Archive for the ‘Healthcare Village’ Category

Healthcare Costs Starting to Slow Down

Wednesday, October 26th, 2011

The increase annually in healthcare costs appears to be slowing.  According to Sandra Block of Gannett News Service, “If there’s any good news to be found, it’s that the increase in overall costs of providing healthcare to employees has slowed.  Tower projects an increase of 5.9 percent in 2012, which represents a significant change from 7.6 percent in 2011.  Mercer, another human resources consulting firm, predicts that employee healthcare costs will rise 5.4 percent in 2012.  That’s small consolation, though, to employees whose income hasn’t kept pace with the rise in healthcare costs.  In August, personal income fell 0.1 percent from July, driven by a decline in wages and salaries, according to the Bureau of Economic Analysis.”

There’s bad news for Americans whose healthcare insurance is provided by their employer.  According to Towers Watson, a human resources consultant, employers will pass on cost increases primarily through higher employee premium contributions.  Towers Watson says that 66 percent of firms will increase employees’ share of premiums for single-only coverage in 2012; 73 percent will increase the share of premiums for dependent coverage.  A survey by the National Business Group on Health (NBGH) found that 53 percent of employers intend to increase employees’ share of premiums, while 39 percent plan to increase in-network deductibles.

The yearly survey by NBGH, a not-for-profit alliance of 83 of nation’s largest companies — employing more than million workers — expect healthcare costs to continue rising significantly faster than inflation because of medical inflation and the Patient Protection and Affordable Care Act.  “This is an unsustainable model for our country,” said Helen, Darling, the NBHG’s president and CEO, referring to the financial strains caused by the ongoing increases.  Some believe that the rising healthcare costs stemmed from components of the 2010 federal healthcare law, including its mandate to cover the offspring of workers up to age 26 and its coming bans on caps for annual benefit limits.  Employers said a variety of cost-saving moves to counter the rising cost of their health coverage, including encouraging employees to use centers of excellence for transplants and other procedures.  “Even if they spend more on the initial admission, they spend less overall due to less need for readmission or re-treatments,” Darling said, in reference to incentivizing employees to seek treatment at highly rated hospitals.

At the time of year when open enrollment begins, employers want their employees to be healthier as a means of controlling costs.

Employers also will encourage their employees to choose high-deductible plans — with lower premiums – and persuade workers to be savvy healthcare shoppers.  Some employers will require significantly higher premiums for employees who do not agree to monitor their own health and address problems.  At a time when both employers and workers are weary of paying more for health coverage, experts say it’s important this year to closely study new wellness programs — as well as all the other options on the table — to take advantage of any savings.  “Healthcare costs are going to continue to grow significantly and for your own health and your own wealth and financial good, you need to get fully engaged in understanding what your choices are,” said Tony Holmes, a partner with Mercer.

Holmes said employers expect to pay 5.4 percent more for health plans in 2012 — about a half percentage point below the typical increase over the past 10 years.  Nearly one-third of employers plan to increase premiums for employees, according to Holmes.  Charges to cover a spouse or children are even more likely to climb; more than 40 percent of large employers plan to increase the costs for dependents.

Some businesses are moving away from co-pays, where employees pay a fixed dollar amount for healthcare services and the plan picks up the rest. Instead, they’re charging workers a percentage of the total costs.  That has the goal of making consumers more aware of the total cost of the healthcare they use.  “We are clearly seeing a march toward a more aggressive consumerist system,” the NBHG’s Darling.

Mercer also found that utilization of healthcare services has slowed in 2011. The difficult economy, higher deductibles and other forms of increased employee cost-sharing, may impact utilization, Mercer said.  “Because employees have less disposable income and are working longer hours, they are less likely to seek non-urgent care.”  Additionally, utilization may be slowing because of employer programs aimed at earlier detection of health problems, Mercer said.  “Earlier risk identification and health education, along with improvements in drug therapies and medical technology, are keeping people with health risks and chronic conditions away from the emergency room,” Susan Connolly, a partner in Mercer’s Boston office, said.  The findings are based on responses from almost 1,600 employers.  In the end, approximately 2,800 employers are expected to respond, with the results — including the actual average healthcare plan cost increase for 2011 — to be released this year.

Self-Administered Epidurals Seem to Ease Childbirth Pain

Wednesday, February 16th, 2011

Women who control the amount of epidural anesthesia they get during labor and delivery use approximately 30 percent less medication than when given a standard dose from a doctor, according to a new study. “We looked at patient-controlled epidural anesthesia, and found the women were basically as comfortable as women on a continuous dose, and there was a 30 percent reduction in the amount of anesthesia used,” said Dr. Michael Haydon, the study’s author and a perinatologist at Long Beach Memorial Medical Center in California.

Epidurals are a common form of anesthesia administered during childbirth, according to the American Congress of Obstetricians and Gynecologists.  With an epidural, a small catheter is inserted into the spine’s epidural space, and a painkiller is then infused to numb the area.  Epidurals have a low risk of side effects, which can include nausea, backache, sudden drops in blood pressure, severe headache and more difficulty pushing (often resulting in the need for forceps or a Cesarean delivery), according to the American Pregnancy Association.

The study included 270 women, with two-thirds being given a steady infusion of drugs, while the other third was given a hand-held controller so the anesthesia could be delivered as needed.  The women could not keep requesting extra pain relief, as each press of the button delivered a dose, then “locked out” additional presses for a set period.  While there were no differences in the duration of labor, those using “patient-controlled epidural analgesia” (PCEA) used approximately 30 percent less anesthetic.  Patient satisfaction was generally the same, although the women who self administered the drugs did report more pain during the final stage of labor.  Additionally, there was some evidence that forceps deliveries were fewer in the PCEA group.

“My personal belief is that epidurals tend to slow labor down.  So, if you can get away with less medication with patient-controlled analgesia, I think it’s a wonderful thing,” said Dr. Peter Bernstein, a professor of clinical obstetrics and gynecology and women’s health at Montefiore Medical Center and Albert Einstein College of Medicine in New York City.  “And, it’s not a surprise to me that women used less anesthesia.  If you can titrate your own medication, you’re probably not going to give yourself a lot. An anesthesiologist will tend to give you a little bit more because they want to make sure there’s no pain,”

So how reliable are the findings?  The study hasn’t yet been published in a medical journal, but was presented at a medical conference by the researchers.  As a result, medical experts have not been able to look in detail at how the study was conducted or its results, making it hard to determine the reliability of the findings. This was a random controlled trial, which is the best type of study for comparing treatments.  The study was also “double blind”, in which neither the women nor their physicians knew which type of anesthesia they were being given because all participants were given buttons to push.

FDA to Put Gruesome Warning Labels on Cigarette Packs

Tuesday, November 23rd, 2010

FDA is ramping up its anti-smoking efforts with extremely graphic new warning labels.  The Food and Drug Administration (FDA) has concluded that years of warnings about the dangers of smoking cigarettes, the availability of nicotine patches and gum has not worked.  Instead, the FDA is proposing to put gruesome images on cigarette packs that warn of the consequences of smoking.  Tobacco is the leading cause of early and preventable deaths in the United States, accounting for 433,000 annual deaths and approximately 33 percent of all cancer deaths.  The healthcare reform law provides free access to anti-smoking therapies; the stimulus bill included $225 million to support local, state and national anti-smoking programs.

The proposed images, which include one of a man suffering a heart attack and another of a mother blowing smoke in her baby’s face, would cover half the front and back of each pack if adopted.  “When the rule takes effect, the health consequences of smoking will be obvious every time someone picks up a pack of cigarettes,” said Margaret A. Hamburg, FDA Commissioner.  The FDA plans to choose nine images by June 22.  After October 22, 2012, cigarette manufacturers who refuse to put the new warnings on their product will be banned from selling their brands in the United States.  Anti-tobacco activists applauded the move.  “In implementing the new warnings, the United States is catching up to scientific best practices,” said Matthew Myers of the Campaign for Tobacco-Free Kids.

Not surprisingly, some tobacco companies are not thrilled.  R. J. Reynolds Tobacco Company, which is already suing the government over tobacco regulations, is reviewing the proposed warnings.  “It is worth noting that the legality of requiring larger and graphic warnings is part of our lawsuit that is currently pending,” said company spokesman David Howard.  Philip Morris USA, on the other hand, has been supportive of FDA regulations; the company “has actively participated in the FDA’s rule-making and public comment process and plans to do the same on this proposal.”

Canada, which has used graphic warnings since 2000, has seen a significant reduction in smoking.  “It’s always difficult to point to a particular policy and say it’s due to that,” said David Hammond, a researcher of the University of Waterloo in Ontario.  In fact, smoking rates in Canada have fallen approximately 20 percent since 1985.  “But all the evidence does point to the fact that these things do help.  The bottom line is that there’s no magic bullet.  But about one-third of smokers say this increases their motivation to quit, and about the same proportion of former smokers say they remind them why they quit.”

Republicans “A Pledge to America” Vows to Repeal the Affordable Care Act

Sunday, October 3rd, 2010

House Republicans want to repeal the Affordable Care Act.Republicans are threatening to repeal the Patient Protection and Affordable Care Act as part of their “A Pledge to America” proposal.  On the six-month anniversary of healthcare reform’s enactment, House Republicans issued their “Pledge” , which proposes overturning the law and replacing it with “real reforms” focusing on medical liability reforms to control “junk lawsuits” and defensive medicine.  Other elements of the “Pledge” would expand health saving accounts; ban taxpayer funding of abortion; allow people to buy insurance across state lines; assure access for patients with pre-existing conditions by expanding state high-risk pools and reinsurance programs; as well as cutting the cost of coverage.

According to Stephanie Cutter, assistant to the president for special projects, “The (Republicans’) agenda claims to protect people with pre-existing conditions, but it repeals the new law’s ban on discriminating against uninsured Americans, including children who have a pre-existing condition.  It will mean that seniors will pay more for their prescription drugs, and their new free preventive Medicare benefits will be cut.”

Ron Pollack, executive director of Families USA, noted that the GOP proposal “will raise taxes by more than $40 billion on up to four million small businesses that provide health benefits to their employees…and will result in premium increases by eliminating the billions of dollars in cost-saving measures.”

Democratic lawmakers assailed the “Pledge” as recycled ideas that will only intensify the nation’s problems.  “Republicans want to return to the same failed economic policies that hurt millions of Americans and threatened our economy,” said Nadeam Elshami, a spokesman for Speaker of the House Nancy Pelosi (D-CA).  Even if Republicans vote to repeal the Affordable Care Act, President Barack Obama still has the power to veto their legislation.  It’s likely that he would use his veto power to protect one of his major legislative achievements.

HHS Gives 11 Wellness Programs $31 Million

Wednesday, September 29th, 2010

Wellness gets $31 million to fight obesity and smoking.At present, seven of every 10 deaths among Americans are due to chronic conditions such as heart disease, cancer, stroke and diabetes.  These diseases also eat up 75 percent of the nation’s annual healthcare spending.

New wellness programs are getting a boost from the Affordable Care Act in the form of $31 million to help communities cut obesity, increase physical activity and improve nutrition.  The funding is contained in the Department of Health and Human Services’ (HHS) Communities Putting Prevention to Work (CPPW) program, a prevention and wellness program that is overseen by the Centers for Disease Control and Prevention (CDC).

“As I’ve seen throughout the year in my work with Let’s Move!, prevention works when it comes to improving the health of our families,” said First Lady Michelle Obama.  “These critical investments will help more communities across America tackle serious challenges like childhood obesity, while promoting physical activity and healthy eating.” The funding is being awarded to communities that have resources in place to increase the availability of healthy food and beverages; enhance access to safe places to encourage physical activity; discourage smoking; and promote environments that are smoke free.  Of the 11 awards announced, 10 are dedicated to anti-obesity programs and one to smoking cessation.

“To realize our goals of improving the health of Americans and lowering our nation’s healthcare costs, we must address the underlying factors that influence our families’ health – factors like the foods we eat and the conditions that exist in our homes, neighborhoods and workplaces,” said HHS Secretary Kathleen Sebelius.  “With Communities Putting Prevention to Work, we’re creating evidence-based models that we can replicate on a large scale to permanently reduce the chronic diseases plaguing so many of our communities.”  Already this year, CPPW has given nearly $492 million to support community and statewide hotlines and media campaigns that promote healthy living.

Medical R&D Could Benefit From Proposed Tax Breaks

Tuesday, September 28th, 2010

Proposed tax breaks could boost medical innovation, create U.S. jobs. Medical research will get a boost from the Obama administration’s proposed stimulus package that creates a permanent research and experimentation (R&E) tax credit for companies that carry out research-and-development (R&D) activities in the United States. Under the proposal, R&E tax credits would total as much as 20 percent, with $100 billion allocated over 10 years to qualifying research firms.  According to President Obama, he will pay for the tax breaks by ending loopholes that let companies benefit financially by moving jobs and R&D overseas.

Medical device manufacturers’ lobbyists claim it’s too early to determine how much the R&E tax credits will promote product innovation and create new jobs.  The Advanced Medical Technology Association, however, applauded the move.  Bret Loper, senior executive vice president government affairs, said “AdvaMed has long supported making the R&D credit permanent.  We look forward to seeing the details of this new proposal and the other tax changes being discussed today to determine how they will affect America’s medical technology companies.”

The National Venture Capital Association, which recently started the Medical Innovation & Competitiveness Coalition, counters that the new initiative will primarily benefit large companies rather than start-ups.  “What our experience has been is that if a company is not profitable and paying taxes, they wouldn’t be eligible” for the tax credits, said Emily Mendell, the association’s spokesman.

Fear of Falling

Thursday, September 23rd, 2010

Fear of falling in the elderly often due to psychological factors and not physiological.Older people are naturally concerned about falling because of the consequences a tumble can involve. A recent study by Neuroscience Research Australia has found that to much worry about falling – even if physiological tests indicate low risk – increases the probability that an individual will fall.  The study also found that older people who are at high physical risk of falling but tend to not think about it, fall less often than their more concerned counterparts.

Published in the British medical journal BMJ, the study followed 500 Sydney residents with an average age of 78 who underwent medical, physiological and neuropsychological tests.  The majority of participants were able to correctly evaluate their likelihood of falling, though one-third were wrong in their self assessments.  This group felt more or less susceptible than their strength, balance, reaction time and other physical characteristics indicated.  The research team labeled 11 percent as the “anxious” group, who had a higher perceived risk than was physiologically true.  Another 20 percent were called “stoics” and were at risk of falling even though they didn’t think about it very often.  Over the year of the study, the anxious people did have more falls, with 40 percent suffering injuries.  Only 33 percent of the so-called stoics fell, despite the fact they were at higher physical risk.

According to Stephen Lord, an applied physiologist who was part of the research team, “These anxious people were more likely to be depressed, to have restricted their activities, and it looks as though these factors feed on each other.  People who are fearful do less, and that leads to deconditioning, to a loss of strength and balance.  They become preoccupied with the possibility.  The stoics, by contrast, maintained more positive attitudes and more active lives despite their physical problems.

FCC Is Connecting Healthcare Providers With Remote Patients Via Computer

Wednesday, September 1st, 2010

National Broadband Plan expands telemedicine to patients who live in rural areas.  Access to healthcare isn’t always convenient for Americans who live in remote rural areas.  To fill the void, high-speed internet connections are being put into place to bring top-quality healthcare to patients via computer. The Federal Communications Commission (FCC) has pledged $400 million a year to connect approximately 10,000 rural healthcare providers under its National Broadband Plan.

A case in point is Redway, CA – a town of 1,200 located 200 miles north of San Francisco – whose Redwoods Rural Health Center and Dr. Wendi Joiner serve 4,000 patients, many of whom do not live within easy driving distance of the clinic.  According to Dr. Joiner, “It’s a special challenge.  I love it, but sometimes I feel like there should be two or three of me.  It happens a lot where we’re asked to do things that we’re not specialists in.”

The FCC’s rural telemedicine plan will make it easier for rural people to access healthcare, according to chairman, Julius Genachowski.  “If you have rural connectivity for healthcare, then patients don’t have to drive two or three or four hours for their treatments – instead, (they) can stay back where they live, consult with a medical professional remotely.”  The FCC’s pilot program has been successful and expanded the reach of the University of California, Davis Medical Center’s telemedicine clinic.

According to Dr. Tom Nesbitt, who heads the UC Davis rural program, his hospital serves 3,000 patients annually who live in remote locations.  “The demand would even be greater if the remote locations had equipment, bandwidth and training.”  The money to make this possible is already available through the Universal Service Fund, which brings telephone service to rural areas.  Genachowski is transferring the money to broadband to improve the availability of healthcare in remote locations.  “One of the greatest forms of savings will come from healthcare spending that we don’t have to make because we catch problems earlier.  We can treat and diagnose remotely,” he said.

Healthcare Reform Has $250 Million to Create New Primary-Care Sites

Wednesday, August 25th, 2010

HHS has $250 million to fund primary care.  With little fanfare, the Obama administration has released $250 million to establish “new access points,” locations designed specifically to house primary-care services in underserved neighborhoods.  The facilities are intended to mirror community health centers.  Created by the new healthcare reform law, the grants will be awarded by the Health Resources and Services Administration.

Kathleen Sebelius, Secretary of Health and Human Services, said “These funds reflect the administration’s steadfast commitment to improving and expanding access to vital primary healthcare services.  From our cities to our smallest towns, each health center has an important role to play, ensuring access to services in its community.”

Organizations eligible for the funding include public and non-profit groups, including tribal and faith-based community organizations.  All must meet health center funding requirements.