CenterStage: February is American Heart Month - Are Your Loved Ones Knowledgeable?

Heart disease is the leading cause of death for men and women in the United States. Every year, 1 in 4 deaths are caused by heart disease, according to the American Heart Association.

Talking with your loved ones about heart disease can be awkward, but it’s important. In fact, it could save a life. At the dinner table, in the car, or even via text, have a heart-to-heart with your loved ones about improving heart health as a family. Engaging those you care about in conversations about heart disease prevention can result in heart-healthy behavior changes.

Source: Wellness Layers (27 June 2017). Retrieved from http://www.wellnesslayers.com/june-2017-american-heart-association-launched-its-new-heart-and-stroke-patient-support-network-and-patients-registry-powered-by-rmdy/

Here are three reasons to talk to the people in your life about heart health and three ways to get the conversation started.

Three Reasons You Should Talk to Your Loved Ones About Heart Health

#1. More than physical health is at risk

Millions of people in the US don’t know that they have high blood pressure. High blood pressure raises the risk for heart attacks, stroke, heart disease, kidney disease and many other health issues. Researchers are learning that having high blood pressure in your late 40s or early 50s can lead to dementia later in life. Encourage family members to be aware of blood pressure levels and monitor them consistently.

 

#2. Feel Younger Longer

Just as bad living habits can age you prematurely and shorten your lifespan, practicing good heart healthy habits can help you feel younger longer. On average, U.S. adults have hearts that are 7 years older than they should be, according to the Center for Disease Control and Prevention. Just beginning the conversation with the people in your life that you care about can begin to make changes in their heart health.

 

#3. You Are What You Eat

Even small changes can make a big difference. Prepare healthier versions of your favorite family recipes by making simple ingredient swaps, simply searching the internet is all it usually takes to find an easy ingredient alternative. Find a new
recipe to cook for your family members, or get in the kitchen together and you’ll finish with something delicious and possibly making some new favorite memories as well. When grocery shopping, choose items low in sodium, added sugar, and trans fats, and be sure to stock up on fresh fruits and vegetables.

Three Ways to Start the Conversation

  1. Encourage family members to make small changes, like using spices to season food instead of salt.
  2. Motivate your loved ones to incorporate physical activity into every day. Consider a family fitness challenge and compete with each other to see who can achieve the best results.
  3. Avoid bad habits together. It has been found that smokers are twice as likely to quit if they have a support system. This applies to practicing healthier practices as well. Set goals and start by making small, positive changes, chances are they may have a big difference.

The key to heart health is a healthy lifestyle. It’s important to try to let go of bad habits that increase your risk of heart disease. By setting small, achievable goals and tracking those goals, you can possibly extend your life expectancy a little bit each day.

Heart disease can be prevented by making healthy choices and consciously monitoring health conditions. Making healthy choices a topic of conversation with your family and loved ones is a great way to open the door to healthier practices in all walks of life.

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5 things to know about this year’s flu

The nation is having a Terrible, Horrible, No Good, Very Bad flu season.

Flu is widespread in 46 states, according to reports to the U.S. Centers for Disease Control and Prevention (CDC).

Nationally, as of mid-December, at least 106 people had died from the infectious disease.

In addition, states across the country are reporting higher-than-average flu-related hospitalizations and emergency room visits. Hospitalization rates are highest among people older than 50 and children younger than 5.

In California, which is among the hardest-hit states, the virus struck surprisingly early this season. The state’s warmer temperatures typically mean people are less confined indoors during the winter months. As a result, flu season usually strikes later than in other regions.

Health experts aren’t sure why this season is different.

“We’re seeing the worst of it right now,” said Dr. Randy Bergen, a pediatrician who is leading Kaiser Permanente-Northern California’s anti-flu effort. “We’re really in historic territory, and I just don’t know when it’s going to stop.” (Kaiser Health News, which produces California Healthline, is not affiliated with Kaiser Permanente.)

Here are five things you should know about this flu season:

1. It’s shaping up to be one of the worst in recent years.

The H3N2 influenza A subtype that appears to be most prevalent this year is particularly nasty, with more severe symptoms including fever and body aches. Australia, which U.S. public health officials follow closely in their flu forecasting — in part because their winter is our summer — reported a record-high number of confirmed flu cases in 2017. Another influenza B virus subtype also is circulating, “and that’s no fun, either,” Bergen said.

Flu season in the U.S. typically starts in October and ends in May, peaking between December and February.

2. This season’s flu vaccine is likely to be less effective than in previous years.

U.S. flu experts say they won’t fully know how effective this season’s vaccine is until the it’s over. But Australia’s experience suggests effectiveness was only about 10 percent. In the U.S., it is 40 to 60 percent effective in an average season. Vaccines are less protective if strains are different than predicted and unexpected mutations occur.

3. You should get the flu shot anyway.

Even if it is not a good match to the virus now circulating, the vaccine helps to ease the severity and duration of symptoms if you come down with the flu.

Children are considered highly vulnerable to the disease. Studies show that for children a shot can significantly reduce the risk of dying.

High-dose vaccines are recommended for older people, who also are exceptionally vulnerable to illness, hospitalization and death related to the flu, according to the CDC.

“Some protection is better than no protection,” Bergen said, “but it’s certainly disappointing to have a vaccine that’s just not as effective as we’d like it to be.

Shots may still be available from your doctor or local health clinic, as well as at some chain drugstores. Check the Vaccine Finder website for a location near you.

4. Basic precautions may spare you and your family from days in bed.

As much as possible, avoid people who are sick. Wash your hands frequently and avoid touching your mouth, nose and eyes.

Masks aren’t particularly effective in keeping you from catching the flu, although they may help keep sick people who wear them from spreading their germs further.

If you are sick, cover your cough and stay home from work if you can, Bergen said. Remaining hydrated, eating nutritious foods and exercising can also help strengthen your immune system.

Because elderly people are so vulnerable to the flu, some nursing homes and assisted living facilities may limit visitors and resident activities, depending on the level of illness.

 

5. Don’t mistake flu symptoms for those of a common cold.

The hallmarks of flu are fever and body aches that accompany cough and congestion, Bergen said.

If you feel as if you’re having trouble breathing, or if your fever can’t be controlled with medication like Tylenol, check with your doctor. It’s even more important for patients to see a doctor if they have a chronic medical condition like diabetes or heart disease, or if they are young or elderly.

Kaiser Permanente doctors now are being advised to prescribe antiviral drugs like Tamiflu — given as a pill or, for kids, an oral suspension — even without a lab test for influenza, Bergen said. According to a report in the Los Angeles Times, however, Tamiflu supplies are running low.

And Bergen cautioned that these medications are only partly effective, reducing the time of illness by just a day or two.

Read the original article.

Source:
Kaiser Health News (22 January 2018). "5 things to know about this year’s flu" [Web blog post]. Retrieved from address http://workwell.unum.com/2018/01/5-things-know-years-flu/

Tax Bill Provision Designed To Spur Paid Family Leave To Lower-Wage Workers

Sen. Deb Fischer, R-Neb., arrives in the Capitol for a vote on Tuesday, Nov. 7, 2017. She recently proposed a tax credit to companies that offer at least two weeks of paid family or medical leave annually to workers. (Bill Clark/CQ Roll Call)

Tucked into the new tax law is a provision that offers companies a tax credit if they provide paid family and medical leave for lower-wage workers.

Many people support a national strategy for paid parental and family leave, especially for workers who are not in management and are less likely to get that benefit on the job. But consultants, scholars and consumer advocates alike say the new tax credit will encourage few companies to take the plunge.

The tax credit, proposed by Sen. Deb Fischer (R-Neb.), is available to companies that offer at least two weeks of paid family or medical leave annually to workers, but two key criteria must be met. The workers must earn less than $72,000 a year and the leave must cover at least 50 percent of their wages.

If contributing at the half-wage level, a company receives a tax credit equal to 12.5 percent of the amount it pays to the worker. The tax credit will increase on a sliding scale if the company pays more than 50 percent of wages. It could go up to a maximum credit of 25 percent of the amount the employer paid for up to 12 weeks of leave.

Payments to full- and part-time workers taking family leave who’ve been employed for at least a year would be eligible for the employer’s tax break. But the program, which is designed to test whether this approach works well, is set to last just two years, ending after 2019.

Aparna Mathur, a resident scholar in economic policy studies at the American Enterprise Institute, says the new tax credit sidesteps a pitfall for Republicans. They are wary of any legislation mandating that employers provide paid leave. The tax credit also is appropriately aimed at lower-wage workers who are most likely to lack access to paid leave, said Mathur, who co-authored a recent report on paid family leave.

But it’s not a big enticement.

“Providing this benefit is a huge cost for employers,” Mathur said. “It’s unlikely that any new companies will jump on board just because they have a 12.5 to 25 percent offset.”

That view is shared by Vicki Shabo, vice president for workplace policies and strategies at the National Partnership for Women & Families, an advocacy group, who said it will primarily benefit workers at companies already offering paid family leave. The new tax credit “just perpetuates the boss lottery,” she added.

Heather Whaling said her 22-person public relations company probably qualifies for the new tax credit, but she doesn’t think it’s the right approach. Whaling, the president of Geben Communication in Columbus, Ohio, already offers paid leave. The company provides up to 10 weeks of paid leave at full pay for new parents. Four employees have taken leave, and by divvying up their work to other team members and hiring freelancers they’ve been able to get by.

“It is an expense, but if you plan and budget carefully it’s not cost-prohibitive,” she said.

The tax credit isn’t big enough to provide a strong incentive to provide paid leave, said Whaling, 37. Besides, “having access to paid family leave shouldn’t be luck of the draw, it should be available to every employee in the country.”

Still, the tax credit may be appealing to companies that have been considering adding a paid family and medical leave benefit, said Rich Fuerstenberg, a senior partner at benefits consultant Mercer.

By defraying some of the cost, the tax credit could help “tip them over” into offering paid leave, he said. But  “I’m not even sure I’d call it the icing on the cake,” Fuerstenberg said. “It’s like the cherry on the icing.”

Only 15 percent of private-sector and state and local government workers had access to paid family and medical leave in 2017, according to the Bureau of Labor Statistics’ National Compensation Survey. Eighty-eight percent had access to unpaid leave, however.

Under the federal Family and Medical Leave Act, employers with 50 or more workers generally must allow eligible employees to take unpaid leave for up to 12 weeks annually for specified reasons. These include the birth or adoption of a child, caring for your own or a family member’s serious health condition, or leave for military caregiving or deployment. An individual’s job is protected during such leaves.

A tax credit that can be claimed at the end of the year is unlikely to encourage small businesses to offer paid family and medical leave, said Erik Rettig, an expert on family leave policies at the Small Business Majority, which advocates for those firms on national policy.

“It isn’t going to help the family business that has to absorb the costs of this employee while they’re gone,” Rettig said.

A better solution, according to Shabo and others, is to provide a paid family leave benefit that’s funded by employer and/or employee payroll contributions. Sen. Kirsten Gillibrand (D-N.Y.) and Rep. Rosa DeLauro (D-Conn.) last year reintroduced such legislation. Their bill would guarantee workers, including those who are self-employed, up to 12 weeks of family and medical leave with as much as two-thirds of their pay.

A handful of mostly Democratic states — including California, New Jersey, Rhode Island and New York — have similar laws in place, and a program in the District of Columbia and Washington state will begin in 2020.

“We know from states that this approach works for both employees and their bosses,” Shabo said.

Read the original article.

Source:
Andrews M. (23 January 2018). "Tax Bill Provision Designed To Spur Paid Family Leave To Lower-Wage Workers" [Web blog post]. Retrieved from address https://khn.org/news/tax-bill-provision-designed-to-spur-paid-family-leave-to-lower-wage-workers/

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Top 10 Corporate Wellness Habits to Adopt During 2018

With the New Year in full swing, you may be considering how to turn your life around for the better -  drop pounds, kill unhealthy chocolate addictions, quit binging every Netflix season ever, etc... But what about making lasting habits within the workplace?

 

Too often, we make a list of resolutions, and we forget where we spend most our time. Work is work, but that doesn’t mean we can’t implement some of the changes we make in our personal lives in the workplace, as well.

 

Today, we thought we’d offer up 10 different ideas for employers (or for employees to offer to their boss) to try and implement within the workplace – from wellness challenges to recess. Try one, combine a few, or do them all! The best part about making resolutions is making them unique to yourself and your company. So, don’t be afraid to get creative!

  1. Offer healthy alternatives to traditional junk food items

 

Just a simple switch of snack foods in the office can cut unnecessary calories! Snacking on healthy items can make mindless snacking not so bad.

  1. Offer standing desks

 

This easy switch will be one of the new year’s trendiest wellness tactics. Select desk options that allow users to easily switch between standing and sitting while working to allow for better blood flow throughout the day.

PIXNIO - Image usage: Image is in public domain, not copyrighted, no rights reserved, free for any use.

  1. Try a wellness challenge

 

There’s nothing like some healthy interoffice competition to get people motivated. Select a wellness challenge that is easy and effortless to incorporate into your workplace. This could be a monthly or a weekly challenge, switch it up each month/week to keep things interesting!

 

  1. On-site yoga classes

 

Another wellness trend that will continue into 2018 is managing stress through yoga. Mindfulness and meditation offer a slew of benefits to help employees relieve stress. Invite an instructor to your office every couple of weeks to guide the team through a yoga class.

  1. Celebrate “Wellness Wednesday”

 

Make hump day something to celebrate and begin to tackle wellness in the office in a manageable way. One day a week can be a gateway to a much healthier lifestyle.

  1. Listen to your employees

Survey employees to find out what is working and what isn’t instead of wasting time and energy on things that aren’t engaging your employee population. Use a site like Survey Monkey or Google Forms to create a survey to collect feedback from employees.

  1. Participate in a 5K or other group fitness activities

Find a 5K in your community or choose another group fitness activity and cover the entry fee for anyone choosing to participate.

 

  1. Post signs near elevators and escalators encouraging employees to take the stairs instead

Sometimes just seeing this reminder is all the motivation needed to be a little more active!

  1. Schedule recess

Pick a 15-minute time of the afternoon for everyone to get away from his or her desk. Go outside, socialize with each other and enjoy some fresh air! Taking walks has also been shown to increase creativity.

  1. Reward volunteers

 

Pay your employees for any volunteer hours up to a certain amount or allot a certain amount of time each month for employees to get away from their desk and get active in the community. Ideas include volunteering at a local food bank or cleaning up a local park, beach, or trail. You’ll benefits from both team building and group physical exercise!

 

Give one or more of these ideas a try and if they work out for you, let us know! The important lesson here is to remember your work-life is just as important to better as your personal life. When it comes to New Year Resolutions, make sure they encompass every aspect of your life and definitely don’t forget to include your employees in your thoughts.

Stay healthy, have fun, and Happy New Year!

No mat needed: Yoga at your desk

A sticky mat seems de rigueur for modern-day yogis, but that doesn’t mean a long piece of rubber is required to take part in the ancient practice.

Yoga first and foremost is about being present, and it starts with attentive breathing. You can do that anywhere and without props.

Once you’ve got the hang of steady breathing, matching inhales and exhales to movements helps your body relieve tension and your muscles wake up. In fact, the key to the physical practice of yoga is matching conscious breath to movement. It’s also a big part of what makes yoga feel great. Without it, you’d be doing calisthenics.

We’ve rounded up a few yoga exercises you can do easily and safely at work. All require standing – good news, given sitting is pretty bad for us. It’s best to do them with your feet flat on the ground.

 

Stand with your feet hip-distance apart. Inhale as you bring your arms overhead. Keep your chin level with the ground. Exhale as you soften your knees and twist your torso to the right, letting your head follow and dropping your arms to shoulder-height. Inhale as you turn back to center, lifting your arms overhead. Do the twist to the left. Repeat this pattern several times.

Benefits: Strengthens abdominal muscles, shoulders and upper arms. Stretches back and chest. Lubricates joints of the spine, including in the neck, and shoulders.

Chair

Stand with your feet hip-distance apart, arms at your sides. Inhale as you lift the crown of your head. Exhale as you bend your knees (typically you want to track each knee over the middle of its corresponding foot), like you’re sitting back in a chair. Hinge at your hips, tilting your torso forward up to 45 degrees. Lift your arms to a comfortable height. Inhale as you return to standing, crown lifted, arms lengthening down. Repeat several times.

Benefits: Strengthens front thighs, buttocks, core, upper back and upper arms. Stretches calves and side torso. Lengthens spine. Lubricates joints of the ankles, knees, hips and shoulders.

Triangle

Stand with your feet slightly wider than hip-distance apart, toes pointing same direction as your chest, then turn your right foot 90 degrees to the right, and your left foot about 15 degrees to the right, making sure your left toes point the same direction as your left knee. Inhale as you extend your arms out from the shoulders and lengthen your spine. Exhale as you tilt your torso to the right, releasing your right arm toward your right leg and your left arm up to a comfortable height. Don’t turn your chest toward your right leg. Drop your gaze to the ground if you feel tension in your neck. Hold for several breaths, and repeat with the left leg.

Benefits: Strengthens front thighs, buttocks, side torso and neck. Stretches calves, back thighs and side torso. Lubricates joints of the hips and shoulders.

 

 

You can read the original article here.

Source:
Malek M. (2 May 2017). "No mat needed: Yoga at your desk" [Web blog post]. Retrieved from address http://worklife.coloniallife.com/2017/05/no-mat-needed-yoga-desk/?utm_sq=flegx3i374&utm_source=Twitter&utm_medium=social&utm_campaign=WorkLifeTweets&utm_content=Articles


Some States Roll Back ‘Retroactive Medicaid,’ A Buffer For The Poor — And For Hospitals

From Kaiser Health News, let's take a look at the latest regarding Medicaid.


If you’re poor, uninsured and fall seriously ill, in most states if you qualify for Medicaid — but weren’t enrolled at the time — the program will pay your medical bills going back three months. It protects hospitals, too, from having to absorb the costs of caring for these patients.

But a growing number of states are rescinding this benefit known as “retroactive eligibility.” On Nov. 1, Iowa joined three states that have eliminated retroactive coverage for some groups of Medicaid patients since the Affordable Care Act passed. Each state had to secure approval by the federal government.

Retroactive eligibility has been a feature of Medicaid for decades, reflecting the program’s emphasis on providing a safety net for poor, disabled and other vulnerable people. In contrast to private insurance, determining Medicaid eligibility can be complex and the application process daunting, advocates say. A patient’s medical condition also may keep families from applying promptly for coverage.

All four states — Arkansas, Indiana and New Hampshire, in addition to Iowa — have expanded Medicaid under the health law, which allowed states to include adults with incomes up to 138 percent of the federal poverty level, or about $16,000 for one person. So, in theory, most adults are required to have insurance under the ACA. In practice, each state still has a significant number of uninsured, ranging from 5 to 8 percent of the population.

The retroactive coverage “can compensate for the sorts of errors and lapses that can so easily occur on the part of both the applicant and the government bureaucracy” that delay applications, said Gordon Bonnyman, staff attorney at the Tennessee Justice Center, a public interest law firm that represents low-income and uninsured residents.

State and federal officials say eliminating the retroactive coverage helps encourage people to sign up for and maintain coverage when they’re healthy rather than waiting until they’re sick to enroll. It also fits into federal officials’ efforts to make Medicaid, the federal-state program that provides health care for low-income adults and children, more like private insurance.

But consumer advocates and health care providers say the shift will saddle patients with hefty medical bills and leave hospitals to absorb more uncompensated care when patients can’t pay. Some worry this could be the start of a trend.

In Iowa, the change applies to just about anyone coming into Medicaid — except for pregnant women and children under age 1. The change will affect up to 40,000 residents annually and save the program more than $36 million a year.

“We’re making it a lot more likely that Medicaid-eligible members are going to incur significant medical debt,” said Mary Nelle Trefz, health policy associate at the Child & Family Policy Center in Des Moines, whose organization opposed the change.

When someone has a traumatic health event, the initial focus is to get them stabilized, not figure out how to pay for it, said MaryBeth Musumeci, associate director of the Program on Medicaid and the Uninsured at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

Patients may neglect to apply immediately for Medicaid, leaving them financially responsible for days or months of care they received before they got in their application, even though they may have been eligible for Medicaid all along.

That’s not the only issue, advocates say. Unlike the commercial insurance market where re-enrollment through someone’s employer is routine, Medicaid requires that beneficiaries’ eligibility be reassesed every year.

“People fall through the cracks,” said Andrea Callow, associate director of Medicaid initiatives at Families USA, a consumer advocacy group.

In addition, complications can arise for people who might need Medicaid coverage for long-term care services. “The criteria are complicated. For a layperson to find those criteria and figure out if they’re eligible” is challenging and they may need extra time, said Musumeci. Once patients have secured coverage, they may already have accrued hefty expenses.

Maybe so, but some people argue that a 90-day retroactive eligibility guarantee is counterproductive.

“We’re trying to get people to behave more responsibly, not less responsibly,” said Gail Wilensky, an economist who oversaw the Medicaid and Medicare programs in the early 1990s under President George H.W. Bush. “That is not the signal you’re sending” with three months of retroactive eligibility. A 30-day time frame is more reasonable, Wilensky said.

In contrast to Iowa, the waivers in Arkansas, Indiana and New Hamsphire generally apply only to adults who gained coverage under the law’s Medicaid expansion. (Indiana’s waiver also applies to other groups.)

Kentucky has a request pending that, like Iowa, would eliminate retroactive Medicaid eligibility except for pregnant women and children under 1, according to KFF.

Under federal law, officials can waive some Medicaid coverage rules to give states flexibility to experiment with different approaches to providing services. And retroactive eligibility waivers in Medicaid are hardly new. A few states like Tennessee have had them in place for years. Tennessee officials eliminated retroactive eligibility for all Medicaid beneficiaries in 1994 when the state significantly expanded coverage under TennCare, as Medicaid is known there. At the time, the state even allowed uninsured people to buy into the program who wouldn’t otherwise qualify based on income, said Bonnyman.

“There was no reason for anybody to be uninsured except undocumented immigrants,” said Bonnyman. “It didn’t seem to have the potential for harm.”

But state officials revamped that program after serious financial problems. Eligibility for TennCare has become more restrictive again.

Other states that waived retroactive coverage for at least some Medicaid groups include Delaware, Maryland, Massachusetts and Utah, according to the Kaiser Family Foundation.

Bonnyman said his group frequently works with Medicaid beneficiaries who have medical bills they can’t afford that accumulated during the months before they applied for Medicaid.

“If you’re a moderate- to low-income working family, one or two days in the hospital is enough to ruin you financially,” he said.

 

You can read the original article here.

Source:
Andrews M. (14 November 2017). "Some States Roll Back ‘Retroactive Medicaid,’ A Buffer For The Poor — And For Hospitals" [Web blog post]. Retrieved from address https://khn.org/news/some-states-roll-back-retroactive-medicaid-a-buffer-for-the-poor-and-for-hospitals/


hand in the sun

10 surprisingly great places to retire in the U.S.

At Saxon, we care about retirement and offering you the best plans. In this article, we take a look at Forbes's list of the top 10 places to retire. Do any of these places sound peaceful to you?


Probably the biggest retirement decision you’ll face (after: Can I ever?) is: Where should I retire? To help, U.S. News has just come out with its first Best Places to Retire in the United States ranking of the 100 largest metropolitan areas. Some of its Top 10 spots will surely surprise you and you may also wonder why certain parts of the country failed to make the cut.

Credit: Shutterstock

“This is a much more comprehensive analysis than we’ve done in the past,” said Emily Brandon, U.S. News senior editor for retirement. “Before, we’ve done themed lists like 10 Places to Retire on Social Security Alone and 10 Retirement Spots With Year-Round Nice Weather.”

How U.S. News Ranked the Best Places to Retire

This time, U.S. News first asked people 45 and older to indicate the “attributes of a retirement destination that are most important to them” and collected responses from 841 of them. “What people told us was most important to them in a place to retire was 'being affordable' but also, they wanted to feel happy there,” said Brandon.

Based on the survey responses, the researchers then assigned weightings in indices of six broad categories — happiness living in particular metro areas; housing affordability for homeowners and renters; health care quality, based on the U.S. News Best Hospitals rankings; retiree taxes (sales and income); the strength of local job markets and what U.S. News calls “Desirability,” which means how strongly Americans said they’re interested in living in a given metro area. After all that number crunching, a Best Places ranking emerged.

The Top 10

The Top 10 best places to retire in America, according to U.S. News:

  1. Sarasota, Fla.
  2. Lancaster, Pa.
  3. San Antonio, Texas
  4. Grand Rapids, Mich.
  5. El Paso, Texas
  6. McAllen, Texas
  7. Daytona Beach, Fla.
  8. Pittsburgh, Pa.
  9. Austin, Texas
  10. Washington, D.C.

“Most of the places scored well on some measures, but not on others,” said Brandon.

That’s a fact. Sarasota had high scores for Happiness, Desirability and Retiree Taxes and decent ones in the other categories. McAllen didn’t fare well in the Job Market category and Washington, D.C. got a low ranking for Housing Affordability. El Paso and Grand Rapids were weak in the Desirability category.

Why Places Scored Well and Didn't

The reason four Texas metro areas made it into the Top 10? “Affordable housing, low taxes and above-average levels of happiness,” said Brandon.

The three winners in the Middle Atlantic states (Lancaster, Pittsburgh and Washington, D.C.) had high rankings because of happy residents and access to high quality health care, Brandon noted.

You may have noticed that the Top 10 largely consists of small- and mid-size cities and no California or New York City-area metros. “I think a lot of that has to do with housing prices,” said Brandon. “Almost no California places scored high in the list largely because housing prices are out of reach for many people with low- or even mid-range incomes.” California home prices are 150% above the U..S. average, overall. The highest-ranked California metro area in the U.S. News list is San Diego, which came in at No. 21.

What About the Weather?

Somewhat strangely, the U.S. News ranking didn’t factor in weather at all.

“We had some discussion about whether to include weather,” said Brandon. “It’s tricky because not everyone has the same preferences when it comes to weather. Some people want four seasons. Some find snowy winters terrible.” The upshot: the rankers left out this variable.

How the U.S. News List Compares With Other Rankings

The U.S. News list is markedly different from other recent Best Places to Retire rankings from Forbes and WalletHub.

The 25 places Forbes chose, after looking at 550 communities, were in big and small cities and skewed toward warm and moderate climates; its top places included Clemson, S.C., Port Charlotte, Fla. and Green Valley, Ariz. None of its 25 were in the U.S. News Top 10.

WalletHub looked at the retiree-friendliness of the 150 largest U.S. cities across 40 metrics and its top picks were mostly large ones. Three cities in Florida topped the list: Orlando, Tampa and Miami. Austin was the only one in both WalletHub’s Top 10 and U.S. News’.

What the Rankings Can't Rank

You won’t want to move to any place in retirement just because it’s on a Best Places list, of course. And no ranking can account for a key retirement location criteria for many people: proximity to family members.

Still, Best Places to Retire rankings can be a useful part of your research as long as you closely read their methodology, so you understand what the raters were rating.

“These types of surveys can be a great starting point in deciding where to retire,” said Brandon. “It all comes down to your personal preferences. Your criteria for what makes a best place to retire may be different than for others.”

 

You can read the original article here.

Source:

Eisenberg R. (2 October 2017). "U.S. News Offers A New Take On The Best Places In The U.S. To Retire" [Web blog post]. Retrieved from address https://www.forbes.com/sites/nextavenue/2017/10/02/u-s-news-offers-a-new-take-on-the-best-places-in-the-u-s-to-retire/#4d26f87c60ec

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Collaborative Innovation Is Necessary To Advance In Health Care

Technology has taken over the modern way-of-life, and it definitely hasn't stopped in health care. Check out this intriguing articles from Forbes on why collaboration between tech and health care may just be necessary for the progression of wellness.

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As health needs grow, it is imperative that innovation is at the frontier of change, to keep the health needs and requirements of the 21st century scalable. For innovation in health care to be sustained at an economically and fiscally responsible pace, it has to be a collaborative effort, requiring input from diverse stakeholders and key players in the industry. A collaborative health care system that includes information sharing, cross-industry cooperation and open innovation can lead to beneficial industry practices like cost reduction and time efficiency. Together, these practices set a precedent for growth and development at a more rapid pace.

An Efficient Method Of Doing Things

Toeing the line of technology advancements, innovation within the health care system has pioneered the development of cost-efficient, highly-optimized pragmatic solutions to many industry and individual health challenges. Artificial retinasrobotic nurses and gene therapy are just a few examples of plentiful recent innovations. These innovative technologies pose solutions to medical feats that, in the past, have overwhelmed medical practitioners, and thereby are expected to permit better health care delivery to patients and the global population. However, for these new advancements to be successfully implemented and established within the health care system, they must be met with collaboration and cooperation.

Creating A Synergistic Environment

Open, collective innovation like Project Data Sphere, designed to collate big data and bridge the distant segments of the health care industry, markup the necessity of innovation in the sector. In the case of Project Data Sphere, the goal is to facilitate the creation of a connected health care network bereft of the many loopholes characteristic of the system. Interoperability between key segments of the industry has always been a rate limiting factor. A unified platform capable of linking these segments together can have a significant impact on the sector.

Multiple companies are undertaking projects to build "cloud-based, big data platform" solutions that manage data to give the health industry the necessary edge it needs to manage itself. This ranges from cloud-based platforms powered by libraries of clinical, social and behavioral analytics utilized for sharing information across multiple hospitals, to using big data and advanced analytics for clinical improvements, financial analysis and fraud and waste monitoring.

Collaborating To Go Digital

Concurrent with the world’s continued adoption of digital technologies is the rapid expansion of the digital health care market — an expansion fostered by collaboration among global leaders of digital innovation in the health care industry. The partnership between major players in both the private and public sectors has engineered a growing list of innovative digital health care solutions.

Just last year an Israeli-based pharmaceutical company joined forces with Santa Clara, California-based Intel to develop wearables that routinely record and analyze symptoms of Huntington’s disease. The data collected is processed to help grade motor symptom severity associated with the disease.

Most times, singular organizations lack the human and financial resources to orchestrate grand schemes of innovation alone — but collaboration presents a practical route to overcoming the limitations that hinder novelty, leading to quicker turnarounds and advancements.

Scaling The Barriers To Innovation

If the push for innovation in the health care system is to thrive, then the complexities and obstacles that have continually stifled progress must be confronted. Aside from collaboration, other notable barriers to innovation include:

• The immediate return mentality: By default, most leaders show a preference for innovative solutions that offer immediate financial rewards. Innovative solutions with brighter prospects but long term financial incentives are in most instances placed on a back burner.

• Bureaucracy in the distributive network:Innovators have to wade through multiple third parties if they are to stand any chance of getting their products to the end user, a process that is not only daunting but financially implicative.

• Stringent regulatory practices: In addition to scaling through the bureaucracy, innovative solutions looking to make a market appearance have to pass several screenings, some of which have been tagged redundant by experts.

Innovation is a necessary tool in the health care sector that gives an essential boost to scale insurmountable obstacles and limitations. For health care to evolve into a more sophisticated and efficient system, cross-industry collaboration and inter-professional cooperation must become the norm.

 

You can read the original article here.

Source:

Pando A. (19 September 2017). "Collaborative Innovation Is Necessary To Advance In Health Care" [Web blog post]. Retrieved from address https://www.forbes.com/sites/forbestechcouncil/2017/09/19/collaborative-innovation-is-necessary-to-advance-in-health-care/2/#6743d07669c9


Pagers, AI, And Google: 3 Tales Of Technology And Medicine

 As a society, we owe technology applause for helping improve our medical abilities tenfold. Today, we thought it would be fun to take a look back on how technological advancements have succeeded in making our medicine better than ever, and how they continue to do so. Take a moment of your time to read this article from Forbes on Pagers, AI, and Google.


Medicine and technological advancement have been intimately intertwined, from the invention of the stethoscope to the latest innovations in MRI scanning. But the road isn’t always smooth. There can be interesting bumps and glitches along the way, as illustrated by these three recent stories.

1) Old tech can linger

The Guardian recently reported that the UK National Health Service uses more than 10% of the world’s pagers. The pagers cost £6.6 million ($8.9 million) per year. Furthermore, the UK will soon only have one provider of pagers nationwide after Vodafone exits the market.

One critic noted, “Taxpayers will wonder why the NHS is spending millions on outdated technology, especially at a time when savings need to be made.”

As a young doctor in the 1990s, I carried a pager. But nowadays, most physicians I know use cell phones to take emergency calls. However, The Guardian notes that there are still a few advantages to pagers, namely:

...[S]lightly more reliability. Where mobile phone networks can be patchy, or slow, or overloaded, the separate paging network offers a modest improvement in reception and reach, especially in rural areas. Compared with modern smartphones, pager batteries also last much longer.

I can see pagers lingering on for special niche applications. But for most people, their time has passed.

By Jakez (Own work), Creative Commons BY-SA 3.0, via Wikimedia Commons.

An old pager/beeper.

2) New tech can be overhyped

I believe that artificial intelligence (AI) will some day have a major impact in the practice of medicine. But STAT News reporters Casey Ross and Ike Swetlitz have described how the IBM Watson AI system “isn’t living up to the lofty expectations IBM created for it.”

Specifically, the Watson for Oncology was intended to help improve cancer care by helping physician with treatment recommendations based on the best available worldwide data

Ross and Swetlitz reported:

While it has emphatically marketed Watson for cancer care, IBM hasn’t published any scientific papers demonstrating how the technology affects physicians and patients. As a result, its flaws are getting exposed on the front lines of care by doctors and researchers who say that the system, while promising in some respects, remains undeveloped...

Perhaps the most stunning overreach is in the company’s claim that Watson for Oncology, through artificial intelligence, can sift through reams of data to generate new insights and identify, as an IBM sales rep put it, “even new approaches” to cancer care. STAT found that the system doesn’t create new knowledge and is artificially intelligent only in the most rudimentary sense of the term.

Because of problems with Watson, the highly-regarded MD Anderson Cancer Center (part of the University of Texas) cancelled its partnership with Watson “amid internal allegations of overspending, delays, and mismanagement.”

I still believe that AI will revolutionize medical care, even if specific products might not (yet) be ready for prime time. I take heart in the fact that the Apple Newton was also a product not ready for prime time — but it did set the stage for the much more successful Apple iPhone and the current mobile technology revolution. Similarly, I think the long-term future of medical AI remains bright, even if specific products may struggle to meet expectations.

3) Current technology can alter the doctor-patient relationship in unexpected ways

Many patients routinely use search engines like Google to find good doctors or to learn more about their physician’s professional qualifications. But to what extent should doctors be searching for information on their patients?

Erene Stergiopoulos discusses this issue in a fascinating essay, “Getting Googled by Your Doctor”:

Searching for patients’ information online gives physicians a way to gather collateral data about a patient who either cannot or will not communicate important clinical information, says Paul Appelbaum, a psychiatrist, professor at Columbia University, and world expert in medical ethics and the law...

That online collateral information is especially useful [in the acute setting, Applebaum] says, where patients may be psychotic, intoxicated, or suicidal. In these acute settings, social media can provide clinicians with valuable context to make decisions — whether the patient uses drugs or alcohol, has self-harmed, or has family support...

However, Stergiopoulos notes that patients can feel betrayed if content from their social media posts ends up in their medical record without their consent.

Furthermore, this can create medico-legal problems:

As more and more providers Google to guide their decisions, they may be shifting the clinical standards to which all practitioners are held... If practitioners neglect that standard, and something preventable goes wrong, they risk accusations of malpractice. In other words, if patient-targeted online searches become the new standard of care, then clinicians could become liable for information patients post online. If a patient leaves a suicidal message on Facebook, and the clinician misses it, there’s a future — seemingly more plausible by the day — in which that clinician could be sued for malpractice if the patient then attempts suicide.

In informal discussions with other health professionals, some colleagues have said they never Google their patients. Others do so selectively. Yet others consider it a legitimate part of conscientious medical practice. And some physicians feel strongly that if patients can Google their doctors, they as physicians should similarly be able to Google their patients.

Clearly, this is an area where medical and legal standards are still evolving. In the meantime, if patients are uncomfortable with their physicians Googling them, they might wish to make their preferences clear ahead of time, before they and their doctor suffer a misunderstanding.

You can read the original article here.
Source:
Hsieh P. (25 September 2017). "Pagers, AI, And Google: 3 Tales Of Technology And Medecine" [Web blog post]. Retrieved from address https://www.forbes.com/sites/paulhsieh/2017/09/25/pagers-ai-and-google/3/#67ac15ab7a47

New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women


You can read the original article here.

Source:

Sobel L., Salganicoff A., Rosenzweig C. (6 October 2017). "New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women" [Web Blog Post]. Retrieved from address https://www.kff.org/womens-health-policy/issue-brief/new-regulations-broadening-employer-exemptions-to-contraceptive-coverage-impact-on-women/

The Trump Administration has issued new regulations that significantly broaden employers’ ability to be exempt from the Affordable Care Act’s (ACA) contraceptive coverage requirement.  The regulation opens the door for any employer or college/ university with a student health plan with objections to contraceptive coverage based on religious beliefs to qualify for an exemption. Any nonprofit or closely-held for-profit employer with moral objections to contraceptive coverage also qualifies for an exemption. Their female employees, dependents and students will no longer be entitled to coverage for the full range of FDA approved contraceptives at no cost.

On October 6, 2017, the Trump Administration issued two new regulations greatly expanding the types of employers that may be exempt from the Affordable Care Act’s (ACA) contraceptive coverage requirement.  These regulations are a significant departure from the Obama-era regulations that only granted an exception to houses of worship.  One of the regulations allows nonprofits or for-profit employer with an objection to contraceptive coverage based on religious beliefs to qualify for an exemption and drop contraceptive coverage from their plans.  The other regulation also exempts all but publicly traded employers with moral objections to contraception from rule. These new policies, effective immediately, also apply to private institutions of higher education that issue student health plans. The immediate impact of these regulations on the number of women who are eligible for contraceptive coverage is unknown, but the new regulations open the door for many more employers to withhold contraceptive coverage from their plans.

New regulations from the Trump administration greatly expand exemption from #ACA contraceptive coverage rule

Contraceptive coverage under the ACA has made access to the full range of contraceptive methods affordable to millions of women. This provision is part of a set of key preventive services that has been identified by the Health Resources and Services Administration (HRSA) for women that must be covered without cost-sharing. Since it was first issued in 2012, the contraceptive coverage provision has been controversial. While very popular with the public, with over 77% of women and 64% of men reporting support for no-cost contraceptive coverage, it has been the focus of litigation brought by religious employers, with two cases (Zubik v Burwell and Burwell v Hobby Lobby)  reaching the Supreme Court. This brief explains the contraceptive coverage rule under the ACA, the impact it has had on coverage, and how the new regulations issued by the Trump Administration change the contraceptive coverage requirement for employers and affect women’s coverage.

How do the new regulations change contraceptive coverage requirements for employers?

Since they were announced in 2011, the contraceptive coverage rules have evolved through litigation and new regulations. Most employers were required to include the coverage in their plans. Houses of worship could choose to be exempt from the requirement if they had religious objections. This exception meant that women workers and female dependents of exempt employers did not have guaranteed coverage for either some or all FDA approved contraceptive methods if their employer had an objection. Religiously affiliated nonprofits and closely held for-profit corporations were not eligible for an exemption, but could choose an accommodation. This option was offered to religiously affiliated nonprofit employers and then extended to closely held for-profitsafter the Supreme Court ruling in Burwell v. Hobby Lobby. The accommodation allowed these employers to opt out of providing and paying for contraceptive coverage in their plans by either notifying their insurer, third party administrator, or the federal government of their objection. The insurers were then responsible for covering the costs of contraception, which assured that their workers and dependents had contraceptive coverage while relieving the employers of the requirement to pay for it.

As of 2015, 10% of nonprofits with 5,000 or more employees had elected for an accommodation without challenging the requirement. This approach, however, has not been acceptable to all nonprofits with religious objections.1 In May 2016, the Supreme Court remanded Zubik v. Burwell, sending seven cases brought by religious nonprofits objecting to the contraceptive coverage accommodation back to the respective district Courts of Appeal. The Supreme Court instructed the parties to work together to “arrive at an approach going forward that accommodates petitioners’ religious exercise while at the same time ensuring that women covered by petitioners’ health plans receive full and equal health coverage, including contraceptive coverage.”2

On October 6, 2017, the Trump Administration issued new regulations greatly expanding eligibility for the exemption to all nonprofit and closely-held for-profit employers with objections to contraceptive coverage based on religious beliefs or moral convictions, including private institutions of higher education that issue student health plans (Figure 1).  In addition, publicly traded for-profit companies with objections based on religious beliefs also qualify for an exemption. There is no guaranteed right of contraceptive coverage for their female employees and dependents or students. Table 1 presents the changes to the contraceptive coverage rule from the Obama Administration in the new Interim Final regulations issued by the Trump Administration.

Figure 1: Employers Objecting to Contraceptive Coverage: Exemptions and Accommodations Under the Trump Administration Regulations

The accommodation will be available to employers that previously qualified for the accommodation.  They now will also have the choice of an exemption. The federal departments issuing the regulations posit that these new rules will have limited impact on the number of women losing contraceptive coverage.   However, it is not clear how many employers previously utilizing the accommodation will now opt for an exemption, resulting in the loss of contraceptive coverage for their employees and dependents.  In addition, there are also an unknown number of organizations that were not previously eligible for either the accommodation or exemption that may now opt for an exemption. These new regulations create two new categories of employers who can now qualify for an exemption or can voluntarily chooses an accommodation:  1) publicly traded for-profit companies with a religious objection and 2) nonprofit and closely held for-profit employers who have a moral objection to contraceptives, a considerably larger pool of employers than when the exemption was available only to those who were employees of a house of worship or who were eligible for an accommodation in the past.

Table 1: Summary of Changes in the Contraceptive Coverage Regulations for Objecting Entities
  Obama Administration
August 2012 to October 5, 2017
Trump Administration
Effective October 6, 2017
What types of contraceptives must plans cover without cost-sharing? At least one of each of the 18 FDA approved contraceptive methods for women, as prescribed, along with counseling and related services must be covered without cost-sharing. No change
Are any employers “exempt” from the contraceptive mandate?
  • Religious institutions defined as “houses of worship”
  • Grandfathered plans
  • No notice to employees is required. Women workers and female dependents must pay for their own contraceptives.
  • Religious institutions defined as “houses of worship”
  • Grandfathered plans
  • Nonprofit or  for-profit employers (including publicly traded companies), insurers, or private colleges or universities that issue student insurance plans with a religious objection to contraceptive coverage
  • Nonprofit or closely held for-profit employers, insurers, or private colleges or universities that issue student insurance plans with a moralobjection to contraceptive coverage
  • Notice is only required if the plan previously included contraceptive coverage. Women workers and female dependents must pay for their own contraceptives.
Who pays for contraceptive coverage for employees of organizations receiving an exemption?
  • The cost of contraceptives is borne by women workers and female dependents.
  • There is no guarantee of contraceptive coverage for employees of an exempt organization.
  • The employer may choose to cover some methods, but has no obligation to cover all 18 FDA methods without cost sharing
No change

What type of employers may seek an “accommodation” to avoid paying for contraceptives in their plans?  
  • Closely held for-profit corporations and religiously affiliated nonprofits with religious objections to contraception can opt out of providing and paying for contraceptive coverage
  • Notice must be provided to either their insurer, third party administrator, or the federal government of their objection.
  • Women workers and female dependents receive no cost contraceptive coverage.
  • Any entity (except for houses of worship) eligible for an exemption can choose the accommodation instead of the exemption.
  • Notice must be provided to either their insurer, third party administrator, or the federal government of their objection.
  • Women workers and female dependents receive no cost contraceptive coverage.
Who pays for contraceptive coverage for employees of organizations receiving an accommodation?
  • Insurance companies of firms obtaining an accommodation must pay for contraceptive coverage.
  • Third-party administrators (TPA) of self-funded health plans must cover the costs of contraceptives for employees. The costs of the benefit are offset by reductions in the fees the TPA pays to participate in the federal exchange.
No change
When can entities change from an accommodation to an exemption? N/A
  • When an employer or private college or university currently using the accommodation opts for an exemption, the revocation of contraceptive coverage will be effective on the first day of the first plan year that begins 30 days after the date of the revocation or 60 days notice may be given in a summary of benefits statement.
  • The issuer or third party administrator is responsible for providing the notice to the beneficiaries.

How has the contraceptive coverage rule affected women?

Contraceptive use among women is widespread, with over 99% of sexually-active women using at least one method at some point during their lifetime.3 Contraceptives make up an estimated 30-44% of out-of-pocket health care spending for women.4 Since the implementation of the ACA, out-of-pocket spending on prescription drugs has decreased dramatically (Figure 2). The majority of this decline (63%) can be attributed to the drop in out-of-pocket expenses on the oral contraceptive pill for women.5 One study estimates that roughly $1.4 billion dollars per year in out-of-pocket savings on the pill resulted from the ACA’s contraceptive mandate.6  By 2013, most women had no out-of-pocket costs for their contraception, as median expenses for most contraceptive methods, including the IUD and the pill, dropped to zero.7

Figure 2: The Contraceptive Coverage Policy Has Had a Large Impact on Out-Of-Pocket Spending in a Short Amount of Time

This provision has also influenced the decisions women make in their choice of method. After implementation of the ACA contraceptive coverage requirement, women were more likely to choose any method of prescription contraceptive, with a shift towards more effective long-term methods.8  High upfront costs of long-acting methods, such as the IUD and implant, had been a barrier to women who might otherwise prefer these more effective methods.  When faced with no cost-sharing, women choose these methods more often9, with significant implications for the rate of unintended pregnancy and associated costs of childbirth.10

Finally, decreases in cost-sharing were associated with better adherence and more consistent use of the pill. This was especially true among users of generic pills.  One study showed that even copayments as low as $6 were associated with higher levels of discontinuation and non-adherence,11 increasing the risk of unintended pregnancy.

Do states with no-cost contraceptive coverage laws allow exemptions to objecting entities?

The federal standards under Affordable Care Act created a minimum set of preventive benefits that applied to most health plans regulated by the federal government (self-funded plans, federal employee plans) and states (individual, small and large group plans), including contraceptive coverage for women with no cost-sharing.  States have also historically regulated insurance, and many have had mandated minimum benefits for decades. State laws, however, have more limited reach in that they only apply to state regulated fully insured plans, do not have jurisdiction over self-funded plans, where 61% of covered workers are insured.12 In self-funded plans, the employer assumes the risk of providing covered services and usually contracts with a third party administrator (TPA) to manage the claims payment process. These plans are overseen by the Federal Department of Labor under the Employer Retirement Income Security Act (ERISA) and are only subject to federally established regulations.13  The ACA sets a minimum standard of coverage for preventive services for all plans. However, state laws regulating insurance, including contraceptive coverage, can require fully insured plans to provide coverage beyond the federal standards.

Eight states have strengthened and expanded the federal contraceptive coverage requirement (CA, IL, MD, ME, NV, NY, OR, VT).  Another 20 states have contraceptive equity laws that require plans to cover contraceptives if they also provide coverage for prescription drugs but they do not necessarily require coverage of all FDA-approved contraceptives or ban cost-sharing (Figure 3).

Figure 3: Many States Have Contraceptive Coverage Requirements

Many of the 28 states that have passed contraceptive coverage laws (both equity and no-cost coverage) have a provision for exemptions, but the laws vary from state to state and only apply to fully insured plans.  This means that there may be a conflict between the state and federal requirements when it comes to religious exemptions.  In some states with a contraceptive coverage requirement, some employers who are eligible for an exemption under federal law will not qualify for an exemption under state law (Table 2). Employers in those states will have to have to meet the standards established by their state even though they may qualify for an exemption based on the new federal regulations.  This conflict may set the stage for future litigation.

Table 2: State Requirements for No-Cost Contraceptive Coverage
StateDate Effective Applies to Coverage required without cost sharing Exemptions allowed
  Private plans Medicaid With RX all FDA approved OTC Vasectomy Religious Moral
CaliforniaJanuary 2015 X MCOs X Narrowly defined nonprofit religious employers None
IllinoisJanuary 2017 X X X
except male condoms
Any employer, or insurer with a religious objection Any employer, or insurer with a moral objection
MarylandJanuary 2018 X X X X X Religious organizations if the coverage conflicts with the organization’s bona fide religious beliefs and practices None
MaineJanuary 2019 X X Narrowly defined nonprofit religious employers None
NevadaJanuary 2018 X X X Insurers affiliated with a religious organization None
New YorkAugust 2017 X X Narrowly defined nonprofit religious employers* None
OregonAugust 2017 X X X Narrowly defined nonprofit religious employers None
VermontOctober 2016 X X – and all other public health assistance programs X X None None
NOTES: *Requires the insurer to offer a rider to policyholders so that women will have contraceptive coverage.
SOURCE: Kaiser Family Foundation analysis of state laws and regulations.

Conclusion

The Trump Administration’s new regulations substantially expand the exemption to nonprofit and for-profit employers, as well as to private colleges or universities with religious or moral objections to contraceptive coverage. It is unknown how many of these employers and colleges will maintain coverage through the accommodation as before and how many will now opt for the exemption leaving their students, employees and dependents without no-cost coverage for the full range of contraceptive methods. As a result of the new regulation, choices about coverage and cost-sharing will be made by employers and private colleges and universities that issue student plans. For many women, their employers will determine whether they have no-cost coverage to the full range of FDA approved methods.  Their choice of contraceptive methods may again be limited by cost, placing some of the most effective yet costly methods out of financial reach.

You can read the original article here.

Source:

Sobel L., Salganicoff A., Rosenzweig C. (6 October 2017). "New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women" [Web Blog Post]. Retrieved from address https://www.kff.org/womens-health-policy/issue-brief/new-regulations-broadening-employer-exemptions-to-contraceptive-coverage-impact-on-women/