louise, played by actors Harry Johnson and Louise Caire Clark, play a middle class couple despairing over the state of health care. The commercials, paid for by the Health Insurance Association of America, were so effective, they’re often credited with forever changing how public relations techniques can influence change.
New commercials will be revealed today at the National Press Club in Washington, with the support of several groups, including the Cancer Society Cancer Action Network, American Hospital Association, Catholic Health Association, Families USA, National Federation of Independent Business, and America’s Health Insurance Plans.
Says the group of the new commercials:
Airing throughout the Democratic and Republican conventions, the famous couple at the kitchen table will remind America that they are still waiting “for a better way.”
Can’t remember the old commercials? Check out this from YouTube: