What Percentage of Your Life Will You Spend Exercising?
Original post benefitspro.com
How much of your life will you spend exercising?
Reebok and Censuswide, a global consulting firm, studied exercise habits of people in nine different countries and came to the conclusion that the average person spends 0.69 percent of their life working out.
Or, as the shoe company chose to frame it: Of the 25,915 days the average human lives, only 180 will be spent on fitness. “25,915” is the name of Reebok’s new brand campaign focused on encouraging exercise.
To be sure, “fitness” is not the same as physical activity. Manual laborers throughout the world burn calories effectively without ever getting a gym membership. Reebok acknowledges that fact, pointing out that the average person still walks or runs the equivalent of the Earth’s circumference nearly twice in their lifetime.
But in an increasingly mechanized world in which more and more workers spend their days in offices, it is more important than ever for people to make a conscious effort to get exercise.
"As a brand dedicated to promoting and supporting health and fitness around the world, we felt compelled to shine a light on the disparities between what we may aspire to achieve and what we're willing to do about it," said Yan Martin, vice president of brand management at Reebok. "It gives us a renewed urgency to get out there and live fuller, healthier lives. If we all traded in 30 minutes of phone time for a jog, we could actually help change the dynamics of global wellness."
To highlight the point, Reebok calculated that 41 percent of the average person’s life is spent engaging with technology. That amounts to 10,625 days in a lifetime.
In addition, the average person will spend 29.75 percent of his life sitting down, 6.8 percent socializing with a loved one, and 0.45 percent having sex.
Americans Don't Do Much to Avoid Hearing Loss
Original post benefitspro.com
Have you ever even heard of healthy hearing habits?
If not, you’re probably not alone. Relatively few Americans appear to pay much attention to their ears, according to a recent survey conducted by Wakefield Research on behalf of EPIC Hearing Healthcare.
The survey found that only a quarter of U.S. adults have had their hearing checked in the past two years.
In contrast, nearly two-thirds of Americans make a trip to the dentist at least annually. Three-quarters wear some type of corrective lens — either glasses or contact lenses — to address poor eyesight.
The survey also revealed that very few understand the risks to hearing presented by a number of different conditions and behaviors, including diabetes (22 percent) and smoking (14 percent).
Granted, it’s hard to believe that evidence showing how smoking harms hearing would be the game-changer that gets people to quit their habit, considering that people are more than aware of the other substantial health risks linked to tobacco use.
But overall hearing health would likely improve if the topic was more often emphasized by physicians and other health experts. According to EPIC, only 8 percent of employer-based wellness programs include hearing health.
But according to EPIC, only one in five people who would benefit from hearing aids actually have them. Even worse, people who don’t discuss hearing issues with their doctors often do not adopt habits to prevent hearing loss.
Hearing loss is often a problem that snowballs, explains EPIC. Dr. William Luxford, medical director of House Clinic. He says that people who begin to lose their hearing engage in behavior that exacerbates the problem, such as turning up the volume on their TV.
“A lot of people aren’t aware how important preventive care is for their hearing health,” he says. “Regular, comprehensive hearing exams by an audiologist are the best way to establish a baseline for your hearing and ensure any hearing loss is caught early so further damage can be prevented or minimized and hearing can be improved as quickly as possible.”
Study Suggests Plan Transparency Doesn’t Reduce Costs
Original post benefitspro.com
“Transparency” and “choice” are keywords associated with health plan consumers these days. But there’s no guarantee those key words will lead to the keyword phrase “lower health plan costs.”
One survey of the employees of two large employers reports that, given transparency and choice, plan members did not reduce their costs, and even increased them a bit.
As reported in the Journal of the American Medical Association, a Harvard-led study of plan member choices showed that when employees spent more time reviewing plan options, they did not necessarily choose a cheaper plan. The study compared two groups of employees — one with a plan that included a price transparency/comparison tool, and another that did not.
The end result: The group with the transparency tool at its disposal spent slightly more (about $59 per member) on a plan in 2012 than in 2011. The control group with no tool spent about $18 more.
However, the study included a big caveat: “Only a small percentage of eligible employees” used the tool.
Such studies can offer some value to the overall discussion of reducing health costs. However, this study’s small focus (employees of two companies), when it took place (before comparison tools had truly entered the health plan lexicon), and the relatively few folks who used it, probably suggests that perhaps it could be used as the starting point for a broader study based upon more recent data.
Why Employers Should Boost Dental Benefits Enrollment
Original post benefitsnews.com
You might eat a balanced diet and squeeze in a mix of cardio and weight-lifting workouts every week to stay healthy. But to be truly healthy, you’ve got to focus on more than just working out and eating well. Believe it or not, you’ve also got to focus on oral health.
The link between oral health and cardiovascular health isn’t new; however, there is new evidence that more closely ties periodontitis, better known as gum disease, to heart attacks and stroke. One study showed that treating oral inflammation caused by gum disease with a topical remedy reduced vascular inflammation, which is a leading risk of hypertension, heart attack and stroke.
Heart disease is a serious problem in the United States — one in four people will die of the malady if it goes untreated. It’s also a major expense for Americans, including employees and employers who sponsor their health plans; heart disease costs nearly $1 billion a day in medical care and lost productivity.
Gum disease can affect more than just the heart. For pregnant women, it can also affect unborn babies. The bacteria caused by periodontitis can get into the blood stream and target the fetus, contributing to premature birth or low birth weight. Not only does prematurity and low birth weight put newborns at risk for issues in the beginning of life and learning, as well as developmental issues later on, it’s also costly for a family. In its first year, a preemie can cost around $49,000 in expenses, compared to just $4,551 for an infant who doesn’t experience complications. The March of Dimes reports that pre-term birth costs more than $12 billion in excess healthcare costs.
Diabetics also need to pay special attention to their oral health. In addition to monitoring their feet, eyes, kidneys and heart for complications, they are more prone to periodontitis. A higher risk of gum disease can make it more difficult to control blood glucose, and can also cause disease and infections in the bones that hold teeth in place, making it more difficult to chew. Gum disease may also lead to tooth loss. Diabetes costs the United States $322 billion in a combination of healthcare fees and lost productivity.
It’s important for employers and employees to understand how oral health plays a part in overall health, and that simple, inexpensive treatment can save businesses and plan participants thousands of dollars and countless hours of pain and suffering.
Analyzing claims data is one way to see how oral health might affect employees. The highest number of claims typically comes from cardiovascular, maternity, diabetes and musculoskeletal claims — all of which are exacerbated by periodontitis.
For years, dental health was given a back seat in health plans, wellness initiatives and employee education. Most initiatives focused on preventing heart disease through diet and exercise, and focused little, if at all, on dental care. Many health plans did not — and still do not — include dental coverage, which is a minimal expense compared to other program costs overall. Consequently, employees may simply write off dental care because they may not have a history of cavities. But dental coverage and consistent employee education and communication can help them understand the risks, develop good habits and begin to take their dental health into their own hands.
Employers can work closely with insurance brokers to understand medical and dental coverage, and what their costs and claims are for both. They’ll likely see that medical claims are far higher than dental claims. They can then work together with benefit consultants to create an affordable dental plan, or bridge the gap between dental and medical for those at higher risk for periodontitis issues so that employees can get the treatment they need.
Finally, employers need a long-term communication strategy to educate employees on the value of benefit offerings and the importance of good oral hygiene. They’ll be happy and healthier, and the employer’s medical costs will decrease.
Everybody wins.
Making Sense of the Alphabet Soup of Healthcare Spending Accounts
Original post benefitnews.com
Employers are passing more and more healthcare responsibility to their employees, and in some cases, giving them a greater share of the financial burden. Likewise, businesses are looking for ways to help employees manage healthcare expenses. There are a number of products for that purpose, and while they’re similar, they’re not the same.
With acronyms being used to explain still-new concepts, it can be difficult for employees to understand the difference between them or even to remember which product they use. It’s important to educate them about these products so they get the most out of them.
Health savings account. A health savings account is like a 401(k) retirement account for qualified medical expenses. An HSA helps people pay for medical expenses before they hit their deductible. Employers and employees can both contribute money tax-free, and the money can be rolled over from year to year with only a maximum annual accrual. All contributed funds can be invested once a specific minimum is met (determined by the bank).
HSA-compatible health plans don’t include first-dollar coverage (except for preventive care), which means employees must meet a deductible before benefits will be paid by a health plan. This deductible is set by the IRS each year; in 2016, high-deductible health plans must have a deductible of at least $1,300 for an individual and $2,600 for a family.
Employees and employers can both contribute funds to build an HSA, and all funds count toward the annual maximum. The employee “owns” the HSA and the money that’s in it.
HSA funds can be spent on qualified medical expenses as outlined by section 213(d) of the IRS tax code, dental, vision, Medicare and long-term care premiums, and COBRA (if unemployed). After age 65, health premiums can also be withdrawn, but are subject to income tax.
Just like a 401(k), the account is portable. If the owner of the HSA changes jobs, the money can still be used for medical expenses, but the employee can no longer contribute to it.
Health reimbursement accounts. HRAs help employees pay for medical expenses before a deductible is met. But unlike an HSA, employees cannot contribute to an HRA, only employers. The money an employer places in an HRA can be used for medical expenses not covered by a health plan, such as deductibles and copays for qualified medical expenses as outlined by section 213(d) of the IRS tax code, dental, vision, Medicare and long-term care premiums. The associated health plan can have any deductible amount — there are no minimums and the plan does not have to be a high-deductible health plan. Unlike an HSA, an HRA is not portable, and funds can’t be used for non-medical reasons, even with a penalty. Funds also don’t typically earn interest and are not invested.
Employers must be more involved with HRA accounts since they are the only party who can deposit money; they also determine if funds can be rolled over from one year to the next.
Flexible spending accounts. FSAs allow employees to defer part of their income to pay for medical expenses tax free as part of a Section 125 cafeteria plan. Allowable expenses include those outlined by section 213(d) of the IRS tax code as well as dental and vision expenses. Both employers and employees can contribute to an FSA; however, the amount employees plan to contribute at the beginning of the year can’t be changed mid-year. FSA funds can’t be invested and fees associated with the plan are normally paid by the employer. There are no underlying plan restrictions and these accounts can be maintained alongside traditional health plans. The employer owns the account and is responsible for the management.
Funds in an FSA can be rolled over only if there is a carryover provision; in this case, $500 can be carried to the next year.
With an FSA, individuals must substantiate need for a reimbursement at the time of service by keeping receipts and filling out a form. Some FSAs include “smart” debit cards that automatically pay certain copays and don’t require documentation.
Determining which is best
HSAs, HRAs and FSAs serve slightly different purposes and can even co-exist in some circumstances. For example, those enrolled in an HSA can contribute to a limited-used FSA. Those enrolled in an HRA can also contribute to an FSA without limitations.
HSAs work well for employers who don’t want to add to administrative burdens or additional costs. And they’re a great way to give employees a way to offset the costs of qualified high-deductible health plans and save for post-retirement health expenses. However, employers may want to stray from an HSA or refrain from fully funding the account early in the year if there’s high turnover at a company; the money deposited goes with the employee when they leave.
For employees, HSAs provide investment opportunity and are portable; they also encourage consumerism and are cost-effective to administer. But one of the biggest advantages is that the employee doesn’t have to pre-determine expenses since unused funds carry over.
HRAs can work well for an employer that is not offering a qualified high-deductible health plan but wants to promote consumerism while self-funding a portion of the risk. The funds contributed are immediately available and completely funded by the employer, which is an advantage to the employee. However, there is no tax advantage to employees and the fund can’t be transferred.
FSAs are the most appropriate for employers offering traditional health plans. Employees benefit because they can contribute pre-tax dollars and the funds are immediately available. But the “use it or lose it” provision is a definite disadvantage for employees.
There are pros and cons to all three funds. It’s best to review them carefully to determine which ones will work for your business, and make sure to communicate the funds’ features and restrictions to your employees.
5 Ways Employers Can Optimize the Value of Maternity Care for Employees
Original post benefitnews.com
For many employers, discussions with employees about pregnancy focus on one topic: maternity leave.
Yet, it is important to remember that length of maternity leave is only one of several important decisions made by an employee preparing for childbirth.
Expecting parents are highly engaged in selecting a provider and developing a birth plan — choices that will ultimately influence the cost and quality of care a mother and her child will receive. For younger employees, a pregnancy, whether their own or their spouse’s, may be the first significant contact he or she has had with the healthcare system, thus underscoring the weight attributed to each decision.
Maternity care is also an important issue for employers, as obstetric admissions are typically the single most common admission in commercial populations. Verisk Health’s normative database shows that on average, a maternity admission costs an employer upwards of $9,000, and pre-natal and post-natal care typically contribute another 20-30% of spend. When you consider that 6% of women between the ages of 19 and 44 have a child each year, the costs add up fast.
Given the importance of maternity care to both employees and employers, the question is how to optimize the value of the care your employees receive.
Understanding the value equation
High risk pregnancies and outlier cases aside, maternity care is a relatively homogenous condition category. However, there is substantial variability in cost. We have observed as high as 50% variation within costs in a single market for vaginal deliveries without complications.
Variations in utilization rates of certain procedures can also increase costs substantially without necessarily improving outcomes.
For example, here in Massachusetts, the Health Policy Commission found 50% variation in Cesarean section (C-section) rates among the top 10 hospitals (by number of discharges). This compounds the issue with hospital pricing, since C-sections can cost as much as 50% more than a vaginal delivery.
In addition to increasing costs, C-section overutilization can also lead to poorer outcomes. According to the American College of Obstetricians and Gynecology, C-sections put the mother at greater risk of infection, heavy blood loss, and surgical complications while simultaneously increasing the newborn’s risk of infection, respiratory issues, and lower APGAR scores.
Elective deliveries and episiotomies are also areas of potential overuse, and their incidence rates can be tracked to gauge the quality of care delivered.
While the American College of Obstetricians and Gynecologists requires 39 weeks of gestation prior to elective delivery, research shows that more than one-third of elective repeat C-sections are not performed in accordance with this guideline. When these guidelines are not followed, newborns are more susceptible to respiratory distress syndrome, temperature regulation issues, high levels of bilirubin, and hearing, vision, and learning defects.
In addition to restricting elective pre-term deliveries, ACOG also recommends restricted use of episiotomies due to the increased risk of muscle tear, bleeding, and infection. However, data indicates that episiotomies are an often used routine obstetrical practice.
Other maternity quality measures reinforce evidence-based standards of care. To reduce a mother’s risk of pulmonary embolism after C-section, ACOG recommends the use of pneumatic compression devices or venous thrombus embolus (VTE) prophylaxis. Likewise, all newborns should be screened for early onset hyperbilirubinemia prior to discharge from the hospital.
Driving greater value: The agenda for employers
Maternity care presents an ideal starting point for value-based purchasing initiatives because it is high volume, clinically homogenous, and exhibits wide variety in cost and quality. While decisions in maternity care will always be driven by patient preferences, here are a few ways employers can help improve the value of care their employees receive:
1. Know the numbers. Analyze your claims data to identify the top hospitals that your employees use, the amount you spend at each facility, and differences in costs between the hospitals. Use the quality measures published in the Leapfrog Hospital Survey to benchmark performance against nationally recognized standards.
2. Spark dialogue with providers. Once you’ve assessed which hospitals provide the best value for maternity care, share your analysis with the most significant facilities. In our experience, several larger employers are using their data to enable more transparent, collaborative conversations. If your presence is smaller, work with a local purchasing group to make your voice heard.
3. Raise awareness among expectant parents. In parallel with sharing data with providers, develop a communication plan to educate your employees about their options. Developing a birth plan is one of the most actively researched healthcare decisions, especially for first time parents. However, the research can often be more focused on the amenities of the facility than quality and outcomes. Since patient engagement is so high for maternity care, it may be easier to drive behavioral change among expectant parents than it is for other health issues often targeted by employers (e.g., weight loss).
4. Champion payment reform. Several state Medicaid programs have adopted innovative episode-based payment systems to reward high-value maternity care. Forward-thinking employers can use model contract language from Catalyst for Payment Reform to help incorporate these types of strategies into their agreements with health plans. According to CPR, payment strategies such as bundled payment and blended payment (a single rate for any type of delivery) can help address the issues associated with overutilization in maternity care.
5. Consider reference pricing and incentives. Long term, employers may consider changing plan incentives to encourage high-value maternity care. For example, an employee might shoulder a greater share of the cost burden for an elective C-section if it is not medically necessary or physician advised. Since personal preference is such a factor in maternity care delivery, this concept will need to be handled with sensitivity.
In many ways, maternity care is a microcosm of the challenges in our healthcare system. We routinely perform “medical miracles,” particularly for neonatal care, and yet there is substantial room for improvement in routine care. By advancing value-based purchasing initiatives, employers can play a key role in helping improve the cost and quality of maternity care.
Hearing and Vision Being Tied into Wellness Programs
Originalpost benefitnews.com
Medical experts have long argued that poor oral hygiene and neglected vision care can undermine overall physical health. The same thinking is now being applied to hearing loss, which is reportedly on the rise and taking a toll on employee productivity, emphasizing a need for more advisers and their clients to consider the inclusion of hearing and vision health with wellness programming.
Advisers “can make sure their clients are aware that healthy senses are often missing from traditional wellness strategies,” says Brad Volkmer, president and CEO of EPIC Hearing Healthcare, “and they can bring solutions to help clients integrate areas like hearing and vision health into their wellness offerings.”
As many as 30% of working Americans suspect they have hearing loss, but have not sought treatment and admit it has affected their work performance, according to a 2013 EPIC Hearing Healthcare survey of 1,500 U.S. employees.
This seems to be one area that worksite health and wellness has overlooked. A 2015 EPIC survey of 518 benefits professionals, for example, found that only 8% of employers integrate hearing health into their wellness programs. Most of those respondents (86%) said they were willing to take action if they knew that untreated hearing loss was hurting employee job performance.
As many as one-fifth of Americans 12 years or older have hearing loss so severe that it may make communication difficult, according to a Johns Hopkins study published in the Archives of Internal Medicine. Researchers estimate that 30 million Americans, or 12.7% of the population, have hearing loss in both ears, and about 48 million, or 20.3%, have hearing loss in at least one ear. What’s surprising is that 65% of people with hearing loss are actually younger than age 65, notes the Better Hearing Institute.
EPIC offers a hearing-health wellness program called “Listen Hear! Live Well” that can be integrated into an employer’s existing wellness effort or offered on a stand-alone basis. Among the company’s suggested tips for producers when talking with employer clients about the importance of treating hearing loss and maintaining healthy senses:
- Integrate hearing, vision and oral health into health education. The hope is that through these efforts, employers can help erase any stigma associated with hearing loss and quell employee fears about being poorly perceived by their employer. Content for company wellness newsletters, brochures, videos, presentations, advice hotlines, etc., is available free of charge through some programs.
- Check healthy senses through screenings. This can be done at employee health fairs and events with the help of local audiologists, optometrists and dentists who may be willing to offer complimentary screenings and deliver educational presentations.
- Make incentives accessible. Employers can offer incentives and discounts to employees who complete vision and hearing exams in order to promote preventive care. For example, those who participate in four educational activities in EPIC’sListen Hear! program can earn a discount on hearing treatments.
- Minimize financial barriers to care. Employers can elect to cover healthy senses through ancillary benefits and the use of various savings vehicles to help ease out-of-pocket expenses. An HSA or FSA can be used to help pay for hearing aids, eyeglasses or contact lenses. Without such assistance, these costs can be staggering. Hearing aids, for example, cost on average about $1,500, but can be as high as $3,000 to $5,000, according to the National Institutes of Health. Also, more than one-third of people surveyed in 2014 by Wakefield Research on behalf of National Vision, Inc. said did not see their eye doctor that year because they couldn’t afford the visit.
Trending: Virtual Healthcare Gains Broader Acceptance
Original post benefitsnews.com
The Cadillac tax may have been postponed until 2020 but that doesn’t mean employers have put healthcare cost containment measures on the backburner. In fact, new research shows 90% of employers are planning myriad measures to control rising healthcare costs.
The 2016 Medical Plan Trends and Observations Report, released today by DirectPath and CEB, highlights top trends in employers’ 2016 healthcare strategies. Overwhelmingly, employers are continuing to shift a larger share of healthcare costs to employees, often through high-deductible health plans, according to the report.
The use of telemedicine, meanwhile, continues to grow, with almost two-thirds of organizations offering or planning to offer such a service by 2018 – a 50% increase from the previous year.
“Employees often say that they go to the emergency room because it's hard to get a doctor's appointment. With telemedicine, you've got 24/7 access and you don't necessarily need an appointment,” notes Kim Buckey, vice president of compliance communications at DirectPath. “That's certainly a huge driver of avoiding those visits to the emergency room or even the urgent care clinic because telemedicine is typically less expensive than an urgent care visit, as well.”
Buckey says it “makes sense” for employers to investigate telemedicine – the remote diagnosis and treatment of patients via phone calls, email and/or video chat – because employees are increasingly accepting of virtual access to just about everything.
“How many employees now are just grabbing their phones, iPads, or computers when they need information? That's something that people are comfortable with using and they don't have to leave their house to get quality care,” she says.
Spousal and tobacco surcharges are also expected to grow, according to the CEB data. Twelve percent of employers surveyed already have spousal surcharges in place, while 29% expect to introduce them in the next three years. Twenty-one percent of employers already have tobacco surcharges in place, while 26% expect to implement them in the next three years.
“I think we're going to see more and more of those, particularly as employers focus more on wellness initiatives,” says Buckey, adding that a robust communications plan is needed before implementing tobacco or spousal surcharges.
“People don't understand basic concepts like deductibles, co-pays, co-insurance, let alone how to make a decision about what plan to choose, or frankly, what's the best way of receiving care,” she says. “As more and more of these provisions are added to plans, they have the potential of being even more confusing and off-putting to employees, so having a robust communications plan in place that addresses all of these issues [is important]. ... There certainly will be cases where these surcharges aren't going to apply to a large percentage of the population. You just want to make sure that the folks who are affected, understand how they're affected and why.”
Health Care Reform Added 20 Million Adults to Coverage Rolls
Original post businessinsurance.com
More than 20 million adult Americans have gained health insurance coverage due to the health care reform law, the U.S. Department of Health and Human Services said in a report released Thursday.
“Thanks to the Affordable Care Act, 20 million Americans have gained health care coverage. We have seen progress in the last six years that the country has sought for generations,” HHS Secretary Sylvia Burwell said in a statement.
The HHS report noted that coverage gains varied widely by race and ethnicity. For example, among white non-Hispanic adults, the uninsured rate as of Feb. 22 was 7%, down from 14.3% as of Oct. 1, 2013, while during the same period the uninsured rate among black non-Hispanic adults declined to 10.6% from 22.4%, and among Hispanic adults to 30.5% from 41.8%.
Several health care reform law provisions are credited with the gains in coverage, including those that authorized federal premium subsidies to lower-income individuals obtaining coverage in ACA-authorized exchanges and others that expanded Medicaid eligibility and required group health care plans to extend coverage to employees' adult children until they turn 26.
Prior to that last change, employers typically ended coverage for employees' children at age 18 or 19, or 23 or 24 if a full-time college student.
Agencies Propose Revised SBC Template and Uniform Glossary
Original post shrm.org
The federal agencies overseeing the Affordable Care Act announced a 30-day comment period ending on March 28, 2016, regarding proposed revisions to the Summary of Benefits and Coverage (SBC) and related documents that employers must provide to eligible employees for each of their health plans, following the Feb. 26 publication of an official notice in the Federal Register.
The revisions could be effective for employer-provided plan years beginning with the second quarter of 2017.
On Feb. 25, the Departments of Labor (DOL), Treasury, and Health and Human Services (HHS) released the proposed revised SBC template and revised uniform glossary, along with revised instructions for group plans. Under the Affordable Care Act, SBCs and the uniform glossary must be given to new hires and to employees during open enrollment.
The agencies had issued a final rule regarding SBCs and related documents in June 2015. However, revisions to the SBC template and the uniform glossary were delayed to allow the agencies to complete consumer testing and receive additional input from the public and stakeholders.
Providing Plan Details
In an analysis posted at the Health Affairs Blog, Timothy Jost, a professor at the Washington and Lee University School of Law in Lexington, VA., noted that among the proposed changes the revised documents would:
• Better identify services covered before the deductible applies.
• Disclose whether the plan has “embedded” deductibles and out-of-pocket limits (under which enrollees in family coverage can meet individual deductibles or out-of-pocket limits before the family limits are met).
• Disclose more information on tiered networks in relation to coverage of common medical events.
Though it may not provide the clarity employers and employees are looking for, "on the whole, the proposed revised SBC is a distinct improvement over the current SBC,” commented Jost.