Friday, January 30

Health Care and Private Health Exchanges

The world is changing for healthcare in large part due to the Affordable Care Act, or ObamaCare as it is known in the common tongue. One of the key elements currently driving the market is the concepts of health exchanges, both public and private. The public exchanges are run by several of the states, and the federal government also has one that has been historically problematic. However, this material is dedicated to private exchanges in the commercial business market.

According to MCOL, private health insurance exchanges are gaining currency as a way for employers to cut health care costs, reduce their administrative burden and increase the benefit choices they offer to covered employees. Multiple studies now indicate that U.S. employers are increasingly looking at private exchange options for both active and retired employees. Brokers, consultants, payers and other intermediaries offer private exchanges, but a mix of vested interests is at play among these service providers.

The second annual study by the Private Exchange Evaluation Collaborative (PEEC) affirms a continuing interest in private exchanges among employers. The national survey, based on the responses of 446 employers, reports heightened interest on the part of employers in private exchanges as a strategy for full-time active and retirees, but the potential transition must address a number of critical considerations. The survey is also the first national assessment that specifically captures the experience of early adopters of both private exchanges for active employees as well as retirees.

Private exchanges are flexible and can be customized to address the needs of any employer group, unlike public exchanges, which are targeted to individuals and small groups, according to Booz & Company. For instance, private exchanges can design benefits tiers specific to employer segments with robust multichannel employee decision support. Another advantage is that private exchanges can offer a broader range of retail products, such as dental and life insurance and even non-insurance products, than public exchanges can. Two private exchange models are emerging:

Single-carrier exchanges: These exchanges are promoted by a single payor and target employers that wish to maintain some role in choosing both the insurance carrier and plan design. Depending on how involved employers want to be in benefits design and negotiation, products may be customized and priced for the employee group or individuals.

Multi-carrier exchanges: These exchanges, predominantly promoted by third-party intermediaries such as brokers or benefits consultants, will provide a broad range of payor and plan design options and encourage employers to take a more hands-off role. For payors, multi-carrier exchanges that list individual prod­ucts on a menu of offerings pose com­moditization risk that could squeeze payor margins.

According to Array Health, purchasing health insurance through a private exchange will become the new normal as more and more employers move to defined contribution plans and customers become much more comfortable taking more of an active role in selecting and personalizing their health coverage. However, insured's need to educate themselves and understand how the system really works. Hopefully this technology will help, but if insured's do not have "Skin in the Game" they will continue the life habits that cause high claims.

At the end of the day it’s still a matter of premium in vs claims paid out. Exchanges are good at lowering the premium side of the equation by offering less expensive plans for the low utilizers to take advantage of. However, the exchange really doesn't impact the cost impact of the heavy utilizers who really drive the overall cost of the employer’s plan. If premium goes down and claims stay the same the outcome is obvious. To cut costs, you have to cut claims - pure and simple.

According to Forbes Magazine, a recent report by the Kaiser Foundation underscores one such lesson – the growing take up of private exchanges has the potential to be a catalyst for some major revolutions in our health care system. In 2014, about 2.5 million people across companies of all sizes will be enrolled in health insurance through so-called private exchanges. These are analogous in some ways to ObamaCare’s state and federal-based health insurance exchanges but instead are run by private consultancies like Aon Hewitt or Mercer.

The Kaiser report also notes that consultancies Accenture and Oliver Wyman both predict somewhere around 40 million enrollment by 2018. If these projections bear out, that would make the private employer exchange market about 24 percent of the total employer market, based on CBO projections. Much more detail on this info can be found at this site: http://www.forbes.com/sites/theapothecary/2014/10/15/are-private-exchanges-the-future-of-health-insurance/.

But not all employers are wild about the private exchange approach. The National Business Coalition on Health produced a survey the organization said “resoundingly” rejects private exchanges as a way to control rising health care costs, according to Forbes Magazine. Though the language in the coalition’s release was strong, its survey showed 5 percent of more than 330 employers already use a private exchange and “8 percent are considering such a move within the next three years.”

NBCH said 55 percent of respondents will “never” stop sponsoring health coverage in favor of giving employees money to buy through a private exchange. More material on this topic is available at this website: http://www.forbes.com/sites/brucejapsen/2014/10/08/more-employers-shifting-health-to-private-exchanges/.
 
According to Benefits Pro, Bruce Hentschel leads strategy development for the Specialty Benefits Division of the Principal Financial Group, and writes that private exchanges are here to stay; but for advisors and their small employer clients, questions still remain about their value. Is the opportunity they offer more myth than reality? Likely, the answer is a bit of both. If you are participating or plan to participate in one or more private exchanges, here are a few suggestions for you to consider:

·         Define your strategy first and then seek an exchange that provides the best fit. There are dozens of types of exchanges all designed to meet different types of objectives, at varying levels of sophistication, service and support. For example, some generate a quote for an employer; others don’t. Some offer ongoing benefit data management; some don’t. Some use defined contribution concepts exclusively; others don’t offer defined contribution at all.

·         Practice due diligence. Even some of the best and most successful exchanges lack the necessary infrastructure to allow for scale and administrative simplification.

·         Experiment, and don’t be afraid to switch exchanges if the one you’re working with isn’t meeting your needs. Yes, they can be time-consuming and potentially expensive to implement. But, it’s okay to “fail fast and fail cheap” versus dumping additional time, resources and/or money into an exchange that doesn’t really get the result you desire.

Private exchanges will go through tremendous change and in a relatively short period of time, and the options will eventually narrow down to a few winning models. For more details, visit this website: http://www.benefitspro.com/2015/01/29/private-exchanges-myth-vs-reality.

Employers must review material and the value proposition for any participation in the private exchange market. Granted, more transparency and education are needed. Brokers can play a big part with those opportunities. If you are considering transferring your health care business for you and your employees into a private health exchange, it pays to do your homework and listen to trusted experts in the field. Don’t go it alone, or you could find yourself with more issues than you imagined.

Until next time.
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Tuesday, January 13

Health Care and Leukemia

One of the most dreaded diagnoses you can get from your doctor, and one that everyone fears, is the word cancer. In particular, those who are diagnosed with Leukemia have a difficult time understanding why and how they contract this disease. Children can be especially hard hit with various types of leukemia; but caught early enough, the outcome can be very positive.

Leukemia is cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system. Many types of leukemia exist. Some forms of leukemia are more common in children. Other forms of leukemia occur mostly in adults. The disease starts in the white blood cells; in people with leukemia, the bone marrow produces abnormal white blood cells, which don't properly function.

According to the Leukemia Research Foundation, every four minutes, someone is diagnosed with blood cancer – more than 176,000 new cases are expected this year in the United States. More than 310,000 Americans are living with leukemia. This disease causes more deaths than any other cancer among children and young adults under the age of 20; however, leukemia is diagnosed 10 times more often in adults than children. Every day 143 Americans are diagnosed with leukemia, and 66 lose the fight. Much more detailed material can be found at this website: http://www.allbloodcancers.org/disease-information-support .

The exact cause of leukemia is unknown. Different kinds of leukemia are believed to have different causes. Both inherited and environmental (non-inherited) factors are believed to be involved. Risk factors include smoking, ionizing radiation, some chemicals (such as benzene), prior chemotherapy, and Down syndrome. People with a family history of leukemia are also at higher risk.

There are four main types of leukemia: acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML), as well as a number of less common types. Leukemia is part of a broader group of neoplasms which affect the blood, bone marrow, and lymphoid system, known as tumors of the hematopoietic and lymphoid tissues.

Treatment may involve some combination of chemotherapy, radiation therapy, targeted therapy, and bone marrow transplant, in addition to supportive care and palliative care as needed. Certain types of leukemia may be managed with watchful waiting. The success of treatment depends on the type of leukemia and the age of the person.

The average five-year survival rate is 57% in the United States. In children under 15, the five-year survival is greater than 60 to 85%, depending on the type of leukemia. In people with acute leukemia who are cancer-free after five years, the cancer is unlikely to return. More details on Leukemia can be located at this site: http://en.wikipedia.org/wiki/Leukemia .

According to the American Cancer Fund, leukemia symptoms can vary widely, depending on the type of leukemia you have. Common leukemia symptoms include:

·         Fever or chills 
·         Recurrent nosebleeds
·         Persistent fatigue, weakness
·         Frequent or severe infections
·         Bone pain or tenderness
·         Losing weight without trying
·         Swollen lymph nodes, enlarged liver or spleen
·         Easy bleeding or bruising
·         Excessive sweating, especially at night

Leukemia symptoms are often vague and not specific. You may overlook early leukemia symptoms because they may resemble symptoms of the flu and other common illnesses.
Rarely, leukemia may be discovered during blood tests for some other condition. Much more info on this topic can be found at this site: https://americancancerfund.org/cancer-types/leukemia/.

Acute lymphoblastic leukemia (ALL), also called acute lymphocytic leukemia or acute lymphoid leukemia, is a fast-growing cancer of a type of white blood cells called lymphocytes. About 6,000 people in the United States are diagnosed with ALL each year. It is the most common type of leukemia in children under age 15. However, it can affect people of any age. The cause of ALL is unknown, according to the National Cancer Institute.

If you are diagnosed with a blood cancer like leukemia, or an immune system or genetic disease, a bone marrow or cord blood transplant (also called a BMT) may be a treatment option for you. Learning more about your disease and treatment options will help you make informed decisions about your care. A significant amount of material concerning this disease can also be found at this site: http://bethematch.org/For-Patients-and-Families/Learning-about-your-disease/.  

ALL progresses rapidly, replacing healthy cells that produce functional lymphocytes with leukemia cells that can't mature properly, according to Cancer Treatment Centers of America. The leukemia cells are carried in the bloodstream to other organs and tissues, including the brain, liver, lymph nodes and testes, where they continue to grow and divide. The growing, dividing and spreading of these leukemia cells may result in a number of possible symptoms. You can find options for treatment and more at this website: http://www.cancercenter.com/leukemia/.

It is impossible in one short article to discuss all the ramifications about leukemia, its affect on your body, and possible outcomes. The list of websites in this information can serve as an initial guide to help with how to begin researching more options and resources to know more about leukemia. If you feel that you or someone you know may be experiencing certain health issues symptomatic to this disease, visit your health care provider or family physician for a more thorough diagnosis. The sooner you can begin treatment, the better opportunity you have for long term survival. Always consult a doctor or trained medical practitioner for any problems regarding your health.

Until next time.
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Friday, January 9

Health Care and Anti-Aging

Ever since Adam and Eve were kicked out of the Garden of Eden, mankind has been looking for ways to stop the aging process. Although the life span thousands of years ago when they were around was hundreds of years, the thought lingering in the back of everyone’s mind at some point was “How do I get rid of these wrinkles?” Well, when you’re 698, likely you look like a Sharpei anyway. However, since the average life span today is typically in the 70’s for most people, looking younger is much more of an issue.

The process of turning back the clock for your skin starts when you’re young—stay out of the sun, don’t go to the tanning booth so much, and eat healthy food. Most 6 year olds aren’t that concerned about frown lines, age spots, and crowfeet around the eyes; but when people get into their twenties, the need to suppress the aging process becomes much more critical. Too much exposure to UVA and UVB rays, smoking, drinking alcohol, stress, less sleep, and bad food all start to add up to damaging your health.

At the risk of sounding vain, the need to look younger is very common among most adults. What’s the secret to great hair, pore-free complexion, or flawless teeth? Everyone wants to have the inside scoop. And, since no one has yet been able to locate the Fountain of Youth, the best way to begin the process of looking younger is going to be found in common sense and some practical application of products designed to help you do just that.

According to Health.com, “anti-inflammatories are the best anti-agers out there. From improving heart and immune functions to helping hair grow and skin look supple, they truly do wonders.” Also, another tip is to avoid processed sugar in your diet. The reason: It speeds up the aging process by binding to and eventually weakening the collagen in your skin, which can lead to premature wrinkles and sagging.

For better looking teeth, you can snack on anything with malic acid—like strawberries, apples, and grapes—which act as a natural tooth cleanser and help break down stains. Coffee has the same affect on staining teeth. Avoid drinking a lot over a long period of time at one sitting, especially if you use cream or sugar. Plus, blow drying your hair damages it over time. Put a small amount of conditioner or treatment mask into damp hair before blow-drying. The conditioner not only tames fly-aways and frizz but also provides serious hydration. 

Additionally, Q-tips and cotton balls will only get you so far—you need the right gadgets to get gorgeous. These essentials make it easy to look flawless. So, stock your beauty kit now. For many more anti-aging tips, visit this website: http://www.health.com/health/gallery/0,,20306759,00.html .

Also, if you want an entire video library on anti-aging secrets, you can always visit Dr. Oz’s recommendations on his website: http://www.doctoroz.com/topic/anti-aging . Dr. Oz has cutting-edge information on anti-aging techniques and guidelines. Learn how to slow aging from the inside out! Plus, get pertinent information on beauty products, supplements, diet and nutrition, mental health, and fitness routines to turn back the clock.

As well, be careful not to overuse retinol based products for your skin. Vitamin-A derivatives [like retinol and the widely prescribed Retin-A] are strong molecules that focus on short-term results, over-stimulating the skin without considering the long-term consequences. This is not a sustainable approach for beauty and youth, according to Simon Erani, the founder and CEO of The Somme Institute in New York, and reported on Into The Gloss.com.

According to information on this website: http://intothegloss.com/2013/03/anti-aging-in-your-twenties-too-much-too-soon-skin-care-products-retinol/ ,   “The only problem with those drugs is that women’s skin is already considerably thinner than men’s, and these medications take off the top layer—so you’ve lost the first or second layer of your skin, and though your skin looks fresh and bright and great, it can actually get worse. With repeated use, retinol products begin to thin out your skin and will eventually make you more susceptible to UVA rays. If you're not wearing adequate SPF all the time, with passing years you’ll have more melasma, more discoloration... Plus, they can be way too harsh on the skin, even if you don’t feel the redness.”

From Dr. Elizabeth Hale, vice president of the Skin Cancer Foundation and a Clinical Associate Professor of Dermatology at the NYU Langone Medical Center “…there’s two types of aging of the skin: intrinsic aging, which would happen if you lived in a vacuum or a bubble, and then there’s extrinsic, which is sun-exposure and smoking, which accelerate your skin’s break-down. I’m a believer in prevention, even in your twenties, so that you can age gracefully and naturally, versus trying to reverse the signs of UV exposure or smoking later on. The number one thing you can do is just wear sunscreen. Every single day. Ninety percent of the signs of premature aging come from UV exposure.”

According to the American Academy of Anti-Aging Medicine, around the world, people are seeking medical guidance for ways to stay healthy, active, and vital well into their older years. As a result, the principles of the anti-aging lifestyle are gaining rapid and widespread acceptance as a framework for lifelong habits for healthy living. Anti-aging medicine is the pinnacle of biotechnology joined with advanced clinical preventive medicine.

The specialty is founded on the application of advanced scientific and medical technologies for the early detection, prevention, treatment, and reversal of age-related dysfunction, disorders, and diseases. It is a healthcare model promoting innovative science and research to prolong the healthy lifespan in humans. As such, anti-aging medicine is based on principles of sound and responsible medical care that are consistent with those applied in other preventive health specialties.

The anti-aging medical model aims to both extend lifespan as well as prolong healthspan - the length of time that people are able to live productively and independently. Much more material about this topic is located at this site: http://www.a4m.com/conferences-attendees-what-is-anti-aging-medicine.html.

For seniors, the need and desire to turn back the aging clock is even greater. According to a study on physical activities in the senior population by Humboldt University, “Running mitigates the age-related deterioration of walking economy whereas walking for exercise appears to have minimal effect on the age-related deterioration in walking economy.”  Active seniors who regularly run or walk experience a definite difference in aging over those who are sedentary. For more details, visit this website: http://www.worldhealth.net/news/run-stay-young/ .

Aging happens. What you can do about it to either slow down or mask the process is literally based on your lifestyle, medicine and certain products, and your genes. Inevitably, at some point, you are going to be old. Looking old and acting old are not always the same thing. Remember, the older you get, the more responsibility you have to take care of yourself so that the features you were given at birth are still recognizable when you come to the end of life.

Until next time.
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Wednesday, January 7

Health Care and Phlebitis

When individuals have medical issues with veins that get inflamed, the pain can be severe. Inflammation of veins is called phlebitis. Typically, it is not life threatening if treated right away and can be easily cured in many cases. The inflammation may cause pain and swelling.
Superficial phlebitis affects veins on the skin surface. The condition is rarely serious and is usually resolved with local treatment of the inflammation with warm compresses and anti-inflammatory medications.

However, more severe cases of inflammation in veins may be caused by a blood clot. When the inflammation is caused by a blood clot or thrombus, it is called thrombophlebitis and usually occurs in leg veins; but it may also affect the veins in the arms. There are two sets of veins in the arms and legs, 1) the superficial veins that run just under the skin, and 2) the deep veins.

According to Dr. Andrew Weil, symptoms depend on the location of the inflammation. Superficial phlebitis can cause symptoms such as:

·         Redness along the path of the vein
·         Warmth, tenderness, or swelling in affected area
·         Itching or burning in affected area
·         Low-grade fever.

These symptoms may feel worse when the affected area (such as a leg) is lowered, particularly in the morning. Superficial phlebitis is uncomfortable but rarely serious. If clotting occurs, the inflamed vein will feel like a hard string or cord under the skin, and won't collapse like a normal varicose vein.

Deep vein thrombophlebitis often causes no symptoms at all. When it does, symptoms include warmth, redness, and swelling in the affected limb. Deep vein thrombophlebitis is dangerous because the blood clot lodged in the vein (called a deep venous thrombosis or DVT) can break free and travel to a person's lungs, a situation that is often fatal. Chest pain and shortness of breath are early signs that this has occurred. Much more detail on this topic can be found at this website: http://www.drweil.com/drw/u/ART03146/Phlebitis.html.

The following, according to the National Institutes of Health (NIH), increase your chances for thrombophlebitis:

·         Being hospitalized for a major surgery or with a major illness
·         Disorders that make you more likely to develop blood clots
·         Sitting for a long period of time (such as on a long airplane trip)

Your health care provider can usually diagnose the condition based on how the affected area looks. You may need to have your pulse, blood pressure, temperature, skin condition, and circulation frequently checked to make sure you don't have complications. If the cause cannot be easily identified, one or more of the following tests may be done:

·         Blood coagulation studies
·         Doppler ultrasound
·         Venography

Thrombophlebitis and other forms of phlebitis usually respond to prompt medical treatment, according to the NIH. More detailed material can be found by visiting this site:  http://www.nlm.nih.gov/medlineplus/ency/article/001108.htm.

According to New York University (NYU) Medical School, some factors that increase your chance of developing superficial phlebitis include:

·         Trauma especially to the lower leg
·         Blood clotting disorder
·         Sitting for long periods of time, such as riding in a car or on an airplane
·         Prolonged bed rest
·         Prior episodes of phlebitis
·         Certain cancers
·         Paralysis, which may be caused by a stroke
·         Family history of blood clotting disorders
·         Obesity
·         Pregnancy

If you are diagnosed with superficial thrombophlebitis, follow your doctor's instructions. More info on this medical problem can be found at this site: http://medicine.med.nyu.edu/conditions-we-treat/conditions/phlebitis.

The long-term goals of treatment of superficial phlebitis are to reduce symptoms and reduce the risk of complications. Your health care provider will recommend the treatment option that is right for you, according to the Cleveland Clinic. The main goal of initial treatment is to control pain and inflammation. You will likely be prescribed pain medication and an anti-inflammatory medication such as ibuprofen.

Rarely is anticoagulation with medications such as Coumadin or Heparin warranted. Much of this process is self-limited, with complete resolution of symptoms within a few weeks. You can find more info about phlebitis at this site: http://my.clevelandclinic.org/services/heart/disorders/hypercoagstate/vs_phlebitis.

Superficial phlebitis inflammationgenerally is reduced within 7-10 days, but it may be 3-6 weeks for the problem to be entirely gone. Deep vein thrombophlebitis may require more aggressive treatment, including hospitalization, strong anticoagulants, and a variety of possible surgical procedures, according to this site:  http://www.diagnose-me.com/symptoms-of/phlebitis-thrombophlebitis.html.

If you feel that you may be suffering from symptoms related to phlebitis, see your doctor or a health care provider right away. You don’t want to delay treatment as the issue may be beyond your immediate relief by self examination and care at home without medical diagnosis. The condition can quickly escalate to more severe medical issues. Although, phlebitis is a temporary problem, it pays to be careful with treatment and professional medical advice.  

Until next time.
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