An appeals court has denied the University of Notre Dame's request for a new hearing in its lawsuit challenging part of the federal health care law that forces it to cover contraceptives in its health insurance for students and employees.
Reported by Journal Gazette 18 hours ago.
Appeals panel denies Notre Dame new suit hearing
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United States: "You Need To Wear More Make-Up Because Of Your Wrinkles"– Employer Settles For $300,000 - Fox Rothschild LLP
Your may remember the epithet in the title above from a post of ours from last year when an EEOC lawsuit was filed against a Long Island health insurance broker.
Reported by Mondaq 16 hours ago.
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What hospitals don't want you to know about C-sections
*What hospitals don't want you to know about C-sections*
Pregnant women put a lot of trust in their doctors and hospitals. But a Consumer Reports investigation of more than 1,500 hospitals in 22 states suggests that such trust may be misplaced. It found that in many hospitals, far too many babies enter this world through cesarean section.
While some C-sections are absolutely necessary for the health of the mother or baby, the high C-section rates in our low-scoring hospitals are “unsupportable by professional guidelines and studies of birth outcomes,” said Elliot Main, M.D., director of the California Maternal Quality Care Collaborative and former chairman of the department of obstetrics and gynecology at the California Pacific Medical Center in San Francisco, who reviewed our data.
Our Ratings reveal that C-section rates vary dramatically—even between neighboring hospitals. For example, almost 55 percent of pregnant women anticipating low-risk deliveries—that is, women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is properly positioned—nonetheless undergo a C-section at Los Angeles Community Hospital. But at California Hospital Medical Center, also in Los Angeles, the rate of C-sections for low-risk deliveries is 15 percent; at Western Medical Center Anaheim, 28 miles away, it’s about 11 percent.
Or consider El Paso, Texas. At Sierra Medical Center, 37 percent of low-risk deliveries are C-sections; four miles away at University Medical Center of El Paso the rate is about 15 percent. It’s a similar story in Colorado. Denver Health Medical Center earned a top score with a C-section rate of about 8 percent, while nearby Presbyterian-St. Luke’s Medical Center got low marks for a rate of about 20 percent.
We found this startling scenario playing out over and over in communities large and small across the U.S. Because a hospital’s C-section rate can be hard to find, it’s likely that most families are unaware of the huge differences in medical practice.
And unfortunately, it’s usually much easier to find a hospital with a high C-section rate than a low one. Overall, 66 percent of the hospitals in our Ratings earned our lowest or second-lowest score, while only 12 percent got either of our top two marks.
“We think it’s time those hidden numbers are brought to light,” said John Santa, M.D., medical director of Consumer Reports Health. “How you deliver your baby should be determined by the safest delivery method, not which hospital you choose.”
Change is already afoot. Evidence on the fallout from too many C-sections has grown so alarming that numerous health organizations have made lowering rates a priority. In March 2014, two major women’s health organizations—the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine—teamed to publish groundbreaking new practice guidelines aimed at preventing unnecessary cesarean births.
But hospitals can be bureaucratic institutions where the wheels of change move slowly. We’ll look at why C-sections remain so overused. And our Ratings—the most comprehensive ever on C-sections for individual U.S. hospitals—can help families choose the right place to deliver their baby.
Find your hospital's C-section rate
We have rated more than 1,500 hospitals in 22 states on their C-section rates for low-risk deliveries—that is, women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is properly positioned. Those states are: Arizona, California, Colorado, Florida, Iowa, Illinois, Kentucky, Massachusetts, Maryland, North Carolina, New Jersey, Nevada, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Vermont, Washington, and Wisconsin. (You can also download a PDF of the Avoiding C-section Ratings for all 22 states.) And see our complete hospital Ratings, including information on C-section rates as well as other measures of hospital quality and safety.
Melek Speros of Austin, Texas, says her doctor warned her late in her first pregnancy that her pelvis might be too small to allow for a vaginal delivery. "I was really surprised because I'm 5'8" tall with a large frame," Speros said. Reluctantly, her doctor agreed to allow her to “try” a vaginal birth by inducing labor eight days before her due date at St. David’s South Austin Medical Center (which earned low marks in our Ratings.) When the induction didn’t quickly work, he recommended a C-section. "He said that a vaginal birth would be unsafe, that my baby could get stuck and suffer serious harm," Speros said.
She took him at his word, and delivered her first son by C-section as well as her second son two years later. That’s no surprise: Mothers who deliver a first baby by C-section are about 90 percent more likely to deliver subsequent babies that way, too. But with her third, in what she describes as "the culmination of my hopes and dreams about giving birth," Speros vaginally delivered a healthy 9-pound boy.
Speros’ experience—feeling pressured into a C-section without being informed about her birthing options—prompted her to change career plans, switching from lawyer to childbirth educator. And indeed getting reliable information about how hospitals approach childbirth can be difficult. For example, while hospitals often target expectant mothers with ads featuring cherubic infants and cozy birthing rooms, they seldom publicize their rates for surgical deliveries.
There are times when a surgical birth is the safest option. For example, C-sections can be lifesaving when the outlet from the womb is blocked by the placenta (a condition called placenta previa) or the baby isn’t properly positioned for birth by, for example, lying sideways in the uterus instead of head down. And with modern obstetrical care, C-sections are quite safe.
But a C-section—the second most commonly performed surgical procedure in the country, requiring a 6-inch incision in the abdomen and a second through the uterus—is major surgery, and thus takes longer to recover from than a vaginal delivery and also carries additional risks.
“C-sections increase the risk of mortality and complications,” says Kent Heyborne, M.D., chief of obstetrics at Denver Health Medical Center, which had the lowest C-section rate of any hospital in our Ratings with at least 5,000 low-risk deliveries over the two-year period included in our analysis. “But we’re just now becoming aware of the down stream effects.”
Carol Sakala, Ph.D., director of Childbirth Connection programs at the National Partnership for Women & Families, agrees. “Unless there is a definitive need for a C-section, vaginal birth has major benefits for moms and babies, both in the short term and throughout the course of their lives,” she said.
To begin with, although having a C-section may sound like a shortcut, it’s not. Speros says that although her C-sections went smoothly, it still took much longer to recover from them than it did from the vaginal birth of her third son.
And like others who've had abdominal surgery, she has lingering numbness at the site of the incision. Nineteen percent of women who’ve had a C-section report pain at the incision site being a major problem in the two months following delivery. That’s according to Listening to Mothers III, a national survey conducted by Harris Interactive for the Childbirth Connection of 2,400 mothers who gave birth to single babies in a hospital from July 2011 through June 2012. That compares with 11 percent of women who gave birth vaginally who cited a painful perineum (the area between the vagina and anus) as a major problem. And women with C-sections were more likely to say that the pain lasted six months or longer, too.
Life-threatening complications are rare whether babies are born vaginally or by C-section. But compared with women giving birth vaginally, healthy, low-risk women undergoing their first C-section were three times more likely to suffer serious complications—such as severe bleeding, blood clots, heart attack, kidney failure, and major infections—according to a 14-year analysis of more than 2 million women in Canada published in 2007 and cited by the new ACOG/SMFM guidelines.
And the risk of complications increases with each subsequent cesarean delivery. “Once you’ve had a C-section, there’s a big chance that all future births will also be by cesarean," Main said. "And that’s when the risks really start to rise.”
Vaginal delivery for uncomplicated births is also better for babies. They are less likely to suffer breathing problems and more likely to be breastfed, perhaps because it’s easier to get breastfeeding going when mothers are not recovering from major surgery. Some research suggests that over the long-term, babies born vaginally may be slightly less prone to chronic ailments such as asthma, allergies, or obesity, perhaps due in part to a protective effect from beneficial bacteria transferred from the mother during birth.
The number of C-sections performed in the U.S. has leveled off in the last few years, but is still up 500 percent since 1970. All those C-sections have not translated into substantially better outcomes for mothers and babies. The infant death rate in the U.S., while low, is higher than that of most other industrialized nations. And the maternal death rate actually increased slightly from 1990 to 2013, according to an analysis published May 2, 2014, online in The Lancet medical journal.
In part those grim statistics reflect the fact that American women today tend to be older and heavier going into pregnancy. But experts say that the main problem is a health care system that no longer values normal birth and focuses on scheduling labor, in part for patient and doctor convenience.
In the U.S. far fewer babies are born on holidays such as the Fourth of July or days around Thanksgiving or Christmas, we found when we examined three year's worth of data on births compiled for us by the Centers for Disease Control and Prevention. That could be because hospitals tend to schedule C-sections for times when they are well staffed—or because doctors, and even some mothers, may not want deliveries to interrupt their holidays.
That level of control requires increased use of interventions such as inducing, or starting, labor before a woman’s due date, which might increase the risk of cesarean delivery, or just scheduling a C-section from the start.
Another major problem is that many doctors intervene because they think that labor is moving too slowly and that longer labors lead to complications. But those assumptions are based on outdated information, says Aaron Caughey, M.D., Ph.D., chair of the department of obstetrics and gynecology and associate dean for women’s health research and policy at Oregon Health and Science University in Portland, Ore., and lead author on the new ACOG/SMFM guidelines.
The new guidelines help clear up when providers should act and when they have to be patient and let nature take its course. The absence of solid, up-to-date guidelines might have allowed other factors, including concerns about malpractice suits, to drive up the number of C-sections, Caughey says.
In addition, hospitals keeping watch on their financial bottom lines may turn a blind eye to high C-section rates. Medicaid and private health insurance pay about 50 percent more for C-sections than for vaginal births. Halving the total number of C-sections performed in the U.S. would save about $5 billion yearly, according to the Center for Healthcare Quality & Payment Reform, which advocates for higher-quality, lower-cost health care.
Our Ratings are based on the C-section rates for mothers who anticipate low-risk deliveries—that is, for women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is properly positioned. While complications such as problems with the baby’s heartbeat could happen during labor and require intervening surgically, experts say that the vast majority of women in that low-risk category should be able to have a vaginal birth.
The average C-section rate for low-risk deliveries among the hospitals we looked at was about 18 percent—much higher than the national average of 12.6 percent in 2000, a benchmark we used to develop our Ratings. (Note that the average total C-section rate, which includes all cesarean deliveries not just low-risk ones, is 33 percent.)
And some hospitals performed much better—or worse—than average. C-section rates ranged from less than 5 percent at Saint Croix Regional Medical Center in Saint Croix Falls, Wis., to a high of almost 57 percent at Three Rivers Medical Center in Louisa, Ky.
So why do some hospitals have higher rates than others?
Unfortunately, we found no simple answers. Prospect Medical Holdings, the company that owns Los Angeles Community Hospital, says it treats “a significantly higher percentage of low-income and transient patients, many of whom have had little or no prenatal or primary care prior to delivery.” Those women may be at higher risk because of gestational diabetes or high blood pressure, a representative told us.
Our analysis did find slightly higher rates at hospitals in large urban areas compared with hospitals in smaller cities, perhaps because they see more women with risk factors not accounted for in our data or they have a larger proportion of first-time moms. But many similar hospitals serving similar populations manage to keep C-section rates low. For example, Saint Anthony Hospital in Chicago treats many low-income patients but still earned a high Rating, with a C-section rate of 9 percent of babies.
Our Ratings also confirm findings from other research showing significant regional differences. The lowest rates were in mountain states, the West coast, and the upper Midwest. For-profit hospitals also tended to have higher C-section rates.
But none of those factors come close to explaining the wide variation we found, the experts we consulted say.
Too often the medical establishment blames mothers. “They must be older, fatter, sicker, or they must be requesting C-sections,” Main said. “But that’s completely bogus. As a doctor I can convince almost any woman in labor to have a C-section.” Even after you account for things such as mothers’ age and weight, according to Main, you are still left with huge discrepancies of care.
Almost two-thirds of women in the Listening to Mothers survey who had their first C-section said their doctor was the decision maker, and more than one-quarter said they felt pressured to have the surgery.
“What it boils down to is culture,” Main said. “Culture of the hospital, the nursing staff, even the patients.” He points out that hospitals with a culture of facilitating vaginal birth—those that allow vaginal birth after cesarean, for example, or those where 10 percent or more of births are attended by nurse midwives—have far lower rates of C-sections.
A culture such as the one you find at Denver Health Medical Center, where Heyborne works. Lots of places say they have an “institutional philosophy” against too many C-sections, says Heyborne, but, “It's how we’ve translated that into action that makes a difference.” He says that as a teaching hospital, Denver Health is fully staffed with health care providers 24/7. “A lot of C-sections are done at 5 or 6 in the evening," Heyborne said. "We don’t have those pressures here. No one is trying to get home to dinner or the golf course.”
In addition he says that the hospital has firm policies against using interventions that might lead to cesareans, such as inducing labor without a medical reason. And Heyborne credits an active midwifery service. “About one-third of our births are managed by midwives and that helps keep the emphasis on natural birth processes.”
The Ratings are based on the C-section rates for mothers who anticipate a low-risk delivery—that is, women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is the proper position for delivery. The Ratings include all mothers, not just first-time mothers. The data the Ratings are based on do not include information on factors that may increase the risk for a C-section, such as heart problems in the mother or fetus, pregnancy-related high blood pressure, diabetes, obesity, or any other chronic disease.
The data come from the 22 states that had data available for us to analyze: Arizona, California, Colorado, Florida, Iowa, Illinois, Kentucky, Massachusetts, Maryland, North Carolina, New Jersey, Nevada, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Vermont, Washington, and Wisconsin.
It covers births during a two-year period between 2009 and 2012, depending on the state. We include hospitals with a minimum of 100 low-risk deliveries over that two-year period.
For more details, read more on how we rate hospitals and our technical report on hospital Ratings.*Hospitals with high or low C-section rates
*
The table below shows the 10 hospitals in our Ratings with the lowest C-section rates that had at least 5,000 low-risk deliveries over two years.Hospitals with low C-section rates
-*Name and location *-
-*C-section rate (%)*-
(lower is better)Denver Health Medical Center, Denver 7.9
Utah Valley Regional Medical Center, Provo, Utah 8.3
McKay-Dee Hospital Center, Ogden, Utah 9.2
Intermountain Medical Center, Murray, Utah 9.6
Monmouth Medical Center, Long Branch, N.J. 10.0
JPS Health Network, Fort Worth, Texas 10.3
Bakersfield Memorial Hospital, Bakersfield, Calif. 10.5
University Medical Center, Las Vegas 10.9
Columbia St. Mary's Hospital Milwaukee, Milwaukee 11.4
WakeMed Raleigh Campus, Raleigh, N.C. 11.6
The table below shows the 10 hospitals in our Ratings with the highest C-section rates that at least 5,000 low-risk deliveries over two years.
Hospitals with high C-section rates
Name and location
-C-section rate (%)-
(lower is better)
Virginia Hospital Center – Arlington, Arlington, Va. 27.1
Lenox Hill Hospital, New York City 27.2
Las Palmas Medical Center, El Paso, Texas 28.1
Inova Fairfax Hospital, Falls Church, Va. 28.4
Baptist Hospital of Miami, Miami 28.8
Providence Memorial Hospital, El Paso, Texas 29.2
The Woman's Hospital of Texas, Houston 29.2
Jackson Health System, Miami 29.7
Hackensack University Medical Center, Hackensack, N.J. 31.5
South Miami Hospital, Miami 44.9
What you can do to avoid C-sections
To lower your risk of a C-section, take the following steps.
*• Find out your hospital’s C-section rate.* Start with our hospital Ratings. If your hospital is not included, ask the person who will deliver your baby about the hospital’s rates. Remember: lower is usually better. The average national C-section rate for low-risk deliveries, the measure used in our Ratings, is about 18 percent, a rate we consider too high. A more reasonable figure is 12.6 percent, the national average in 2000 and a benchmark we used to develop our Ratings. (Note that the average total C-section rate, which includes all cesarean deliveries not just low-risk ones, is 33 percent.)
*• Choose your provider carefully. *It’s good to know the C-section rates for your doctor, too, so ask whether his or her practice tracks their C-sections. “Even if they don’t know the exact percent, providers should be able to articulate their philosophy about supporting vaginal birth,” Caughey said. Also ask how the new ACOG/SMFM guidelines may affect the practice’s approach to labor and delivery. If your provider is unaware of the new standards, or is dismissive of them, you may want to find a different one.
*• Watch your weight. *If you are overweight, strive to shed excess pounds before becoming pregnant. Overweight and obese women have a much higher risk of C-section than normal weight women. And once you’re pregnant, talk with your provider about the healthy weight gain for you. Women who are overweight should plan to gain less than those who are not.
*• Stay fit.* Women who take part in structured exercise during pregnancy are less likely to need a C-section, research suggests. Talk to your health care provider about appropriate forms of exercise, such as walking, swimming, and aerobic or yoga classes for pregnant women.
*• Don’t rush things*. Doctors should not try to induce labor unless there’s a good medical reason—for example, if a woman’s membranes rupture (her “water breaks”) and labor doesn’t start on its own or she is two weeks overdue. Trying to induce labor before a woman’s body is ready can lead to surgical delivery if labor doesn’t progress.
*• Don’t worry too much about big babies. *The possibility of a large baby is frequently used to justify a cesarean delivery, but that’s not warranted, according to the new ACOG/SMFM guidelines. To begin with, methods used to assess the baby’s weight toward the end of the pregnancy are not very accurate. Also, babies typically have to be 11 pounds or larger to justify a C-section, according to Caughey.
*• Get support during labor.* Consider hiring a doula, a trained birth assistant who can provide physical and emotional support throughout labor and delivery. Women who have continuous support from someone who is not a friend, family member, or a member of the hospital staff labor for shorter periods and are less likely to need interventions, research shows. Ask your insurer if it will cover doula care.
*• Ignore the clock. *The new ACOG/SMFM guidelines call for allowing more time in each phase of labor and delivery. In general, decisions on whether to intervene should be based on how well mothers and babies are doing, not how much time has passed.
For additional steps you can take before and during pregnancy to help ensure the best possible outcomes, see our report "What to Reject When You’re Expecting."
-And see these additional resources-
American College of Obstetricians and Gynecologists Patient Resources
American College of Nurse Midwives Patient Resources
Childbirth Connection
March of Dimes Pregnancy
March of Dimes Nacer Sano
Office of Women's Health Pregnancy Resources
What to do if you need a C-section
Sometimes a planned C-section is the safest option for you and your baby. And even if you’ve planned for a vaginal birth, complications may arise that necessitate a surgical delivery. All expectant families should discuss cesarean deliveries with their provider so that they understand what’s involved and are not caught off guard. The following steps can help ensure a safe, satisfying birth experience for you and your family.
*• Be wary of early C-sections.* Babies’ delivered before 39 weeks are more apt to have breathing problems or other issues. C-sections should not be scheduled before that point unless there’s a valid medical reason.
*• Discuss your preferences.* Ask if a birthing partner can be with you in the surgery room and recovery area. When will you be able to hold and breastfeed your baby? Skin-to-skin contact between moms and babies right after delivery facilitates bonding and breastfeeding.
*• Ask for antibiotics at the time of surgery.* That reduces the risk of infection. You don’t need them afterward unless you develop an infection.
*• Ask that your uterus be closed with two layers of stitching.* If you decide to have another baby vaginally, so called double-layering stitching will hold more securely during labor and delivery.
*• Request measures to prevent blood clots.* That might include wearing inflatable devices on your legs until you can walk on your own or taking a prescription blood thinner. Ask the nursing staff to help you get up and move around as soon as you are able to do so.
*• Ask for help breastfeeding.* Getting started breastfeeding as you recover poses extra challenges. A lactation consultant can provide invaluable support and advice.
*• Marshal support.* Plan to have extra support at home so you can focus on recovering and getting to know your new baby.
Find your hospital's C-section rate
We have rated more than 1,500 hospitals in 22 states based on their C-section rates for low-risk deliveries—that is, women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is properly positioned. Those states are: Arizona, California, Colorado, Florida, Iowa, Illinois, Kentucky, Massachusetts, Maryland, North Carolina, New Jersey, Nevada, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Vermont, Washington, and Wisconsin. (You can also download a PDF of the Avoiding C-section Ratings for all 22 states.) And see our complete hospital Ratings, including information on C-section rates as well as other measures of hospital quality and safety.*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*
*Subscribe now!*
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Reported by Consumer Reports 15 hours ago.
Pregnant women put a lot of trust in their doctors and hospitals. But a Consumer Reports investigation of more than 1,500 hospitals in 22 states suggests that such trust may be misplaced. It found that in many hospitals, far too many babies enter this world through cesarean section.
While some C-sections are absolutely necessary for the health of the mother or baby, the high C-section rates in our low-scoring hospitals are “unsupportable by professional guidelines and studies of birth outcomes,” said Elliot Main, M.D., director of the California Maternal Quality Care Collaborative and former chairman of the department of obstetrics and gynecology at the California Pacific Medical Center in San Francisco, who reviewed our data.
Our Ratings reveal that C-section rates vary dramatically—even between neighboring hospitals. For example, almost 55 percent of pregnant women anticipating low-risk deliveries—that is, women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is properly positioned—nonetheless undergo a C-section at Los Angeles Community Hospital. But at California Hospital Medical Center, also in Los Angeles, the rate of C-sections for low-risk deliveries is 15 percent; at Western Medical Center Anaheim, 28 miles away, it’s about 11 percent.
Or consider El Paso, Texas. At Sierra Medical Center, 37 percent of low-risk deliveries are C-sections; four miles away at University Medical Center of El Paso the rate is about 15 percent. It’s a similar story in Colorado. Denver Health Medical Center earned a top score with a C-section rate of about 8 percent, while nearby Presbyterian-St. Luke’s Medical Center got low marks for a rate of about 20 percent.
We found this startling scenario playing out over and over in communities large and small across the U.S. Because a hospital’s C-section rate can be hard to find, it’s likely that most families are unaware of the huge differences in medical practice.
And unfortunately, it’s usually much easier to find a hospital with a high C-section rate than a low one. Overall, 66 percent of the hospitals in our Ratings earned our lowest or second-lowest score, while only 12 percent got either of our top two marks.
“We think it’s time those hidden numbers are brought to light,” said John Santa, M.D., medical director of Consumer Reports Health. “How you deliver your baby should be determined by the safest delivery method, not which hospital you choose.”
Change is already afoot. Evidence on the fallout from too many C-sections has grown so alarming that numerous health organizations have made lowering rates a priority. In March 2014, two major women’s health organizations—the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine—teamed to publish groundbreaking new practice guidelines aimed at preventing unnecessary cesarean births.
But hospitals can be bureaucratic institutions where the wheels of change move slowly. We’ll look at why C-sections remain so overused. And our Ratings—the most comprehensive ever on C-sections for individual U.S. hospitals—can help families choose the right place to deliver their baby.
Find your hospital's C-section rate
We have rated more than 1,500 hospitals in 22 states on their C-section rates for low-risk deliveries—that is, women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is properly positioned. Those states are: Arizona, California, Colorado, Florida, Iowa, Illinois, Kentucky, Massachusetts, Maryland, North Carolina, New Jersey, Nevada, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Vermont, Washington, and Wisconsin. (You can also download a PDF of the Avoiding C-section Ratings for all 22 states.) And see our complete hospital Ratings, including information on C-section rates as well as other measures of hospital quality and safety.
Melek Speros of Austin, Texas, says her doctor warned her late in her first pregnancy that her pelvis might be too small to allow for a vaginal delivery. "I was really surprised because I'm 5'8" tall with a large frame," Speros said. Reluctantly, her doctor agreed to allow her to “try” a vaginal birth by inducing labor eight days before her due date at St. David’s South Austin Medical Center (which earned low marks in our Ratings.) When the induction didn’t quickly work, he recommended a C-section. "He said that a vaginal birth would be unsafe, that my baby could get stuck and suffer serious harm," Speros said.
She took him at his word, and delivered her first son by C-section as well as her second son two years later. That’s no surprise: Mothers who deliver a first baby by C-section are about 90 percent more likely to deliver subsequent babies that way, too. But with her third, in what she describes as "the culmination of my hopes and dreams about giving birth," Speros vaginally delivered a healthy 9-pound boy.
Speros’ experience—feeling pressured into a C-section without being informed about her birthing options—prompted her to change career plans, switching from lawyer to childbirth educator. And indeed getting reliable information about how hospitals approach childbirth can be difficult. For example, while hospitals often target expectant mothers with ads featuring cherubic infants and cozy birthing rooms, they seldom publicize their rates for surgical deliveries.
There are times when a surgical birth is the safest option. For example, C-sections can be lifesaving when the outlet from the womb is blocked by the placenta (a condition called placenta previa) or the baby isn’t properly positioned for birth by, for example, lying sideways in the uterus instead of head down. And with modern obstetrical care, C-sections are quite safe.
But a C-section—the second most commonly performed surgical procedure in the country, requiring a 6-inch incision in the abdomen and a second through the uterus—is major surgery, and thus takes longer to recover from than a vaginal delivery and also carries additional risks.
“C-sections increase the risk of mortality and complications,” says Kent Heyborne, M.D., chief of obstetrics at Denver Health Medical Center, which had the lowest C-section rate of any hospital in our Ratings with at least 5,000 low-risk deliveries over the two-year period included in our analysis. “But we’re just now becoming aware of the down stream effects.”
Carol Sakala, Ph.D., director of Childbirth Connection programs at the National Partnership for Women & Families, agrees. “Unless there is a definitive need for a C-section, vaginal birth has major benefits for moms and babies, both in the short term and throughout the course of their lives,” she said.
To begin with, although having a C-section may sound like a shortcut, it’s not. Speros says that although her C-sections went smoothly, it still took much longer to recover from them than it did from the vaginal birth of her third son.
And like others who've had abdominal surgery, she has lingering numbness at the site of the incision. Nineteen percent of women who’ve had a C-section report pain at the incision site being a major problem in the two months following delivery. That’s according to Listening to Mothers III, a national survey conducted by Harris Interactive for the Childbirth Connection of 2,400 mothers who gave birth to single babies in a hospital from July 2011 through June 2012. That compares with 11 percent of women who gave birth vaginally who cited a painful perineum (the area between the vagina and anus) as a major problem. And women with C-sections were more likely to say that the pain lasted six months or longer, too.
Life-threatening complications are rare whether babies are born vaginally or by C-section. But compared with women giving birth vaginally, healthy, low-risk women undergoing their first C-section were three times more likely to suffer serious complications—such as severe bleeding, blood clots, heart attack, kidney failure, and major infections—according to a 14-year analysis of more than 2 million women in Canada published in 2007 and cited by the new ACOG/SMFM guidelines.
And the risk of complications increases with each subsequent cesarean delivery. “Once you’ve had a C-section, there’s a big chance that all future births will also be by cesarean," Main said. "And that’s when the risks really start to rise.”
Vaginal delivery for uncomplicated births is also better for babies. They are less likely to suffer breathing problems and more likely to be breastfed, perhaps because it’s easier to get breastfeeding going when mothers are not recovering from major surgery. Some research suggests that over the long-term, babies born vaginally may be slightly less prone to chronic ailments such as asthma, allergies, or obesity, perhaps due in part to a protective effect from beneficial bacteria transferred from the mother during birth.
The number of C-sections performed in the U.S. has leveled off in the last few years, but is still up 500 percent since 1970. All those C-sections have not translated into substantially better outcomes for mothers and babies. The infant death rate in the U.S., while low, is higher than that of most other industrialized nations. And the maternal death rate actually increased slightly from 1990 to 2013, according to an analysis published May 2, 2014, online in The Lancet medical journal.
In part those grim statistics reflect the fact that American women today tend to be older and heavier going into pregnancy. But experts say that the main problem is a health care system that no longer values normal birth and focuses on scheduling labor, in part for patient and doctor convenience.
In the U.S. far fewer babies are born on holidays such as the Fourth of July or days around Thanksgiving or Christmas, we found when we examined three year's worth of data on births compiled for us by the Centers for Disease Control and Prevention. That could be because hospitals tend to schedule C-sections for times when they are well staffed—or because doctors, and even some mothers, may not want deliveries to interrupt their holidays.
That level of control requires increased use of interventions such as inducing, or starting, labor before a woman’s due date, which might increase the risk of cesarean delivery, or just scheduling a C-section from the start.
Another major problem is that many doctors intervene because they think that labor is moving too slowly and that longer labors lead to complications. But those assumptions are based on outdated information, says Aaron Caughey, M.D., Ph.D., chair of the department of obstetrics and gynecology and associate dean for women’s health research and policy at Oregon Health and Science University in Portland, Ore., and lead author on the new ACOG/SMFM guidelines.
The new guidelines help clear up when providers should act and when they have to be patient and let nature take its course. The absence of solid, up-to-date guidelines might have allowed other factors, including concerns about malpractice suits, to drive up the number of C-sections, Caughey says.
In addition, hospitals keeping watch on their financial bottom lines may turn a blind eye to high C-section rates. Medicaid and private health insurance pay about 50 percent more for C-sections than for vaginal births. Halving the total number of C-sections performed in the U.S. would save about $5 billion yearly, according to the Center for Healthcare Quality & Payment Reform, which advocates for higher-quality, lower-cost health care.
Our Ratings are based on the C-section rates for mothers who anticipate low-risk deliveries—that is, for women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is properly positioned. While complications such as problems with the baby’s heartbeat could happen during labor and require intervening surgically, experts say that the vast majority of women in that low-risk category should be able to have a vaginal birth.
The average C-section rate for low-risk deliveries among the hospitals we looked at was about 18 percent—much higher than the national average of 12.6 percent in 2000, a benchmark we used to develop our Ratings. (Note that the average total C-section rate, which includes all cesarean deliveries not just low-risk ones, is 33 percent.)
And some hospitals performed much better—or worse—than average. C-section rates ranged from less than 5 percent at Saint Croix Regional Medical Center in Saint Croix Falls, Wis., to a high of almost 57 percent at Three Rivers Medical Center in Louisa, Ky.
So why do some hospitals have higher rates than others?
Unfortunately, we found no simple answers. Prospect Medical Holdings, the company that owns Los Angeles Community Hospital, says it treats “a significantly higher percentage of low-income and transient patients, many of whom have had little or no prenatal or primary care prior to delivery.” Those women may be at higher risk because of gestational diabetes or high blood pressure, a representative told us.
Our analysis did find slightly higher rates at hospitals in large urban areas compared with hospitals in smaller cities, perhaps because they see more women with risk factors not accounted for in our data or they have a larger proportion of first-time moms. But many similar hospitals serving similar populations manage to keep C-section rates low. For example, Saint Anthony Hospital in Chicago treats many low-income patients but still earned a high Rating, with a C-section rate of 9 percent of babies.
Our Ratings also confirm findings from other research showing significant regional differences. The lowest rates were in mountain states, the West coast, and the upper Midwest. For-profit hospitals also tended to have higher C-section rates.
But none of those factors come close to explaining the wide variation we found, the experts we consulted say.
Too often the medical establishment blames mothers. “They must be older, fatter, sicker, or they must be requesting C-sections,” Main said. “But that’s completely bogus. As a doctor I can convince almost any woman in labor to have a C-section.” Even after you account for things such as mothers’ age and weight, according to Main, you are still left with huge discrepancies of care.
Almost two-thirds of women in the Listening to Mothers survey who had their first C-section said their doctor was the decision maker, and more than one-quarter said they felt pressured to have the surgery.
“What it boils down to is culture,” Main said. “Culture of the hospital, the nursing staff, even the patients.” He points out that hospitals with a culture of facilitating vaginal birth—those that allow vaginal birth after cesarean, for example, or those where 10 percent or more of births are attended by nurse midwives—have far lower rates of C-sections.
A culture such as the one you find at Denver Health Medical Center, where Heyborne works. Lots of places say they have an “institutional philosophy” against too many C-sections, says Heyborne, but, “It's how we’ve translated that into action that makes a difference.” He says that as a teaching hospital, Denver Health is fully staffed with health care providers 24/7. “A lot of C-sections are done at 5 or 6 in the evening," Heyborne said. "We don’t have those pressures here. No one is trying to get home to dinner or the golf course.”
In addition he says that the hospital has firm policies against using interventions that might lead to cesareans, such as inducing labor without a medical reason. And Heyborne credits an active midwifery service. “About one-third of our births are managed by midwives and that helps keep the emphasis on natural birth processes.”
The Ratings are based on the C-section rates for mothers who anticipate a low-risk delivery—that is, women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is the proper position for delivery. The Ratings include all mothers, not just first-time mothers. The data the Ratings are based on do not include information on factors that may increase the risk for a C-section, such as heart problems in the mother or fetus, pregnancy-related high blood pressure, diabetes, obesity, or any other chronic disease.
The data come from the 22 states that had data available for us to analyze: Arizona, California, Colorado, Florida, Iowa, Illinois, Kentucky, Massachusetts, Maryland, North Carolina, New Jersey, Nevada, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Vermont, Washington, and Wisconsin.
It covers births during a two-year period between 2009 and 2012, depending on the state. We include hospitals with a minimum of 100 low-risk deliveries over that two-year period.
For more details, read more on how we rate hospitals and our technical report on hospital Ratings.*Hospitals with high or low C-section rates
*
The table below shows the 10 hospitals in our Ratings with the lowest C-section rates that had at least 5,000 low-risk deliveries over two years.Hospitals with low C-section rates
-*Name and location *-
-*C-section rate (%)*-
(lower is better)Denver Health Medical Center, Denver 7.9
Utah Valley Regional Medical Center, Provo, Utah 8.3
McKay-Dee Hospital Center, Ogden, Utah 9.2
Intermountain Medical Center, Murray, Utah 9.6
Monmouth Medical Center, Long Branch, N.J. 10.0
JPS Health Network, Fort Worth, Texas 10.3
Bakersfield Memorial Hospital, Bakersfield, Calif. 10.5
University Medical Center, Las Vegas 10.9
Columbia St. Mary's Hospital Milwaukee, Milwaukee 11.4
WakeMed Raleigh Campus, Raleigh, N.C. 11.6
The table below shows the 10 hospitals in our Ratings with the highest C-section rates that at least 5,000 low-risk deliveries over two years.
Hospitals with high C-section rates
Name and location
-C-section rate (%)-
(lower is better)
Virginia Hospital Center – Arlington, Arlington, Va. 27.1
Lenox Hill Hospital, New York City 27.2
Las Palmas Medical Center, El Paso, Texas 28.1
Inova Fairfax Hospital, Falls Church, Va. 28.4
Baptist Hospital of Miami, Miami 28.8
Providence Memorial Hospital, El Paso, Texas 29.2
The Woman's Hospital of Texas, Houston 29.2
Jackson Health System, Miami 29.7
Hackensack University Medical Center, Hackensack, N.J. 31.5
South Miami Hospital, Miami 44.9
What you can do to avoid C-sections
To lower your risk of a C-section, take the following steps.
*• Find out your hospital’s C-section rate.* Start with our hospital Ratings. If your hospital is not included, ask the person who will deliver your baby about the hospital’s rates. Remember: lower is usually better. The average national C-section rate for low-risk deliveries, the measure used in our Ratings, is about 18 percent, a rate we consider too high. A more reasonable figure is 12.6 percent, the national average in 2000 and a benchmark we used to develop our Ratings. (Note that the average total C-section rate, which includes all cesarean deliveries not just low-risk ones, is 33 percent.)
*• Choose your provider carefully. *It’s good to know the C-section rates for your doctor, too, so ask whether his or her practice tracks their C-sections. “Even if they don’t know the exact percent, providers should be able to articulate their philosophy about supporting vaginal birth,” Caughey said. Also ask how the new ACOG/SMFM guidelines may affect the practice’s approach to labor and delivery. If your provider is unaware of the new standards, or is dismissive of them, you may want to find a different one.
*• Watch your weight. *If you are overweight, strive to shed excess pounds before becoming pregnant. Overweight and obese women have a much higher risk of C-section than normal weight women. And once you’re pregnant, talk with your provider about the healthy weight gain for you. Women who are overweight should plan to gain less than those who are not.
*• Stay fit.* Women who take part in structured exercise during pregnancy are less likely to need a C-section, research suggests. Talk to your health care provider about appropriate forms of exercise, such as walking, swimming, and aerobic or yoga classes for pregnant women.
*• Don’t rush things*. Doctors should not try to induce labor unless there’s a good medical reason—for example, if a woman’s membranes rupture (her “water breaks”) and labor doesn’t start on its own or she is two weeks overdue. Trying to induce labor before a woman’s body is ready can lead to surgical delivery if labor doesn’t progress.
*• Don’t worry too much about big babies. *The possibility of a large baby is frequently used to justify a cesarean delivery, but that’s not warranted, according to the new ACOG/SMFM guidelines. To begin with, methods used to assess the baby’s weight toward the end of the pregnancy are not very accurate. Also, babies typically have to be 11 pounds or larger to justify a C-section, according to Caughey.
*• Get support during labor.* Consider hiring a doula, a trained birth assistant who can provide physical and emotional support throughout labor and delivery. Women who have continuous support from someone who is not a friend, family member, or a member of the hospital staff labor for shorter periods and are less likely to need interventions, research shows. Ask your insurer if it will cover doula care.
*• Ignore the clock. *The new ACOG/SMFM guidelines call for allowing more time in each phase of labor and delivery. In general, decisions on whether to intervene should be based on how well mothers and babies are doing, not how much time has passed.
For additional steps you can take before and during pregnancy to help ensure the best possible outcomes, see our report "What to Reject When You’re Expecting."
-And see these additional resources-
American College of Obstetricians and Gynecologists Patient Resources
American College of Nurse Midwives Patient Resources
Childbirth Connection
March of Dimes Pregnancy
March of Dimes Nacer Sano
Office of Women's Health Pregnancy Resources
What to do if you need a C-section
Sometimes a planned C-section is the safest option for you and your baby. And even if you’ve planned for a vaginal birth, complications may arise that necessitate a surgical delivery. All expectant families should discuss cesarean deliveries with their provider so that they understand what’s involved and are not caught off guard. The following steps can help ensure a safe, satisfying birth experience for you and your family.
*• Be wary of early C-sections.* Babies’ delivered before 39 weeks are more apt to have breathing problems or other issues. C-sections should not be scheduled before that point unless there’s a valid medical reason.
*• Discuss your preferences.* Ask if a birthing partner can be with you in the surgery room and recovery area. When will you be able to hold and breastfeed your baby? Skin-to-skin contact between moms and babies right after delivery facilitates bonding and breastfeeding.
*• Ask for antibiotics at the time of surgery.* That reduces the risk of infection. You don’t need them afterward unless you develop an infection.
*• Ask that your uterus be closed with two layers of stitching.* If you decide to have another baby vaginally, so called double-layering stitching will hold more securely during labor and delivery.
*• Request measures to prevent blood clots.* That might include wearing inflatable devices on your legs until you can walk on your own or taking a prescription blood thinner. Ask the nursing staff to help you get up and move around as soon as you are able to do so.
*• Ask for help breastfeeding.* Getting started breastfeeding as you recover poses extra challenges. A lactation consultant can provide invaluable support and advice.
*• Marshal support.* Plan to have extra support at home so you can focus on recovering and getting to know your new baby.
Find your hospital's C-section rate
We have rated more than 1,500 hospitals in 22 states based on their C-section rates for low-risk deliveries—that is, women who haven’t had a C-section before, don’t deliver prematurely, and are pregnant with a single baby who is properly positioned. Those states are: Arizona, California, Colorado, Florida, Iowa, Illinois, Kentucky, Massachusetts, Maryland, North Carolina, New Jersey, Nevada, New York, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Vermont, Washington, and Wisconsin. (You can also download a PDF of the Avoiding C-section Ratings for all 22 states.) And see our complete hospital Ratings, including information on C-section rates as well as other measures of hospital quality and safety.*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*
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Reported by Consumer Reports 15 hours ago.
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NJ residents select costliest health insurance plans in the nation, website says
NJ shoppers chose more comprehensive coverage than people in other states.
Reported by NJ.com 15 hours ago.
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In NJ, 80-90 percent of Obamacare enrollees have paid their premiums
Between 80 and 90 percent of people who bought health insurance through Obamacare have paid for their first month’s premium, according to the three companies that sell those plans in New Jersey
Reported by NJ.com 15 hours ago.
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Obama Complains to Hollywood Donors of 'Frustration'
President Barack Obama told donors at an exclusive Hollywood fundraiser for the Democratic Party that he needed their help to undo the "frustration" of politics in Washington. There is "an anxiety, and a sense of frustration," the president--now in his sixth year of office--complained, according to a report in Variety, adding that "the challenges out there remain daunting and we have a Washington that’s not working." In repeated fundraising trips to California over the past two years, Obama has repeatedly cast Republicans as the chief obstacle to progress in Washington, imploring donors to help restore Democrats to complete control of Capitol Hill. In February 2013, flush with the optimism of his recent re-election, Obama even predicted that former Speaker of the House Nancy Pelosi would be restored to her position after the 2014 midterm vote.
That prospect now looks impossible, and Democrats are widely considered likely to lose control of the Senate as well. Obama's own approval rating has crashed as a result of repeated confrontations with Congress, broken promises on health insurance, a string of scandals, and a slew of foreign policy setbacks. Still, he told donors in L.A. that "the principal reason" for the lack of progress "is that there is just a fundamental difference in what we as Democrats believe and what this particular brand of Republicans that we've got in Congress believes."
Obama delivered his remarks at the private home of Walt Disney Studios chairman Alan Horn before proceeding to an awards gala at the USC Shoah [Holocaust] Foundation, where he received an honor from Steven Spielberg--and delivered remarks that evoked a similar tone of frustration and "powerlessness." Reported by Breitbart 12 hours ago.
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Insurance Executives: Obamacare Fees Will Be Passed on to Consumers
Fees imposed on health insurance providers by the government - expected to raise over $100 billion over 10 years - as part of Obamacare will be passed on to policyholders, health insurance executives told a House Energy and Commerce Committee on Wednesday.
Reported by Newsmax 13 hours ago.
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Fitch Affirms Blue Shield of California's IFS at 'A'; Outlook Stable
CHICAGO--(BUSINESS WIRE)--Fitch Ratings has affirmed Blue Shield of California's (BSC) Insurer Financial Strength (IFS) rating at 'A'. The Rating Outlook is Stable. Today's affirmation completes a periodic review of BSC's rating and recent financial performance. Key factors considered in the review include expectations for comparatively rapid growth in BSC's membership due to the company's participation on the California health insurance exchange and pressure on profitability and capitalization
Reported by Business Wire 12 hours ago.
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A lot more people are about to learn they can't keep their plans if they like them
It's almost time for Stage Two of the great ObamaCare dump, as the truly breathtaking depths of Barack Obama's Big Lie are exposed... and America is shoved closer to the howling abyss of single-payer health care, the transformation nobody voted for.
Kaiser Health News explains something that ObamaCare critics predicted, with typical accuracy, years ago: employers have strong incentives to chuck their employees into those hideous ObamaCare exchanges, rather than continuing to provide the sort of health insurance we're all accustomed to. For the cost of a modest trans-Constitutional tax/penalty, the corporate world can wash its hands of health insurance entirely:
Can corporations shift workers with high medical costs from the company health plan into online insurance exchanges created by the Affordable Care Act? Some employers are considering it, say benefits consultants.
“It’s all over the marketplace,” said Todd Yates, a managing partner at Hill, Chesson & Woody, a North Carolina benefits consulting firm. “Employers are inquiring about it and brokers and consultants are advocating for it.”
Patients with preexisting medical conditions like diabetes drive health spending. But those who undergo expensive procedures such as organ transplants are a burden to the company as well. Since most big corporations are self-insured, shifting even one high-cost member out of the company plan could save the employer hundreds of thousands of dollars a year—while increasing the cost of claims absorbed by the marketplace policy by a similar amount.
And the health law might not prohibit it, opening a door to potential erosion of employer-based coverage.
“Such an employer-dumping strategy can promote the interests of both employers and employees by shifting health care expenses on to the public at large,” wrote two University of Minnesota law professors in a 2011 paper that basically predicted the present interest.
Awww, isn't that sweet? Employers and employees can both promote their interests by having the former dump the latter into heavily subsidized public programs that offer low-quality, high-cost insurance with restricted provider networks! Guess whose interests don't seem to matter to any of these geniuses? *Taxpayers, *i.e. the people who have to shoulder the burden of all these subsidies.
This apocalyptic round of employer-dumping is the reason Obama violated the Constitution to illegally push all those ObamaCare deadlines back - he didn't want it happening right before the 2014 election, which would have gone from being a Democrat massacre to a mass funeral for their entire party. Now that the worst of it has been safely delayed until after November, get ready for some future round of chripy press releases from the Administration touting the really huge number of people using those ObamaCare exchanges. Think it was annoying for these con artists to boast of 7 million "enrollments" in April, when 6 million of them were people who were stripped of their insurance coverage by ObamaCare? Multiply that by a factor of ten.
The other problem that will be created by employer-dumping is the utter collapse of ObamaCare's finances, but they'll fix that by printing up some more magic pixie-dust deficit money, denouncing everyone who objects to the debt surge as a heartless ghoul who wants poor people to die. Later, they'll jack up your taxes to cover that deficit spending, and if you object, people like Barack Obama will compare you to a deadbeat diner trying to skip out on your tab at Denny's. Insurance premiums will rise steadily during that fiscal shell game, and if you object to that, you'll be told ObamaCare is the "settled law of the land," nothing can be done about it now, and remembering the good old days of affordable high-quality insurance is a thoughtcrime. Reported by Breitbart 11 hours ago.
Kaiser Health News explains something that ObamaCare critics predicted, with typical accuracy, years ago: employers have strong incentives to chuck their employees into those hideous ObamaCare exchanges, rather than continuing to provide the sort of health insurance we're all accustomed to. For the cost of a modest trans-Constitutional tax/penalty, the corporate world can wash its hands of health insurance entirely:
Can corporations shift workers with high medical costs from the company health plan into online insurance exchanges created by the Affordable Care Act? Some employers are considering it, say benefits consultants.
“It’s all over the marketplace,” said Todd Yates, a managing partner at Hill, Chesson & Woody, a North Carolina benefits consulting firm. “Employers are inquiring about it and brokers and consultants are advocating for it.”
Patients with preexisting medical conditions like diabetes drive health spending. But those who undergo expensive procedures such as organ transplants are a burden to the company as well. Since most big corporations are self-insured, shifting even one high-cost member out of the company plan could save the employer hundreds of thousands of dollars a year—while increasing the cost of claims absorbed by the marketplace policy by a similar amount.
And the health law might not prohibit it, opening a door to potential erosion of employer-based coverage.
“Such an employer-dumping strategy can promote the interests of both employers and employees by shifting health care expenses on to the public at large,” wrote two University of Minnesota law professors in a 2011 paper that basically predicted the present interest.
Awww, isn't that sweet? Employers and employees can both promote their interests by having the former dump the latter into heavily subsidized public programs that offer low-quality, high-cost insurance with restricted provider networks! Guess whose interests don't seem to matter to any of these geniuses? *Taxpayers, *i.e. the people who have to shoulder the burden of all these subsidies.
This apocalyptic round of employer-dumping is the reason Obama violated the Constitution to illegally push all those ObamaCare deadlines back - he didn't want it happening right before the 2014 election, which would have gone from being a Democrat massacre to a mass funeral for their entire party. Now that the worst of it has been safely delayed until after November, get ready for some future round of chripy press releases from the Administration touting the really huge number of people using those ObamaCare exchanges. Think it was annoying for these con artists to boast of 7 million "enrollments" in April, when 6 million of them were people who were stripped of their insurance coverage by ObamaCare? Multiply that by a factor of ten.
The other problem that will be created by employer-dumping is the utter collapse of ObamaCare's finances, but they'll fix that by printing up some more magic pixie-dust deficit money, denouncing everyone who objects to the debt surge as a heartless ghoul who wants poor people to die. Later, they'll jack up your taxes to cover that deficit spending, and if you object, people like Barack Obama will compare you to a deadbeat diner trying to skip out on your tab at Denny's. Insurance premiums will rise steadily during that fiscal shell game, and if you object to that, you'll be told ObamaCare is the "settled law of the land," nothing can be done about it now, and remembering the good old days of affordable high-quality insurance is a thoughtcrime. Reported by Breitbart 11 hours ago.
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How to Choose a Fertility Clinic
There are various types of fertility clinics and choosing the right one suitable for one's individual needs is crucial.Infertility treatment has advanced in modern times. This is good news for those wanting to become parents in the natural way, but could not. Progress in infertility treatment procedures has made it possible for more people to become parents as compared to a decade ago. One's doctor might have suggested a fertility clinic as a part of one's infertility treatment and acting upon that advice one's first step is to choose a fertility clinic.
Points to consider while selecting a fertility clinic
The success rate of the fertility clinic is not the only factor to be considered while making this decision. As with anything else, a thorough background check is an absolute necessity before you choose a fertility clinic. There are several issues that need to be addressed besides success rates, namely the type of clinic, financial aspects, health insurance, etc.
Be an informed IVF patient
Before you visit a fertility clinic, it is important that you have a basic knowledge of the process. Recommendations for selections may come from one's doctor or friends and relatives. But, one's own research in this matter is extremely vital. After all, this is a big decision for you - one that involves a change in one's life as well as a lot of money and time.
Types of Fertility Clinics
There are various types of fertility clinics and choosing the right one suitable for one's individual needs is crucial. Sole practitioners or a small set-up with about two to eight physicians might offer a pleasant, personalized experience with the doctors being available to personally take care of one's case.
Large, full service fertility clinics offer the advantage of labs, equipment and resources, but might not always provide personalized services. In a large set up, meeting with the doctor to resolve any queries might not always be possible; you'd mostly be dealing with staff and nurses as regards one's treatment.
University and hospital based Infertility clinic Mumbai are another option available when choosing a fertility clinic. At such clinics, you might benefit from the research and use of the latest technology, although bureaucracy is an issue that you contend with.
The Financial Aspects of Infertility Treatment
One of the issues to consider before you choose a Fertility Clinic is finance. The costs of treatment vary from IVF treatment cost clinic and are dependent on one's individual case. It is important to know the cost of the infertility treatment procedure in advance so that you are mentally and financially prepared.
Also, find out whether one's health insurance covers fertility treatment procedures. If it does, then you would want to choose a doctor listed in one's health insurance policy to take advantage of the coverage.
Besides the above-mentioned factors, there are some general issues to be considered before you choose a fertility clinic. Not all of us are fortunate enough to live within shouting distance of a IVF treatment india. Travel time, therefore is an important issue to consider when you choose a fertility clinic.
Check here :- http://www.indiansurrogacy.com/
Company Contact Information
Ambassadors Of Surrogacy
Nikki Bains
71 Somersby Gardens
Ilford, Essex
IG4 5DY
44 7727 192698
News and Press Release Distribution From I-Newswire.com Reported by i-Newswire.com 12 hours ago.
Points to consider while selecting a fertility clinic
The success rate of the fertility clinic is not the only factor to be considered while making this decision. As with anything else, a thorough background check is an absolute necessity before you choose a fertility clinic. There are several issues that need to be addressed besides success rates, namely the type of clinic, financial aspects, health insurance, etc.
Be an informed IVF patient
Before you visit a fertility clinic, it is important that you have a basic knowledge of the process. Recommendations for selections may come from one's doctor or friends and relatives. But, one's own research in this matter is extremely vital. After all, this is a big decision for you - one that involves a change in one's life as well as a lot of money and time.
Types of Fertility Clinics
There are various types of fertility clinics and choosing the right one suitable for one's individual needs is crucial. Sole practitioners or a small set-up with about two to eight physicians might offer a pleasant, personalized experience with the doctors being available to personally take care of one's case.
Large, full service fertility clinics offer the advantage of labs, equipment and resources, but might not always provide personalized services. In a large set up, meeting with the doctor to resolve any queries might not always be possible; you'd mostly be dealing with staff and nurses as regards one's treatment.
University and hospital based Infertility clinic Mumbai are another option available when choosing a fertility clinic. At such clinics, you might benefit from the research and use of the latest technology, although bureaucracy is an issue that you contend with.
The Financial Aspects of Infertility Treatment
One of the issues to consider before you choose a Fertility Clinic is finance. The costs of treatment vary from IVF treatment cost clinic and are dependent on one's individual case. It is important to know the cost of the infertility treatment procedure in advance so that you are mentally and financially prepared.
Also, find out whether one's health insurance covers fertility treatment procedures. If it does, then you would want to choose a doctor listed in one's health insurance policy to take advantage of the coverage.
Besides the above-mentioned factors, there are some general issues to be considered before you choose a fertility clinic. Not all of us are fortunate enough to live within shouting distance of a IVF treatment india. Travel time, therefore is an important issue to consider when you choose a fertility clinic.
Check here :- http://www.indiansurrogacy.com/
Company Contact Information
Ambassadors Of Surrogacy
Nikki Bains
71 Somersby Gardens
Ilford, Essex
IG4 5DY
44 7727 192698
News and Press Release Distribution From I-Newswire.com Reported by i-Newswire.com 12 hours ago.
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NM exchange enrollees cost more than $6K each, study says
It cost taxpayers $6,181 to enroll each of the more than 32,000 people who have gotten health insurance through the New Mexico Health Insurance Exchange and the federal individual exchange, according to a report Thursday. New Mexico’s cost per enrollee was the seventh highest in the nation, according to the report by Jay Angoff, former Missouri Insurance Commissioner who is now with the Washington, D.C., law firm of Mehri & Skalet PLLC. New Mexico has gotten $123.3 million in federal grants…
Reported by bizjournals 11 hours ago.
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Why Health Insurance Won't Cover Your Medical Marijuana
Patients who use medical marijuana for pain and other chronic symptoms can take an unwanted hit: Insurers don't cover the treatment, which costs as much as $1,000 a month.
Once the drug of choice for hippies and rebellious teens, marijuana in recent years has gained more mainstream acceptance for its ability to boost appetite, dull pain and reduce seizures in everyone from epilepsy to cancer patients. Still, insurers are reluctant to cover it, in part because of conflicting laws. While 21 U.S. states have passed laws approving it for medical use, the drug still is illegal federally and in most states.
But perhaps the biggest hurdle for insurers is the U.S. Food and Drug Administration hasn't approved it. Major insurers generally don't cover treatments that are not approved by the FDA, and that approval depends on big clinical studies that measure safety, effectiveness and side effects.
That research can take years and millions of dollars. And while the FDA has approved treatments like Marinol that contain a synthetic version of an ingredient in marijuana, so far, no one has gained approval for a treatment that uses the whole plant.
As a result of the obstacles, advocates for medicinal marijuana say insurers likely won't cover the drug in the next few years. In the meantime, medical marijuana users — of which advocates estimate there are more than 1 million nationwide — have to find other ways to pay for their treatment.
Bill Britt, for instance, gets his supply for free from a friend whom he helps to grow the plants. Britt lives mostly on Social Security income and uses marijuana every day for epileptic seizures and leg pain from a childhood case of polio.
"I'm just lucky I have somebody who is helping me out, but that could go away at any time," said Britt, 55, who lives in Long Beach, California. "I am always worried about that."
Insurers have not seen enough evidence that marijuana is safe and more effective than other treatments, said Susan Pisano, a spokeswoman for America's Health Insurance Plans, an industry trade group.
Marijuana's Schedule I classification under the federal Controlled Substances Act makes it difficult to conduct clinical studies that might provide that evidence. The classification means the drug is considered to have a high potential for abuse and no accepted medical use. And that means extra precautions are required in order to study it.
Researchers have to apply to the FDA to approve their study. Public Health Service, another arm of the Department of Health and Human Services, also may review it, a process that can take months.
The Drug Enforcement Administration has to issue a permit after making sure researchers have a secure place to store the drug. Researchers also have to explain the study plan to the National Institute on Drug Abuse, or NIDA, another agency within Health and Human Services.
And researchers have to use marijuana supplied by NIDA, which contracts with the University of Mississippi to grow the only federally sanctioned source of the drug. That can limit the options for strains of marijuana researchers can study.
On top of that, researchers must find a location where the marijuana can be smoked or vaporized and scientists can monitor the patients afterward. That's no easy task, especially when dealing with public universities.
"The word 'marijuana' is just so politically radioactive," said Dr. Sue Sisley, a University of Arizona psychiatrist who is trying to study the drug as a possible treatment for military veterans with post-traumatic stress disorder.
The American Medical Association has called for a change in marijuana's classification to one that makes it easier for research to be conducted. The current classification prevents physicians from even prescribing it in states where medical use is permitted. Instead, they can only recommend it to patients.
There is no easy and cheap way to get the drug legally. Patients in states where medical marijuana is legal can either grow it or buy it from government-approved dispensaries.
At dispensaries, an eighth of an ounce, which produces three to seven joints, costs between $25 and $60, said Mike Liszewski, policy director for Americans for Safe Access, which advocates for safe and legal access to therapeutic cannabis. He noted that such an amount may not last long for patients who use the drug regularly to control pain or before every meal to help their appetites. Those patients might spend $1,000 a month or more.
Patients may get a price break from their dispensary if they have a low income, but that depends on the dispensary.
Growing marijuana costs less but takes three or four months. And success depends on a number of factors, including the grower's skill. And there are other problems: Britt, from Long Beach, California, tried growing it in his backyard only to have thieves steal it.
Allen St. Pierre, executive director of the nonprofit National Organization for the Reform of Marijuana Laws, or NORML, thinks insurers may eventually cover vaporized or eaten forms of marijuana. But he says when that happens depends, in part, on factors like who wins the 2016 presidential election.
Even if the FDA approves medicinal marijuana, there's no guarantee that insurance coverage will become widespread. Big companies that pay medical bills for their workers and dependents decide what items their insurance plans cover. They may not be eager to add the expense.
Meanwhile, patients like Kari Boiter, 33, continue to get medical marijuana however they can. Boiter has a genetic disorder that causes pain, nausea and vomiting, and she uses marijuana she helps grow in a cooperative garden to control the symptoms.
Boiter, who lives in Tacoma, Washington, and is unemployed, said she'd have to go back to largely ineffective prescriptions, or do without treatment if the cooperative went away.
"It would be really hard for me," she said. Reported by Huffington Post 10 hours ago.
Once the drug of choice for hippies and rebellious teens, marijuana in recent years has gained more mainstream acceptance for its ability to boost appetite, dull pain and reduce seizures in everyone from epilepsy to cancer patients. Still, insurers are reluctant to cover it, in part because of conflicting laws. While 21 U.S. states have passed laws approving it for medical use, the drug still is illegal federally and in most states.
But perhaps the biggest hurdle for insurers is the U.S. Food and Drug Administration hasn't approved it. Major insurers generally don't cover treatments that are not approved by the FDA, and that approval depends on big clinical studies that measure safety, effectiveness and side effects.
That research can take years and millions of dollars. And while the FDA has approved treatments like Marinol that contain a synthetic version of an ingredient in marijuana, so far, no one has gained approval for a treatment that uses the whole plant.
As a result of the obstacles, advocates for medicinal marijuana say insurers likely won't cover the drug in the next few years. In the meantime, medical marijuana users — of which advocates estimate there are more than 1 million nationwide — have to find other ways to pay for their treatment.
Bill Britt, for instance, gets his supply for free from a friend whom he helps to grow the plants. Britt lives mostly on Social Security income and uses marijuana every day for epileptic seizures and leg pain from a childhood case of polio.
"I'm just lucky I have somebody who is helping me out, but that could go away at any time," said Britt, 55, who lives in Long Beach, California. "I am always worried about that."
Insurers have not seen enough evidence that marijuana is safe and more effective than other treatments, said Susan Pisano, a spokeswoman for America's Health Insurance Plans, an industry trade group.
Marijuana's Schedule I classification under the federal Controlled Substances Act makes it difficult to conduct clinical studies that might provide that evidence. The classification means the drug is considered to have a high potential for abuse and no accepted medical use. And that means extra precautions are required in order to study it.
Researchers have to apply to the FDA to approve their study. Public Health Service, another arm of the Department of Health and Human Services, also may review it, a process that can take months.
The Drug Enforcement Administration has to issue a permit after making sure researchers have a secure place to store the drug. Researchers also have to explain the study plan to the National Institute on Drug Abuse, or NIDA, another agency within Health and Human Services.
And researchers have to use marijuana supplied by NIDA, which contracts with the University of Mississippi to grow the only federally sanctioned source of the drug. That can limit the options for strains of marijuana researchers can study.
On top of that, researchers must find a location where the marijuana can be smoked or vaporized and scientists can monitor the patients afterward. That's no easy task, especially when dealing with public universities.
"The word 'marijuana' is just so politically radioactive," said Dr. Sue Sisley, a University of Arizona psychiatrist who is trying to study the drug as a possible treatment for military veterans with post-traumatic stress disorder.
The American Medical Association has called for a change in marijuana's classification to one that makes it easier for research to be conducted. The current classification prevents physicians from even prescribing it in states where medical use is permitted. Instead, they can only recommend it to patients.
There is no easy and cheap way to get the drug legally. Patients in states where medical marijuana is legal can either grow it or buy it from government-approved dispensaries.
At dispensaries, an eighth of an ounce, which produces three to seven joints, costs between $25 and $60, said Mike Liszewski, policy director for Americans for Safe Access, which advocates for safe and legal access to therapeutic cannabis. He noted that such an amount may not last long for patients who use the drug regularly to control pain or before every meal to help their appetites. Those patients might spend $1,000 a month or more.
Patients may get a price break from their dispensary if they have a low income, but that depends on the dispensary.
Growing marijuana costs less but takes three or four months. And success depends on a number of factors, including the grower's skill. And there are other problems: Britt, from Long Beach, California, tried growing it in his backyard only to have thieves steal it.
Allen St. Pierre, executive director of the nonprofit National Organization for the Reform of Marijuana Laws, or NORML, thinks insurers may eventually cover vaporized or eaten forms of marijuana. But he says when that happens depends, in part, on factors like who wins the 2016 presidential election.
Even if the FDA approves medicinal marijuana, there's no guarantee that insurance coverage will become widespread. Big companies that pay medical bills for their workers and dependents decide what items their insurance plans cover. They may not be eager to add the expense.
Meanwhile, patients like Kari Boiter, 33, continue to get medical marijuana however they can. Boiter has a genetic disorder that causes pain, nausea and vomiting, and she uses marijuana she helps grow in a cooperative garden to control the symptoms.
Boiter, who lives in Tacoma, Washington, and is unemployed, said she'd have to go back to largely ineffective prescriptions, or do without treatment if the cooperative went away.
"It would be really hard for me," she said. Reported by Huffington Post 10 hours ago.
↧
Health insurers just say no to marijuana coverage
Once the drug of choice for hippies and rebellious teens, marijuana in recent years has gained more mainstream acceptance for its ability to boost appetite, dull pain and reduce seizures in everyone from epilepsy to cancer patients. Major insurers generally don't cover treatments that are not approved by the FDA, and that approval depends on big clinical studies that measure safety, effectiveness and side effects. Britt lives mostly on Social Security income and uses marijuana every day for epileptic seizures and leg pain from a childhood case of polio. Insurers have not seen enough evidence that marijuana is safe and more effective than other treatments, said Susan Pisano, a spokeswoman for America's Health Insurance Plans, an industry trade group. Marijuana's Schedule I classification under the federal Controlled Substances Act makes it difficult to conduct clinical studies that might provide that evidence. "The word 'marijuana' is just so politically radioactive," said Dr. Sue Sisley, a University of Arizona psychiatrist who is trying to study the drug as a possible treatment for military veterans with post-traumatic stress disorder. At dispensaries, an eighth of an ounce, which produces three to seven joints, costs between $25 and $60, said Mike Liszewski, policy director for Americans for Safe Access, which advocates for safe and legal access to therapeutic cannabis. Big companies that pay medical bills for their workers and dependents decide what items their insurance plans cover.
Reported by SeattlePI.com 10 hours ago.
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CareFirst Awards Nearly $1 Million Through Nurse-Education Partnership
Third round of Project RN funding raises total investment to $3 million.
Baltimore, MD (PRWEB) May 08, 2014
CareFirst BlueCross BlueShield (CareFirst) plans to invest an additional $960,000 in stipends to as many as 12 nursing students pursuing advanced degrees to become nurse educators through the company’s Project RN nurse education partnership program.
Project RN’s 2014 grant awards include $80,000 stipends over 36 months for one student at each of the following schools: Bowie State University; Marymount University; Coppin State University; Notre Dame of Maryland University; Stevenson University; George Washington University; Towson University; University of Maryland-Baltimore; Salisbury University; Johns Hopkins University; and George Mason University. A 12th stipend will be awarded to a student at Morgan State University, pending the anticipated accreditation of its nursing program by the Commission on Collegiate Nursing Education later this year.
Students pursuing masters or doctoral level nursing degrees at the selected universities were eligible to apply for the CareFirst-funded stipends and were selected by each university on an individual basis. The stipends can be used by students beginning classes in the spring or fall semesters of 2014.
Since 2007, Project RN has helped alleviate the shortage of qualified nurse educators in regional schools with grant recipients committing to teach nurses at schools in Maryland, D.C. or Northern Virginia for at least three years after receiving their degree.
“Few know that one of the root causes of the nursing shortage is a lack of qualified nurse educators,” said Maria Tildon, CareFirst’s Senior Vice President of Public Policy and Community Affairs. “Project RN identifies skilled candidates and gives them the tools they need to succeed as nurse educators in our communities. Without dedicated nurse educators, our health care system will continue to experience a shortage of qualified bedside nurses.”
The total number of job openings for nurses will reach 1.05 million by 2022, according to the American Association of Colleges of Nursing (AACN) and the Bureau of Labor Statistics.
To date, CareFirst has invested nearly $3 million in 42 nursing students seeking advanced degrees to become nurse educators. More information about Project RN can be found on the CareFirst Commitment website.
About CareFirst BlueCross BlueShield
In its 77th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.4 million individuals and groups in Maryland, the District of Columbia and Northern Virginia. In 2013, CareFirst contributed nearly $57 million to community programs designed to increase the accessibility, affordability, safety and quality of health care throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our website at http://www.carefirst.com or follow us on Twitter: http://twitter.com/CareFirst_News. Reported by PRWeb 10 hours ago.
Baltimore, MD (PRWEB) May 08, 2014
CareFirst BlueCross BlueShield (CareFirst) plans to invest an additional $960,000 in stipends to as many as 12 nursing students pursuing advanced degrees to become nurse educators through the company’s Project RN nurse education partnership program.
Project RN’s 2014 grant awards include $80,000 stipends over 36 months for one student at each of the following schools: Bowie State University; Marymount University; Coppin State University; Notre Dame of Maryland University; Stevenson University; George Washington University; Towson University; University of Maryland-Baltimore; Salisbury University; Johns Hopkins University; and George Mason University. A 12th stipend will be awarded to a student at Morgan State University, pending the anticipated accreditation of its nursing program by the Commission on Collegiate Nursing Education later this year.
Students pursuing masters or doctoral level nursing degrees at the selected universities were eligible to apply for the CareFirst-funded stipends and were selected by each university on an individual basis. The stipends can be used by students beginning classes in the spring or fall semesters of 2014.
Since 2007, Project RN has helped alleviate the shortage of qualified nurse educators in regional schools with grant recipients committing to teach nurses at schools in Maryland, D.C. or Northern Virginia for at least three years after receiving their degree.
“Few know that one of the root causes of the nursing shortage is a lack of qualified nurse educators,” said Maria Tildon, CareFirst’s Senior Vice President of Public Policy and Community Affairs. “Project RN identifies skilled candidates and gives them the tools they need to succeed as nurse educators in our communities. Without dedicated nurse educators, our health care system will continue to experience a shortage of qualified bedside nurses.”
The total number of job openings for nurses will reach 1.05 million by 2022, according to the American Association of Colleges of Nursing (AACN) and the Bureau of Labor Statistics.
To date, CareFirst has invested nearly $3 million in 42 nursing students seeking advanced degrees to become nurse educators. More information about Project RN can be found on the CareFirst Commitment website.
About CareFirst BlueCross BlueShield
In its 77th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.4 million individuals and groups in Maryland, the District of Columbia and Northern Virginia. In 2013, CareFirst contributed nearly $57 million to community programs designed to increase the accessibility, affordability, safety and quality of health care throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our website at http://www.carefirst.com or follow us on Twitter: http://twitter.com/CareFirst_News. Reported by PRWeb 10 hours ago.
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Smart Spending: How to plan financially for leave
According to most experts, it's a tricky balance of preparation and innovation. Federal law does not require FMLA leave to be paid, but the Society for Human Resource Management's 2013 Employee Benefits Survey found that 21 percent of organizations did offer paid family leave. Bruce Elliott, manager of compensation and benefits at SHRM, points out that this means in some states employees can take time off to care for an aunt or other relative that may not be covered under federal law. Energize Your Career and Life by Taking a Break, suggest creating a new account or slush fund that is dedicated solely for your time off. Again and again, experts cautioned against using retirement savings, because the penalties and tax consequences rarely make it worth it. Make sure to factor in the costs for continuing your health insurance into your budget as well. Some employers offer flexible spending accounts, which allow employees to put cash aside pre-tax to help cover medical costs. This may help ease some of the sting from expenses either during your leave or upon your return. [...] if your living situation has dramatically changed, such as the addition of another dependent or major disability, you may want to speak to a tax professional about what expenses you can deduct on your taxes in the future.
Reported by SeattlePI.com 10 hours ago.
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State Exchange Enrollment Projections Provide Clarity Into Diverse U.S. Health Insurance Market
BURLINGTON, Mass., May 8, 2014 /PRNewswire/ -- Decision Resources Group's projections of 2014 exchange enrollment reveal great regional diversity in U.S. health insurance markets. State Exchanges, which opened for enrollment October 1, 2013, are both state- and federally-run. Many...
Reported by PR Newswire 9 hours ago.
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Good Programs Survive Only If We Pay Attention
At the White House Correspondents Dinner, President Obama joked about the rough year he had with the roll-out of the Affordable Care Act (ACA). That said, it is useful to take a serious moment to reflect on the importance of programs that invest in the public health. For the ACA, the bottom line is a positive one: a large number of Americans who were locked out of the insurance market- either because of affordability issues or because insurers wouldn't offer them coverage- can now access the health insurance market. This is undoubtedly a good thing.
A large part of the ACA's long-term success and sustainability will hinge on its ability to provide significant and meaningful support to individuals who could not otherwise access health insurance. If the public does not see that people are directly benefiting from the program, support will erode and the program's future will be in doubt. Fortunately, the enrollment success and direct patient benefits of the ACA, makes it well suited to build long-term public support. Unfortunately, not all public health care programs are on such solid footing.
I was reminded of this fact when I saw a recent report studying the problems in a little known but widely used public health program dubbed simply "the 340B Program." The 340B program was created in 1992, and it requires that certain qualifying federally-funded clinics and hospitals that are presumed to treat high numbers of uninsured, indigent patients receive discount prices for medicines. Importantly, while the law does not specify that entities participating in the program pass on those discounts to needy patients, the presumption was that the entities would be stewards of the program and ensure its benefits get passed to those in need of assistance.
At first, the vast majority of the program's participants were true safety net facilities dedicated to serving the poorest and most vulnerable. Many of these facilities were clinics and public hospitals based in low-income areas that served disproportionate numbers of indigent patients. More recently, hospitals that are less focused on safety net populations have realized that they too could take advantage of the program's discounts. These hospitals have fueled the program's exponential growth rate as qualifying hospitals have sought to leverage the program to maximize revenue instead of benefit patients.
The most recent report used newly available government data to look at the share of hospital costs that 340B hospitals were spending on free or reduced price care for low-income patients. The report found that charity care represented less than 5% of hospital costs at more than 80% of 340B hospitals. More alarmingly, about a quarter of 340B hospitals provide charity care that represents less than 1% of the hospitals costs. And while defenders of the status quo attacked the report for being privately-funded, it came on the heels of a report by the HHS Office of Inspector General outlining the proliferation and problems caused by a regulatory change in 2010 that permitted entities participating in the program to contract with an unlimited number of for-profit pharmacies. The inclusion of for-profit companies such as chain drug stores (in a program that is otherwise limited to not-for-profit providers) has only exacerbated concerns with 340B.
The short truth is that the 340B program has problems, and it is rapidly approaching the point of unsustainability. The combination of unsustainable growth combined with dubious financial gains created out of a public health program should give everyone pause.
These financial schemes have led to complex profit-sharing arrangements with for-profit contract pharmacies and have created massive incentives for hospitals to buy up physician practices so that hospitals can increase the number of prescriptions that qualify for the 340B discount (allowing them to further maximize revenue from the program without patients necessarily seeing any benefit). At the very least, the program seems due for what would be just the second Congressional hearing on the program in its 20 years of existence.
As a physician, I will be the first to recognize the value and importance of the 340B program, and it needs to have an important role going forward. It is a valuable public health program that provides tools to assist the neediest among us who still do not have access to coverage, even after ACA is fully implemented (an unfortunately high number due to the intransigence of some states in expanding their Medicaid programs). But when programs designed to assist the neediest among us are abused or exploited, it can undermine future efforts to help those same populations by breeding cynicism about government's ability to develop and sustain programs that effectively serve the most vulnerable.
And that is why every public health advocate should be willing to push for reform of 340B; we need the program to be sustainable for those who need it, and we need to create effective public health programs that serve as examples of sound policy for everyone to see.
Howard Dean, MD is the former Governor of Vermont. He currently serves as an independent consultant for McKenna Long & Aldridge LLP, which represents a wide variety of clients, including those interested in health policy. Views are his own. Reported by Huffington Post 8 hours ago.
A large part of the ACA's long-term success and sustainability will hinge on its ability to provide significant and meaningful support to individuals who could not otherwise access health insurance. If the public does not see that people are directly benefiting from the program, support will erode and the program's future will be in doubt. Fortunately, the enrollment success and direct patient benefits of the ACA, makes it well suited to build long-term public support. Unfortunately, not all public health care programs are on such solid footing.
I was reminded of this fact when I saw a recent report studying the problems in a little known but widely used public health program dubbed simply "the 340B Program." The 340B program was created in 1992, and it requires that certain qualifying federally-funded clinics and hospitals that are presumed to treat high numbers of uninsured, indigent patients receive discount prices for medicines. Importantly, while the law does not specify that entities participating in the program pass on those discounts to needy patients, the presumption was that the entities would be stewards of the program and ensure its benefits get passed to those in need of assistance.
At first, the vast majority of the program's participants were true safety net facilities dedicated to serving the poorest and most vulnerable. Many of these facilities were clinics and public hospitals based in low-income areas that served disproportionate numbers of indigent patients. More recently, hospitals that are less focused on safety net populations have realized that they too could take advantage of the program's discounts. These hospitals have fueled the program's exponential growth rate as qualifying hospitals have sought to leverage the program to maximize revenue instead of benefit patients.
The most recent report used newly available government data to look at the share of hospital costs that 340B hospitals were spending on free or reduced price care for low-income patients. The report found that charity care represented less than 5% of hospital costs at more than 80% of 340B hospitals. More alarmingly, about a quarter of 340B hospitals provide charity care that represents less than 1% of the hospitals costs. And while defenders of the status quo attacked the report for being privately-funded, it came on the heels of a report by the HHS Office of Inspector General outlining the proliferation and problems caused by a regulatory change in 2010 that permitted entities participating in the program to contract with an unlimited number of for-profit pharmacies. The inclusion of for-profit companies such as chain drug stores (in a program that is otherwise limited to not-for-profit providers) has only exacerbated concerns with 340B.
The short truth is that the 340B program has problems, and it is rapidly approaching the point of unsustainability. The combination of unsustainable growth combined with dubious financial gains created out of a public health program should give everyone pause.
These financial schemes have led to complex profit-sharing arrangements with for-profit contract pharmacies and have created massive incentives for hospitals to buy up physician practices so that hospitals can increase the number of prescriptions that qualify for the 340B discount (allowing them to further maximize revenue from the program without patients necessarily seeing any benefit). At the very least, the program seems due for what would be just the second Congressional hearing on the program in its 20 years of existence.
As a physician, I will be the first to recognize the value and importance of the 340B program, and it needs to have an important role going forward. It is a valuable public health program that provides tools to assist the neediest among us who still do not have access to coverage, even after ACA is fully implemented (an unfortunately high number due to the intransigence of some states in expanding their Medicaid programs). But when programs designed to assist the neediest among us are abused or exploited, it can undermine future efforts to help those same populations by breeding cynicism about government's ability to develop and sustain programs that effectively serve the most vulnerable.
And that is why every public health advocate should be willing to push for reform of 340B; we need the program to be sustainable for those who need it, and we need to create effective public health programs that serve as examples of sound policy for everyone to see.
Howard Dean, MD is the former Governor of Vermont. He currently serves as an independent consultant for McKenna Long & Aldridge LLP, which represents a wide variety of clients, including those interested in health policy. Views are his own. Reported by Huffington Post 8 hours ago.
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Health insurance payments from Obamacare reach 80 percent
Health insurance companies told members of Congress Wednesday that more than 80 percent of people who've signed up under Obamacare have gone on to pay their health insurance premiums — a necessary step for the enrollment figures touted by the administration to hold up.
Reported by Christian Science Monitor 8 hours ago.
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First and Only in Houston: Children’s Memorial Hermann Hospital Now Offers Comprehensive Neuro-Neonatal ICU Program
Through this new capability, Children’s Memorial Hermann Hospital will be able to offer the best possible outcomes for newborn babies with neurological complications.
Houston, TX (PRWEB) May 08, 2014
Children’s Memorial Hermann Hospital is proud to become one of only a handful of hospitals in the nation – and the first and only hospital in Houston – to offer a highly specialized, comprehensive Neuro-Neonatal Intensive Care Unit (Neuro-NICU) Program. Through this new capability, Children’s Memorial Hermann Hospital will be able to offer the best possible outcomes for newborn babies with neurological complications.
“From the initial planning phase to in-depth staff training to acquiring all of the necessary top-of-the-line equipment, including five new aEEG (amplitude-integrated EEG) machines, this groundbreaking program has been three years in the making,” said Nicole Francis, clinical director of Neonatal Services at Children's Memorial Hermann Hospital. “Timing is critical when it comes to these cases and we strongly believe that with access to this cutting-edge clinical technology, we will be able to deliver a higher quality level of care to this very specific neonatal patient population, faster than ever before.”
One such possible neurological complication is birth hypoxia (hypoxic-ischemic encephalopathy, also known as perinatal asphyxia), which happens when newborns are deprived of oxygen before, during, or shortly after birth. This lack of oxygen damages brain and spinal cord cells. According to the American Journal of Neuroradiology, birth hypoxia happens in two to 10 per 1000 newborns who are born at term, and more for those who are born prematurely. Depending on the severity of the hypoxia, resulting conditions can range from extreme mental disabilities and/or seizures to death.
Previously, the only available option for monitoring these babies was a regular EEG (electroencephalography), which records the brain's spontaneous electrical activity over a short period of time, usually 20 to 30 minutes. But, if no relevant brain activity is recorded during that time, then no data is delivered and no action can be taken.
Thanks to this brand new, specialized medical equipment and the highly-trained nursing and physician team of advanced neonatal specialists, Children’s Memorial Hermann Hospital is uniquely qualified to treat this group of patients. With five state-of-the-art aEEG machines now available, nurses can continuously record a baby’s brain function in real time, with easier initiation and for an extended period of 24 hours or longer if needed.
“This around-the-clock, uninterrupted monitoring system will allow for the delivery of faster, better data which will lead to faster, more accurate diagnoses and, therefore, speedier treatment options provided by our team of expert pediatric neurologists and neurosurgeons,” said Dr. Gretchen Von Allmen, director of the Pediatric Epilepsy Program at Children’s Memorial Hermann Hospital and assistant professor at UTHealth Medical School.
The program launched in late April and, on day one of operation, the team of neonatal specialists was able to put the new equipment to work on a newborn child in need. “Shortly after our son, Morris, was born at Memorial Hermann Southwest Hospital, our physicians there were concerned he may have been suffering from birth asphyxia due to complications with the umbilical cord during delivery,” said Morris’ father, Kristian Dunford. “When they told us they wanted to rush him via Memorial Hermann Life Flight® to Children’s Memorial Hermann Hospital, his mother and I were of course very scared. But then they explained it was to get him to the new Neuro-NICU and into the care of the top experts in this field in the city. That helped to reassure us – to know our newborn son would be in the best possible hands.”
“After several days of close monitoring, thankfully all of Morris’ tests came back negative and, last week, we were able to bring home our happy baby boy,” said Dunford. “We will always be grateful to the teams at both Memorial Hermann campuses who collaborated quickly and seamlessly to help ensure the health and safety of our firstborn child.”
Symptoms of birth hypoxia may include increased muscle tone; poor feeding behavior; excessive crying; excessive sleepiness or lethargy; irregular breathing; irregular eye movement; irregular heart rate and blood pressure; absence of reflexes such as sucking, swallowing and grasping; or seizures. When one suspects birth hypoxia, it is imperative that the infant get to a specialist to begin treatment and monitoring within six hours of delivery.
The new Neuro-NICU program will be operating in addition to the whole-body cooling service Children’s Memorial Hermann Hospital has already been offering this patient population for more than a decade. By lowering the temperature of an oxygen-deprived newborn and cooling the baby’s vasculature thereby allowing the brain to rest, physicians have seen great success in improved outcomes by saving brain cells that may have otherwise died or been severely damaged.
“As one of the first hospitals in the nation to use whole-body hypothermia for newborns suffering from birth hypoxia, our team has been leading the way in research and technology in the field of neuro-neonatology for many years,” said Susie Distefano, CEO of Children’s Memorial Hermann Hospital. “Now with the addition of our new 24-hour Neuro-NICU monitoring program, we are continuing to refine and speed medical treatment for these complex cases by improving upon the already advanced level of care we have available to these tiny patients, delivering the best possible results.”
###
About Memorial Hermann
An integrated health system, Memorial Hermann is known for world-class clinical expertise, patient-centered care, leading edge technology, and innovation. The system, with its exceptional medical staff and more than 20,000 employees, serves to advance health in Southeast Texas and the Greater Houston community. Memorial Hermann’s 12 hospitals include three hospitals in the Texas Medical Center, including the Texas Trauma Institute – a level I trauma center which houses the Life Flight® air ambulance – a hospital for children and a rehabilitation hospital, eight suburban hospitals, and a second rehabilitation hospital in Katy. The system also operates three Heart & Vascular Institutes, the Mischer Neuroscience Institute, three Ironman Sports Medicine Institute locations, cancer centers, imaging and surgery centers, sports medicine and rehabilitation centers, outpatient laboratories, a chemical dependency treatment center, a home health agency, a retirement community and a nursing home. As an Accountable Care Organization, the system also offers employers health solutions and health benefit plans through its wholly owned Memorial Hermann Health Insurance Company.
About Children’s Memorial Hermann Hospital
Part of the 12-hospital Memorial Hermann Health System, Children’s Memorial Hermann Hospital is a 278-bed hospital dedicated to pediatric and neonatal care with an additional 68 beds dedicated to women’s services. The hospital’s special compassion and healing expertise has distinguished it as one of the finest children’s hospitals in the nation. In partnership with The University of Texas Health Science Center at Houston Medical School, Children’s Memorial Hermann Hospital specialists provide care for more than 120,000 patient visits annually, including the tiniest premature infants, children and adolescents. Memorial Hermann takes a holistic approach to healthcare, offering programs and services that address the physical, social, psychological and spiritual aspects of well-being. An integrated health system, Memorial Hermann is known for world-class clinical expertise, patient-centered care, leading-edge technology and innovation. The system, with its exceptional medical staff and 22,000 employees, serves southeast Texas and the greater Houston community. Learn more about Children’s Memorial Hermann Hospital. Reported by PRWeb 8 hours ago.
Houston, TX (PRWEB) May 08, 2014
Children’s Memorial Hermann Hospital is proud to become one of only a handful of hospitals in the nation – and the first and only hospital in Houston – to offer a highly specialized, comprehensive Neuro-Neonatal Intensive Care Unit (Neuro-NICU) Program. Through this new capability, Children’s Memorial Hermann Hospital will be able to offer the best possible outcomes for newborn babies with neurological complications.
“From the initial planning phase to in-depth staff training to acquiring all of the necessary top-of-the-line equipment, including five new aEEG (amplitude-integrated EEG) machines, this groundbreaking program has been three years in the making,” said Nicole Francis, clinical director of Neonatal Services at Children's Memorial Hermann Hospital. “Timing is critical when it comes to these cases and we strongly believe that with access to this cutting-edge clinical technology, we will be able to deliver a higher quality level of care to this very specific neonatal patient population, faster than ever before.”
One such possible neurological complication is birth hypoxia (hypoxic-ischemic encephalopathy, also known as perinatal asphyxia), which happens when newborns are deprived of oxygen before, during, or shortly after birth. This lack of oxygen damages brain and spinal cord cells. According to the American Journal of Neuroradiology, birth hypoxia happens in two to 10 per 1000 newborns who are born at term, and more for those who are born prematurely. Depending on the severity of the hypoxia, resulting conditions can range from extreme mental disabilities and/or seizures to death.
Previously, the only available option for monitoring these babies was a regular EEG (electroencephalography), which records the brain's spontaneous electrical activity over a short period of time, usually 20 to 30 minutes. But, if no relevant brain activity is recorded during that time, then no data is delivered and no action can be taken.
Thanks to this brand new, specialized medical equipment and the highly-trained nursing and physician team of advanced neonatal specialists, Children’s Memorial Hermann Hospital is uniquely qualified to treat this group of patients. With five state-of-the-art aEEG machines now available, nurses can continuously record a baby’s brain function in real time, with easier initiation and for an extended period of 24 hours or longer if needed.
“This around-the-clock, uninterrupted monitoring system will allow for the delivery of faster, better data which will lead to faster, more accurate diagnoses and, therefore, speedier treatment options provided by our team of expert pediatric neurologists and neurosurgeons,” said Dr. Gretchen Von Allmen, director of the Pediatric Epilepsy Program at Children’s Memorial Hermann Hospital and assistant professor at UTHealth Medical School.
The program launched in late April and, on day one of operation, the team of neonatal specialists was able to put the new equipment to work on a newborn child in need. “Shortly after our son, Morris, was born at Memorial Hermann Southwest Hospital, our physicians there were concerned he may have been suffering from birth asphyxia due to complications with the umbilical cord during delivery,” said Morris’ father, Kristian Dunford. “When they told us they wanted to rush him via Memorial Hermann Life Flight® to Children’s Memorial Hermann Hospital, his mother and I were of course very scared. But then they explained it was to get him to the new Neuro-NICU and into the care of the top experts in this field in the city. That helped to reassure us – to know our newborn son would be in the best possible hands.”
“After several days of close monitoring, thankfully all of Morris’ tests came back negative and, last week, we were able to bring home our happy baby boy,” said Dunford. “We will always be grateful to the teams at both Memorial Hermann campuses who collaborated quickly and seamlessly to help ensure the health and safety of our firstborn child.”
Symptoms of birth hypoxia may include increased muscle tone; poor feeding behavior; excessive crying; excessive sleepiness or lethargy; irregular breathing; irregular eye movement; irregular heart rate and blood pressure; absence of reflexes such as sucking, swallowing and grasping; or seizures. When one suspects birth hypoxia, it is imperative that the infant get to a specialist to begin treatment and monitoring within six hours of delivery.
The new Neuro-NICU program will be operating in addition to the whole-body cooling service Children’s Memorial Hermann Hospital has already been offering this patient population for more than a decade. By lowering the temperature of an oxygen-deprived newborn and cooling the baby’s vasculature thereby allowing the brain to rest, physicians have seen great success in improved outcomes by saving brain cells that may have otherwise died or been severely damaged.
“As one of the first hospitals in the nation to use whole-body hypothermia for newborns suffering from birth hypoxia, our team has been leading the way in research and technology in the field of neuro-neonatology for many years,” said Susie Distefano, CEO of Children’s Memorial Hermann Hospital. “Now with the addition of our new 24-hour Neuro-NICU monitoring program, we are continuing to refine and speed medical treatment for these complex cases by improving upon the already advanced level of care we have available to these tiny patients, delivering the best possible results.”
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About Memorial Hermann
An integrated health system, Memorial Hermann is known for world-class clinical expertise, patient-centered care, leading edge technology, and innovation. The system, with its exceptional medical staff and more than 20,000 employees, serves to advance health in Southeast Texas and the Greater Houston community. Memorial Hermann’s 12 hospitals include three hospitals in the Texas Medical Center, including the Texas Trauma Institute – a level I trauma center which houses the Life Flight® air ambulance – a hospital for children and a rehabilitation hospital, eight suburban hospitals, and a second rehabilitation hospital in Katy. The system also operates three Heart & Vascular Institutes, the Mischer Neuroscience Institute, three Ironman Sports Medicine Institute locations, cancer centers, imaging and surgery centers, sports medicine and rehabilitation centers, outpatient laboratories, a chemical dependency treatment center, a home health agency, a retirement community and a nursing home. As an Accountable Care Organization, the system also offers employers health solutions and health benefit plans through its wholly owned Memorial Hermann Health Insurance Company.
About Children’s Memorial Hermann Hospital
Part of the 12-hospital Memorial Hermann Health System, Children’s Memorial Hermann Hospital is a 278-bed hospital dedicated to pediatric and neonatal care with an additional 68 beds dedicated to women’s services. The hospital’s special compassion and healing expertise has distinguished it as one of the finest children’s hospitals in the nation. In partnership with The University of Texas Health Science Center at Houston Medical School, Children’s Memorial Hermann Hospital specialists provide care for more than 120,000 patient visits annually, including the tiniest premature infants, children and adolescents. Memorial Hermann takes a holistic approach to healthcare, offering programs and services that address the physical, social, psychological and spiritual aspects of well-being. An integrated health system, Memorial Hermann is known for world-class clinical expertise, patient-centered care, leading-edge technology and innovation. The system, with its exceptional medical staff and 22,000 employees, serves southeast Texas and the greater Houston community. Learn more about Children’s Memorial Hermann Hospital. Reported by PRWeb 8 hours ago.
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WANTED: Work-Life Professionals -- Study Reveals Employers Missing the Mark When Relying on Work-life Amateurs
Last week's report from the Families and Work Institute is a riveting but disturbing update to their periodic National Study of Employers. This is a significant piece of work, because it describes in excruciating detail how the Great Recession has reconfigured key dimensions of the U.S. workplace. It answers questions many of us have been pondering for years. Like all research studies, it raises others.
The report begins and ends with the assertion that "during this period of economic instability, employers have continued to reinvent work practices, policies, programs and benefits." Unfortunately, this optimistic stance is not supported by the data. In reality, many of the key findings directly contradict any credible evidence of reinvention, such as the news that there is declining support for creating a culture of flexibility, that face time is even more highly valued over results today, that fewer employers now reward managers for supporting effective flexible work arrangements, and that the lengths of parental leaves for new fathers have declined at precisely the moment in history when men are increasingly invested in co-parenting.
The predominant take-away is that employers have taken to practice what can only be described as work-life on the cheap. The overarching message is that any program that costs money has been trimmed.
Over the past six years, employers have increased health insurance co-pays, shortened caregiver leaves for new fathers and employees caring for seriously ill family members, and are significantly less likely to provide any full-time pay for maternity-related disability. Employers are contributing less to community programs that help the families that work for them, have all but curtailed childcare vouchers and subsidies, have reduced investment in training managers on the effective implementation of flexibility and diversity initiatives, and give less time off for other, more general education and training.
As for workplace flexibility, the crown jewel of the work-life portfolio, we are told that "the forms of flexibility that have increased allow employees to work longer hours or adjust work times to take care of daily concerns while still getting their work done." Although the most important business driver for employers participating in this study is retention, the drop in reduced hours options and support for career flexibility is attributed later in the report to a "reduced emphasis on long-term retention of employees interested in taking extended periods away from work." In other words, those employees who fit the mold of the classic "ideal worker" are valued, but the tenure of those who actually practice flexibility might be at risk.
If the message were simply that money is temporarily scarce and employers need to allocate it wisely; let's figure out how to distribute it to mutual benefit that would be understandable. After all, there have been other, albeit lesser recessions throughout the decades of work-life practice. Unlike the situation described in this report, however, these prior economic dips were notable for stimulating growth in organizational support for work-life. This may sound counter-intuitive until you consider that, as benefits go, work-life support is an absurdly inexpensive investment for the well-documented returns that accrue. It is when money becomes scarce that people remember how valued and morale-boosting such non-monetary offerings as flexibility, community volunteering and the creative use of time off are. This periodic "reset" precipitated by business cycles has until now fueled optimism within the work-life community about the slow but steady strengthening of work-life progress as the ever-changing nature of work evolves.
What is so distressing about the situation described in this report is how retrograde the workplace landscape has become. Employers value the ideal worker over the new age contributor. There is an obsession with cost over return on investment, revealing that cost containment trumps employee and family sustainability. Culturally embedded flexibility is withering, underscoring a lack of comprehension about work-life as a strategic endeavor in concert with other people functions. This entire scenario is about as far from reinvention as it gets.
The extent of the erosion of work-life support documented in this report cannot be explained entirely by this particular financial downturn, corrosive as it has been. There are obviously other factors in play.
It is no coincidence that during this same 6 year time frame, an unprecedentedly large number of the work-life practitioners who have served as change agents throughout corporate America for decades have left their posts. This significant brain drain has been amplified by a surprising proportion of employers who have chosen not to replace them, often shifting the function to benefits, or another HR function whose primary mindset is compliance. This is an unfortunate loss in the midst of what is looking like a decade-long financial firestorm. Culture change, reinvention, and forging new ways to work -- these are complicated endeavors that require expertise and experience not entirely resident in other HR functions.
The economy is slowly healing itself, so the money part of the equation is solvable. But without more Chief Quality of Life Officers at the right hand of leadership teams, the mismatch between the workplace described and the workforce in place will not spontaneously right itself. Fortunately, work-life certification exists, the requisite competencies defined, and sophisticated toolkits built. Employers need only realize that they won't prosper in this age of global specialization by reaching back to a last century DIY approach. Reported by Huffington Post 7 hours ago.
The report begins and ends with the assertion that "during this period of economic instability, employers have continued to reinvent work practices, policies, programs and benefits." Unfortunately, this optimistic stance is not supported by the data. In reality, many of the key findings directly contradict any credible evidence of reinvention, such as the news that there is declining support for creating a culture of flexibility, that face time is even more highly valued over results today, that fewer employers now reward managers for supporting effective flexible work arrangements, and that the lengths of parental leaves for new fathers have declined at precisely the moment in history when men are increasingly invested in co-parenting.
The predominant take-away is that employers have taken to practice what can only be described as work-life on the cheap. The overarching message is that any program that costs money has been trimmed.
Over the past six years, employers have increased health insurance co-pays, shortened caregiver leaves for new fathers and employees caring for seriously ill family members, and are significantly less likely to provide any full-time pay for maternity-related disability. Employers are contributing less to community programs that help the families that work for them, have all but curtailed childcare vouchers and subsidies, have reduced investment in training managers on the effective implementation of flexibility and diversity initiatives, and give less time off for other, more general education and training.
As for workplace flexibility, the crown jewel of the work-life portfolio, we are told that "the forms of flexibility that have increased allow employees to work longer hours or adjust work times to take care of daily concerns while still getting their work done." Although the most important business driver for employers participating in this study is retention, the drop in reduced hours options and support for career flexibility is attributed later in the report to a "reduced emphasis on long-term retention of employees interested in taking extended periods away from work." In other words, those employees who fit the mold of the classic "ideal worker" are valued, but the tenure of those who actually practice flexibility might be at risk.
If the message were simply that money is temporarily scarce and employers need to allocate it wisely; let's figure out how to distribute it to mutual benefit that would be understandable. After all, there have been other, albeit lesser recessions throughout the decades of work-life practice. Unlike the situation described in this report, however, these prior economic dips were notable for stimulating growth in organizational support for work-life. This may sound counter-intuitive until you consider that, as benefits go, work-life support is an absurdly inexpensive investment for the well-documented returns that accrue. It is when money becomes scarce that people remember how valued and morale-boosting such non-monetary offerings as flexibility, community volunteering and the creative use of time off are. This periodic "reset" precipitated by business cycles has until now fueled optimism within the work-life community about the slow but steady strengthening of work-life progress as the ever-changing nature of work evolves.
What is so distressing about the situation described in this report is how retrograde the workplace landscape has become. Employers value the ideal worker over the new age contributor. There is an obsession with cost over return on investment, revealing that cost containment trumps employee and family sustainability. Culturally embedded flexibility is withering, underscoring a lack of comprehension about work-life as a strategic endeavor in concert with other people functions. This entire scenario is about as far from reinvention as it gets.
The extent of the erosion of work-life support documented in this report cannot be explained entirely by this particular financial downturn, corrosive as it has been. There are obviously other factors in play.
It is no coincidence that during this same 6 year time frame, an unprecedentedly large number of the work-life practitioners who have served as change agents throughout corporate America for decades have left their posts. This significant brain drain has been amplified by a surprising proportion of employers who have chosen not to replace them, often shifting the function to benefits, or another HR function whose primary mindset is compliance. This is an unfortunate loss in the midst of what is looking like a decade-long financial firestorm. Culture change, reinvention, and forging new ways to work -- these are complicated endeavors that require expertise and experience not entirely resident in other HR functions.
The economy is slowly healing itself, so the money part of the equation is solvable. But without more Chief Quality of Life Officers at the right hand of leadership teams, the mismatch between the workplace described and the workforce in place will not spontaneously right itself. Fortunately, work-life certification exists, the requisite competencies defined, and sophisticated toolkits built. Employers need only realize that they won't prosper in this age of global specialization by reaching back to a last century DIY approach. Reported by Huffington Post 7 hours ago.
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