MBGH's new website is now live at http://www.memphisbusinessgroup.org/home.
As of July 14, 2010, our Blog is fully integrated into our new website, so all new posts are on the website. You can continue to visit our old Blog on this blogspot for posts prior to July 13, 2010.
We look forward to having you visit our new site. Let us know what you think!
Sunday, August 8, 2010
Tuesday, July 13, 2010
MBGH Update: Methodist Healthcare Quality Report Cards Now On-line
Memphis Business Group on Health (MBGH) applauds Methodist Le Bonheur Healthcare (Methodist) for making their quality of care report card public on their websites. Specifically, MBGH is pleased with this initiative for the following reasons:
• MBGH has been working with Memphis-area hospitals since 1997 to improve transparency. As advocates for our member employers, we’ve consistently pressured hospitals to measure and publicly report their performance and to use this information to improve the quality of care they provide.
• MBGH has been asking Methodist to report quality information separately for their adult hospitals since 2002. In response to our request for Methodist to participate in our Leapfrog initiative, they have responded to The Leapfrog Group Annual Hospital Survey separately for each adult hospital. Until now, other publicly available quality reports have only been at the system level, essentially reporting average performance across the system. System-level reporting has not been useful to employers as they try to educate their employees about selecting hospitals that provide higher quality care. In this new initiative, Methodist is reporting quality information by facility which is a significant advancement.
• MBGH has asked Memphis-area hospitals to report their performance on a regular basis, which allows employer purchasers and employees to track performance over time, including whether hospitals improve performance or if there is lack of improvement. Methodist has committed to reporting this information regardless of whether it shows they are providing quality care or if they need to improve, thereby providing the good news and the not-so-good news.
This initiative is an excellent first step in increasing transparency with area employer purchasers and employees/potential patients. MBGH asks that all Memphis-area hospitals look to this as a local transparency standard they should try to meet and exceed.
As this initiative takes root, MBGH asks all Memphis-area hospitals, including Methodist, to add additional critical information to their online information. Information on outcomes, such as survival rates/mortality rates; structure measures such as staffing in ICUs and computerized physician order entry; and hospital acquired conditions, such as falls, pressure ulcers, and infections is already available and would not require significant work to add to the reports.
Gary Shorb, President and CEO of Methodist Le Bonheur Healthcare, emphasizes their commitment to working with MBGH and purchaser employers to provide additional information that is useful to employers and their employees. MBGH is meeting with Gary and senior Methodist staff to work out the specifics and timeline. We will keep you up-to-date as details are finalized.
We welcome the opportunity to work with other Memphis-area hospitals, as well, as they develop their transparency strategies.
In the meantime, we encourage you to access and use the Methodist Healthcare information by clicking below:
Methodist Healthcare Adult Quality
Le Bohneur Children’s Hospital Quality
• MBGH has been working with Memphis-area hospitals since 1997 to improve transparency. As advocates for our member employers, we’ve consistently pressured hospitals to measure and publicly report their performance and to use this information to improve the quality of care they provide.
• MBGH has been asking Methodist to report quality information separately for their adult hospitals since 2002. In response to our request for Methodist to participate in our Leapfrog initiative, they have responded to The Leapfrog Group Annual Hospital Survey separately for each adult hospital. Until now, other publicly available quality reports have only been at the system level, essentially reporting average performance across the system. System-level reporting has not been useful to employers as they try to educate their employees about selecting hospitals that provide higher quality care. In this new initiative, Methodist is reporting quality information by facility which is a significant advancement.
• MBGH has asked Memphis-area hospitals to report their performance on a regular basis, which allows employer purchasers and employees to track performance over time, including whether hospitals improve performance or if there is lack of improvement. Methodist has committed to reporting this information regardless of whether it shows they are providing quality care or if they need to improve, thereby providing the good news and the not-so-good news.
This initiative is an excellent first step in increasing transparency with area employer purchasers and employees/potential patients. MBGH asks that all Memphis-area hospitals look to this as a local transparency standard they should try to meet and exceed.
As this initiative takes root, MBGH asks all Memphis-area hospitals, including Methodist, to add additional critical information to their online information. Information on outcomes, such as survival rates/mortality rates; structure measures such as staffing in ICUs and computerized physician order entry; and hospital acquired conditions, such as falls, pressure ulcers, and infections is already available and would not require significant work to add to the reports.
Gary Shorb, President and CEO of Methodist Le Bonheur Healthcare, emphasizes their commitment to working with MBGH and purchaser employers to provide additional information that is useful to employers and their employees. MBGH is meeting with Gary and senior Methodist staff to work out the specifics and timeline. We will keep you up-to-date as details are finalized.
We welcome the opportunity to work with other Memphis-area hospitals, as well, as they develop their transparency strategies.
In the meantime, we encourage you to access and use the Methodist Healthcare information by clicking below:
Methodist Healthcare Adult Quality
Le Bohneur Children’s Hospital Quality
Wednesday, July 7, 2010
DOL FAQ on Mental Health Parity Offers Guidance for Grandfathered Plans
Click here to read Buck Consultants' summary of how recently released DOL FAQ (click here to read) on mental health parity impacts grandfathered status under health reform.
Tuesday, June 29, 2010
J.D. Power 2010 Employer Health Insurance Plan Study Shows Low Satisfaction Rates
According to J.D. Power, there are overall low employer satisfaction rates (61%) with health plans. Service outranks cost & benefits as satisfaction driver. Employee plan servicing ranked #1, with account servicing and product offering/design ranking 2nd & 3rd. Go to http://bit.ly/blTq3t for the press release re: major study findings.
The LA Times reports that health plans are ramping up customer service to compete post-health reform. Guess the JD Power employer survey was right! http://bit.ly/9N82ix
.
The LA Times reports that health plans are ramping up customer service to compete post-health reform. Guess the JD Power employer survey was right! http://bit.ly/9N82ix
.
MBGH Participating in TN's All Claims Database Development
MBGH is a member of the Tennessee Health Information Committee which oversees the development of TN's all claims database in terms of information that is collected and information that is publicly reported.
Click here to read a report which summarizes why states are creating these all claims databases. Examples of how information from these databases can be used include:
Click here to read a report which summarizes why states are creating these all claims databases. Examples of how information from these databases can be used include:
- Employers can begin to understand the variation in cost and utilization by geographic area within a state;
- The value equation (cost & quality) of new health care services can be assessed;
- The design and implementation of health reforms can be informed by data and data can be tracked to determine impact;
- Compare prevalence of disease across populations;
- Determine payer competitiveness;
- Report on the cost and quality of individual providers.
PWC Report Forecasts 2011 Employer Health Benefit Trends
PricewaterhouseCoopers’ Health Research Institute surveyed 700 U.S.-based companies, small through jumbo sized, to gauge their perspectives on health care costs and benefits program priorities for 2011. Interviews were conducted in the first quarter of 2010. Click here for a copy of the report.
Major findings include:
Major findings include:
- Medical costs are projected to increase 9% in 2011.
- More employers will move away from co-payments & toward co-insurance at the point of care.
- Hospitals, getting less from Medicare, will cost-shift to employers/commercial to make it up.
- Providers will merge and consolidate, creating greater leverage in negotiations with health plans.
- Employers plan to add more worksite wellness & health promotion programs.
MBGH Worksite Wellness Project with Health Department Gets National Recognition
Click here to see the article on this project in the Memphis Business Journal.
The Memphis Business Group on Health (MBGH) received one of seven national Community Health Partnerships (CHP) Population Health Seed Grants. The $12,911 grant was awarded by the National Business Coalition on Health through the Community Coalitions Health Institute (CCHI).
The grant will fund a joint program between the Memphis Business Group on Health (MBGH) and the Memphis Shelby County Health Department (MSCHD) to study the effectiveness of the Move More, Eat Better…It All Works Together Fitness Challenge in the workplace.
The MSCHD has been offering the Move More, Eat Better…It All Works Together Fitness Challenge through churches and community centers. The program is funded by the State of Tennessee Department of Health. Despite the fact that the program is free to employers, The MSCHD has had a difficult time getting employers to offer it at worksites.
Memphis Business Group on Health is a coalition of member employers sharing solutions and providing tools to manage the cost and quality of health benefits. As part of the grant, MBGH has secured participation of four member employers, including the Memphis Shelby County Airport Authority and Merck. The employers will enroll approximately 120 employees in the challenge, which lasts six weeks.
Health department staff will record the employee’s blood pressure, weight and Body Mass Index (BMI) at the beginning of the challenge and compare it to the employee’s final numbers six weeks later. During that period, MSCHD staff will provide weekly educational programs to employees on topics such as nutrition and exercise.
Incentives for participants include pedometers, waist circumference tape measure, hand sanitizer, jar grips, pens, notepads. The grand prize, a George Foreman grill, is awarded to the participant making the most significant progress toward better health.
The Memphis Business Group on Health will track the initiative from an employer’s perspective, measuring employee engagement, realized benefits, and employer satisfaction. As part of the grant, MBGH will recommend how the program may be modified to make it more successful in the workplace in the future. Results will be published in a white paper and made available to employers and other communities.
“In Memphis, employers have historically perceived the Health Department as an organization that helps the uninsured and the under-insured and not employers,” said Cristie Upshaw Travis, Chief Executive Officer of The Memphis Business Group on Health. “The department is an underutilized resource that we can tap to help deliver better value to our member organizations. For example, we worked with the MSCHD to help our employers implement H1N1 Flu shot programs.”
The Memphis Business Group on Health (MBGH) received one of seven national Community Health Partnerships (CHP) Population Health Seed Grants. The $12,911 grant was awarded by the National Business Coalition on Health through the Community Coalitions Health Institute (CCHI).
The grant will fund a joint program between the Memphis Business Group on Health (MBGH) and the Memphis Shelby County Health Department (MSCHD) to study the effectiveness of the Move More, Eat Better…It All Works Together Fitness Challenge in the workplace.
The MSCHD has been offering the Move More, Eat Better…It All Works Together Fitness Challenge through churches and community centers. The program is funded by the State of Tennessee Department of Health. Despite the fact that the program is free to employers, The MSCHD has had a difficult time getting employers to offer it at worksites.
Memphis Business Group on Health is a coalition of member employers sharing solutions and providing tools to manage the cost and quality of health benefits. As part of the grant, MBGH has secured participation of four member employers, including the Memphis Shelby County Airport Authority and Merck. The employers will enroll approximately 120 employees in the challenge, which lasts six weeks.
Health department staff will record the employee’s blood pressure, weight and Body Mass Index (BMI) at the beginning of the challenge and compare it to the employee’s final numbers six weeks later. During that period, MSCHD staff will provide weekly educational programs to employees on topics such as nutrition and exercise.
Incentives for participants include pedometers, waist circumference tape measure, hand sanitizer, jar grips, pens, notepads. The grand prize, a George Foreman grill, is awarded to the participant making the most significant progress toward better health.
The Memphis Business Group on Health will track the initiative from an employer’s perspective, measuring employee engagement, realized benefits, and employer satisfaction. As part of the grant, MBGH will recommend how the program may be modified to make it more successful in the workplace in the future. Results will be published in a white paper and made available to employers and other communities.
“In Memphis, employers have historically perceived the Health Department as an organization that helps the uninsured and the under-insured and not employers,” said Cristie Upshaw Travis, Chief Executive Officer of The Memphis Business Group on Health. “The department is an underutilized resource that we can tap to help deliver better value to our member organizations. For example, we worked with the MSCHD to help our employers implement H1N1 Flu shot programs.”
Health Reform Resources Added in June
Quite a bit of activity in June related to health reform. You can click the following links to access the latest information. Don't forget to click here to go to MBGH's Health Reform Resource Center for the 30+ postings on health reform information important for employers.
Click here to read Health Reform GPS's summary of Health Insurance Reforms & Grandfathered Plans (6/26/10)
Click here to read the HHS press release on regulations for grandfathered plans (6/14/10).
Click here to read the HHS Q&A on the regulations for grandfathered plans (6/14/10)
Click here to read National Business Coalition on Health's Action Alert on the release of the official application & application instructions for the early retiree reninsurance program (6/29/10)
Click here to read Milliman's assessment of the impact of health reform on Large Employers (6/11/10)
Click here to read FAQ's about health reform from Buck Consultants (6/21/10)
Click here to read Health Reform GPS's summary of Health Insurance Reforms & Grandfathered Plans (6/26/10)
Click here to read the HHS press release on regulations for grandfathered plans (6/14/10).
Click here to read the HHS Q&A on the regulations for grandfathered plans (6/14/10)
Click here to read National Business Coalition on Health's Action Alert on the release of the official application & application instructions for the early retiree reninsurance program (6/29/10)
Click here to read Milliman's assessment of the impact of health reform on Large Employers (6/11/10)
Click here to read FAQ's about health reform from Buck Consultants (6/21/10)
Saturday, June 5, 2010
Memphis Medical News Reports on MBGH Leapfrog Rewards
Thursday, June 3, 2010
Why Do Employees Not Take Their Meds?
Interestingly, cost is the not the only reason. Seems convenience is too. This article suggests physician offices should dispense prescription drugs. Evidence also shows that worksite clinics that dispense drugs save employees and employers dollars and increase adherence.
Click here to read the blog post on this issue.
Click here to read the blog post on this issue.
Memphis Hospitals Continue to be Challenged by Infections
Click here to read the latest article on hospital infection rates in Memphis.
MBGH has been working through The Leapfrog Group and other ways to push hospitals to reduce hospital infections, which cost both dollars and lives.
Click here to see Leapfrog Hospital Survey results for Memphis hospitals which include infectionr rates in ICUs. Share this important information with your employees so they can select hospitals that provide a higher level of quality, safe care.
MBGH has been working through The Leapfrog Group and other ways to push hospitals to reduce hospital infections, which cost both dollars and lives.
Click here to see Leapfrog Hospital Survey results for Memphis hospitals which include infectionr rates in ICUs. Share this important information with your employees so they can select hospitals that provide a higher level of quality, safe care.
Work-Site Clinics Beginning to Show Up in Memphis
MBGH suggests that as work-site clinics expand their focus from helping employees with acute episodes (such as sinus infections, colds, etc) to providing on-going care for those with chronic conditions, the value of work-site clinics will increase for employers.
Click here to read the article describing how work-site clinics, though slow to catch on in Memphis, are beginning to pop up over town.
Click here to read the article describing how work-site clinics, though slow to catch on in Memphis, are beginning to pop up over town.
Friday, May 28, 2010
Implementing Mental Health Parity
Issues covered include:
Deductibles and out of pocket limits
Coordination with EAP services
Separate coverages or benefit packages
How to deal with providers, specialists, primary care
Quantitative vs. non-quantitative benefits (very controversial)
Compliance
Wednesday, May 26, 2010
More Updates on MBGH's Health Reform Resource Center
- Employer uptake on early retiree reinsurance program
- How employers are handling expanding coverage to <27 year olds
- Guidance on Extension of Children's Health Coverage to Age 26
- New resource on health reform provisions that apply to grandfathered plans
- How employers are reacting to Health Reform
Thursday, May 20, 2010
Mercer Reports on How Large Employers Are Reacting to Health Reform
Click here to read results from Mercer's survey of 800 large employers which shows that:
■Early estimates of cost impact range from moderate to severe, with 30% of employers surveyed still in the dark
■Even so, the excise tax on high-cost plans – which doesn’t kick in until 2018 – tops employers’ list of concerns
■Retailers concerned about cost of expanding coverage to more part-timers
■Employers considering several options for offsetting cost of covering adult children
Most large employers are waiting unitl their new plan years to implement coverage for <27 year olds. Click here to read an NPR article on this aspect of the survey results.
■Early estimates of cost impact range from moderate to severe, with 30% of employers surveyed still in the dark
■Even so, the excise tax on high-cost plans – which doesn’t kick in until 2018 – tops employers’ list of concerns
■Retailers concerned about cost of expanding coverage to more part-timers
■Employers considering several options for offsetting cost of covering adult children
Most large employers are waiting unitl their new plan years to implement coverage for <27 year olds. Click here to read an NPR article on this aspect of the survey results.
Thursday, May 13, 2010
Pushing for Market-Level Health Plan Performance Reporting
But I am struck by the fact that although reporting at the plan or vendor level often works for individual employers, those of us involved in community-level change need this valuable information cut in a different way. For example, health plans in TN report their HEDIS measures at a statewide level. Works for employers that have employees across the state, but does not work for those of us wondering how plans are peforming in Memphis specifically. Another example is the wealth of information that will become available through NCQA's relative resource use reports, which, once again, look at the plan's performance across the entire state.
It is great to know how health plans perform, in general across TN, but it would be even more powerful and actionable to know how they perform in each market in TN. That would tell us more about our own providers and their performance and help identify what we need to improve locally and may even give us hints about how to improve it. Because of contracting methods here in Memphis, where plans contract either with Baptist or Methodist, but generally not with both, we could even begin to understand if there are any real differences in the quality and resource use between our two major hospital systems and their affiliated physicians.
Understanding whether these differences exist between Baptist & Methodist is critical to local employers, and their employees, in knowing where to go for safe, high quality, efficient care.
NCQA is pushing itself to be relevant, vital, and address the current issues that are even more important due to health reform. The next challenge will be how to make this information relevant and usable by communities as well as individual employers. I hope I can bring this perspective to NCQA as I continue to serve on their Purchaser Advisory Council.
Sunday, May 9, 2010
More Resources on Grandfathered Plans & Early Retiree Reinsurance Now on MBGH Health Reform Resource Center
Great resources from national experts now uploaded on MBGH's Health Reform Resource Center on our temporary website. Click here to access the following:
Proskauer's presentation on Grandfathered Plans & Exception for Collectively Bargained Agreements (4/29/10)
Groom Law Group chart identifying sections effective for Grandfathered Plans (4/2/10)
Groom Law Group Memo on Interim Final Regulationson Retiree Reinsurance Program (5/6/10)
Buck Consultant's summary of HHS Interim Final Regulations on Retiree Reinsurance Program (5/6/10)
Paul Hasting's "Early Retiree" Retiree Health Insurance Initial Observations & First Guidance (5/4/10)
Proskauer's presentation on Grandfathered Plans & Exception for Collectively Bargained Agreements (4/29/10)
Groom Law Group chart identifying sections effective for Grandfathered Plans (4/2/10)
Groom Law Group Memo on Interim Final Regulationson Retiree Reinsurance Program (5/6/10)
Buck Consultant's summary of HHS Interim Final Regulations on Retiree Reinsurance Program (5/6/10)
Paul Hasting's "Early Retiree" Retiree Health Insurance Initial Observations & First Guidance (5/4/10)
Thursday, May 6, 2010
Check Out New Postings on MBGH's Health Reform Resource Center
- IRS guidance on tax-free employer-provided heatlh insurance for children under 27
- HHS Releases Regulations on Early Retiree Reinsurance Program from Buck Consultants
- How Will Reform Affect Large Employers? from Jenny Ivy at Benefits Selling
- Employee Benefit News is Establishing Health Reform Study Groups
Friday, April 30, 2010
MBGH Recognizes 5 Memphis-area Hospitals for "Best Odds of Survival"
Click here to read about MBGH's Leapfrog awards to 5 Memphis-area hospitals that have "best odds of survival" in the Memphis Daily News.
Click here to read the press release which talks about other Memphis-area findings from the Leapfrog Hospital Survey, including how Memphis hospitals compare to hospitals nationally on COST of care.
Click here to read the press release which talks about other Memphis-area findings from the Leapfrog Hospital Survey, including how Memphis hospitals compare to hospitals nationally on COST of care.
Monday, April 26, 2010
Memphis Employers Using Incentives & Data to Control Health Benefit Costs
Check out MBGH's comments on how Memphis-area employers are controlling health benefit costs through employee incentives and providing data to make informed choices. Click here to read the Memphis Business Journal article.
Sunday, April 25, 2010
Work-Site Clinics Gaining Favor Over Retail Clinics
Tuesday, April 20, 2010
Get the latest on Retiree Reinsurance Program
Sunday, April 18, 2010
Curious About How Part-Time Employees Are Addressed in Health Rerform?
Saturday, April 17, 2010
MBGH Presents on Health Reform to Tennessee Personnel Management Assoc.
Tuesday, April 13, 2010
Latest on How Employers Are Preparing (Reacting) to Health Reform
As the dust begins to settle on what actually was passed in health reform, employers are reacting and beginning to prepare to deal with what appears to lie ahead. Greatest concern is being voiced over extending dependent coverage to age 26; extending coverage to part-time employees that work 30 hours/week; caps on FSAs; and the elimination of tax deductability for Mediare Part D subsidies for retiree health plans and on lifetime and annual limits, all of which will increase employer costs.
But many say the version that passed is less onerous than previous versions with delays in implementation of controversial issues including the excise tax on "cadillac" plans and the inclusion of some positives in terms of payment & quality demonstrations. Plus, employers "dodged" the strong employer mandate that had been in the House bill.
In addition to all of these changes, and more, employers will take on additional administrative tasks, which, as we all know, end up costing employers significantly in compliance issues.
Read these two article to get a feel for how employers are preparing and reacting as the dust begins to settle.
Click here for "Employers Scamble to Catch Up with Health Reform's Immediate Impact" and here to read "Benefit Managers Eye Impact of Health Reforms".
But many say the version that passed is less onerous than previous versions with delays in implementation of controversial issues including the excise tax on "cadillac" plans and the inclusion of some positives in terms of payment & quality demonstrations. Plus, employers "dodged" the strong employer mandate that had been in the House bill.
In addition to all of these changes, and more, employers will take on additional administrative tasks, which, as we all know, end up costing employers significantly in compliance issues.
Read these two article to get a feel for how employers are preparing and reacting as the dust begins to settle.
Click here for "Employers Scamble to Catch Up with Health Reform's Immediate Impact" and here to read "Benefit Managers Eye Impact of Health Reforms".
Friday, April 9, 2010
The VA Saves $3 Billion over 10 Years with HIT Systems
The VA system reports that implementing health information technology has saved them $3billion from 1997-2007 through reductions in duplicated tests and medical errors, as well as operating efficiencies. Technology implemented included computerized patient records, bar coded medications, radiology, laboratory and medication ordering. Imagine the savings we could have in Memphis if all of our systems implemented these same technologies!!! Quality of care also improved during this period. You can track Memphis hosptial progress in implementing computerized provider order entry for medications by reviewing The Leapfrog Hospital Survey results here (see "Prevent Medication Errors"). We have a long way to go in this area. Methodist Healthcare indicates that Methodist North and Le Bonheur are now operational and the remainder of the system should be operational by 2011.
Click here to read an article about the VA experience.
Click here to read an article about the VA experience.
Thursday, April 8, 2010
MBGH Celebrates the Spirit of Memphis
Get into the Spirit of Memphis!!! Our city, heritage, music, food, culture, people...our spirit...is what makes us great. Celebrate it!!
Tuesday, April 6, 2010
More on How Health Reform Impacts Employers: Latest from SHRM
Monday, April 5, 2010
Resource for Employers to "Navigate Health Reform"
Friday, April 2, 2010
Employers: Focus on These Aspects of Health Reform NOW!!!
Click here to hear Steve Wojcik, vice president of public policy for the National Business Group on Health, offer his take on what employers should have top of mind between now and when the biggie components of the Patient Protection and Affordable Care Act take effect in 2014 and 2018.
Thursday, April 1, 2010
MBGH Says: Real Cost Reform is Still to Come
There is also a link to the Leapfrog Hospital Survey results for Memphis hospitals.
Check the Memphis Business Quarterly blog out regularly for other Memphis business-related postings.
Not Paying for Readmissions Spurs Improvements in Patient Care
It is estimated that 75% of the Medicare admissions readmitted to the hospital within 30 days of discharge were preventable. In total, the cost of readmissions to Medicare is approximately $17.4 billion annually.
Medicare's decision NOT to pay for preventable/avoidable readmissions to hospitals has gotten attention. Significant work is now being done by hospitals to put better discharge and/or transfer processes into place to better coordinate care, ensure patients have support systems at home and get needed followup services. A good example of how aligning payments with desired outcomes serves as the main "carrot or stick" to get action. And, a good example of how poor quality care drives high cost.
Click here to read the article. The clear connection between aligning payment with expected outcomes is in the last paragrah.
Medicare's decision NOT to pay for preventable/avoidable readmissions to hospitals has gotten attention. Significant work is now being done by hospitals to put better discharge and/or transfer processes into place to better coordinate care, ensure patients have support systems at home and get needed followup services. A good example of how aligning payments with desired outcomes serves as the main "carrot or stick" to get action. And, a good example of how poor quality care drives high cost.
Click here to read the article. The clear connection between aligning payment with expected outcomes is in the last paragrah.
Wednesday, March 31, 2010
Patient Safety Incidents Cost $8.9 Billion Annually
Latest Health Grade's Patient Safety in American Hospitals study finds that there was little progress in reducing patient safety incidents in hospitals for Medicare patients in 2009. They estimate that these patient safety incidents added $8.9billion to the cost of health care in 2009 and that almost 100,000 Medicare patients died as a result of these incidents.Top performing hospitals had 43% fewer incidents than poorly performing hospitals.One more example of how costly poor quality is!!!
Click here to read an article about the report.
Click here to read an article about the report.
Find Out How Health Reform Impacts Self-Insured Employers
Monday, March 29, 2010
Corporations Push For Repeal of Redeuced Tax Deductions in Health Reform Law
Key corporations claim that health reform bill's repeal of employer tax deductions for retiree drug subsidies will hurt their bottom lines.
Click here to read the NY Times article.
Click here to read the NY Times article.
Sunday, March 28, 2010
Follow MBGH on Twitter!
MBGH is now on Twitter! Help us grow our followers by clicking the twitter logo.
Thursday, March 25, 2010
It's Coming Down to the Wire, Help Memphis Get Google Fiber!!
Show your support for Memphis to get Google Fiber. Go to http://www.google.com/appserve/fiberrfi/public/options to complete a nomination for Memphis; join Google Fiber for Memphis, TN's Facebook page
Wednesday, March 24, 2010
Attend University of Memphis Health Law & Public Polcy Symposium, March 26
Click here for brochure and registration
Health Law and Public Policy:
An Introduction to America's Trillion Dollar Business
History will cement this week as the one which saw the passing of the most significant health law legislation in half a century. Join us for an up-to-the-minute discussion with national authorities never before brought together in Memphis, on The Health Care Ecosystem in Transition; Biomedical Research; Health Care and Economic Development; Health Information Management, Electronic Records and E-Discovery; Perspectives on Health Care Reform; and a Leadership Panel Discussion on Health Care and Public Policy. The day's program will close with an outstanding Leadership Panel comprised of the CEOs from St. Jude Children's Research Hospital, Baptist Memorial Health Care Corporation, Methodist LeBonheur Healthcare, and St. Francis Healthcare. You don't want to miss this.
Friday, March 26, 2010
8:30 a.m. – 6:00 p.m.
To be held at the beautiful new downtown location of the
Cecil C. Humphreys School of Law
One North Front Street
Memphis, Tennessee
Health Law and Public Policy:
An Introduction to America's Trillion Dollar Business
History will cement this week as the one which saw the passing of the most significant health law legislation in half a century. Join us for an up-to-the-minute discussion with national authorities never before brought together in Memphis, on The Health Care Ecosystem in Transition; Biomedical Research; Health Care and Economic Development; Health Information Management, Electronic Records and E-Discovery; Perspectives on Health Care Reform; and a Leadership Panel Discussion on Health Care and Public Policy. The day's program will close with an outstanding Leadership Panel comprised of the CEOs from St. Jude Children's Research Hospital, Baptist Memorial Health Care Corporation, Methodist LeBonheur Healthcare, and St. Francis Healthcare. You don't want to miss this.
Friday, March 26, 2010
8:30 a.m. – 6:00 p.m.
To be held at the beautiful new downtown location of the
Cecil C. Humphreys School of Law
One North Front Street
Memphis, Tennessee
Tuesday, March 23, 2010
Memphis Businesses Get Head Start on Health Reform through MBGH
Click here to read the ABC24 Eyewitness News report (aired on March 23 at 5:00) on the role MBGH plays in health reform.
In the interview, Cristie Upshaw Travis said that even though access to health care dominates the talk about health care reform, Travis said there’s more to the issue. “If we don’t pay attention to the cost and quality of services that everybody receives, we will never see an end to increased costs related to health care.”
In the interview, Cristie Upshaw Travis said that even though access to health care dominates the talk about health care reform, Travis said there’s more to the issue. “If we don’t pay attention to the cost and quality of services that everybody receives, we will never see an end to increased costs related to health care.”
MBGH "Ahead of the Health Reform Curve"
Click here to read the Daily News article on MBGH being a leader in preparing Memphis employers, hospitals, health plans and other providers for health reform.
Note: Cristie Upshaw Travis is a member of the Purchaser Advisory Council for NCQA, not a member of the Board.
Note: Cristie Upshaw Travis is a member of the Purchaser Advisory Council for NCQA, not a member of the Board.
Thursday, March 18, 2010
What Do Physicians Think Employers Should Do?
What do physicians think employer's should do?
82% think employers should offer employees incentives to manage their chronic diseases and/or stay healthy
70% think employers should reduce or waive copays to increase adherence on medications
These strategies are consistent with the current emphasis on "value-based benefit design" which uses benefit design to motivate employees to use high value services which will keep them as healthy as possible for as long as possible.
What do physicians want from employers?
62% want to know about worksite and employer-based programs so they can counsel patients on participation
47% think benefit design should "be an extension of the physician's treatment program" leaving them in control of treatment decisions.
The study, conducted by the Midwest Business Group on Health, also concludes that communication between employers, employees and physicians is critical to improving/maintaining health.
Check out an article on the study by clicking here.
82% think employers should offer employees incentives to manage their chronic diseases and/or stay healthy
70% think employers should reduce or waive copays to increase adherence on medications
These strategies are consistent with the current emphasis on "value-based benefit design" which uses benefit design to motivate employees to use high value services which will keep them as healthy as possible for as long as possible.
What do physicians want from employers?
62% want to know about worksite and employer-based programs so they can counsel patients on participation
47% think benefit design should "be an extension of the physician's treatment program" leaving them in control of treatment decisions.
The study, conducted by the Midwest Business Group on Health, also concludes that communication between employers, employees and physicians is critical to improving/maintaining health.
Check out an article on the study by clicking here.
Thursday, March 11, 2010
Unnecessary Angiograms Are Very Costly to Your Health Plan
Recent study released in the New England Journal of Medicine shows that 62% of 400,000 patients that had no known heart disease and were not receiving emergency heart care had no significant heart blockage found in their angiogram results. The study suggests that physicians should do a better job of identifying those patients that need an angiogram, especially for the 20-30% of the patients that have no symptoms.
Medicare pays about $1,400 for an outpatient angiogram and $3,000 for an inpatient angiogram. Private payors typically pay more. So performing angiograms on patients that do not have significant heart blockage is very costly to you as an employer. For these 62% of the patients, payments could be an estimated $446 million (note: estimated by MBGH. Although the test may have not shown any significant blockage, it may still have been appropriate for some of these patients)
So, what can you do about this?
Medicare pays about $1,400 for an outpatient angiogram and $3,000 for an inpatient angiogram. Private payors typically pay more. So performing angiograms on patients that do not have significant heart blockage is very costly to you as an employer. For these 62% of the patients, payments could be an estimated $446 million (note: estimated by MBGH. Although the test may have not shown any significant blockage, it may still have been appropriate for some of these patients)
So, what can you do about this?
- Encourage your employees to discuss less invasive alternatives, and the risks associted with these as well as angiograms, with their physician.
- Check with your health plan to see what type of decision support tools they are offering your employees and how they let your employees know these tools are available. Also ask them how many employees actually use these tools.
- Consider plan design triggers that require accessing decision support services for non-emergencies through the plan prior to scheduling invasive tests.
Wednesday, March 10, 2010
Latest Health Reform & Legislative Update from MBGH & NBCH
Click here for the latest update on health reform and the Mental Health Parity Act provided by the National Business Coalition on Health.
Updates on:
Updates on:
- Part-Time Employee
- Health Savings Accounts (HSAs)
- Retiree Drug Subsidy Tax
- Insurance Reform Effective Dates and Transition Period
- Interim Final Regs Issued for the Mental Health Parity and Addiction Equity Act of 2008
Monday, March 8, 2010
Cost Effective, Quality, Safe Care Must Be Part of the Med's Plan
Merely waiving co-pays and deductibles is not enough to accomplish what The Commercial Appeal's editorial says the Med must do: "The Med has to convince potential paying patients that it's a quality alternative for medical care."
Waiving co-pays and deductibles reduces financial barriers for patients, but in no way ensures that the care they receive is efficient, high quality, and safe. People should have information on the cost and quality of care at the Med to decide if the waived financial requirements are "worth it". But much of the cost and quality information that is available for all the other hospitals in Memphis is not available for the Med because the Med does not publicly report this information through The Leapfrog Group's Annual Hospital Survey (click here to get results for other Memphis hospitals).
Information that is publicly available on the Med's quality of care shows that significant opportunities for improvement exist. For example, recently released statistics on central line infections in ICUs shows that in 2008, the Med's rate of infection was approximately 238% above the average (click here to read Consumer Reports Health article and click here to get State of Tennessee report) . The Med indicates that they have been addressing this issue, but it would be good for us to know what progress they have made in bringing the infection rate down. If the Med reported to The Leapfrog Group survey, we would know how effective their improvement efforts have been and could track their progress.
In addition, the Med's scores on patient experience of care measures from Medicare's survey for the 12-months ending March 2009 show that only 56% of the patients would "definitely recommend" the hospital to others (compared to a national and statewide 68% average).
Finding a financial solution to the Med's situation is essential, but the Med owes us cost-effective, high quality, and safe care. They owe us this under all circumstances, but especially if they are going to offer us financial incentives to use their services. It is not right to ask people to make the decision to come to the Med based only on the fact that they will "save money". The Med should participate, as all other Memphis hospitals do, in the Leapfrog survey so people can decide if the quality of care they are likely to receive is worth saving money because there are no co-pays or deductibles.
Click here to read the latest Commerical Appeal editorial.
Waiving co-pays and deductibles reduces financial barriers for patients, but in no way ensures that the care they receive is efficient, high quality, and safe. People should have information on the cost and quality of care at the Med to decide if the waived financial requirements are "worth it". But much of the cost and quality information that is available for all the other hospitals in Memphis is not available for the Med because the Med does not publicly report this information through The Leapfrog Group's Annual Hospital Survey (click here to get results for other Memphis hospitals).
Information that is publicly available on the Med's quality of care shows that significant opportunities for improvement exist. For example, recently released statistics on central line infections in ICUs shows that in 2008, the Med's rate of infection was approximately 238% above the average (click here to read Consumer Reports Health article and click here to get State of Tennessee report) . The Med indicates that they have been addressing this issue, but it would be good for us to know what progress they have made in bringing the infection rate down. If the Med reported to The Leapfrog Group survey, we would know how effective their improvement efforts have been and could track their progress.
In addition, the Med's scores on patient experience of care measures from Medicare's survey for the 12-months ending March 2009 show that only 56% of the patients would "definitely recommend" the hospital to others (compared to a national and statewide 68% average).
Finding a financial solution to the Med's situation is essential, but the Med owes us cost-effective, high quality, and safe care. They owe us this under all circumstances, but especially if they are going to offer us financial incentives to use their services. It is not right to ask people to make the decision to come to the Med based only on the fact that they will "save money". The Med should participate, as all other Memphis hospitals do, in the Leapfrog survey so people can decide if the quality of care they are likely to receive is worth saving money because there are no co-pays or deductibles.
Click here to read the latest Commerical Appeal editorial.
Friday, March 5, 2010
Benefit Plan Costs Could Increase if Med waives Co-Pays, Deductibles
The Med's strategy could end up costing Shelby County's benefit plan a lot more money!! Co-pays and deductibles play an important role in encouraging employees to use the appropriate level of care..e.g., a primary care physician vs. an emergency room. If insured employees go to the Med vs. their physician office because there is no co-pay, costs will increase to the plan. Something that needs to be thought about..
Click here to read the CA article.
Click here to read the CA article.
Saturday, February 27, 2010
7 Ways to Cut Benefit Costs Without Cutting Coverage
Although this article is from 2007, these strategies are still something to at least think about!! MBGH still hears a lot about:
Covering preventive services at 100%
Mandating mail order
Moving from the carrot to the stick (or as a speaker referred to it lately, as a "frozen carrot")
Auditing enrolled dependents
Click here to read the Workforce.com article. You will need to register to see the article,but it is free!!
Covering preventive services at 100%
Mandating mail order
Moving from the carrot to the stick (or as a speaker referred to it lately, as a "frozen carrot")
Auditing enrolled dependents
Click here to read the Workforce.com article. You will need to register to see the article,but it is free!!
Handy Tool to Assess Your Dental Benefit Offerings
Check out this article which gives you an easy way to assess the quality of your dental benefits. Key aspects include:
Offering the right preventive services
Giving employees access to dental risk assessments
Maximizing flexible spending accounts
Communicating effectively with your employees
Click here for the article from Workforce.com. You will need to register, but it is free!!
Offering the right preventive services
Giving employees access to dental risk assessments
Maximizing flexible spending accounts
Communicating effectively with your employees
Click here for the article from Workforce.com. You will need to register, but it is free!!
More Cost-Effective Dental Benefits Now Available
Tailoring dental benefits to the needs of your employees, including medical conditions they may have such as diabetes, can help you save dollars down the road. Click here to read the Workforce.com article. You may need to register, but it is free!!
Friday, February 26, 2010
MBGH Launches: Tobacco Cessation Benefits Tools & Solutions
MBGH launches its first Tools & Solutions center focusing on tobacco cessation benefits. Building off of our successful February 25, 2010 meeting, Smoking Cessation: The Purchaser Perspective, MBGH has created a web page dedicated to key information employers need to manage the cost & quality of their tobacco cessation benefits.Click here to access the web page.
Included on this web page are:
MBGH is committed to providing our members with current tools & solutions to manage the cost & quality of their health benefits in an ever-changing environment.
Included on this web page are:
- Presentations from the February 25, 2010 meeting
- Purchaser's Guide: Summary Plan Description Language for tobacco use treatment
- Partnership for Prevention Business Outreach Package on Tobacco Cessation
- Employer Case Studies
- Sample Policies
- Publications
MBGH is committed to providing our members with current tools & solutions to manage the cost & quality of their health benefits in an ever-changing environment.
Thursday, February 25, 2010
Pharmacist-based Program Proves Effective for Diabetics in Polk County, FL
An employer-based clinical pharmacist counseling program for type 2 diabetes patients in Polk County, FL led to a 9% improvement in A1C levels, a 30% decrease in hospitalizations, and a 24% decrease in ER visits. These results of this 2005 study are reported in the February 15, 2010, American Journal of Health-System Pharmacy.
The pharmacist provided six 30-minute counseling sessions and copays were waived for disease-related medications, supplies, and non-prescription products. Participants were asked to sign an agreement to comply with program rules and processes. A total of 564 enrolled in the program and 477 were still active in the program at the end of 12 months.
Click here to read the article.
The pharmacist provided six 30-minute counseling sessions and copays were waived for disease-related medications, supplies, and non-prescription products. Participants were asked to sign an agreement to comply with program rules and processes. A total of 564 enrolled in the program and 477 were still active in the program at the end of 12 months.
Click here to read the article.
Wednesday, February 24, 2010
Price Increases Drive Spikes in Massachusetts Health Care Costs & Premiums
Massachusetts' recent spikes in health care cost (and increases in premiums) have been caused primarly (75%) by price increases from hospitals and physicians and only 25% have been caused by utilization increases.
The preliminary report from the Massachusetts' Attorney General, also finds that provider payments do not correlate to quality of care or to the actual cost of providing the service. Instead, payments are closely related to provider size and market dominance.
The report also found that in some instances some providers were paid twice as much for the same service as other providers.
Click here to read the article.
The preliminary report from the Massachusetts' Attorney General, also finds that provider payments do not correlate to quality of care or to the actual cost of providing the service. Instead, payments are closely related to provider size and market dominance.
The report also found that in some instances some providers were paid twice as much for the same service as other providers.
Click here to read the article.
Tuesday, February 23, 2010
Cut Cost by Reducing Hospital-Acquired Conditions: Sepsis & Pneumonia
Study results reported by Extending the Cure in The Archives of Internal Medicine indicate that patients that develop sepsis (a systemic response to infection) after surgey end up staying an extra 11 days in the hospital at an average cost of an additional $33,000. In addition, 20% of these patients die of the infection.
The study also found that patients that develop pneumonia after surgery, often due to a dirty ventialtor tube, stay in the hospital an extra 14 days and cost an additional $46,000. 11% of these patients die of the pneumonia.
According to Ramanan Laxminarayan, Ph.D., principal investigator, "In many cases, these conditions could have been avoided with better infection control in hospitals.”
This study presents one more piece of evidence that improving the quality & safety in hospitals not only saves lives, but saves dollars as well.
Click here to read the article.
The study also found that patients that develop pneumonia after surgery, often due to a dirty ventialtor tube, stay in the hospital an extra 14 days and cost an additional $46,000. 11% of these patients die of the pneumonia.
According to Ramanan Laxminarayan, Ph.D., principal investigator, "In many cases, these conditions could have been avoided with better infection control in hospitals.”
This study presents one more piece of evidence that improving the quality & safety in hospitals not only saves lives, but saves dollars as well.
Click here to read the article.
Improve Worksite Wellness Programs with Social Networking
Click here to hear the podcast.
MBGH 2010 Health & Productivity Forum Panel Featured in Business Insurance
Click here to read the Business Insurance article.
Monday, February 22, 2010
President Obama Releases 11-page Outline of Health Reform Proposal
President Obama has released his health reform proposal outline.
Click here to read a Modern Healthcare article.
Clickk here to see the outline.
Click here to read a Modern Healthcare article.
Clickk here to see the outline.
Saturday, February 20, 2010
Power Pauses Can Increase Your Employee's Productivity & Effectiveness
Even better, combine a Power Pause with a physical activity, such as walking, biking, or jogging. This alone time, combined with physical activity, can really rejuvenate the spirit as well as body!!
Try it yourself and considser sharing this concept with your employees in your next employee newsletter!!
Click here to read the CA article on Power Pauses.
Friday, February 19, 2010
Be Alert on Monday, February 22: Obama to Release Compromise Health Bill
President Obama to release compromise health bill in advance on health summit to be held next week. Plans are to attach the compromise bill to a budget bill, which should avert a Republican fillibuster. But Congressional Democrats have not yet seen the compromise bill and have not signed on yet. Republicans are cautioning Democrats not to "finalize" their bill until after the summit.
The Plan will be posted on the internet Monday morning, so check it out early.
Click here to read the article.
The Plan will be posted on the internet Monday morning, so check it out early.
Click here to read the article.
HHS & Insurance Company Exchange Heats Up
HHS Secretary Kathleen Sebelius announced the release of a new report "Insurance Companies Prosper: Families Suffer" and blasts insurance companies for significantly raising premiums, using MI (56%), ME (23%), CA (39%), and CT (24%) as examples. But insurance companies are striking back claiming that the plan "villification" should stop and that the premium increases should be put into perspective, especially as it relates to healthcare cost increases.
Click here to read an article from HealthLeaders Media.
Click here for a copy of the report.
Click here to read an article from HealthLeaders Media.
Click here for a copy of the report.
MBGH Leading Employer Contributions to Improving Health in Memphis
MBGH supports the Commercial Appeal's call for employers, churches, civic organizations, and government to get involved in improving health in Memphis..each group should work within their sphere of influence & responsibility to contribute to the overall improvement in our community's health...MBGH is taking leadership in working with employers by sharing solutions and providing employers tools includng health benefit design, worksite health-related programs, and building an overall culture of health to improve the health and productivity of their employees and to use their health benefit dollars efficiently.
Click here to read the editorial.
Click here to read the editorial.
Thursday, February 18, 2010
Health Plan Performance Improving Slightly for Diabetes, But More Work Needed
The National Business Coalition on Health's just released 2009 Health Plan Diabetes Performance report shows that there is only slight improvement in outreach and outcomes for diabetics in the surveyed plans. Approximately 81% of the diabetics had at least one A1C test, but approximately 43% of them had uncontrolled blood sugar levels.
These challenging outcomes exist even while large numbers of plans and their customers are using:
So, what are you doing in your plan design to help your outcomes improve?
This annual report is based upon results for the 70 health planscovering approximately 96 million Americans that particated in NBCH's 2009 eValue8 program. In Tennessee, BlueCross BlueShield of Tennessee and CIGNA Healthcare of TN provided information through Memphis Business Group on Health.
Click here to read the Business Insurance article on the report.
Click here to access a copy of the report.
These challenging outcomes exist even while large numbers of plans and their customers are using:
- Disease management
- Personal health assessments
- Gaps in care reminders for physicians
- NCQA's physician recognition program which identifies physicians with quality outcomes for their diabetic patients.
So, what are you doing in your plan design to help your outcomes improve?
This annual report is based upon results for the 70 health planscovering approximately 96 million Americans that particated in NBCH's 2009 eValue8 program. In Tennessee, BlueCross BlueShield of Tennessee and CIGNA Healthcare of TN provided information through Memphis Business Group on Health.
Click here to read the Business Insurance article on the report.
Click here to access a copy of the report.
Wednesday, February 17, 2010
Reduce Total Cost & Improve Diabetes Medication Adherence through Value-Based Plan Design
A CVS-Caremark study released in the American Journal of Pharmacy Benefits shows that eliminating or reducing co-pays for diabetes medication can improve medication adherence. The study compared 20,000 participants in a value-based benefit design to over 190,000 participants in a standard 3-tier co-pay benefit design.
A separate study released by the New England Healthcare Institute shows that not taking medications properly leads to higher costs, more hospitalizations, and poorer health, adding about $290 billion annually to the nation's health care spending.
Click here to read about the study findings.
A separate study released by the New England Healthcare Institute shows that not taking medications properly leads to higher costs, more hospitalizations, and poorer health, adding about $290 billion annually to the nation's health care spending.
Click here to read about the study findings.
Check Out How Shelby County Ranks
Check out how Shelby County ranks in the County Health Rankings just released by the Robert Wood Johnson Foundation & the University of Wisconsin. Click here to get to a snapshot of Shelby County's results.
Our biggest opportunities are in improving health behaviors (especially obesity, binge drinking, chlamydia rate, and teen pregnancy rate) and our physical environment (including air pollution, access to healthy foods, and liquor store density).
Shelby County's socieo-economic status also significantly affects our rankings. Our low high school graduation rates, high rates of children in poverty, high percentage of single-parent households, and high violent crime rate all impact our score.
We scored ok on clinical care with moderate improvement opportunities in most measures.
The rankings consider:
Mortality
Morbidity
Health behaviors
Clinical care
Social & economic factors
Physical environment.
Our biggest opportunities are in improving health behaviors (especially obesity, binge drinking, chlamydia rate, and teen pregnancy rate) and our physical environment (including air pollution, access to healthy foods, and liquor store density).
Shelby County's socieo-economic status also significantly affects our rankings. Our low high school graduation rates, high rates of children in poverty, high percentage of single-parent households, and high violent crime rate all impact our score.
We scored ok on clinical care with moderate improvement opportunities in most measures.
The rankings consider:
Mortality
Morbidity
Health behaviors
Clinical care
Social & economic factors
Physical environment.
Tuesday, February 2, 2010
Bredesen's Budget Includes No Extra Funds for The Med
Looks like a "business as usual" proposal from The Med is a non-starter. Where is the creative plan that paints a different vision?
Click here to read more details.
Click here to read more details.
Friday, January 29, 2010
MBGH Convenes Members to Improve Depression Care for Employees
Thank you to Donna Marshall, Executive Director of the Colorado Business Group on Health, for meeting with 9 Memphis employers to encourage them to improve the depression care their employees receive. Donna's visit is part of a National Institutes of Mental Health-funded research project to understand how employers make benefit decisions regarding depression care. MBGH's eValue8 project shows that there is significant improvement needed in behavioral health care in Tennessee. Attendees learned that they should encourage their plans to:
Provide feedback to physicians about the quality of depression care they provide their patients
Lower co-pays, co-insurance for depression medication
Lower co-pays, co-insurance for behavioral health physician visits.
These 3 actions lead to improved adherence to therapy which results in better outcomes, health, and productivity. In other words, cuts total costs.
Attendees have access to Donna for technical assistance and will provide study investigators information at 12 and 24 months on any changes made in benefits or benefit design. Thanks again Donna for bringing this valuable information to our members!!
Addressing Over-Use by Reducing Diagnostic Imaging Services
The quality crisis is generally described as consisting of:
Addressing mis-use has generally been philosophically supported because, after all, how can someone morally support harming people in the system? Although philosophical support has been there, what to do to reduce or eliminate mis-use has been very controversial and progress has been slow.
But, work on over-use has been almost non-existent. Reducing over-use will directly impact health care organization's revenue. But now that cost has reared its head again as a major issue for purchasers, reducing over-use of services that provide little to no clinical value is back on the front burner.
In November 2008, the National Priorities Partnership, a group of 32 organizations convened by the National Quality Forum, announced 6 priorities, including reducing "overuse" of services that provide little to no clinical value (click here to learn more about all 6 priorities). The Partnership actually listed potential areas of over-use that should be addressed.
The over-use that seems to be front and center is diagnostic imaging. Significant work is being conducted
in both Washington state and Minnesota. Click here to read Bruce Seigel's (National Director of the Aligning Forces for Quality project) blog post on how organizations in these states are addressing overuse of imaging services by publicly reporting physician use of imaging services and establishing community-wide standars for appropriate use of imaging.
- Under-use
- Mis-use, and
- Over-use.
Addressing mis-use has generally been philosophically supported because, after all, how can someone morally support harming people in the system? Although philosophical support has been there, what to do to reduce or eliminate mis-use has been very controversial and progress has been slow.
But, work on over-use has been almost non-existent. Reducing over-use will directly impact health care organization's revenue. But now that cost has reared its head again as a major issue for purchasers, reducing over-use of services that provide little to no clinical value is back on the front burner.
In November 2008, the National Priorities Partnership, a group of 32 organizations convened by the National Quality Forum, announced 6 priorities, including reducing "overuse" of services that provide little to no clinical value (click here to learn more about all 6 priorities). The Partnership actually listed potential areas of over-use that should be addressed.
The over-use that seems to be front and center is diagnostic imaging. Significant work is being conducted
in both Washington state and Minnesota. Click here to read Bruce Seigel's (National Director of the Aligning Forces for Quality project) blog post on how organizations in these states are addressing overuse of imaging services by publicly reporting physician use of imaging services and establishing community-wide standars for appropriate use of imaging.
Two-Track Approach to Making Health Reform Happen
Pelosi has indicated that a two-pronged approach will be taken to health reform:
Delayed issues are likely to include new taxes, insurance exchanges, and expansion of Medicaid.
Click here to read the article, which includes detailed lists of what is likely to be in any health reform package that is passed in the short-term and those reforms that will, most likely, have to wait.
- Pass those reform items where there is general agreement between the Senate and House versions now.
- Delay more comprehensive health reform.
Delayed issues are likely to include new taxes, insurance exchanges, and expansion of Medicaid.
Click here to read the article, which includes detailed lists of what is likely to be in any health reform package that is passed in the short-term and those reforms that will, most likely, have to wait.
Thursday, January 28, 2010
A Thoughtful Commentary on Health Reform
I can't do this piece justice to summarize, so please just read. You (and/or I) may not agree with all he says, but he does lay the issues out in a thoughtful manner. Well worth the read..
Click here to read more.
Click here to read more.
Wednesday, January 27, 2010
Health Care Reform & GINA Update Week of January 25, 2010
NBCH reports on the latest strategies being considered by the Democrats regarding health reform. The update describes the strategy and comments on how likely the strategy is to succeed.
The update also includes the latest on GINA.
Click here to go to MBGH's temporary website to download the full health reform update.
The update also includes the latest on GINA.
Click here to go to MBGH's temporary website to download the full health reform update.
Tuesday, January 26, 2010
Cleveland Clinic Expands Wellness Benefits to Dependents
Cleveland Clinic now offers their wellness programs free of charge not only to employees, but to dependents as well. Free benefits include weight loss programs, smoking cessation treatment and medications, and fitness center memberships.
This is just one more step in a progressive wellness initiative that began in 2005. That year, Cleveland Clinic instituted smoke free campuses and in 2007 stopped hiring smokers. Since then, they have banned trans fats from their cafeterias and paitent meals.
By making wellness a "family benefit" Cleveland Clinic hopes to be an employer of choice.
Click here to read more.
This is just one more step in a progressive wellness initiative that began in 2005. That year, Cleveland Clinic instituted smoke free campuses and in 2007 stopped hiring smokers. Since then, they have banned trans fats from their cafeterias and paitent meals.
By making wellness a "family benefit" Cleveland Clinic hopes to be an employer of choice.
Click here to read more.
Health Care Reform Update: Implications of the MA Election
Congressional leaders and the Obama Administration reportedly remain close to a very delicate and tedious agreement on several aspects of a final health care reform bill, though the process may be seriously influenced by result of the special senatorial election in Massachusetts (MA) yesterday to fill the seat of Senator Edward Kennedy (D-MA). The Republican senatorial candidate, Scott Brown (R) won yesterday with 52 percent of the votes against Massachusetts State Attorney General Martha Coakley, who garnered 46 percent of the votes.
IMPACT ON HEALTH CARE REFORM (HCR): Once Senator-elect Scott Brown is sworn in (the date has yet to be announced), the Democrats will lose their filibuster-proof "supermajority" in the Senate, and the House of Representatives could be compelled to pass the earlier Senate-passed bill outright or quickly negotiate a compromise bill before the new Senator can be sworn in.
At that stage, the budget reconciliation process (requiring only a simple, 51-vote majority in the Senate) could be used to advance a possible second health bill that would follow closely on the heels of the first measure to carry out the key provisions currently being negotiated among congressional leaders and the Obama Administration.
As a contingency plan, the Senate and the Obama administration also still seem to be “courting” centrist Senate Republicans such as Olympia Snowe (R-ME) to solidify the 60 votes needed to pass HCR. The White House and Senate leadership also is working to ensure their own caucus is behind the bill (i.e. Senators Nelson (OK) and Landrieu (LA). In addition, the House is struggling to maintain the 218 votes needed to pass their newest version of HCR when the time comes. Caucus defections are plentiful though the latest House version seems to be more moderate (no public plan and no Cadillac plan excise tax) which could capture more conservative Democrat votes (this is the group that defected during the original House vote in July due to cost and abortion language concerns).
In terms of advocacy, everyone still is moving forward in the belief that the final product can still be improved before its final consideration by the House of Representatives and Senate.
Some of the major priority employer concerns with HCR legislation include
• the need for the legislation to reduce health care costs and improve quality,
• avoidance of onerous mandates that would limit the flexibility and innovation that are the foundation of the employer-based system,
• maintenance of the ERISA regulatory structure and
• the need for supportive tax policy that will not undermine employer-sponsored health coverage or add to its cost.
Monday, January 25, 2010
Value-Based Insurance Design Can Be Cost Effective
A study released in the January 21, 2010 edition of Health Affiars conducted by Michael Chernew at Harvard Medical School showed that a value-based insurance design that reduced copays to encourage employees to use high value medical services lead to reduced use of "non-drug services" which more than offset the increase in prescription drug use encouraged by the lower copay.
Click here to read the abstract and to access the full article.
Click here to read the abstract and to access the full article.
Senate Health Reform Bill Could Cost Businesses Additional 7-10%
The HR Policy Association, a group of the country's 300 largest firms, estimates that if the Senate version of health reform were to pass, large businesses could see their health care benefit costs increase an additional 7-10% over the next decade. This cost increase is in addition to current trend increases.
The analysis, performed by Applied Economic Strategies, includes costs associated with new taxes and cost-shifting to private sector payors that is likelys to occur with decreases in Medicare and Medicaid funding.
Click here to read more.
The analysis, performed by Applied Economic Strategies, includes costs associated with new taxes and cost-shifting to private sector payors that is likelys to occur with decreases in Medicare and Medicaid funding.
Click here to read more.
Sunday, January 24, 2010
Whole Foods Kicks Off "Health Starts Here" Initiative
Look for the new "Health Starts Here" program for Whole Foods team members and customers. In-store programs, recipes & educational material, and identifying healthy, nutrient-dense foods by posting signs with Aggregate Nutrient Density Index (ANDI) scores are all part of the program.
Whole Foods Team Members have two additional programs to support their healthy eating: more significant discounts off Whole Foods purchases if they are nicotine-free and meet cholesterol, blood pressure, and BMI targets; and a total immersion program, which includes medical consultation at no cost to the employee, at certain locations.
Click here to read more.
Whole Foods Team Members have two additional programs to support their healthy eating: more significant discounts off Whole Foods purchases if they are nicotine-free and meet cholesterol, blood pressure, and BMI targets; and a total immersion program, which includes medical consultation at no cost to the employee, at certain locations.
Click here to read more.
Saturday, January 23, 2010
Study Shows Incentive-based Fitness Programs Reduce Cost
A study published in the American Journal of Health Promotion on January 21, 2010 shows that members participating in an insurance plan's incentive-based fitness wellness program had lower healthcare costs, fewer hospital admissions, and shorter lengths of stay in the hospital when they were hospitalized. The study does indicate that more research is needed to understand the long-term effectiveness of these incentive-based programs.
Click here to read more.
Click here to read more.
Chattanooga Hospital Not Hiring Tobacco Users
Memorial Hospital in Chattanooga has decided not to hire tobacco users. The Hospital indicates this decision was made as part of its commitment to a healthy community and not to save health benefit costs. The new rule does not impact current employees. The hospital will add nicotine testing to its existing program to screen for illegal drugs.
Click here to read more.
Click here to read more.
Workplace Wellness Programs Do Generate Savings!
A recent article in Health Affairs reports that Harvard University investigators found workplace wellness programs can generate $3.27 in savings for every $1.00 spent & absenteeism savings of $2.73 for every dollar spent!!
Click here to read more.
Click here to read more.
Health Care Reform Premium Impact
Although it looks like health reform is not moving forward in it current form for now (or maybe ever), it is still interesting to know what type of impact reform would have on premium costs. Wellpoint has calculated the impact of health reform on premium rates in 14 states where Wellpoint operates. Taking a look at Georgia, Kentucky & Missouri, the closest states to TN, may give us an idea of what TN could expect in the individual and small group (fully insured) market. Click here to access the detailed information.
Although the percent change is different in each state, there are common results: highest increases for younger/healthy individuals or small groups, substantial increases in average age/health individual market, and significant decreases for older/less healthy.
Younger/ Healthy Average Age/ Average Health Older/ Less Healthy
Georgia:
Individual 130% 72% -18% (decrease)
Small Employer 69% 14% -38% (decrease)
Kentucky:
Individual 178% 106% -17% (decrease)
Small Employer 99% 21% -39% (decrease)
Missouri
Individual 178% 106% -17% (decrease)
Small Employer 89% 17% -26% (decrease)
Although the percent change is different in each state, there are common results: highest increases for younger/healthy individuals or small groups, substantial increases in average age/health individual market, and significant decreases for older/less healthy.
Younger/ Healthy Average Age/ Average Health Older/ Less Healthy
Georgia:
Individual 130% 72% -18% (decrease)
Small Employer 69% 14% -38% (decrease)
Kentucky:
Individual 178% 106% -17% (decrease)
Small Employer 99% 21% -39% (decrease)
Missouri
Individual 178% 106% -17% (decrease)
Small Employer 89% 17% -26% (decrease)
Tuesday, January 12, 2010
MBGH Has a New Look
We also have a new way of describing ourselves.
“MBGH is a coalition of employers sharing solutions and providing tools to manage the cost and quality of health benefits in an ever-changing environment. We do this by providing access to critical market data, facilitating best-practice sharing among the market’s leading employers, and offering practical tools for successfully managing healthcare benefits.”
Our new tagline sums it up, we are about “Connections. Tools. Solutions”
Connections. MBGH programs and initiatives support our “sharing solutions”.
• Topic-focused in-person meetings
• MBGH’s Annual Conference
• Webinars addressing health and benefit issues identified by our members
• Newsletters, blogs and social media for networking and learning
• Publication of a membership directory so members can contact each other directly.
Tools. These are the resources MBGH provides our members to help improve performance of health plans. In 2010, we’ll launch a new website with a resource and tool kit section addressing:
• Benefit design
• Vendor management
• Worksite-based programs
• Employee engagement.
Solutions. In addition to sharing tools and solutions targeting what employers can do to improve health benefit plan performance, MBGH remains committed to health care system reform in Memphis and nationally. Our members’ health plans perform best when the health care system is cost-efficient and provides high-quality care. MBGH will continue our leadership in measuring and reporting cost and quality performance and implementing employer-based programs/approaches to facilitate improvement in:
• Hospitals (Leapfrog)
• Physicians (Aligning Forces for Quality through Healthy Memphis Common Table)
• Health plans (eValue8)
We are developing tools for you and your employees to use this information to improve the performance of your health benefits through employee engagement, health plan contracting, and network selection.
It is exciting to have this new look, especially as we enter a new decade. We look forward to working with you in 2010 and beyond.
Wednesday, January 6, 2010
"No One Knows What Goes On Behind Closed Doors..."
House starts health reform reconciliation process in closed door meetings. Pelosi indicates the House will not necessarily just adopt the Senate bill as written, specifically re: the Public Option.
Click here to read more.
Click here to read more.
Tuesday, January 5, 2010
Save Dollars & Improve Health By Avoiding Hospital Acquired Infections
On average, hospital acquired infections add $15,000 to a patient's hospital bill. One in 20 patients admitted to the hosptial get a hospital acquired infection. Your cost and the health of your employees are impacted significantly by these hospital acquired infections!!!
You can reduce your cost and improve the care for your employees and their families by sharing this CDC podcast on your intranet to educate your employees about how to protect themselves and their families from hosptial acquired infections if they are admitted to a hospital. CDC is making this podcast available to hospitals to play for patients upon admission, but being prepared ahead of time is the best policy and the hospitals your employees use may not play this video.
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You can reduce your cost and improve the care for your employees and their families by sharing this CDC podcast on your intranet to educate your employees about how to protect themselves and their families from hosptial acquired infections if they are admitted to a hospital. CDC is making this podcast available to hospitals to play for patients upon admission, but being prepared ahead of time is the best policy and the hospitals your employees use may not play this video.
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Be Prepared for New Health Benefit Mandates in Health Reform
New Metlife survey shows 30% of employers don't expect their health benefits to change after health reform..but, there are plan design mandates in both House & Sentate versions that have profound implications for employers and that would change benefits.
Click here to read the SHRM article that outlines these mandates as well as other interesting findings from the Metlife survey.
Click here for a review of the implications of health reform for employers from Mintz Levin law firm.
Click here to read the SHRM article that outlines these mandates as well as other interesting findings from the Metlife survey.
Click here for a review of the implications of health reform for employers from Mintz Levin law firm.
No Formal Conference Committee Reconciliation for Health Reform?
It looks like the Dems are considering bypassing the formal Conference Committee reconciliation process of forging a single health reform bill to send back to both the House and Senate. Instead, they are considering letting House and Senate Democratic leaders hammer out a bill (in private meetings), probably largely based on the Senate version, to send back to the House.Upon passage in the House, the bill would then go back to the Senate. This approach is being considered to minimize the Republican's ability to delay passage. But, Republicans are concerned this approach "shuts out the American people and breaks one of President Obama's signature campaign promises."
Click here to read the article.
Click here to read the article.
Friday, January 1, 2010
2009 Was a Great Year for MBGH!!
2009 was great for MBGH..celebrating hospitals, health plans & physicians that are improving quality & efficiency of care in Memphis, holding our first annual conference, hosting the NBCH Board at Graceland & NBCH meetings in Memphis, and representing Memphis employers in Nashville, DC, Pittsburgh, Dallas, Phoenix, Philadpelphia and beyond..We look forward to 2010!!
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