Breast Cancer Death Rates Down 34% Since 1990
Originally posted October 01, 2013 by Stacy Simon on https://www.cancer.org
A new report from the American Cancer Society finds that death rates from breast cancer in the United States have dropped 34% since 1990. But the rate at which new breast cancers are diagnosed increased slightly among African American women from 2006 to 2010, bringing those rates closer to those of white women, who still have the highest diagnosis rates among women ages 40 and older.
The findings are published in Breast Cancer Facts & Figures 2013-2014 and in Breast Cancer Statistics, 2013 in CA: A Cancer Journal for Clinicians. The reports, published every 2 years, provide detailed analyses of breast cancer trends and present information on known risk factors for the disease, factors that influence survival, the latest data on prevention, early detection, treatment, and ongoing research.
Breast cancer is the most common cancer among women in the United States, after skin cancer. It accounts for nearly 1 in 3 cancers diagnosed in women. By the end of 2013, an estimated 232,340 women will be diagnosed with invasive breast cancer and an estimated 39,620 women will die from breast cancer. The risks generally increase with age. Almost 8 of every 10 new breast cancer cases and almost 9 of every 10 breast cancer deaths are in women 50 years old and older.
In January 2012, more than 2.9 million women living in the U.S. had a history of breast cancer. Some of them were cancer-free, while others still had evidence of cancer and may have been undergoing treatment.
Race and Ethnic Factors
White women get breast cancer at a higher rate than African-American women, but African-American women are more likely to get breast cancer before they are 40, and are more likely to die from it at any age. Incidence and death rates for breast cancer are lower among women of other racial and ethnic groups. Asian and Pacific Islander women have the lowest incidence and death rates.
Disparities also exist regarding the prevalence of breast cancer types among racial and ethnic groups. Breast cancers that are estrogen receptor-negative are often harder to treat because they are not likely to respond to hormone therapy. In every age group, African American women have the highest rates of this type of breast cancer. White women have the highest rates of estrogen receptor-positive breast cancer.
Prevention and Early Detection
- Because obesity and excess weight increase the risk of developing breast cancer, the American Cancer Society recommends that women maintain a healthy weight throughout their life. Losing even a small amount of weight has health benefits and is a good place to start.
- Growing evidence suggests that women who get regular physical activity have a 10%-20% lower risk of breast cancer compared to women who get no exercise. Doing even a little physical activity beyond your regular daily routine can have many health benefits.
- Many studies have confirmed that drinking alcohol increases the risk of breast cancer in women by about 7% to 12% for each serving per day. If you do drink alcohol, the American Cancer Society recommends women limit themselves to no more than 1 drink per day.
- A recent study by American Cancer Society researchers found that current smokers had a 12% higher risk of breast cancer than women who never smoked. Research also suggests that risk may be greater for women who begin smoking before they give birth to their first child. Quitting has numerous health benefits.
- To find breast cancer early, when treatments are more likely to be successful, the American Cancer Societyrecommends women 40 and older have a mammogram and clinical breast exam every year, and younger women have clinical breast exams periodically as well (preferably at least every 3 years).
Citations: Breast Cancer Facts & Figures 2013-2014. Published October 1, 2013. American Cancer Society, Atlanta, Ga.
Breast Cancer Statistics, 2013. Published October 1, 2013 in CA: A Cancer Journal for Clinicians. First author Carol DeSantis, MPH, American Cancer Society, Atlanta, Ga.
7 Breast Cancer Misconceptions
Originally posted September 20, 2013 by Vince Pierri on https://www.ahchealthenews.com
Our nation spends more money on breast cancer research than any other type of cancer. Still, many women are confused about the basics, like the signs, symptoms and treatments.
“With the deluge of information, tips and advice about breast cancer these days, it’s easy to get lost,” says Dr. Heidi Memmel, a breast surgeon at Advocate Health Care. “It’s more important than ever that women have a clear understanding of the issues.”
Dr. Memmel shares 7 of the biggest misconceptions to separate fact from the fiction:
1. Fiction: If I have no family history of breast cancer, then I am not at risk.
Fact: Approximately 70 percent to 75 percent of women who develop breast cancer have no family history.
2. Fiction: There is nothing I can do to reduce my risk of developing breast cancer.
Fact: We can’t completely prevent cancer, but we can reduce the risks by maintaining a healthy weight, exercising, quitting smoking, and reducing our alcohol consumption.
3. Fiction: My mammogram was normal, so I don’t have to worry about getting breast cancer.
Fact: Mammograms are a good annual screening tool, but they do not detect all breast cancers. It is still important to perform a self-breast exam once a month and have a doctor’s exam once a year.
4. Fiction: Underwire bras can increase the risk of breast cancer.
Fact: Underwire bras or trauma to the breast do not increase the risk of developing breast cancer.
5. Fiction: Cancer cells can spread during a biopsy.
Fact: Cancer cells do not spread from a biopsy. A biopsy can confirm that cancerous cells are present.
6. Fiction: I’ve been cancer-free for five years from my diagnosis, so there is no chance of it returning.
Fact: There is less risk of a cancer returning in the breast or elsewhere in the body after five to 10 years, but there is still a slight risk. It’s important to see a doctor regularly and have regular mammograms.
7. Fiction: My weight and the size of my breasts do not affect my risk of breast cancer.
Fact: Obesity significantly increases the risk of developing breast cancer. Obese women are more likely to be diagnosed with more aggressive tumors and diagnosed at a more advanced stage.
For more information on breast health, visit www.Storiesofthegirls.com.
How to Find the Right Leadership Training for Your Company
Originally posted August 07, 2012 by Sharlyn Lauby on https://www.hrbartender.com
There’s lots of talk these days about leadership deficits. Part of the conversation is being fueled by the skills gap. Another part is focused on the Boomers retiring and Millennials entering the workforce. Regardless of the reason, I think we can all agree that strong, capable leadership is necessary for our businesses to survive and thrive.
People have to learn leadership skills from somewhere. Typically, leadership isn't taught in high school or college. Yes, you might learn some theories but without real life examples it’s hard to see how and when those theories should be applied. That’s why organizations have to put some kind of leadership training in place. It allows individuals to tie together the theory they learned and the practical application they’re gaining in the workplace.
I’m guessing I don’t need to sell you on the concept of good leadership. The question is when it comes time to bring leadership training into your organization, what’s the best way to do it? How can you find the right leadership training for your organization? Here are a few things to consider:
Decide what skills to focus on. Make a list of the challenges facing your organization and prioritize them. If you try to tackle too much, it can overwhelm the training participants. Narrow it down to a few skills that will make the most impact and start with those. This is very helpful in designing the program and also can be valuable when determining your training budget.
Talk to several people. Any really good training provider isn't afraid of a client talking to others. Companies make the right decision for their operation and find the training provider who best aligns with their culture. Know a provider’s experience, what industries they've worked in and their philosophy regarding the subject matter.
Like the methods the training provider uses. It’s important to understand the training provider’s style, any models they mention, the books they share and the activities they conduct. For example, if you’re not a fan of games in training, what happens if the trainer uses games? Or maybe doing Karate as part of a teambuilding exercise? You probably want to know about that (and yes, some training providers do that sort of thing). Those conversations should happen early on.
Consider schedules and the operation. Work with your training provider to find a schedule that allows for an excellent program and minimal disruption to the operation. When participants are distracted during training, it’s hard on everyone. A good provider should be able to work with your schedule.
Know what evaluation methods the trainer uses. Ask your training provider what they measure from the training program. If all they do is a Level 1 evaluation, request that they also provide a Level 2. This helps you, the client, have a better understanding of the learning that took place. Trainers often get a bad rap for not showing ROI from their training sessions. These evaluations can provide helpful information.
Discuss ways for participants to practice after the training and retain the material. Let’s face it…training is an investment. Companies want to know their investment is going to stick. Training providers should work with their client companies and find ways for participants to immediately apply the material they've learned. It’s the best way for participants to retain the information. Find out if the vendor offers additional options such as coaching or social learning to help reinforce the initial training.
The next time you’re looking for training, I hope you find this list helpful. It can really make a difference in selecting the right training provider and getting a quality program that will benefit your organization. Please feel free to contact us if you have any questions and check out our list of highly successful, proven training programs and customized solutions that can be tailored to the unique needs of your organization.
Shutdown places ACA guidance in jeopardy
Originally posted October 03, 2013 by Andrea Davis on https://ebn.benefitnews.com
The federal government shutdown could delay much-anticipated guidance on a number of provisions of the Affordable Care Act.
“If the shutdown lasts a week or two, that could really throw a monkey wrench into the timing of guidance,” says Paul M. Hamburger, co-chair of Proskauer’s employee benefits, executive compensation and ERISA litigation practice center. “The biggest problem with the shutdown, vis-a-vis guidance on the ACA, is the ability to get all of this updated guidance from the DOL, HHS and IRS out there quickly before the end of this year.”
At issue is the need for updated guidance on the employer mandate. While the mandate has been delayed until 2015, employers need to start preparing for it now by figuring out how they’re going to accurately measure and report to the IRS on which employees qualify as full time workers.
Hamburger says update guidance was expected in November but the shutdown may delay it. Employers are “just going to have to sit and wait and hope that when the shutdown is over, the guidance will come out,” he says.
Also at stake, he says, is regulatory guidance related to certain coverage mandates coming into effect in 2014. The requirement that waiting periods cannot exceed 90 days, the elimination of pre-existing conditions exclusions and other coverage-related mandates “all need some additional guidance, presumably before 2014,” says Hamburger. “The shutdown is going to dramatically reduce the extent to which that guidance can come out.”
The end result could be more of a reliance on FAQ-type guidance, rather than the preferred way of issuing proposed regulations for review and comment followed by the publication of final rules.
What employers should be doing now, says Hamburger, is looking at those 2014 coverage mandates and figuring out how they’re going to comply, even in the absence of official guidance. In the case of waiting periods, for example, “there are proposed regulations out there and I think employers need to look at that carefully and decide how they’re going to exercise reasonably good faith in interpreting those rules based on their particular waiting period,” he says.
Healthy employees create competitive advantage
Originally posted September 24, 2013 by Emily Holbrook on https://www.lifehealthpro.com
It may come as no surprise to many that healthier employees are more productive employees, creating a competitive advantage for their employer. That's according to a recent study by Integrated Benefits Institute (IBI), a workforce health and productivity research and measurement organization.
The company studied 1,268 employees at 53 organizations and found that employees that work at companies with a strong commitment to a healthy workforce "spend more time working, work more carefully and concentrate better than employees at other organizations," according to the report.
“If a workplace sets a high priority on the health of employees — who, in turn, are healthier and have better job performance — then it can reasonably be said that an employer’s culture gives it a competitive advantage. Workplace culture reflects the priorities of company leadership and is an area where employers have some leverage to improve business performance,” stated IBI research director Kimberly Jinnett, PhD, the main author of the report.
The study also found:
- Not careful at work: Workers in an organization with a weak health culture reported not being careful at work “all” or “most of the time” more than three times more frequently than those who work in organizations with a strong health culture.
- Not working as often: 44 percent more employees who work in an organization with a weak health culture reported not working as often as they should have “all” or “most of the time” as compared with employees in organizations with a strong health culture.
- Not concentrating: 31 percent more employees who work in companies with a weak health culture reported they did not concentrate “all” or “most of the time,” compared with employees in organizations with a strong health culture.
- Getting less work done: There was no difference in the responses from those in a strong versus a weak health culture with regard to getting less work done — but employee health is a differentiating factor. Emotional distress and overall health strongly influence how much an employee accomplishes, and employees in organizations with a weak health culture have worse outcomes on both measures.
IBI President Dr. Thomas Parry said "as more employers recognize that health influences productivity, as well as health care costs, health outcomes such as absence, disability and presenteeism are being brought into the larger discussion of the business cost of poor health."
Of course, this is not the first time that research has shown the connection between poor employer health culture and employee ailments (and therefore, productivity) and it won't be the last. According to IBI, employers that wish to increase their focus on health-related job performance and its impact on the bottom line "should broaden their view from the individual health of employees to additional organizational factors, including health culture and employee well-being."
Companies are, albeit slowly, starting to see the link between employee well-being and productivity.
HR align benefits with business objectives
Originally posted September 24, 2013 by Jennifer Paterson on https://www.employeebenefits.co.uk
Reward and HR professionals are taking steps to ensure that the benefits they offer support the objectives of their organisation, according to research by the Chartered Institute of Personnel and Development (CIPD).
Its Aligning strategy and benefits survey, which is based on responses from 444 organisations, found there is also a strong correlation between workplace outcomes and transparency in employee benefits.
Organizations that prefer to be more transparent about their benefits schemes are more likely to have good employee relations, increased productivity rates, lower absenteeism, good employee retention and low pay discontent.
The research also found that, where respondents’ workforce comprised mostly graduates, there is a higher level of membership in defined contribution pension plans.
Charles Cotton (pictured), reward adviser at the CIPD, said: “HR professionals continually have to ensure that the reward provisions they offer in the workplace are in keeping with the shifting nature of work, and are aligned to both the needs of business and employees and integrated with other aspects of people management strategy.
“Failure to do so will result in inappropriate achievements, skills and behaviours being rewarded and recognised.
“What our research helps to illustrate is that HR [professionals] are not adopting benefits for the sake of it, but are choosing those that match what the firm is trying to achieve. It also shows the impact that employee benefits can have in the workplace in terms of employee retention, absence, productivity and relations.”
Bike and health expert advocates collaborative approach to wellness
Originally posted September 25, 2013 by Kathleen Koster on https://ebn.benefitnews.com
The workplace strategy for health improvement is easily expressed as a bicycling metaphor where bicyclists struggle with the uphill stretches and use caution to coast on downward slopes. Gary Earl, former vice president of benefits and health care for Caesars Entertainment Corporation, suggested employers could learn from the biking world when improving their wellness strategy, speaking during a panel discussion at the Benefits Forum & Expo in New Orleans on Monday.
“Our job [as HR professionals] is to improve the lives of human beings. We’re responsible for that,” explained Earl, founder and team captain of Journey for Health Tour, for which Earl and his team are riding a bicycle 3,000 miles across America to promote health improvement.
While working for Caesars, Earl transformed the company’s outlook on wellness programs and health benefits from a cost-only perspective to an asset for the workforce and business.
“[My employer’s] vision was the traditional vision: to offer affordable benefit plans to employees and to reduce costs. We turned that upside down. We wanted to move it from an expense to an asset,” he said.
He created an affordable equation to prove his strategy would improve the population’s health by developing a mathematic equation to show company executives the value in this paradigm shift.
That equation illustrated how employees’ positive health experience and positive attitude generates an increase in productivity, sustainability and satisfaction, which would lead to an improvement in company earnings.
“We have to look at health benefits as an opportunity, an asset,” Earl stressed.
Earl believes HR and benefits professionals need to hold themselves accountable to improving population health and always passionately advocate wellness—not simply view this responsibility as part of a dry job description.
Over time, we have created the problems afflicting our health system and it’s our responsibility as a community to fix today’s prevalent issues, said Dr. David Whitehouse, MD, chief medical officer, UST GLOBAL, a fellow panelist at the conference session.
“The ecosystem of health and the obesity endemic exist because of modernization. During World War II there were food shortages and we developed preservatives [to make our food last longer]. We then wanted to make our lives more convenient, so we developed transport and we stopped exercising and walking. We have, in fact, through modernization and our own design for comfort, created the epidemic,” said Whitehouse.
Earl seconded that point, adding that these health issues “can’t be viewed in isolation. They are systematic problems, which means that they are interconnected and interrelated. We need to approach this by connecting all aspects of the community, whether it’s faith, safety, education, business or economic development—there’s a real balance to be able to draw them all together.”
He added that business owners could drive this change. “They don’t own that change but they can be a catalyst. By coming together in uncommon ways but for a common purpose stimulates the change,” he said.
Employers and company leaders must connect with communities to make significant change. Applying the bike metaphor again, Earl said that we need to encourage each other when facing uphill challenges and learn from one another to find solutions. And for those downhill stretches, Earl explained that in biking, “you don’t ever coast downhill; you want to keep that leg-mind momentum going.” Employers must also use caution to stay in control of their initiatives and keep forward momentum, without swerving off the edge of the road.
“You’re not going to improve an individual’s health without understanding what those social and environmental elements are,” Earl said. “You have to put in the energy.”
Employers can align medical groups and local systems by working with the community. They can make a customized approach through patient-centered medical homes, on-site clinics or Accountable Care Organizations. Whatever employers develop with their local groups, they must work together to fix the dramatic health issues Americans face and struggle with.
“If we don’t overcome our shyness and work collaboratively then we will live with the misfortunes of our unintended consequences,” said Whitehouse.
Health Q&A: ‘Obamacare’ Exchanges Start as Questions Abound
Originally posted September 30, 2013 by Alex Nussbaum on https://eba.benefitnews.com
Just don’t expect the usual ending to an election: a clear winner at the end of the day.
While the exchanges are expected to open on time, that milestone is unlikely to settle the 3 1/2-year grudge match over the Affordable Care Act. A long enrollment season, complicated by a threatened U.S. government shutdown and a growing list of technical glitches, means it may be as late as April before it’s known how many uninsured Americans sign up under the law.
While the shutdown won’t stop the roll-out, which is largely funded through mandatory appropriations that can’t be curtailed by congressional inaction, it’s an open question whether it will lessen public enthusiasm to enroll. In the meantime, technical glitches are beginning to surface.
People in Oregon, for example, won’t be able to enroll in a plan for the first few weeks unless they go through a broker or designated nonprofit groups, and the exchange in the nation’s capital won’t include premium prices until mid-November.
The Obama administration says other glitches are inevitable as the system starts up. The question is how serious and how long it takes the exchange to fix any issues. An extended crash or a problem calculating subsidies could be an embarrassment for the White House -- and sour consumers just as the administration tries to convince them to enroll.
‘In Between’
“Is it going to be a train wreck, a complete failure? The answer is no,” said Dan Schuyler, a director at Leavitt Partners, a Salt Lake City-based health care consultant. “Is it going to be completely seamless and instantaneous? No. It is going to be somewhere in between.”
The exchanges are at the heart of the law’s efforts to cover more of the 48 million uninsured Americans. About 7 million people will use the system to buy subsidized insurance by the end of the first open enrollment period on March 31, according to congressional projections.
Republicans will spotlight any problem as proof the law is a disaster. Democrats say they’ll overcome technical glitches and the law will sell itself as the uninsured gain benefits. Polls show most Americans side with the skeptics.
“The lights will go on Oct. 1, but they may flicker,” said Jocelyn Guyer, a director at the Washington-based consultant Manatt Health Solutions. “I worry the most about people making premature judgments on the first couple of weeks.”
The Breakdown
Here’s a primer on what to look for, based on interviews with consultants, insurers, analysts and state and federal officials:
Q: Who runs the exchanges?
A: Fourteen states have their own on-line exchanges, with the rest run in whole or part by the U.S. government.
Q: Who will use them?
A: The exchanges are open to people who buy coverage on their own and employees of businesses with 50 or fewer workers, as well as those currently shut out of insurance because of cost or a medical condition.
Subsidies are available, on a sliding scale, to those making as much as four times the poverty level, which is $11,500 for a single person and $24,000 for a family of four. Those making less than 138% of poverty will be eligible for Medicaid if they live in one of the 26 states set to expand the program.
Sign-Up Numbers
Q: How many people will sign up early on?
A: Call it lowering expectations or a realistic assessment: either way, supporters say they don’t expect a flood of enrollees this week.
Insurance buyers have to pay their first month’s premium within 30 days of choosing a plan and the policies don’t take effect until Jan. 1. As a result, the Obama administration says most people will wait until late November or December. Another surge may come in March as the end of the enrollment period nears.
A: The exchanges will march on. That’s because the 2010 law relies primarily on mandatory spending, which congressional inaction can’t stop. It’s the budget category used for benefits such as Medicare, the U.S. health plan for the elderly and disabled, and Social Security.
The U.S. Health and Human Services Department said in a Sept. 27 memo it “would continue large portions of ACA activities, including coordination between Medicaid and the marketplace” in the event of a temporary shutdown.
Core Unaffected
“Many of the core parts of the health-care law are funded through mandatory appropriations and wouldn’t be affected,” Gary Cohen, the director of the Center for Consumer Information and Insurance Oversight at HHS, told reporters on Sept. 24.
Q: Okay, so most of the exchanges will be up and running on time. How do you access them?
A: If all goes as planned, those not covered through work will be able to go on line or dial a call-in center, learn if they’re eligible for tax credits and choose from a menu of private plans. The exchanges can be found atwww.healthcare.gov.
Q: Who won’t use them?
A: Most of us. People who have insurance through their jobs, about 55% of Americans, aren’t directly affected by the law and are automatically in compliance with its mandate that everyone be insured. So are older Americans covered through Medicare.
Individual Mandate
Q: Do I have to buy insurance?
A: Yes, or pay a fine. The law requires that most Americans be insured starting Jan. 1. That can be through work, a government program like Medicare or Medicaid, or by buying on the exchanges. Those who opt out face a penalty starting next year at $95 or 1% of household income, whichever is higher. By 2016, it rises to $695 per individual or 2.5% of household income, whichever is greater.
Q: Is the technology for the exchanges in place?
A: Building the exchanges has been a massive technical lift, requiring computer systems with real-time links to dozens of state and U.S. agencies and private carriers. The administration says the system is ready to go, albeit with delays and reduced capabilities in places like Oregon and Washington.
Company Mandate
Q: Has anything else been delayed?
A: The law requires that large companies offer benefits to anyone working more than 30 hours a week. In July, that rule was postponed until 2015 to ease the burden of compliance.
Last week, officials said a Spanish-language version of the federal website won’t be ready until mid-October and an exchange for small business workers won’t take enrollments until November. Nevada and California also won’t transmit names of new customers to insurers for about a month, Schuyler said.
Q: Will the coverage be affordable?
A: It depends on who you are and where you live. Six in 10 uninsured people will find insurance for less than $100 a month because of subsidies and expansions to Medicaid, the administration said last week. Those who make too much for assistance may be in for sticker shock: the same report said even bare-bones coverage, known as a bronze plan, will average almost $3,000 a year for individuals.
For families, the cost of mid-level coverage, a silver plan, ranges from $559 a month to $1,216 a month in 36 states where the federal government controls the exchanges. Tax credits will reduce the cost for many: a family earning $50,000 a year may find the price of a bronze plan cut to zero in some states.
Young and Healthy
Q: How will insurers cover the costs for all those added sick people?
A: By signing up the young and healthy. The administration said it needs about 40% of new enrollees to be in this group to help balance costs from older, sicker customers and keep premiums stable.
A: No. The polls indicate consistent confusion. Three in five say the law will raise medical costs, and more say they’ll be worse off under it than better, according to a Bloomberg National Poll conducted Sept. 20-23. Half also said Republicans should back off on demands to defund the law, a schizophrenic view that’s persisted for months.
Q: So does anybody like this law?
A: Yes. Sixty-one percent of Hispanics and 91% of blacks, according to a September poll by the Pew Research Center and USA Today. That could make the sales pitch easier because those two groups comprise the bulk of the uninsured in the U.S. – 47% of the total, according to an analysis by the Kaiser Family Foundation. The law also is designed to benefit people with pre-existing medical conditions: insurers will no longer be able to deny them coverage.
Big States
Q: What’s happening in the big states?
A: Supporters have focused on states such as Texas, Florida, Ohio and New Jersey, where many uninsured live and Republican governors refuse to help in enrollment. California, which has the most uninsured, is spending $100 million to promote its exchange while New York plans to spend $27 million to train community groups and brokers to assist consumers.
Q: How much help do consumers get?
A: The administration is spending $67 million to train health workers, hospitals and other groups, called navigators, to help people enroll. Grants didn’t arrive until August, though, and many began a two-week training course this month. If they’re not up to the task, enrollment may suffer.
“You’re going to have tens of thousands if not hundreds of thousands of individuals who have never been exposed to health insurance before -- don’t know what a premium is, what a deductible is,” said Schuyler, the Leavitt Partners consultant.
Changes Needed
Q: Do Democrats think the law needs to change?
A: Some have called for changes: Families of workers whose company plan doesn’t include dependents can’t get subsidies. A tax credit for small businesses has been criticized as ineffective. And there are bipartisan bills in Congress to change a provision that may encourage businesses to cut workers’ hours to avoid insuring them. A quick fix seems unlikely: Republicans say they won’t tinker with a law they consider fundamentally flawed.
Q: What’s happening with Medicaid?
A: While the government health program for low-income Americans is expanding under the law, about half the states have opted out. The Obama administration last week agreed to let Arkansas use the money to help poor citizens buy private insurance on its exchange. The deal could entice other states where Republicans have opposed the expansion.
Expense Rising
Q: Is Obamacare making health-care more expensive?
A: Time will tell.
Medical costs have moderated in the U.S. the past three years, offering some relief to the public and private sectors alike. Prices for medical care rose 1% in July compared with a year earlier, the lowest growth rate since the 1960s, according to U.S. Commerce Department data.
There’s a debate among economists about how much credit to give the health law compared with a weak economy and employer moves to curtail benefits. Obamacare supporters say at least some of the slowdown is thanks to regulations and pilot programs in the act aimed at reducing waste in the medical system.
13 things employers must do to be PPACA-ready
Originally posted September 25, 2013 by Dan Cook on https://www.benefitspro.com
Uncertainty over the impact of health care reform on their businesses has created plenty of anxiety among HR managers and those in the C-Suite.
A recent survey by ADP found almost half of large-company finance managers aren’t fully confident that they understand their responsibilities under the Patient Protection and Affordable Care Act. At small companies, the study found, just 28 percent of those surveyed have developed any sort of plan for controlling their health benefits costs in the wake of health care reform. At large companies, that percent rose to 40 percent — still not very confidence-inspiring.
Executives know reform is going to rock their boat. When asked by ADP whether they thought the public insurance exchanges would have an impact on their company, half of small company respondents thought it would, while nearly 70 percent of large companies responded affirmatively.
To help employers get a better handle on the act’s requirements, ADP has come up with following recommendations for coping with health care reform.
EVALUATE
1. Know the requirements and deadlines:Don’t wallow in fears that are groundless with respect to your company. ADP says you should “invest the time and resources needed to clearly comprehend the act’s legal requirements and time frames in order to accommodate its tax implications and avoid penalties for non-compliance.” Establish a timeline with key milestones to help guide your process.
2. Determine administrative impact on your company: How will oversight of changes mandated by the PPACA increase administrative burden? “A prime example of an ACA provision with potentially large administrative impact is Shared Responsibility. Beginning in 2015, it requires tracking each employee’s full-time or part-time status every month, and maintaining that information as part of employee tax records.” Those kinds of requirements will clearly add to HR’s tasks, and may require additional manpower, at least while systems are being set up.
3. Calculate financial implications: There are myriad ways the mandated healthcare changes, reporting requirements, additional taxes, etc., will affect your cost of doing business. Coverage mandates for your benefits plan design, as well as reform-related taxes and fees, must all be taken into consideration. Over-budget for the short term at least.
EDUCATE
4. Create a written summary of benefits and coverage for employees: This is a four-page (or less) summary of your plan you must provide your employees with. It must be clearly written. Make sure you obtain acknowledgement of receipt of the SBC from employees.
5. Notify your employees of public exchanges: This is the notification of insurance options due Oct. 1. Is this required? Yes. Will you be fined if you don’t do it? Maybe not. Do it anyway. It’s a great way to communicate with your workers.
ENROLL
Sign ’em up: If you have at least 50 full-time employees, you have to offer them affordable health coverage. Make sure you offer the opportunity to enroll to all eligibles. Then develop a system to track, update and report on employee eligibility and enrollment to maintain ongoing compliance.
7. Enroll employees’ dependents: The law requires employers to offer coverage to qualifying dependent children of full-time employees up to age 26. You may also want to consider conducting a dependent eligibility audit, which typically show as many as 15 percent of dependents claimed by employees are not qualified for benefits.
8. Prepare for automatic enrollment: Employers with 200+ full-time employees will soon face new rules for enrolling new employees in the company’s group health plan. If you haven’t already, you’ll need to start thinking about solutions to address this requirement.
9. Assess your exchange/coverage options: Employers will generally choose from three different plan approaches for covering their employees – employer-sponsored plans, private exchanges and the new public exchanges created under the act. You’ll need to determine which works best for you, from both a financial and employee recruiting/retention standpoint.
EXECUTE
10 Get ready to define and track full-time and part-time employees: The act requires this tracking — it’s the basis for many calculations that are coming down the pike. Start tracking now so you won’t have to go back and try to recreate the data later.
11. Offer an employee wellness program: An earlier ADP study showed wellness programs are an increasingly popular strategy for offsetting the expense of healthcare – without passing on additional costs to employees.
12. Get a grip on your medical loss ratio rebates: These are sent to employers from their insurance carrier whenever health insurers do not spend at least a certain percentage of the prior year’s health insurance premiums on healthcare services. If you receive MLR rebate dollars, the plan must make a fiduciary decision about using the dough. A best practice is to communicate to your employees your intention as to how the MLR rebate will be used.
13. Limit employee flexible spending accounts (FSAs): Prior to the enactment of the act, the IRS permitted employers to determine the maximum amount an employee could set aside tax-free in a Flexible Spending Account. Going forward, you will need to enforce a $2,500 annual limit on all employee healthcare FSA contributions.
How much will Obamacare premiums cost? Depends on where you live
Originally posted September 25, 2013 by Sandhya Somashekhar and Sarah Kliff on https://www.washingtonpost.com
A 27-year-old in Austin who earns $25,000 could pay $85 per month for health insurance next year, and a family of four in St. Louis with income of $50,000 might face a $32 monthly premium, according to new federal data on health insurance rates under the Affordable Care Act.
The report, released Wednesday by the Department of Health and Human Services, showed significant variation in the insurance premiums that Americans shopping on the individual market could pay under the president’s health-care overhaul. Across the 48 states for which data were available, the unsubsidized monthly premiums could be as low as $70 for an individual and as high as $1,200 for a moderate plan for a family of four.
The average national premium for an individual policy will be $328 in 2014, before including any of the tax credits that will be available to low- and middle-income Americans to help them purchase coverage.
Officials say these prices will be affordable for people buying insurance through the government marketplaces slated to open next week.
“For millions of Americans, these new options will finally make health insurance work within their budgets,” Health and Human Services Secretary Kathleen Sebelius said.
Information about how much insurance plans will cost under the law, sometimes called Obamacare, has been dribbling out for months on a state-by-state basis.
But the report from the administration, which has been collecting rate information since the spring, offers the first comprehensive look at the effect of the law on many Americans — specifically those who buy coverage privately and not through their employers, as well as low-income uninsured people who are not poor enough to qualify for Medicaid.
Beginning Tuesday, those people will be able to log on to government Web sites called marketplaces to peruse their plan options, apply for government subsidies and sign up for coverage effective next year. That is when the requirement kicks in that virtually every American carry health insurance or face a fine.
The report also includes information for more than two dozen states that declined to set up their own marketplaces, leaving at least part of the job up to the federal government.
Premiums will vary significantly depending on an individual’s income, where she lives and what type of coverage she buys. A 27-year-old in Fairfax County, for example, could spend between $124 and $258 on a health plan, depending on how robust she wants it to be.
A family of four in Fairfax County that earns $50,000 could get a health insurance plan with no premium at all, because the federal tax credit would cover the bill.
Most people using the marketplaces will have incomes low enough to qualify for a government subsidy. A recent administration report found that 56 percent of the roughly 41 million uninsured people eligible for the marketplaces could pay monthly premiums of $100 or less.
Health experts say it is a good sign for consumers that premiums have come in lower than expected. Under the law, the plans must offer a basic set of benefits, including mental health and maternity care, which previously were not included in many private plans. Insurers are also forbidden from rejecting or charging people more because of preexisting conditions.
Many experts worried that those factors would drive up the cost of insurance. They partially credit competition on the marketplaces, where people will be able to directly compare plans from different insurance companies, for restraining premiums.
But they warn that premiums don’t tell the whole story.
The low rates are possible in part because insurance companies created special plans that include fewer in-network doctors and hospitals than many current plans.
This may not be a problem for healthy people who currently lack insurance. But those with illnesses may discover that their specialists are not covered by an exchange insurance plan. Low-income people accustomed to a certain community clinic may find that going there is no longer an option. And everyone may encounter long waits to see a doctor.
In addition, many of the lowest-cost plans may carry high deductibles, despite a cap imposed by the law that limits out-of-pocket costs to $6,350 per person per year.
“Despite the fact that the premiums are lower than expected, enrollees on exchanges are likely to face very high out-of-pocket costs before they hit their cap, and they are at risk of being in very narrow network plans that may or may not include all the providers they need access to,” said Caroline Pearson, vice president of health reform at the consulting firm Avalere Health, which did its own report on rates this month.
Some healthy people may also experience sticker shock on premiums. A recent analysis by the Manhattan Institute, a conservative think tank, found that some people who buy low-cost private plans today could see their rates jump by 24 percent.