Excuse the long absence from the blogosphere. We have been focusing on launching our direct to consumer service and growing our b2b business, as well. www.bWell-informed.com is available to the public to find affordable health insurance (for instance an alternative to often expensive COBRA policies), after learning about it effectively on line.
Since my last blog entry, we have moved from New York City to Cleveland, Ohio. The main purpose is operational cost savings and increased access to b2b and b2c users of bWell-informed Health Plan Forecaster. Headquarter in Cleveand, we also have access to the health and medical capital of the world (Cleveland Clinic, MedicalMart, etc.), and all the associated by products that enrich the business community for companies like bWell-informed.
I had the pleasure of attending, early last week, a health reform discussion at the Intercontinental Hotel, adjacent to the Cleveland Clinic. The most profound statement of the morning Summit sponsored by The Fedeli Group and Ernst and Young, was made by Dr. Delos (Toby) Cosgrove, CEO of the Cleveland Clinic. He said that any legislation we pass federally is simply cost shifting. Dr. Cosgrove proceeded to say if we don't reduce the obesity of Americans and enable providers to be more integrated and organized, no legislation will replace these accomplishments.
So, it's more about the organization of the suppliers and the wellness of the demanders of health care. These thoughts speak to a real marketplace. It is time that we create the conditions necessary for reform like this that sustains not only our health, but our economy.
Tuesday, October 27, 2009
Wednesday, December 10, 2008
Mental health parity legislation a civil rights victory, but price concerns remain
by Elena Skoura, Graduate Intern, bWell-informed
Congress passed a great victory for civil rights on October 3, 2008—the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Act. Named after the deceased Democratic Minnesota senator and the retiring New Mexico Republican senator, the law (HR 1424) requires group health plans of 51 or more employees to cover mental illnesses to the same extent as physical diseases. It is considered a fundamental step towards eliminating the stigma and prejudice the 113 million Americans suffering from mental illness have faced.
The new legislation, which goes into effect for most health plans on January 1, 2010, will extend mental health services to 82 million Americans who live in states that have not already passed mental health parity legislation.
This legislation requires health insurance companies to charge the same deductibles, copayments and out-of-pocket expenses for mental health treatments that they do for physical conditions. Plans are not obliged to offer mental health coverage or cover every mental health condition—but for what they do cover, the costs must be equivalent.
To address concerns that small businesses would find it hard to afford mental health coverage for their employees and might choose to eliminate it altogether, the legislation applies only to group health plans with more than 50 workers. However, small businesses may still be required to offer mental health parity if required by the laws of the state in which they operate.
While MHPA also doesn’t apply to insurance coverage in the individual/non-employment based market, the victory may ultimately impact consumers in the individual market as well. Legislative changes in group health plans often "trickle down" to other types of coverage. If the legislative changes were to apply to individual coverage, consumers could see prices rise considerably to cover the new levels of coverage. To keep plans affordable, some insurers might opt not to offer any mental health coverage at all.
While price remains a concern, the new legislation encourages hope that in the future, human welfare will be approached in a open-minded way. Mental illness should be acknowledged and treated with respect and concern, following the ancient Greek saying: “You shall have a healthy mind in a healthy body”—and vice versa.
Congress passed a great victory for civil rights on October 3, 2008—the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Act. Named after the deceased Democratic Minnesota senator and the retiring New Mexico Republican senator, the law (HR 1424) requires group health plans of 51 or more employees to cover mental illnesses to the same extent as physical diseases. It is considered a fundamental step towards eliminating the stigma and prejudice the 113 million Americans suffering from mental illness have faced.
The new legislation, which goes into effect for most health plans on January 1, 2010, will extend mental health services to 82 million Americans who live in states that have not already passed mental health parity legislation.
This legislation requires health insurance companies to charge the same deductibles, copayments and out-of-pocket expenses for mental health treatments that they do for physical conditions. Plans are not obliged to offer mental health coverage or cover every mental health condition—but for what they do cover, the costs must be equivalent.
To address concerns that small businesses would find it hard to afford mental health coverage for their employees and might choose to eliminate it altogether, the legislation applies only to group health plans with more than 50 workers. However, small businesses may still be required to offer mental health parity if required by the laws of the state in which they operate.
While MHPA also doesn’t apply to insurance coverage in the individual/non-employment based market, the victory may ultimately impact consumers in the individual market as well. Legislative changes in group health plans often "trickle down" to other types of coverage. If the legislative changes were to apply to individual coverage, consumers could see prices rise considerably to cover the new levels of coverage. To keep plans affordable, some insurers might opt not to offer any mental health coverage at all.
While price remains a concern, the new legislation encourages hope that in the future, human welfare will be approached in a open-minded way. Mental illness should be acknowledged and treated with respect and concern, following the ancient Greek saying: “You shall have a healthy mind in a healthy body”—and vice versa.
Wednesday, December 3, 2008
For private Medicare insurers, the honeymoon is over
by Mary Hobson, CMO, bWell-informed
Way back in 1982, Congress fell in love with the idea of allowing private insurers to offer competitive HMO products as an alternative to traditional fee-for-service Medicare options. Seen through rose colored glasses, the marketplace was the cure for all Medicare’s woes. Through the magic of competition, private insurers would provide greater choice, reduced cost, and better quality service.
The legislative body was still in love with the idea in 1997, when it expanded the products private insurers could offer to Medicare eligible to include preferred provider organizations (PPOs), provider-sponsored organizations (PSOs), and private fee-for-service (PFFS) plans. And the love-fest showed no signs of abating even as late as 2004, when the Medicare Modernization act passed, raising payment rates to private providers.
Today, however, with an incoming Democratic regime, the Hill’s long-term romance with “free market” Medicare could be at an end. Helping the “breakup” along? A recent report issued by the respected health policy journal Health Affairs which indicates that taxpayers are actually paying more to subsidize private Medicare plans. Says Marsha Gold, senior fellow at Mathematica Policy Research who authored the report:
“Clearly, the Medicare Modernization Act (MMA) has expanded choice and the private-sector role. But it also has added to Medicare's complexity and costs and has created potential inequities, without apparent improvements in quality.”
While legislators’ ardor is likely to cool substantially, Medicare customers are still flocking to the plans in droves. Today, one in three Medicare beneficiaries with Part D now gets their coverage from private third party providers. Almost a quarter of all Medicare beneficiaries, more than 10 million people, are enrolled in private plans.
Ironically enough, the extra funding these plans receive--according to the report, they are paid 12 percent more on average--is one of the biggest reasons for their popularity. The added value averages more than $1,100 a year per patient, and some of that money goes to provide extra benefits like reduced cost-sharing or reduced premiums for add-on benefits like vision and dental care. A large percentage, however, goes to insurance company profits.
And while some Medicare recipients enjoy a few additional benefits, the overpayments have resulted in an overall rise in Medicare’s costs—with taxpayers and traditional Medicare plan beneficiaries picking up the tab.
2009 looks to be a year in which Congress takes a stand, with support from the White House. On the campaign trail, President-elect Barack Obama called for eliminating the excessive subsidies and paying private plans only what it would cost to treat the same patients under traditional Medicare. Whatever happens, it’s clear that additional monitoring, oversight, and accountability will mean the honeymoon is over for private Medicare insurers.
To download the PDF version of Marsha Gold's report, "Medicare's Private Plans: A Report Card On Medicare Advantage", click here.
Way back in 1982, Congress fell in love with the idea of allowing private insurers to offer competitive HMO products as an alternative to traditional fee-for-service Medicare options. Seen through rose colored glasses, the marketplace was the cure for all Medicare’s woes. Through the magic of competition, private insurers would provide greater choice, reduced cost, and better quality service.
The legislative body was still in love with the idea in 1997, when it expanded the products private insurers could offer to Medicare eligible to include preferred provider organizations (PPOs), provider-sponsored organizations (PSOs), and private fee-for-service (PFFS) plans. And the love-fest showed no signs of abating even as late as 2004, when the Medicare Modernization act passed, raising payment rates to private providers.
Today, however, with an incoming Democratic regime, the Hill’s long-term romance with “free market” Medicare could be at an end. Helping the “breakup” along? A recent report issued by the respected health policy journal Health Affairs which indicates that taxpayers are actually paying more to subsidize private Medicare plans. Says Marsha Gold, senior fellow at Mathematica Policy Research who authored the report:
“Clearly, the Medicare Modernization Act (MMA) has expanded choice and the private-sector role. But it also has added to Medicare's complexity and costs and has created potential inequities, without apparent improvements in quality.”
While legislators’ ardor is likely to cool substantially, Medicare customers are still flocking to the plans in droves. Today, one in three Medicare beneficiaries with Part D now gets their coverage from private third party providers. Almost a quarter of all Medicare beneficiaries, more than 10 million people, are enrolled in private plans.
Ironically enough, the extra funding these plans receive--according to the report, they are paid 12 percent more on average--is one of the biggest reasons for their popularity. The added value averages more than $1,100 a year per patient, and some of that money goes to provide extra benefits like reduced cost-sharing or reduced premiums for add-on benefits like vision and dental care. A large percentage, however, goes to insurance company profits.
And while some Medicare recipients enjoy a few additional benefits, the overpayments have resulted in an overall rise in Medicare’s costs—with taxpayers and traditional Medicare plan beneficiaries picking up the tab.
2009 looks to be a year in which Congress takes a stand, with support from the White House. On the campaign trail, President-elect Barack Obama called for eliminating the excessive subsidies and paying private plans only what it would cost to treat the same patients under traditional Medicare. Whatever happens, it’s clear that additional monitoring, oversight, and accountability will mean the honeymoon is over for private Medicare insurers.
To download the PDF version of Marsha Gold's report, "Medicare's Private Plans: A Report Card On Medicare Advantage", click here.
Friday, November 21, 2008
Healthcare's Influence on Bailout Mania
by Phil Micali, CEO, bWell-informed
This week we saw the CEOs of the Big 3 automakers embarrass themselves with their tin cups in hand on Capitol Hill after flying into Washington on expensive private jets.
The American automakers have two major problems: they don't make competitive products, at least in the US market, and they have let too much health insurance coverage instill negative behaviors in their workers and associated families. Management and unions of the Big 3 have done well to provide health insurance coverage to attract loyal workers, however they have jeopardized our entire economy by allowing that coverage to foster unhealthy personal habits of the same workers and other beneficiaries. Costs have escalated more than any other service or product in our economy. Companies and individuals have lost their competitiveness because of it. Bailout mania is scaring the living daylights out of experts and the common folk. Our sorry state of health coverage and cost of health care is to blame.
Those unhealthy habits may explain why the automakers do not produce cars that consumers demand, like greener cars, smaller cars, longer lasting cars, cars that offer more value. So here we are again on this blog tying health movement with the green movement. It's a virtuous circle (a good one) when green industries and products grow, which produce a healthier environment and people within. A healthier workforce is more likely to produce greener industries and products. Few would argue that this is what makes sense for improving our daily lives and longterm prospects as a person, a family, a nation, and a global community.
With Citigroup announcing 53,000 job cuts this week, and more to come, it is clear lots of people will be looking to learn about something they often take for granted - health insurance. Not only will they become more sensitive to the premium to get health insurance, they will soon learn that in order to afford the premium and the protection against catastrophic, the costs of what they have been demanding in the way of illness care would be better spent on an ounces of prevention.
Health insurance for people that have it needs to be rightsized. For those that don't have it, coverage needs to be provided, either through personal means of paying the premium or eligible private or public programs subsidizing it.
More than any $700 billion dollar bailout, or what is yet to be decided in early December on an additional automaker bailout, universal coverage and prudent spending within and focus on prevention will leave the word bailout less iterated in our daily lexicon.
This week we saw the CEOs of the Big 3 automakers embarrass themselves with their tin cups in hand on Capitol Hill after flying into Washington on expensive private jets.
The American automakers have two major problems: they don't make competitive products, at least in the US market, and they have let too much health insurance coverage instill negative behaviors in their workers and associated families. Management and unions of the Big 3 have done well to provide health insurance coverage to attract loyal workers, however they have jeopardized our entire economy by allowing that coverage to foster unhealthy personal habits of the same workers and other beneficiaries. Costs have escalated more than any other service or product in our economy. Companies and individuals have lost their competitiveness because of it. Bailout mania is scaring the living daylights out of experts and the common folk. Our sorry state of health coverage and cost of health care is to blame.
Those unhealthy habits may explain why the automakers do not produce cars that consumers demand, like greener cars, smaller cars, longer lasting cars, cars that offer more value. So here we are again on this blog tying health movement with the green movement. It's a virtuous circle (a good one) when green industries and products grow, which produce a healthier environment and people within. A healthier workforce is more likely to produce greener industries and products. Few would argue that this is what makes sense for improving our daily lives and longterm prospects as a person, a family, a nation, and a global community.
With Citigroup announcing 53,000 job cuts this week, and more to come, it is clear lots of people will be looking to learn about something they often take for granted - health insurance. Not only will they become more sensitive to the premium to get health insurance, they will soon learn that in order to afford the premium and the protection against catastrophic, the costs of what they have been demanding in the way of illness care would be better spent on an ounces of prevention.
Health insurance for people that have it needs to be rightsized. For those that don't have it, coverage needs to be provided, either through personal means of paying the premium or eligible private or public programs subsidizing it.
More than any $700 billion dollar bailout, or what is yet to be decided in early December on an additional automaker bailout, universal coverage and prudent spending within and focus on prevention will leave the word bailout less iterated in our daily lexicon.
Tuesday, November 18, 2008
Once the income’s gone: health insurance options after a layoff
by Elena Skoura, Graduate Intern, bWell-informed
“My husband's just lost his job and with it our health care benefits.”
In challenging times like these, quotes like the above are becoming increasingly common. But even if they’re not unusual, each and everyone hide a personal or family drama for those who find themselves out of work. One of the biggest causes of drama after a job loss is the uncertainty of losing health care coverage for the employee and his/her family.
The decisions that the newly unemployed must face are not easy emotionally or financially. Those lucky enough to have a coverage option through a family member or spouse still have to act quickly—the terminated employee must apply for insurance through their family member’s insurance within a month of losing the old coverage or the option may no longer be available.
Less frequently, unemployed individuals may find insurance through a trade group or even their church. But such alternatives are usually much more expensive, even though the coverage may be substantially less. Individual policies usually do not include coverage for pre-existing conditions.
The most attractive alternative for many recently laid-off workers is often COBRA. COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, a policy that extends the same group health benefits to former employees for up to 18 months after a layoff. Businesses with over 20 employees must offer a COBRA option; for smaller businesses, state laws may provide similar options.
To be eligible for COBRA, the individual must have been enrolled in the employer’s health plan, which must continue to be active for current employees. An unemployed individual can apply for COBRA once he or she has experienced a “qualifying event” resulting in the loss of health care coverage—including voluntary or involuntary termination of employment for reasons other than misconduct or reduction in the number of hours of employment.
If the individual needs to extend his 18-month COBRA coverage for a longer period of time, he must prove that he has become disabled within the first 60 days of COBRA and send the plan a letter from the Social Security confirming this fact.
COBRA can be a good alternative, especially for those undergoing a medical treatment. However, it can also be very expensive. While employed, the individual typically has to pay only a fraction of their health insurance premium costs, with the employer picking up the rest. Under COBRA, they must pay the entire premium, which can be hundreds per month for an individual, and even thousands for a family.
The options for health coverage after a layoff are few and unappealing. That is probably the main reason why, out of the 2 million people who lose their job every month, 90% average at least a month without any health coverage.
Even though the short term financial implications can be grave, the longer-term threat posed by the possibility of experiencing an expensive health complication when uninsured is worse. And the health implications from lack of health care may be the worst of all.
The bWell-informed Health Plan Forecaster has been designed to help individuals find affordable and appropriate health insurance coverage, whether they’re facing a job loss or simply do not have coverage available through their employer. Visit www.bwell-informed.com today for more information!
“My husband's just lost his job and with it our health care benefits.”
In challenging times like these, quotes like the above are becoming increasingly common. But even if they’re not unusual, each and everyone hide a personal or family drama for those who find themselves out of work. One of the biggest causes of drama after a job loss is the uncertainty of losing health care coverage for the employee and his/her family.
The decisions that the newly unemployed must face are not easy emotionally or financially. Those lucky enough to have a coverage option through a family member or spouse still have to act quickly—the terminated employee must apply for insurance through their family member’s insurance within a month of losing the old coverage or the option may no longer be available.
Less frequently, unemployed individuals may find insurance through a trade group or even their church. But such alternatives are usually much more expensive, even though the coverage may be substantially less. Individual policies usually do not include coverage for pre-existing conditions.
The most attractive alternative for many recently laid-off workers is often COBRA. COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, a policy that extends the same group health benefits to former employees for up to 18 months after a layoff. Businesses with over 20 employees must offer a COBRA option; for smaller businesses, state laws may provide similar options.
To be eligible for COBRA, the individual must have been enrolled in the employer’s health plan, which must continue to be active for current employees. An unemployed individual can apply for COBRA once he or she has experienced a “qualifying event” resulting in the loss of health care coverage—including voluntary or involuntary termination of employment for reasons other than misconduct or reduction in the number of hours of employment.
If the individual needs to extend his 18-month COBRA coverage for a longer period of time, he must prove that he has become disabled within the first 60 days of COBRA and send the plan a letter from the Social Security confirming this fact.
COBRA can be a good alternative, especially for those undergoing a medical treatment. However, it can also be very expensive. While employed, the individual typically has to pay only a fraction of their health insurance premium costs, with the employer picking up the rest. Under COBRA, they must pay the entire premium, which can be hundreds per month for an individual, and even thousands for a family.
The options for health coverage after a layoff are few and unappealing. That is probably the main reason why, out of the 2 million people who lose their job every month, 90% average at least a month without any health coverage.
Even though the short term financial implications can be grave, the longer-term threat posed by the possibility of experiencing an expensive health complication when uninsured is worse. And the health implications from lack of health care may be the worst of all.
The bWell-informed Health Plan Forecaster has been designed to help individuals find affordable and appropriate health insurance coverage, whether they’re facing a job loss or simply do not have coverage available through their employer. Visit www.bwell-informed.com today for more information!
Monday, November 3, 2008
bWell-informed interviewed at Health 2.0 Conference in San Francisco
bWell International was excited to be a sponsor of the Health 2.0 conference in San Francisco this past October 22-23. CEO Philip Micali and CMO Mary Hobson attended the event, and were thrilled to engage with healthcare and tech industry leaders from around the country. Featured action-packed demos of new services and tools, the Health 2.0 conference was a powerful look at how new technologies are transforming the healthcare industry.
Phil Micali was interviewed by ICYou producer Rebecca Fox on the ground at Health 2.0:
The next Health 2.0 conference is being held in Boston April 22-23 and will be a joint conference with the Center for Information Therapy. The theme will be "The Great Debates on the Next Generation of U.S. Healthcare." We hope to see you there!
Phil Micali was interviewed by ICYou producer Rebecca Fox on the ground at Health 2.0:
The next Health 2.0 conference is being held in Boston April 22-23 and will be a joint conference with the Center for Information Therapy. The theme will be "The Great Debates on the Next Generation of U.S. Healthcare." We hope to see you there!
Monday, October 27, 2008
CEO Philip Micali appears on Fox Business News
bWell-informed.com CEO Philip Micali appeared on Fox Business News in two segments this morning. He discussed the cutting edge bWell-informed Health Plan Forecasting tool, as well as provided important insights on the state of health care coverage in today's unstable financial environment and heated political climate.
Click to watch the videos below:
Click to watch the videos below:
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