BREAKING NEWS: AP Story on Increased Costs Caused by Senate Finance Proposal

The Associated Press is out with another story on the new PricewaterhouseCoopers’ report highlighting the increased costs for individuals and families as a result of proposals from the Senate Finance Committee.  Here are some key excerpts:

• “…a new accounting firm study that projects the legislation would add $1,700 a year to the cost of family coverage in 2013, when most of the major provisions in the bill would be in effect.  Premiums for a single person would go up by $600 more than would be the case without the legislation, the PriceWaterhouseCoopers analysis concluded.”
• The study projected that in 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher.”
• It concluded that a combination of factors in the bill — and decisions by lawmakers as they amended it — would raise costs.”
• “Other factors leading to higher costs include a new tax on high-cost health insurance plans, cuts in Medicare payments to hospitals and doctors, and a series of new taxes on insurers and other health care industries, the report said.”
• ‘Health reform could have a significant impact on the cost of private health insurance coverage,’ it concluded.”
• the industry stopped short of signaling all-out opposition.  ’We will continue to work with policymakers in support of workable bipartisan reform,’ Ignagni said in her memo.”

Full AP Article

Is your Company Prepared for the H1N1 Virus

The Harvard School of Public Health study released several weeks ago found that two out of three U.S. businesses are unprepared to deal with the effects of a flu pandemic, when employee absences can be a major disruption.

The Kineo Group’s Crisis Practice has created a H1N1 Readiness Check List that leverages its principals’ expertise from work at the American Red Cross and other global organizations to help leaders manage their workforce effectively.

• Don’t be taken off guard. Those companies with no crisis plan will be surprised by the extent of employee absences and other disruptions, forcing them to be reactive and accept higher losses;
• Review your existing plan, if you have one. Firms with existing crisis communications plans should review and update their plans for H1N1 flu, referencing the latest government guidance, including visiting www.flu.gov. This effort should start immediately and be reviewed monthly;
• Develop a plan now if you don’t. Organizations without existing crisis plans should immediately formulate a basic H1N1 response plan relying heavily upon published guidance from government agencies and medical associations;
• Form an assessment team. Firms should form a team to quickly assess those recommendations, identify issues unique to their industry and develop an action plan;
• Communicate regularly. All companies should communicate regularly to key stakeholders, particularly employees, about what the company is doing, and provide them clear information on what they need to do to sustain the enterprise.
• H1N1  douments:  H1N1 Legislative Brief, H1N1 Employee Awareness Poster, H1N1 Flu Vaccine Poster. For more detailed flu pandemic planning guides please contact me at jsbradley@chhins.com or 631-329-7268.

New Jersey Prepares to Launch Accountable Care Organization

New Jersey is one of the first states to experiment with accountable care organizations, or ACOs, a relatively new health care model that is similar to the patient-centered medical home, or PCMH, and that links primary care and subspecialist practices with area hospitals to create an integrated delivery system. Providers are accountable for costs and the quality of care delivered, and bonuses and penalties are tied to overall spending and quality measures. Learn more

Money Saving Tips on Brand Name Medications

The next time your doctor prescribes a name brand medication it may be worth checking online or with your local pharmacy to see if there is any special money saving offers available.  Many of these brand name drugs have their own dedicated websites that will provide  specific information to obtain savings.  

Provided below is a SAMPLE of medications that have special money saving offers.  This is not an all inclusive listing, so if you do not see a particular medication listed you may want to research the medication online.

Check here to see the sample Brand Name money savings list.

Stores Offering Free Antibiotics and Updated $4 Generic Drug Deals

Stop & Shop: $9.99 90 Day supply

Walmart: $4 30 Day supply, $10 90 Day supply

Kmart: $5/$10/$15  Generic List

Hannaford: $4 30 Day supply, $9.99 90 Day supply

Target: $4 30 Day supply, $10 90 Day Supply

Giant: $9.99 90 Day supply

Free Antibotics

Publix

Wegmans

Schnucks

Giant  

NJ Prescription Drug Price Registry

The NJ Prescription Drug Registry will help consumers compare retail prices charged by pharmacies for the most frequently prescribed prescription drugs. By comparing prices here, consumers can see what a pharmacy has reported to the state that it charged for a specific Rx. You will find that prices for the exact medication will be different from pharmacy to pharmacy and from town to town. To use this registry click here, this link will also be on the right side of my blog titled NJ Prescription Drug Registry. New York and Connecticut have a similar site called Prescription Drug Prices in New York State and CT Attorney General’s Prescription Drug Page.

 

 

Prescription Assistance Program Loosens Eligibility Guidelines, Expands Access

According to a February 2009 Kaiser Health tracking poll more than 53% of all Americans are cutting back on healthcare in someway because of costs concerns. The most common behaviors are relying on home remedies and over the counter drugs rather than going to the doctor. One in four have put off healthcare that they needed more generally and one in five have not filled a needed prescription and one in six have cut pills in half or skipped doses to make their prescription last longer.

Together Rx Access, a prescription savings program sponsored by some of the nation’s largest pharmaceutical companies, has loosened its income eligibility requirements, thereby expanding the number of health consumers who qualify for the program. Share this anyone who is in need of support.

Getting Free or Low Cost Prescription Drugs

 

Given the significant rise in unemployment and people unable to afford the costs of COBRA may people are going without Rx coverage.  Help is available for people to receive free or low cost prescription drugs thru PAP’s.

 

Patient Assistance Programs (PAP’s) are programs set up by drug companies that offer free or low cost drugs to individuals who are unable to pay for their medication. Most of the best known and most prescribed drugs can be found in these programs. All of the major drug companies have patient assistance programs, although every company has different eligibility and application requirements.

 

Eligibility varies program by program. Generally, individuals must have incomes under 200% of the Federal Poverty Level, cannot have prescription coverage from any public or private source and must be a U.S. resident or citizen. Some companies require that the patient has no health insurance.

 

For more on PAP go to RxAssist and spread the good word.       

  

Cuomo Battles Health Insurance Carriers and Posts a Victory for Consumers and Transparency

Cuomo Speaks Out on Victory

Back in February 2008 I reported NY Attorney General, Andrew Cuomo was investigating United Healthcare and has subpoenaed 16 other health plans including Aetna, CIGNA, Humana, and Well Point a subsidiary of Empire Blue Cross Blue Shield to determine how they calculate UCR. UCR is the usual customary and reasonable payment made for medical services rendered outside of the insurance carrier’s network.

Yesterday United Healthcare agreed to close down two Ingenix databases used to determine usual and customary payment rates for services for out of network doctors and pay 50 M to establish a new database that will be run by an independent nonprofit.  This much criticized database was run by Ingenix a subsidiary of United Healthcare. 

Cuomo’s investigation found that the UCR determined by Ingenix database for claims led to underpayments by iurers anywhere from 10 to 28 percent.   United wasn’t the only carrier using this database.

 

This is a huge victory for healthcare transparency for consumers. Under the agreement the new database will come with a web site that allows consumers to see how much they will be reimbursed for services in their area for out of network services

Free Antibiotics at Stop & Shop

Starting January 2, 2009, and continuing through March 21, 2009, Stop & Shop pharmacies are offering a 14-day supply of the most commonly prescribed generic antibiotics for free. Simply bring in your valid prescription from your doctor.

For a list of participating antibiotics, click here.

For a list of frequently asked questions click here.