Why Employees Don’t Stick with Wellness Initiatives
While most employees like wellness programs and feel they help them manage their health, many don’t stay engaged in their programs throughout the year, according to a survey of 1,929 employees by HealthMine.
Less than half of employees stay engaged in their wellness program throughout the entire year.
Employees lack critical information about their personal health. Less than one third know at least one of their key health metrics, which can indicate risk for chronic illness. For example, only 32% of people know their blood pressure. A majority of employees have difficulty interpreting their health information or understanding how to maintain or improve their health.
Eighty-five percent want better information about their risk of chronic disease. Plus, the majority want to know which cancer screenings they need, and the actions they need to maintain or improve their health.
Eighty percent want incentives for wellness. More than half want help from their plan sponsors in setting personal health goals. Even though 30% have been diagnosed with a chronic condition in the last year, most are not getting help with disease management or medication adherence through their wellness programs.
While 70% say their wellness plan helps them manage their health, just 38% say it helps them manage healthcare costs. Even though most consumers agree it’s a good idea to shop for the best deal on medical services before taking action on their health, most never do. For more information, visit healthmine.com.
Employee Wellness Programs Skip Hearing Health
A survey by EPIC Hearing HealthCare reveals that 70% of employers offer a wellness program, but only 8% of these programs integrate hearing health. Employers are far more familiar with wellness programs addressing preventive health issues such as weight control (94%), exercise (89%), smoking (88%), and diabetes management (69%) than programs promoting healthy senses.
Twenty-three percent of employers are familiar with vision programs while only 16% are familiar with hearing health programs. This could be because employers assume that only the retired population is at risk. The truth is that about 30% of employees suspect they have hearing loss, but have not sought treatment; this is consistent among age groups. Employers have a definite change of heart when educated on how untreated hearing loss can affect productivity. Eighty-six percent of employers said they would integrate a hearing health wellness product into their wellness program if they knew that almost all employees with untreated hearing loss say it affects them on the job. For more information, visit epichearing.com/listenhear.
Blue Shield Expands Role of Large Group Rep
Blue Shield of California has expanded the territory for Luke Cirkovic, area vice president of Core Accounts, beyond the Bay Area to include the Central Valley. He now leads the entire Northern California team responsible for new business acquisition and retention for large-employer groups. Cirkovic has more than 10 years of experience in the Northern California marketplace. Since joining Blue Shield in 2006, he has developed sales strategies and broker channel relationships to drive growth around the large account segment.
Californians with the Top Chronic Conditions: 11 Million and Counting
Chronic conditions are the leading cause of death and disability in the United States, and are the biggest contributor to health care costs. But there is wide variation in their incidence. Major differences depend on age, income, race and ethnicity, and insurance status, according to a report by the California HealthCare Foundation. The report finds that many Californians with chronic conditions are delaying needed care because of cost. The following are key findings:
- About 40% of adults have at least one of the five chronic conditions studied.
- High blood pressure is the most common chronic condition, affecting about one in four, or 7.6 million, adults in California.
- The prevalence of chronic conditions falls as income rises. Fourteen percent of adults living under 138% of the federal poverty level have two or more chronic conditions compared to 8% of adults in the range of 400% or more of the federal poverty level.
- 34% of Californians with psychological distress delayed getting needed medical care, and 27% delayed filling prescriptions. Cost or lack of insurance was frequently cited as the reason for these delays.
- 70% of Californians who are 65 or older have at least one chronic condition, compared to 26% of those 18 to 39.
For more information, visit chcf.org/almanac.
Employers forced to pay twice for healthcare seek solution in Sacramento
Assembly Bill 842, by Assemblyman Jim Patterson, addresses a loophole that mandates that construction companies pay twice for healthcare on public works projects. On May 6th 2015, the Assembly Labor and Employment Committee will hear testimony by the Associated Builders and Contractors and employers in California. The bill will ensure that Affordable Care Act (ACA)-compliant health plans provided by employers are accepted by State Government Standards. Contractors who work on public works projects covered by a project labor agreement (PLA) must pay into union trust funds for health insurance even though they already provide health insurance for their employees.
Contractors working on a construction site for a year with 10 employees can expect to pay at least $60,000 in duplicate health benefits. Recent studies by the Kaiser Family Foundation and National Small Business Association reveal that the annual cost of healthcare can be well over $6,000 per employee. Assemblyman Jim Patterson said, “AB 842 lets the contractor show proof he has ACA-compliant health insurance coverage for his employees. A plan that has the required ACA benefits should be sufficient. Companies should not be forced to pay a second time into a separate health plan.” For more information, visit abccentralcal.org.
Insurance Job Opportunities Are on the Rise
The insurance industry saw a small increase in employment with the addition of 5,900 jobs for March, according to the U.S Bureau of Labor Statistics. The insurance industry grew 0.23% in March with 2,525,600 employed insurance workers and an unemployment rate of 2.1%. Over the past 12 months, the number of employed insurance workers increased 83,200 or 3.4% from 2.44 million in March 2014 while the unemployment rate dropped by 1.2%. Insurance carriers and related activities make up the bulk of job growth in the finance and insurance sector, which grew by 6,500 jobs in March. Over the past 12 months, the insurance carriers and related activities subsector has contributed 80% to its parent sector, or 83,200 jobs. For more information, visit insuranceJobs.com.
Americans Are Not Prepared to Face a Disability
Unplanned financial emergencies and medical expenses ranked among Americans’ top three financial fears, according to Northwestern Mutual’s 2015 Planning & Progress Study. However, sobering research from Northwestern Mutual reveals that nearly half of Americans would be in financial trouble in just one month or less after experiencing a disability. Steve Sperka, vice president of disability insurance for Northwestern Mutual said, “People tend to underestimate their risk of disability as well as its potential to wreak havoc on physical and financial health.” Visit NorthwesternMutual.com for a variety of disability tools and educational resources.
Senate Bill Would Expand Access to Pharmacies
The National Community Pharmacists Association (NCPA) strongly endorses The Ensuring Seniors Access to Local Pharmacies Act, S. 1190. The legislation would expand the number of pharmacies that can offer discounted copays for Medicare Part D prescription drugs. It was introduced by Senators Shelly Moore Capito (R-W.Va.), Joe Manchin (D-W.Va.), Tom Cotton (R-Ark.) and Sherrod Brown (D-Ohio).
Medicare beneficiaries in medically under-served areas would be able to access lower copays at any pharmacy that agrees to accept a drug plan’s preferred pharmacy terms and conditions. S. 1190 is a companion bill to H.R. 793, The Ensuring Seniors Access to Local Pharmacies Act, which has been introduced by Reps. Morgan Griffin (R-Va.) and Peter Welch (D-Vt.). NCPA CEO Douglas Hoey, RPh, MBA said, “Medicare beneficiaries should not be confronted with the Hobson’s choice of continuing to patronize their pharmacy at a higher cost or making a long trip to another pharmacy.”
The bill has been endorsed by the Alliance for Retired Americans, the Center for Medicare Advocacy, Families USA, Justice in Aging, the Medicare Rights Center, the National Consumers League, the National Rural Health Association, and the U.S. Pain Foundation. “Today many Medicare beneficiaries are effectively told by drug plan middlemen which pharmacy to use based on exclusionary arrangements among the pharmacy benefit manager (PBM) middlemen and, in most instances, large publicly traded chain pharmacies,” Hoey added. According to a recent Medicare study, in urban areas 54% of preferred pharmacy drug plans failed to meet the government’s threshold for reasonable access to pharmacies. In rural America the closest preferred pharmacy can be 20 miles away or more. For more information, visit ncpanet.org.
How a Network Can Improve the Health of Medicare Beneficiaries
Medicare beneficiaries with diabetes, high blood pressure, or high cholesterol may achieve better health outcomes when using pharmacies that are part of performance-based networks, according to a study by SCAN Health Plan and Express Scripts. Phase I results demonstrated that, when compared to a national sample of retail pharmacies, the pharmacies in the Quality Network achieved 60% higher performance scores for reducing the use of high-risk medications among SCAN members, and 23% higher scores for improving compliance with diabetes treatment guidelines among SCAN members. When compared to a sample of non-SCAN members using the same Quality Network pharmacies, the Quality Network achieved 34% higher scores for high-risk medications and 8% higher scores for diabetes treatment among SCAN members. For more information, visit express-scripts.com.
Five Things to Know About the CMS Part D Data Release
by Allyson Funk of the Pharmaceutical Research and Manufacturers of America
Following the release of Center for Medicaid and Medicare services data on Medicare Part D, here are five things you need to know:
- Part D’s competitive, market-based structure is unique among government programs. Part D is different than other parts of Medicare and other government programs because it relies on competition among private plans that submit bids to offer prescription drug benefits to enrollees. Competition and rebates have been significant in keeping Part D costs $349 billion lower than initial ten-year projections and keeping costs and premiums low for beneficiaries.
- The release does not reflect actual government spending on the Part D program in 2013. According to the Congressional Budget Office (CBO), actual Part D mandatory outlays were $62 billion in 2013, which was only about 10.6% of total Medicare spending that year.
- Significant rebates are negotiated in Part D making the actual cost of drugs lower than reported in the data. The data does not reflect the significant rebates and discounts Part D plans negotiate with pharmaceutical companies. The Medicare Trustees report reveals that many brand-name prescription drugs carry substantial rebates, often as much as 20% to 30%. On average, across all program spending, rebate levels have increased in each year of the program. In fact, actual rebates are above projected levels for each year of the program. The drug that CMS lists as number one of the 10 most expensive drugs in 2013 is actually one of the most highly rebated drugs, with rebates reportedly in excess of 60%.
- The list is already outdated and ignores generic competition. CMS’ list of top-10 drugs, by cost, does not reflect the fact that competition and incentives to control costs have led to high generic utilization in Part D. More than half of the medicines on the list are off-patent or are expected to lose patent protection by 2016. Innovator companies invest in pioneering research to bring new treatments to patients, and over time those medicines become available as lower-cost generic copies. Since Part D’s inception, generic utilization among seniors has increased from about 54% in 2005 to 84% in 2013.
- Use of medicines reduces other medical spending. In 2012, CBO announced a change to its cost-estimating methodology to reflect the fact that increases in prescription drug use could reduce spending for medical services. Enrollment in Part D has improved access to medications recommended to treat congestive heart failure for beneficiaries with limited or no prior drug coverage. An increase in drug adherence for Part D enrollees with congestive heart failure led to over $2.3 billion in annual savings to Medicare, driven by reductions in Parts A and B expenditures. Over the next 10 years, further improvement in adherence among Part D enrollees with CHF could yield an additional $22.4 billion in federal savings.
For more information, visit phrma.org.
A Look at Hispanics’ Health in the United States
A study by the Centers for Disease Control and Prevention (CDC) reveals that heart disease and cancer are the two leading causes of death in Hispanics. Fewer Hispanics than whites die from the 10 leading causes of death, but Hispanics have higher death rates than whites from diabetes, chronic liver disease, and cirrhosis. They have similar death rates from kidney diseases, according to the new Vital Signs.
Health risk can vary by Hispanic subgroup. For example, nearly 66% more Puerto Ricans smoke than do Mexicans. Health risks also vary by whether Hispanics were born in the U.S. or in another country. Hispanics are almost three times as likely to be uninsured as whites. Hispanics in the U.S. are nearly 15 years younger than whites, on average, so taking steps now to prevent disease could mean longer, healthier lives for Hispanics.
The report found different degrees of health risk among Hispanic by country of origin:
- Mexicans and Puerto Ricans are about twice as likely to die from diabetes as whites. Mexicans also are nearly twice as likely to die from chronic liver disease and cirrhosis as whites.
- Smoking among Hispanics (14%) is less common than among whites (24%), but is high among Puerto Rican males (26%) and Cuban males (22%).
- Colorectal cancer screening varies for Hispanics ages 50 to 75 years.
- About 40% of Cubans get screened (29% of men and 49% of women).
- About 58% of Puerto Ricans get screened (54% of men and 61% of women).
- Hispanics are as likely as whites to have high blood pressure. But Hispanic women with high blood pressure are twice as likely as Hispanic men to get it under control.
For more information, visit cdc.gov.
Why Private Exchanges Are Here to Stay
Well-designed private health exchanges can control costs, engage consumers, and offer broad choice, according to third-year enrollment results from the Aon Active Health Exchange. Companies in their second-year renewal had average annual health cost increases of 2.6% over two years, including costs associated with the Affordable Care Act and administration. In contrast, in 2015, average health care cost increases will be 6.5% to 8% for large U.S. companies with comparable plan designs. The study reveals the following:
- 97% of employees enrolled through the exchange website.
- 87% liked being able to choose among multiple carriers.
- 79% of enrollees said they had a good understanding of how they share the cost of group medical coverage with their employer.
- Almost 80% of employees who rated their medical insurance carrier gave them a four-star or a five-star rating.
- 44% chose a Silver plan.
- 16% chose a Gold plan.
- 8% chose Platinum plan.
- 32% chose a Bronze plan.
- Voluntary participation in health savings accounts more than doubled in 2015, with an average contribution of $2,100.
Ken Sperling, Aon’s National Health Exchange Strategy Leader said, “While most individuals migrated toward a plan that was close to what they had before, there were still a meaningful number who chose to buy richer plans for increased coverage or who bought down in terms of coverage to secure a lower premium.”
When choosing a coverage level, most employees based their choice on the following:
- Price (34%)
- The desire to choose a plan that offers coverage similar to their plan (20%).
- Coverage that offers the best level of medical benefits for them (18%).
Employees chose carriers based on the following factors:
- The lowest cost carrier for their selected coverage level (35%).
- The network of doctors (23%).
- Carriers with which they had a good past experience (11%).
The study reveals the following about those re-enrolling in health benefits for 2015:
- 20% switched plan levels, with 12% choosing leaner plan designs and 8% choosing richer coverage.
- 16% switched insurance companies.
- When asked the reason for switching insurance companies, 77% cited price, and 5% said it was because their doctor left the insurer’s network.
Sperling said, “People moved around as prices changed, which is exactly what we expected in a consumer-based, retail marketplace. But when price was not a driver, most consumers stayed where they were in terms of plans and insurance companies even though they had the ability to easily switch. This leads us to believe that they understood the choices they made in the first year of the exchange and were happy with their decisions.” For more information, visit AonHewitt.com.
Website Supports Small Businesses
Allstate, Capital One, LegalZoom, Microsoft, Office Depot, Inc. and Web.com have joined forces to create smallbusinessconnection.com. The free online resource hub is designed to help small business owners address critical business issues. It features information the following:
- Commercial and employee benefit solutions provided by Allstate Business Insurance and Allstate Benefits.
- Cash flow management and financial education resources provided by Capital One.
- Legal solutions provided by LegalZoom.
- Technology solutions provided by Microsoft.
For more information, smallbusinessconnection.com.
Simplified Health Insurance Purchasing
AgileHealthInsurance.com was launched to make it easy for consumers to purchase low-cost alternatives and supplements to Obamacare health plans. The website offers an intuitive online experience and a streamlined application process. Health insurance alternatives to Obamacare are especially important now that the Obamacare Special Enrollment Period for Tax Season ended on April 30th. Obamacare plans will not be available again, without a qualifying life event, until the 2016 open enrollment period begins on November 15th and the earliest that coverage can start for those plans is January 1, 2016. Unfortunately, many consumers are unaware of the Obamacare lockout situation.