Reports in the popular media portrayed King v. Burwell as a case involving premium tax subsidies used to purchase health insurance from public exchanges or marketplaces under the Affordable Care Act (ACA).
Reported by Mondaq 22 minutes ago.
United States: The Impact Of King v. Burwell On "Applicable Large Employers" - Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.
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Hillary Clinton Says Puerto Rico Should Have Access To U.S. Bankruptcy Laws
By Amanda Becker
IOWA CITY, IOWA, July 7 (Reuters) - U.S. Democratic presidential candidate Hillary Clinton said Tuesday that Puerto Rico's public entities should be able to use U.S. bankruptcy laws to restructure some $72 billion in debt.
Like U.S. states, Puerto Rico, a commonwealth, cannot file for bankruptcy protection. Unlike U.S. states, Puerto Rico's public entities, including municipalities, are not covered by U.S. Chapter 9 bankruptcy laws.
Puerto Rico's non-voting delegate in the U.S. Congress has called for legislation that would allow Puerto Rico to access the same bankruptcy laws available to other municipalities, as has Puerto Rico's Governor Alejandro Garcia Padilla.
The U.S. Court of Appeals for the First Circuit late Monday affirmed a lower court decision to strike down Puerto Rican legislation aimed at granting local municipalities the right to enter bankruptcy, but said excluding the U.S. territory's public entities from federal bankruptcy law was unconstitutional.
"Congress and the Obama administration need to partner with Puerto Rico by providing real support and tools so that Puerto Rico can do the hard work it will take to get on a path toward stability and prosperity," Clinton said in a statement provided to Reuters.
"As a first step, Congress should provide Puerto Rico the same authority that states already have to enable severely distressed government entities, including municipalities and public corporations, to restructure their debts under Chapter 9 of the Bankruptcy Code," Clinton added.
Democratic Presidential candidate Hillary Clinton participates in a grassroots organizing event in College Park at Dartmouth College July 3, 2015 in Hanover, New Hampshire. (Photo by Darren McCollester/Getty Images)
The White House said last week that there is "no one in the administration" that is "contemplating a federal bailout of Puerto Rico" but that the U.S. Congress should "take a look at" whether Puerto Rico's government-owned corporations should be able to access Chapter 9 bankruptcy protection.
Congressional Republicans largely oppose such a step. Republican presidential candidate Jeb Bush said in April that he thinks Puerto Rico's public agencies should have the ability to use U.S. bankruptcy laws.
"We're not talking about a bailout, we're talking about a fair shot at success," Clinton said Tuesday.
Clinton said in the statement that the "inconsistent and incoherent" application of U.S. federal law to Puerto Rico contributed to its economic situation, noting high utility rates and unemployment have led to an economy that has shrunk for eight of the last nine years.
"One troubling example of this treatment is the lack of equity in federal funding for Puerto Rico under Medicaid and Medicare," Clinton said of health insurance programs sponsored by the U.S. government.
Clinton, also a former first lady, is the front runner for the Democratic nomination ahead of the general election in November 2016. (Reporting by Amanda Becker in Iowa; additional reporting by Megan Davies in New York; Editing by Nick Macfie)
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 22 hours ago.
IOWA CITY, IOWA, July 7 (Reuters) - U.S. Democratic presidential candidate Hillary Clinton said Tuesday that Puerto Rico's public entities should be able to use U.S. bankruptcy laws to restructure some $72 billion in debt.
Like U.S. states, Puerto Rico, a commonwealth, cannot file for bankruptcy protection. Unlike U.S. states, Puerto Rico's public entities, including municipalities, are not covered by U.S. Chapter 9 bankruptcy laws.
Puerto Rico's non-voting delegate in the U.S. Congress has called for legislation that would allow Puerto Rico to access the same bankruptcy laws available to other municipalities, as has Puerto Rico's Governor Alejandro Garcia Padilla.
The U.S. Court of Appeals for the First Circuit late Monday affirmed a lower court decision to strike down Puerto Rican legislation aimed at granting local municipalities the right to enter bankruptcy, but said excluding the U.S. territory's public entities from federal bankruptcy law was unconstitutional.
"Congress and the Obama administration need to partner with Puerto Rico by providing real support and tools so that Puerto Rico can do the hard work it will take to get on a path toward stability and prosperity," Clinton said in a statement provided to Reuters.
"As a first step, Congress should provide Puerto Rico the same authority that states already have to enable severely distressed government entities, including municipalities and public corporations, to restructure their debts under Chapter 9 of the Bankruptcy Code," Clinton added.
Democratic Presidential candidate Hillary Clinton participates in a grassroots organizing event in College Park at Dartmouth College July 3, 2015 in Hanover, New Hampshire. (Photo by Darren McCollester/Getty Images)
The White House said last week that there is "no one in the administration" that is "contemplating a federal bailout of Puerto Rico" but that the U.S. Congress should "take a look at" whether Puerto Rico's government-owned corporations should be able to access Chapter 9 bankruptcy protection.
Congressional Republicans largely oppose such a step. Republican presidential candidate Jeb Bush said in April that he thinks Puerto Rico's public agencies should have the ability to use U.S. bankruptcy laws.
"We're not talking about a bailout, we're talking about a fair shot at success," Clinton said Tuesday.
Clinton said in the statement that the "inconsistent and incoherent" application of U.S. federal law to Puerto Rico contributed to its economic situation, noting high utility rates and unemployment have led to an economy that has shrunk for eight of the last nine years.
"One troubling example of this treatment is the lack of equity in federal funding for Puerto Rico under Medicaid and Medicare," Clinton said of health insurance programs sponsored by the U.S. government.
Clinton, also a former first lady, is the front runner for the Democratic nomination ahead of the general election in November 2016. (Reporting by Amanda Becker in Iowa; additional reporting by Megan Davies in New York; Editing by Nick Macfie)
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 22 hours ago.
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NBA union reportedly proposing to use TV revenue to help ex-players
The National Basketball Players Association will propose a plan to its members that will designate millions of dollars from the NBA's impending television revenue to aid former players' health insurance costs, Yahoo Sports/FOX Sports 1 NBA Insider Adrian Wojnarowski reported.
Reported by FOX Sports 23 hours ago.
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Quadrino Law Group Relocates to New Headquarters In Melville, New York
The firm has moved to new, expanded offices at 225 Broad Hollow Road, Melville, New York 11747
(PRWEB) July 07, 2015
Quadrino Law Group is pleased to announce the relocation of the firm's headquarters to 225 Broad Hollow Road, Suite 304, Melville, New York 11747. The new facility is a state of the art building, located with easy access to New York City's airports, highways, and rail lines.
Richard Quadrino, the firm's CEO and founder, said, "We are pleased to service our clients from such a premier location and we look forward to our continued success in our practice of law in Melville -- Long Island's main business hub."
The firm handles Health Insurance Claims and Litigation for medical providers, Insurance Class Actions, and Complex Insurance and Commercial Litigation. The lawyers in the firm are each accomplished and credentialed within their fields and have track records of success for clients around the United States. Reported by PRWeb 22 hours ago.
(PRWEB) July 07, 2015
Quadrino Law Group is pleased to announce the relocation of the firm's headquarters to 225 Broad Hollow Road, Suite 304, Melville, New York 11747. The new facility is a state of the art building, located with easy access to New York City's airports, highways, and rail lines.
Richard Quadrino, the firm's CEO and founder, said, "We are pleased to service our clients from such a premier location and we look forward to our continued success in our practice of law in Melville -- Long Island's main business hub."
The firm handles Health Insurance Claims and Litigation for medical providers, Insurance Class Actions, and Complex Insurance and Commercial Litigation. The lawyers in the firm are each accomplished and credentialed within their fields and have track records of success for clients around the United States. Reported by PRWeb 22 hours ago.
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Beyond King v. Burwell: How New Prices and Payments are Changing the Way We'll Receive Healthcare under the Affordable Care Act
In the wake of the recent King v. Burwell Supreme Court decision to uphold subsidies for the 34 state health insurance exchanges under the Affordable Care Act, it's worth understanding why losing them would've made insurance for nearly 6.4 million Americans unaffordable. It boils down to two numbers: the cost of delivering care and the rate that hospitals are paid to do so.
Most physicians are currently paid under a 'fee-for-service' model, a flat sum for each individual test or procedure provided to a patient. It's no surprise then that the number of prescribed tests has skyrocketed over the past two decades as hospitals attempt to increase revenue. For any given condition, the United States both orders and spends more on unnecessary screens and treatments than any other country on Earth, often with no better outcome for the patient. An MRI in the United States costs five times as much as the same MRI in France. Most countries negotiate with healthcare providers to set rates at acceptance levels. Prices are either directly set by the government or are negotiated upon by providers and insurers prior to delivering care. In both instances, the price of healthcare is generally much lower than that of the United States, where, outside of public programs like Medicaid and Medicare, providers can usually charge whatever they can get away with to make up for the high costs of pharmaceuticals and medical devices. Furthermore, the amount paid for a given service is identical regardless of whether the outcome is good or bad. Imagine going to a restaurant and paying the same amount for a meal that left you satisfied and another--that you likely didn't order but were given anyways--that gave you food poisoning. That's how fee-for-service works.
The lack of accountability on the quality of care compounded with a healthcare financing model that rewards hospitals for increasing volume, not value, was a recipe for disaster, causing healthcare spending to jump to nearly 20% of GDP, but left the rate of increase in life expectancy in the dust compared to Europe and Japan.
The U.S. first tried to address rising healthcare costs in the 1990s through a model known as 'global capitation'. Providers were paid a single pre-defined sum to cover all treatment for each patient. If a physician or healthcare organization delivered care to a patient at a cost less than the sum it received, it turned a profit. If it overshot the sum, it lost money. While this model rewarded physicians for spending less, it did nothing to reward physicians for improving outcomes. As a result, physicians had a financial incentive to avoid expensive treatment plans and costly patients, resulting in poor quality care.
In 2012, as an extension of the Affordable Care Act, the Obama Administration launched the Pioneer Accountable Care Organization (ACO), a 'global payments' model that rewards hospitals that deliver quality care at costs lower than a pre-defined benchmark and punishes hospitals that overspend. If hospitals in the program spend below expected costs, they keep 70% of the savings; the other 30% goes to the federal government. If they spend more than expected, they pay the federal government the difference.
Some policymakers and physicians worry that the Affordable Care Act's global, or bundled, payments model is simply disguised capitation. Although bundled payments have a cost control structure similar to global capitation, they have been flexibly designed to avoid its pitfalls by rewarding value-based patient care. Physicians are paid for each patient based on how much treatment would cost for a given clinically defined episode of care. This risk adjustment allows for variability in global payments based on the illness burden of a provider's patient population. Additionally, unlike capitation, providers are directly rewarded for improving patient outcomes, incentivizing consistently-measured, high-quality care. Some global payment models do not involve any punishments for overspending, as opposed to the Pioneer ACO, but continue to reward strong physician performance.
Over the last two years, the Pioneer ACO program has saved $384 million in healthcare costs. In combination with the Medicare Shared Savings Program (MSSP), another global payments initiative, it has contracted with 154 organizations in forty states. All hospitals involved showed improved performance quality measures, readmission rates, and cholesterol level monitoring. Furthermore, patients gave similar rates of satisfaction compared to previous models of care and even reported better access to physicians. The end result is higher quality care at a lower cost for patients.
While Pioneer is illustrative of a step towards progress in managing healthcare costs, it hasn't been perfect. Most 2012 Pioneer participants were large, sophisticated hospital networks with the capability to rapidly change their method of delivering care, very different from the public hospitals that serve the populations that need health reform the most. Of the 32 hospitals that registered for Pioneer in 2012, 13 dropped out and 14 failed to produce any substantial savings. However, most dropout hospital networks still plan to pursue less-aggressive value-based payment models, such as MSSP, and found their experience with Pioneer to be an effective transition for both patients and providers to the global payments model. Additionally, the practice of measuring and collecting data on physician performance and patient outcomes will give both the federal government and providers a more transparent understanding of what treatments work, providing evidence-based information to set prices based on the value of individual treatments. If there's any one change that will reduce U.S. healthcare costs in the long term, it's lowering prices.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 21 hours ago.
Most physicians are currently paid under a 'fee-for-service' model, a flat sum for each individual test or procedure provided to a patient. It's no surprise then that the number of prescribed tests has skyrocketed over the past two decades as hospitals attempt to increase revenue. For any given condition, the United States both orders and spends more on unnecessary screens and treatments than any other country on Earth, often with no better outcome for the patient. An MRI in the United States costs five times as much as the same MRI in France. Most countries negotiate with healthcare providers to set rates at acceptance levels. Prices are either directly set by the government or are negotiated upon by providers and insurers prior to delivering care. In both instances, the price of healthcare is generally much lower than that of the United States, where, outside of public programs like Medicaid and Medicare, providers can usually charge whatever they can get away with to make up for the high costs of pharmaceuticals and medical devices. Furthermore, the amount paid for a given service is identical regardless of whether the outcome is good or bad. Imagine going to a restaurant and paying the same amount for a meal that left you satisfied and another--that you likely didn't order but were given anyways--that gave you food poisoning. That's how fee-for-service works.
The lack of accountability on the quality of care compounded with a healthcare financing model that rewards hospitals for increasing volume, not value, was a recipe for disaster, causing healthcare spending to jump to nearly 20% of GDP, but left the rate of increase in life expectancy in the dust compared to Europe and Japan.
The U.S. first tried to address rising healthcare costs in the 1990s through a model known as 'global capitation'. Providers were paid a single pre-defined sum to cover all treatment for each patient. If a physician or healthcare organization delivered care to a patient at a cost less than the sum it received, it turned a profit. If it overshot the sum, it lost money. While this model rewarded physicians for spending less, it did nothing to reward physicians for improving outcomes. As a result, physicians had a financial incentive to avoid expensive treatment plans and costly patients, resulting in poor quality care.
In 2012, as an extension of the Affordable Care Act, the Obama Administration launched the Pioneer Accountable Care Organization (ACO), a 'global payments' model that rewards hospitals that deliver quality care at costs lower than a pre-defined benchmark and punishes hospitals that overspend. If hospitals in the program spend below expected costs, they keep 70% of the savings; the other 30% goes to the federal government. If they spend more than expected, they pay the federal government the difference.
Some policymakers and physicians worry that the Affordable Care Act's global, or bundled, payments model is simply disguised capitation. Although bundled payments have a cost control structure similar to global capitation, they have been flexibly designed to avoid its pitfalls by rewarding value-based patient care. Physicians are paid for each patient based on how much treatment would cost for a given clinically defined episode of care. This risk adjustment allows for variability in global payments based on the illness burden of a provider's patient population. Additionally, unlike capitation, providers are directly rewarded for improving patient outcomes, incentivizing consistently-measured, high-quality care. Some global payment models do not involve any punishments for overspending, as opposed to the Pioneer ACO, but continue to reward strong physician performance.
Over the last two years, the Pioneer ACO program has saved $384 million in healthcare costs. In combination with the Medicare Shared Savings Program (MSSP), another global payments initiative, it has contracted with 154 organizations in forty states. All hospitals involved showed improved performance quality measures, readmission rates, and cholesterol level monitoring. Furthermore, patients gave similar rates of satisfaction compared to previous models of care and even reported better access to physicians. The end result is higher quality care at a lower cost for patients.
While Pioneer is illustrative of a step towards progress in managing healthcare costs, it hasn't been perfect. Most 2012 Pioneer participants were large, sophisticated hospital networks with the capability to rapidly change their method of delivering care, very different from the public hospitals that serve the populations that need health reform the most. Of the 32 hospitals that registered for Pioneer in 2012, 13 dropped out and 14 failed to produce any substantial savings. However, most dropout hospital networks still plan to pursue less-aggressive value-based payment models, such as MSSP, and found their experience with Pioneer to be an effective transition for both patients and providers to the global payments model. Additionally, the practice of measuring and collecting data on physician performance and patient outcomes will give both the federal government and providers a more transparent understanding of what treatments work, providing evidence-based information to set prices based on the value of individual treatments. If there's any one change that will reduce U.S. healthcare costs in the long term, it's lowering prices.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 21 hours ago.
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Take Down the Confederate Flag - And Raise Up Medicaid Expansion
It's tempting, this summery week, to sit and savor the sweet victory that was handed us by the Supreme Court in late June with the King v. Burwell decision. The court's ruling protected the health care subsidies that allow 6.4 million people to afford their health insurance.
Many of those are people who have health insurance and routine health care for the first time in their lives because of the Affordable Care Act. Now they can breathe a little easier, knowing they can go to the doctor when they are sick, get immunizations, medications and preventive care.
The Supreme Court's ruling came a week after the horrifying news that nine people were killed while praying inside the Emanuel AME church in Charleston, South Carolina.
One of those killed was Rev. Clementa Pinckney, a South Carolina senator who was a tireless advocate for Medicaid expansion in his state. Some called him the "moral conscience of the South Carolina legislature."
The killings in Charleston spurred the long overdue call to remove the Confederate flag from public buildings and from license plates. Removing the symbols of racism and inequity is a significant step. Just as critical is the need to remove racist barriers to quality health care.
We must continue to fight for the nearly four million people who still don't have access to health care because of their state lawmakers' refusal to expand Medicaid. Nearly 90 percent of those in the health care coverage gap live in the South, and they are disproportionately people of color.
It's time to stop debating the right to health care - that discussion is done. Now it's time to make quality health care a reality for everyone. The Affordable Care Act is here to stay.
Billions of dollars in federal funding is in place for legislators to extend health care to everyone in their states. Yet, lawmakers in 19 states have refused to accept that funding - 13 of those states are in the South.
It's time to end policies that perpetuate systemic racism. I ask these legislators and governors - what are you so afraid of that you would deny a mother a visit to the doctor, or a father medication he needs to be strong for his children?
Refusal to expand Medicaid and provide quality health care to all remains a stark and shameful example of our nation's failure to overcome persistent racial disparities.
President Obama, in his elegant eulogy in Charleston, said: "It would be a betrayal of everything Reverend Pinckney stood for, I believe, if we allowed ourselves to slip into a comfortable silence again."
We must all remain uncomfortable - and outspoken - until racism, fear and hate are erased, in our symbols and in our policies. One step must lead to the next step.
Taking down the Confederate flags would be a bold symbolic statement that reconciliation has at long last begun. Expanding Medicaid to millions of people would show that we really mean it.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 19 hours ago.
Many of those are people who have health insurance and routine health care for the first time in their lives because of the Affordable Care Act. Now they can breathe a little easier, knowing they can go to the doctor when they are sick, get immunizations, medications and preventive care.
The Supreme Court's ruling came a week after the horrifying news that nine people were killed while praying inside the Emanuel AME church in Charleston, South Carolina.
One of those killed was Rev. Clementa Pinckney, a South Carolina senator who was a tireless advocate for Medicaid expansion in his state. Some called him the "moral conscience of the South Carolina legislature."
The killings in Charleston spurred the long overdue call to remove the Confederate flag from public buildings and from license plates. Removing the symbols of racism and inequity is a significant step. Just as critical is the need to remove racist barriers to quality health care.
We must continue to fight for the nearly four million people who still don't have access to health care because of their state lawmakers' refusal to expand Medicaid. Nearly 90 percent of those in the health care coverage gap live in the South, and they are disproportionately people of color.
It's time to stop debating the right to health care - that discussion is done. Now it's time to make quality health care a reality for everyone. The Affordable Care Act is here to stay.
Billions of dollars in federal funding is in place for legislators to extend health care to everyone in their states. Yet, lawmakers in 19 states have refused to accept that funding - 13 of those states are in the South.
It's time to end policies that perpetuate systemic racism. I ask these legislators and governors - what are you so afraid of that you would deny a mother a visit to the doctor, or a father medication he needs to be strong for his children?
Refusal to expand Medicaid and provide quality health care to all remains a stark and shameful example of our nation's failure to overcome persistent racial disparities.
President Obama, in his elegant eulogy in Charleston, said: "It would be a betrayal of everything Reverend Pinckney stood for, I believe, if we allowed ourselves to slip into a comfortable silence again."
We must all remain uncomfortable - and outspoken - until racism, fear and hate are erased, in our symbols and in our policies. One step must lead to the next step.
Taking down the Confederate flags would be a bold symbolic statement that reconciliation has at long last begun. Expanding Medicaid to millions of people would show that we really mean it.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 19 hours ago.
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What Do Americans Think About Economic Inequality?
Are Americans disturbed about growing economic inequality in the United States?
Numerous opinion surveys in recent years indicate that substantial majorities of Americans not only recognize that the gap between the wealthy and everyone else has grown, but favor greater economic equality. A Gallup poll conducted in April 2015 found that 63 percent of respondents believed that wealth in the United States should be distributed more evenly. Similarly, a New York Times/CBS News poll conducted in late May 2015 revealed that 66 percent of Americans favored the redistribution of "the money and wealth in this country" along more egalitarian lines.
A key reason for Americans' desire to share the wealth more equally is that many of them think that riches are amassed unfairly. A Pew Research Center survey in January 2014 found that 60 percent of respondents believed that "the economic system in this country unfairly favors the wealthy." Asked about why someone was wealthy, 51 percent said: "Because he or she had more advantages." The New York Times/CBS News poll reported that 61 percent of respondents believed that "just a few people at the top have a chance to get ahead."
Furthermore, despite the many billions of dollars U.S. corporations lavish on advertising and other forms of public relations to give themselves a positive image, Americans are remarkably wary of these giant economic enterprises. According to a Gallup poll of June 2014, only 21 percent of Americans had a great deal of confidence in big business. By contrast, 40 percent of respondents said they had very little or no confidence in it. A year later, another Gallup survey found that Americans' confidence in big business remained stuck at 21 percent -- below historic norms. A survey done by the public relations industry in 2014 reported that, although Americans valued corporate products, 47 percent of the public said that, when it came to ethics, they had little or no trust in major corporations. Health insurance companies, pharmaceutical companies, banks, and energy companies were viewed as the least trustworthy.
By contrast, Americans have a more sympathetic attitude toward considerably less wealthy groups that challenge corporate dominance. The June 2015 Gallup survey found a higher rate of public confidence in unions and, especially, in small businesses. In August 2014, another Gallup survey found that Americans approved of unions by 53 to 38 percent. That was up from five years before, when 48 percent approved and 45 percent disapproved of them. Questioned in the New York Times/CBS News survey, 74 percent of respondents said that large corporations had "too much influence" in "American life and politics today." When it came to unions, however, only 37 percent said they had "too much influence," while 54 percent said they had "too little influence" or "about the right amount of influence."
In an apparent attempt to downplay these signs of public dismay with the economic playing field, the American Enterprise Institute -- a leading champion of the wealthy and corporations -- argued recently that "inequality does not appear to be a top-tier concern" for Americans. This big business think tank also trumpeted the claim that 70 percent of Americans "believe that most people are better off in a free market economy even though some people are rich and some are poor."
Nevertheless, this dismissive appraisal of public concern is called into question by the widespread demand for government action to counter economic inequality. The Pew Research Center's January 2014 opinion poll found that 82 percent of American respondents favored government action to reduce poverty and 69 percent supported government action "to reduce the gap between the rich and everyone else." In May of this year, the New York Times/CBS News survey reported that, by 57 to 39 percent, Americans favored using government to "reduce the gap between the rich and the poor in this country."
Furthermore, most Americans back specific government programs along these lines. The New York Times/CBS News survey found broad public support for the following programs: raising the minimum wage (71 percent); increasing taxes on the rich (68 percent); and requiring employers to provide paid family leave (80 percent). Even the more unusual approach of limiting the pay of top corporate executives received the backing of 50 percent. Other recent polls reveal similar priorities: between 71 percent (CNN/ORC) and 73 percent (Pew) of Americans favor raising the federal minimum wage; 52 percent favor "heavy taxes on the rich" (Gallup); and 54 percent support raising taxes on the wealthy and the corporations (Pew).
Against this backdrop, it is hardly surprising that a relatively unknown figure like U.S. Senator Bernie Sanders, long a sharp critic of the economic divide in American life, is surging in the polls and drawing large, enthusiastic crowds in his campaign for the Democratic presidential nomination. Nor is it any wonder that Hillary Clinton, in her own campaign for that nomination, has started to emphasize economic unfairness. Indeed, even some Republican aspirants for the presidency have begun to adopt a populist rhetoric -- although the specific policies they advocate continue to advance the narrow economic interests of the wealthy and the corporations.
Even so, when the electioneering is over, will the U.S. government really take action to promote greater economic equality? That's anyone's guess. But it's clearly what most Americans want.
Dr. Lawrence Wittner (www.lawrenceswittner.com) is Professor of History emeritus at SUNY/Albany. His latest book is a satirical novel about university corporatization and rebellion, What's Going On at UAardvark?
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 18 hours ago.
Numerous opinion surveys in recent years indicate that substantial majorities of Americans not only recognize that the gap between the wealthy and everyone else has grown, but favor greater economic equality. A Gallup poll conducted in April 2015 found that 63 percent of respondents believed that wealth in the United States should be distributed more evenly. Similarly, a New York Times/CBS News poll conducted in late May 2015 revealed that 66 percent of Americans favored the redistribution of "the money and wealth in this country" along more egalitarian lines.
A key reason for Americans' desire to share the wealth more equally is that many of them think that riches are amassed unfairly. A Pew Research Center survey in January 2014 found that 60 percent of respondents believed that "the economic system in this country unfairly favors the wealthy." Asked about why someone was wealthy, 51 percent said: "Because he or she had more advantages." The New York Times/CBS News poll reported that 61 percent of respondents believed that "just a few people at the top have a chance to get ahead."
Furthermore, despite the many billions of dollars U.S. corporations lavish on advertising and other forms of public relations to give themselves a positive image, Americans are remarkably wary of these giant economic enterprises. According to a Gallup poll of June 2014, only 21 percent of Americans had a great deal of confidence in big business. By contrast, 40 percent of respondents said they had very little or no confidence in it. A year later, another Gallup survey found that Americans' confidence in big business remained stuck at 21 percent -- below historic norms. A survey done by the public relations industry in 2014 reported that, although Americans valued corporate products, 47 percent of the public said that, when it came to ethics, they had little or no trust in major corporations. Health insurance companies, pharmaceutical companies, banks, and energy companies were viewed as the least trustworthy.
By contrast, Americans have a more sympathetic attitude toward considerably less wealthy groups that challenge corporate dominance. The June 2015 Gallup survey found a higher rate of public confidence in unions and, especially, in small businesses. In August 2014, another Gallup survey found that Americans approved of unions by 53 to 38 percent. That was up from five years before, when 48 percent approved and 45 percent disapproved of them. Questioned in the New York Times/CBS News survey, 74 percent of respondents said that large corporations had "too much influence" in "American life and politics today." When it came to unions, however, only 37 percent said they had "too much influence," while 54 percent said they had "too little influence" or "about the right amount of influence."
In an apparent attempt to downplay these signs of public dismay with the economic playing field, the American Enterprise Institute -- a leading champion of the wealthy and corporations -- argued recently that "inequality does not appear to be a top-tier concern" for Americans. This big business think tank also trumpeted the claim that 70 percent of Americans "believe that most people are better off in a free market economy even though some people are rich and some are poor."
Nevertheless, this dismissive appraisal of public concern is called into question by the widespread demand for government action to counter economic inequality. The Pew Research Center's January 2014 opinion poll found that 82 percent of American respondents favored government action to reduce poverty and 69 percent supported government action "to reduce the gap between the rich and everyone else." In May of this year, the New York Times/CBS News survey reported that, by 57 to 39 percent, Americans favored using government to "reduce the gap between the rich and the poor in this country."
Furthermore, most Americans back specific government programs along these lines. The New York Times/CBS News survey found broad public support for the following programs: raising the minimum wage (71 percent); increasing taxes on the rich (68 percent); and requiring employers to provide paid family leave (80 percent). Even the more unusual approach of limiting the pay of top corporate executives received the backing of 50 percent. Other recent polls reveal similar priorities: between 71 percent (CNN/ORC) and 73 percent (Pew) of Americans favor raising the federal minimum wage; 52 percent favor "heavy taxes on the rich" (Gallup); and 54 percent support raising taxes on the wealthy and the corporations (Pew).
Against this backdrop, it is hardly surprising that a relatively unknown figure like U.S. Senator Bernie Sanders, long a sharp critic of the economic divide in American life, is surging in the polls and drawing large, enthusiastic crowds in his campaign for the Democratic presidential nomination. Nor is it any wonder that Hillary Clinton, in her own campaign for that nomination, has started to emphasize economic unfairness. Indeed, even some Republican aspirants for the presidency have begun to adopt a populist rhetoric -- although the specific policies they advocate continue to advance the narrow economic interests of the wealthy and the corporations.
Even so, when the electioneering is over, will the U.S. government really take action to promote greater economic equality? That's anyone's guess. But it's clearly what most Americans want.
Dr. Lawrence Wittner (www.lawrenceswittner.com) is Professor of History emeritus at SUNY/Albany. His latest book is a satirical novel about university corporatization and rebellion, What's Going On at UAardvark?
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 18 hours ago.
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Why The Disdain for American Blue Collar Workers?
Most Americans like to think of the United States as a classless society. At its core, the American Dream has traditionally been defined by the freedom to choose a vocation; a strong belief in economic mobility; and a spirit of egalitarianism.
But, over the last several decades we are bearing witness to the growth of a disturbing streak of aristocratic bias in our cultural fabric and our national temperament; one which is increasingly manifesting itself in the views we hold, and the assumptions we make, about people who work with their hands.
Judgments about intelligence carry great weight in our society, and unfortunately Americans (especially American lawmakers and media elites) are developing an unsettling tendency to make sweeping assessments of people's intelligence, as well as their overall worthiness as human beings, based upon the kind of work they do.
Culturally-speaking, American comedy has increasingly become a forum for abusing blue collar career values in order to provide humor for the white collar class. American comedy is now being used to denigrate the worth of blue collar jobs; make fun of blue collar values; and mock the lifestyle of blue collar families.
If we are not careful, we can easily create a kind of second class system in America whereby only the voices of those whose vocations are seen as more praiseworthy will be heard when it comes to national policy discussions involving such issues as income inequality, economic opportunity and prosperity. The interests of those who toil in the blue collar occupations, or the so-called "dirty jobs," will be cast aside because of a destructive cultural bias that views white collar professions as more representative of innovation in the marketplace, and thus more worthy of policy and legal protections.
A generation or two ago, one could walk the halls of the U.S. Congress (or a state legislature, for that matter) and talk to Representatives, Senators and staff, regardless of political party, and almost universally find someone who had a father, a mother, a brother, or a sister who toiled in a blue-collar occupation. They understood the struggles and the needs that blue-collar workers possessed, and those concerns were almost always considered, if not outright addressed, during policy deliberations.
Today, sadly, that is no longer the case. On any given day, I can find myself speaking to members of Congress, their staffs, and members of the media. And I am more and more astonished at the lack of understanding of how blue collar workers must struggle to survive on a day-to-day basis in America today.
In previous generations, however, policymakers and media representatives held up blue-collar work as worthy vocations. Today, someone who works in the skilled construction trades or some other blue-collar profession is often times viewed by politicians and the media as a sad case. You can almost hear them wondering, privately, where the wrong turn happened. It's almost as if they are asking themselves how any smart, capable person could end up in such an ignoble career.
They don't seem to realize, as is the case with the men and women who comprise North America's Building Trades Unions, that a tremendous amount of highly technical work - both in the classroom and on the job - is required for them to become certified in their given profession. When a student graduates after a four or five year apprenticeship in one of our craft unions, he or she will often also graduate with an Associate's Degree from an accredited community college. And because of articulation agreements with some of the top colleges and universities in the nation, many of our apprentice graduates go on to receive their Bachelor's Degrees; all without incurring a mountain of student loan debt!
America's political and media elites would understand this more thoroughly if they would simply take the time to visit one of the 1,600 Joint Apprenticeship Training Centers (JATCs) located in every state of the nation that our unions and our contractors fund and operate to the tune of $1 billion in private-sector investments every year.
And what makes this almost comical (if it did not have such serious implications) is the fact that the vast majority of America's political and media elites have neither the intellectual or physical attributes necessary to become a skilled craft professional in America today. And yet, they cringe and scream when they cannot find a quality craft person to come to their homes to fix a leaky roof or a broken hot water heater.
Whereas a generation ago lawmakers, their staffs, and the media could instinctively understand and respect the blue-collar work experience because of a life lived by a grandfather, a father, a mother, an uncle, or a brother or sister, today's governing and media elites are several generations removed from such experiences. The work experiences of their immediate families are more often than not that of a businessman, lawyer, academic or some other professional, white-collar occupation. As such, they cannot, and they do not, intuitively grasp the importance of wage and benefit protections, workplace safety standards, or collective bargaining protections.
The current attacks on prevailing wage statutes are a perfect example.
In short, prevailing-wage laws require construction contractors doing business with the government to pay workers at wage levels determined to be "prevailing" in the local area in which the project is being constructed.
These laws were enacted in order to protect local construction crafts people from being undercut by migrant contractors who employed a migrant workforce, and who would enter a state and undercut established wage rates, take the contracts and move on.
Removing prevailing wage statutes provides an incentive for contractors to eliminate training costs, health insurance, and pension contributions in order to achieve low-bid status. In states that have prevailing wage laws, privately-funded pension and healthcare coverage, as well as privately-funded construction workforce training investments, are over 50% higher than in states without prevailing wage laws.
And that is vitally important to taxpayers, because when the construction industry does not pay for the long-term costs of training the next generation of skilled craft workers, as well as the long-term problems associated with the health and retirement costs of the last generation of construction workers those costs typically fall into the lap of the taxpayer.
Additionally, there is currently no solid evidence demonstrating that a state which has already repealed its prevailing wage law has actually realized any cost savings.
For example, in 1996 the state of Kentucky chose to apply its state prevailing wage law to state-funded school construction.
In 1997, the state of Ohio chose to do exactly the opposite. They moved to exempt school construction from its state prevailing wage law.
According to pro-repeal logic, Kentucky should have been faced with higher school construction costs, while Ohio would have seen a dramatic reduction.
However, median square foot costs for school construction did not increase in Kentucky, nor did they drop in Ohio.
All of which begs the question: Where did the money go in Ohio after prevailing wage rates were reduced, yet the state did not realize any savings?
The answer to this question brings me back to the inherent bias against blue collar work in America today.
Ohio did not realize any cost-savings because the money that was slashed from the paychecks of the construction craft workers was simply transferred to the pockets of the other entities involved in government-funded construction projects, including the developers, the architects, the Wall Street financiers, and other professional services.
For decades, prevailing wage laws benefited from bipartisan consensus. The original sponsors of the federal Davis-Bacon Act -- Pennsylvania Sen. James Davis and New York Rep. Robert Bacon -- were both Republicans, as was President Herbert Hoover, who signed the measure into law.
In fact, today over 50 Republican members of the U.S. House of Representatives are on record in support of the federal Davis-Bacon Act.
However, that has not stopped many ultra-conservatives, and some limousine liberals, from attacking these statutes.
In the U.S. House of Representatives, Rep. Steve King (R-IA) holds the distinction of being the most prodigious opponent of the Davis-Bacon Act in Congress.
He has been quoted as saying, "Davis-Bacon is bad for taxpayers and it is bad for small businesses and bad for workers needing a job. Repealing this outdated law would be a big step towards ensuring taxpayer dollars are being used wisely and efficiently."
What continuously amazes me is that the most vocal opponents of the federal Davis-Bacon Act, like Congressman King, more often than not come from districts where the federal wage determinations for construction work are already abysmally low.
Below are current federal wage determinations for highway construction involving the following crafts in Rep. King's home county of Carroll County, Iowa:
Concrete Finisher: $22.70/hour
Laborer: $13.85/hour
Heavy Equipment Operator: $22.95/hour
Construction work, especially highway construction, is seasonal work. Weather plays an integral role in the ability of a construction worker to earn a decent living. A good year for a construction worker is roughly 2,000 hours; while an average year is about 1,500 hours.
Therefore, the annual wages (before taxes) of the above-referenced crafts equates to:
Concrete Finisher: $45,400 (2,000 hours) & $34,050 (1,500 hours)
Laborer: $27,700 (2,000 hours) & $20,775 (1,500 hours)
Heavy Equipment Operator: $45,900 (2,000 hours) & $34,425 (1,500 hours)
These numbers are even more compelling when contrasted with the federal poverty line for a family of four, which for 2015 has been determined to be $24,250.
So, in effect, Representative King is arguing that the current prevailing wages for construction craft workers in his home county, which hover near or below the federal poverty rate for a family of four, are simply too damn high!
Thus is the disdain our culture has developed for America's blue collar professions.
As a nation, we are on a path that seemingly forgets that our society, and our economy, is critically dependent on the strength of those who build and maintain our infrastructure, and who go to work every day and build things with their hands.
It is high time that America, and specifically America's political and media elite, adopted a more unrestricted vision of our nation so that we once again value blue collar occupations (and the standards and protections that afford blue collar families a chance at a decent life) in order to create a truer, richer sense of all that is American, and all that is involved in the wide range of work that surrounds and sustains us.
Sean McGarvey is President of North America's Building Trades Unions
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 17 hours ago.
But, over the last several decades we are bearing witness to the growth of a disturbing streak of aristocratic bias in our cultural fabric and our national temperament; one which is increasingly manifesting itself in the views we hold, and the assumptions we make, about people who work with their hands.
Judgments about intelligence carry great weight in our society, and unfortunately Americans (especially American lawmakers and media elites) are developing an unsettling tendency to make sweeping assessments of people's intelligence, as well as their overall worthiness as human beings, based upon the kind of work they do.
Culturally-speaking, American comedy has increasingly become a forum for abusing blue collar career values in order to provide humor for the white collar class. American comedy is now being used to denigrate the worth of blue collar jobs; make fun of blue collar values; and mock the lifestyle of blue collar families.
If we are not careful, we can easily create a kind of second class system in America whereby only the voices of those whose vocations are seen as more praiseworthy will be heard when it comes to national policy discussions involving such issues as income inequality, economic opportunity and prosperity. The interests of those who toil in the blue collar occupations, or the so-called "dirty jobs," will be cast aside because of a destructive cultural bias that views white collar professions as more representative of innovation in the marketplace, and thus more worthy of policy and legal protections.
A generation or two ago, one could walk the halls of the U.S. Congress (or a state legislature, for that matter) and talk to Representatives, Senators and staff, regardless of political party, and almost universally find someone who had a father, a mother, a brother, or a sister who toiled in a blue-collar occupation. They understood the struggles and the needs that blue-collar workers possessed, and those concerns were almost always considered, if not outright addressed, during policy deliberations.
Today, sadly, that is no longer the case. On any given day, I can find myself speaking to members of Congress, their staffs, and members of the media. And I am more and more astonished at the lack of understanding of how blue collar workers must struggle to survive on a day-to-day basis in America today.
In previous generations, however, policymakers and media representatives held up blue-collar work as worthy vocations. Today, someone who works in the skilled construction trades or some other blue-collar profession is often times viewed by politicians and the media as a sad case. You can almost hear them wondering, privately, where the wrong turn happened. It's almost as if they are asking themselves how any smart, capable person could end up in such an ignoble career.
They don't seem to realize, as is the case with the men and women who comprise North America's Building Trades Unions, that a tremendous amount of highly technical work - both in the classroom and on the job - is required for them to become certified in their given profession. When a student graduates after a four or five year apprenticeship in one of our craft unions, he or she will often also graduate with an Associate's Degree from an accredited community college. And because of articulation agreements with some of the top colleges and universities in the nation, many of our apprentice graduates go on to receive their Bachelor's Degrees; all without incurring a mountain of student loan debt!
America's political and media elites would understand this more thoroughly if they would simply take the time to visit one of the 1,600 Joint Apprenticeship Training Centers (JATCs) located in every state of the nation that our unions and our contractors fund and operate to the tune of $1 billion in private-sector investments every year.
And what makes this almost comical (if it did not have such serious implications) is the fact that the vast majority of America's political and media elites have neither the intellectual or physical attributes necessary to become a skilled craft professional in America today. And yet, they cringe and scream when they cannot find a quality craft person to come to their homes to fix a leaky roof or a broken hot water heater.
Whereas a generation ago lawmakers, their staffs, and the media could instinctively understand and respect the blue-collar work experience because of a life lived by a grandfather, a father, a mother, an uncle, or a brother or sister, today's governing and media elites are several generations removed from such experiences. The work experiences of their immediate families are more often than not that of a businessman, lawyer, academic or some other professional, white-collar occupation. As such, they cannot, and they do not, intuitively grasp the importance of wage and benefit protections, workplace safety standards, or collective bargaining protections.
The current attacks on prevailing wage statutes are a perfect example.
In short, prevailing-wage laws require construction contractors doing business with the government to pay workers at wage levels determined to be "prevailing" in the local area in which the project is being constructed.
These laws were enacted in order to protect local construction crafts people from being undercut by migrant contractors who employed a migrant workforce, and who would enter a state and undercut established wage rates, take the contracts and move on.
Removing prevailing wage statutes provides an incentive for contractors to eliminate training costs, health insurance, and pension contributions in order to achieve low-bid status. In states that have prevailing wage laws, privately-funded pension and healthcare coverage, as well as privately-funded construction workforce training investments, are over 50% higher than in states without prevailing wage laws.
And that is vitally important to taxpayers, because when the construction industry does not pay for the long-term costs of training the next generation of skilled craft workers, as well as the long-term problems associated with the health and retirement costs of the last generation of construction workers those costs typically fall into the lap of the taxpayer.
Additionally, there is currently no solid evidence demonstrating that a state which has already repealed its prevailing wage law has actually realized any cost savings.
For example, in 1996 the state of Kentucky chose to apply its state prevailing wage law to state-funded school construction.
In 1997, the state of Ohio chose to do exactly the opposite. They moved to exempt school construction from its state prevailing wage law.
According to pro-repeal logic, Kentucky should have been faced with higher school construction costs, while Ohio would have seen a dramatic reduction.
However, median square foot costs for school construction did not increase in Kentucky, nor did they drop in Ohio.
All of which begs the question: Where did the money go in Ohio after prevailing wage rates were reduced, yet the state did not realize any savings?
The answer to this question brings me back to the inherent bias against blue collar work in America today.
Ohio did not realize any cost-savings because the money that was slashed from the paychecks of the construction craft workers was simply transferred to the pockets of the other entities involved in government-funded construction projects, including the developers, the architects, the Wall Street financiers, and other professional services.
For decades, prevailing wage laws benefited from bipartisan consensus. The original sponsors of the federal Davis-Bacon Act -- Pennsylvania Sen. James Davis and New York Rep. Robert Bacon -- were both Republicans, as was President Herbert Hoover, who signed the measure into law.
In fact, today over 50 Republican members of the U.S. House of Representatives are on record in support of the federal Davis-Bacon Act.
However, that has not stopped many ultra-conservatives, and some limousine liberals, from attacking these statutes.
In the U.S. House of Representatives, Rep. Steve King (R-IA) holds the distinction of being the most prodigious opponent of the Davis-Bacon Act in Congress.
He has been quoted as saying, "Davis-Bacon is bad for taxpayers and it is bad for small businesses and bad for workers needing a job. Repealing this outdated law would be a big step towards ensuring taxpayer dollars are being used wisely and efficiently."
What continuously amazes me is that the most vocal opponents of the federal Davis-Bacon Act, like Congressman King, more often than not come from districts where the federal wage determinations for construction work are already abysmally low.
Below are current federal wage determinations for highway construction involving the following crafts in Rep. King's home county of Carroll County, Iowa:
Concrete Finisher: $22.70/hour
Laborer: $13.85/hour
Heavy Equipment Operator: $22.95/hour
Construction work, especially highway construction, is seasonal work. Weather plays an integral role in the ability of a construction worker to earn a decent living. A good year for a construction worker is roughly 2,000 hours; while an average year is about 1,500 hours.
Therefore, the annual wages (before taxes) of the above-referenced crafts equates to:
Concrete Finisher: $45,400 (2,000 hours) & $34,050 (1,500 hours)
Laborer: $27,700 (2,000 hours) & $20,775 (1,500 hours)
Heavy Equipment Operator: $45,900 (2,000 hours) & $34,425 (1,500 hours)
These numbers are even more compelling when contrasted with the federal poverty line for a family of four, which for 2015 has been determined to be $24,250.
So, in effect, Representative King is arguing that the current prevailing wages for construction craft workers in his home county, which hover near or below the federal poverty rate for a family of four, are simply too damn high!
Thus is the disdain our culture has developed for America's blue collar professions.
As a nation, we are on a path that seemingly forgets that our society, and our economy, is critically dependent on the strength of those who build and maintain our infrastructure, and who go to work every day and build things with their hands.
It is high time that America, and specifically America's political and media elite, adopted a more unrestricted vision of our nation so that we once again value blue collar occupations (and the standards and protections that afford blue collar families a chance at a decent life) in order to create a truer, richer sense of all that is American, and all that is involved in the wide range of work that surrounds and sustains us.
Sean McGarvey is President of North America's Building Trades Unions
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 17 hours ago.
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The end of the clipboard check-in at your doctor's office is coming
New Mexico Health Connections has partnered with San Francisco-based mobile health company, LifeNexus, to offer NMHC members full access to and control of their health information via a platform called iChip. Officially rolled out this week, iChip is a Health Insurance Portability and Accountability Act (HIPAA)-compliant, cloud-based platform that integrates information from a patient's electronic health record with data pulled from the New Mexico Health Information Exchange, and makes it available…
Reported by bizjournals 16 hours ago.
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Obamacare slashes Washington uninsured rate by nearly 40 percent
At the end of June, the Supreme Court upheld the Affordable Care Act, which has made health insurance coverage available to millions of Americans. So, how much has Washington's state-run health insurance exchange — developed thanks to the ACA — changed the landscape of health coverage here? The Seattle Times last week published an analysis of how the availability of health insurance is impacting consumers and providers in Washington state, noting that while many more are covered, the plans…
Reported by bizjournals 16 hours ago.
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Why Hasn't Mobile Moved Medicine Further Yet?
The advent of the smartphone and mobile "apps" has opened the floodgates in hospital and clinic settings. With the ease of communication and newfound ability to access the web in the palm of our hand, the world has grown smaller for everyday users. Given its current host of systemic predicaments, the medical industry has justifiably shifted its attention to these new technologies to rectify inefficiencies.
Mobile technology raises expectations for health care consumers with the obvious prospect of improved communication between providers and patients. From having your physician's prescriptions on-the-go to being able to rapidly authorize medical record transfers in emergent situations, a promising solution to chronic issues obstructing submaximal care is at our doorstep.
Why, then, have we not reached our full potential? StartUp Health reported a burgeoning digital health sector with $6.9 billion in funding over 551 deals in 2014. Mobile health savvy health insurance company Oscar has captured significant market share with a whopping $320 million of funding and 40,000 members to date. While these strides prove consumer and investor belief in mobile technology, few applications have proven valuable to stakeholders' stringent criteria despite the sheer number of available applications.No single firm has demonstrated an intimate knowledge of the medical industry with delivery of high-quality tools that engage users. The lack of a clear winner in this noisy space has stunted broad adoption. For this reason, heavyweights in the technology industry like Google, Amazon, Facebook and Apple are exciting new entrants to the mobile health scene. In addition to the modular infrastructure offered by these established giants, the greatest value is their proven track record in customer validation and the user experience.
Established technology firms are by no means a shoe-in to win. The inherently low barrier to entry in the mobile health space is a double-edged sword. Though sparse quality control mechanisms are responsible for the sheer volume of subpar apps, they are also the reason why no innovator can be excluded from disrupting the space with the help of hired digital development shops. Excluding the fundamental challenges of operating within the health care industry (i.e. security and compliance standards), the delay in realizing the impact of mobile health technology can be distilled to four fundamental failures.
First, the end user is often forgotten. Often times, hospitals will excitedly reveal a mobile app that provides useful information but has such a poor interface that consumers fail to engage. Fewer apps have engaged users better than Instagram with over 300 million monthly active users. Instagram represents an exceptional product stakeholders in digital health care should not trivialize and learn from greatly. With two-thirds of the Americans owning a smartphone, the problem today is less so the access to digital tools than it is the actual engagement with them.
Second, the balance scale tilts heavily towards "wellness" and less towards "care." Though the return on investment for a mobile app may be greater for a healthy user willing to pay to track health and fitness metrics, those who actually need the increased vigilance in our health system are patients suffering from chronic disease or recovering from surgery. From the perspective of optimizing health outcomes and preventing frivolous costs, the attention needs to shift to vulnerable populations stressing the system. Furthermore, some insurance companies incentivize members by providing mobile apps under the moniker of "mHealth;" this terminology runs the risk of misleading individuals into skipping preventive care visits with their doctor. These apps should optimize medical management in the appropriate clinical context through physician supervision with appropriate FDA regulation as an "mCare" effort instead. The FDA already applies a risk-based approach for assessing mobile medical apps considered accessory to regulated medical devices or transformational into a regulated medical device. More of this patient-centered innovation is needed to solve our system's real issues.
Third, we fail to play to the strengths of smartphones in medicine. Smartphone technology is fundamentally advantageous because users have the freedom to move and communicate without restriction. Given that outcome metrics for the fields of orthopaedic surgery and rheumatology are predicated on physical mobility and patient-reported response to interventions, smartphone technologists should target these specialties first to realize benefits of afflicted patients in real-time. Joint replacement is one of the most common surgical interventions in the world, and being able to track steps taken, or the steps not taken, using the phone's native pedometer has the potential to alert a surgeon of post-operative complications in advance. The current strategy is focused on creating the best apps for the fittest individuals, but the most impactful technologies would be directed towards streamlining assurances of patient safety and physical activity for those with musculoskeletal conditions.
Finally, collaboration is lacking. Smartphones track and store the "small data" of millions of potential patients. When put together, the data tells a greater story. Numerous insidious diseases, from major depression to ovarian cancer, could be detected earlier and managed better when sharing our stored mobile data. While there do exist standout organizations like Fitbit which offer an open developer API, the current landscape is not set up to exchange user data. One such organization that recognizes the meaningful macroscopic conclusions that can be drawn from sharing mobile data is Open mHealth. Founded on the value of facilitating the sharing, storage, and processing of mobile data using an open infrastructure, Open mHealth has already made great strides among individuals with diabetes and veterans with PTSD.
Today, the smartphone is one of the greatest commercially available technologies. With emerging wearable devices like Apple Watch and Jawbone, who knows what our go-to device will be tomorrow? Thus, validation of mobile technology in medicine cannot hinge on today's version of devices. The evidence supporting application of mobile technologies to the medical workflow must maintain modularity and iterative capacity. One example of modular capacity is Apple's open source ResearchKit. Though in a perfect world Apple and Google would have partnered to cover nearly all smartphone users, ResearchKit has the laudable benefit of availability across all current and future iOS devices. Thus, validation is needed just once for survivorship of mobile technology in medicine to be ensured.
The potential for mobile technology in medicine is great, but the current landscape is not yet set up to transform the health care industry. There exists no reliable winner in the marketplace because either our goals are misaligned or our focus has been misplaced. If the objective is to help the well become more well, then we are thriving. However, if we choose to unbridle the capability of mobile technology in medicine by remembering the end user, helping the suffering, playing to the strengths of our resources, and enabling collaboration, we are on the precipice of a truly transformational era in modern medicine.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 15 hours ago.
Mobile technology raises expectations for health care consumers with the obvious prospect of improved communication between providers and patients. From having your physician's prescriptions on-the-go to being able to rapidly authorize medical record transfers in emergent situations, a promising solution to chronic issues obstructing submaximal care is at our doorstep.
Why, then, have we not reached our full potential? StartUp Health reported a burgeoning digital health sector with $6.9 billion in funding over 551 deals in 2014. Mobile health savvy health insurance company Oscar has captured significant market share with a whopping $320 million of funding and 40,000 members to date. While these strides prove consumer and investor belief in mobile technology, few applications have proven valuable to stakeholders' stringent criteria despite the sheer number of available applications.No single firm has demonstrated an intimate knowledge of the medical industry with delivery of high-quality tools that engage users. The lack of a clear winner in this noisy space has stunted broad adoption. For this reason, heavyweights in the technology industry like Google, Amazon, Facebook and Apple are exciting new entrants to the mobile health scene. In addition to the modular infrastructure offered by these established giants, the greatest value is their proven track record in customer validation and the user experience.
Established technology firms are by no means a shoe-in to win. The inherently low barrier to entry in the mobile health space is a double-edged sword. Though sparse quality control mechanisms are responsible for the sheer volume of subpar apps, they are also the reason why no innovator can be excluded from disrupting the space with the help of hired digital development shops. Excluding the fundamental challenges of operating within the health care industry (i.e. security and compliance standards), the delay in realizing the impact of mobile health technology can be distilled to four fundamental failures.
First, the end user is often forgotten. Often times, hospitals will excitedly reveal a mobile app that provides useful information but has such a poor interface that consumers fail to engage. Fewer apps have engaged users better than Instagram with over 300 million monthly active users. Instagram represents an exceptional product stakeholders in digital health care should not trivialize and learn from greatly. With two-thirds of the Americans owning a smartphone, the problem today is less so the access to digital tools than it is the actual engagement with them.
Second, the balance scale tilts heavily towards "wellness" and less towards "care." Though the return on investment for a mobile app may be greater for a healthy user willing to pay to track health and fitness metrics, those who actually need the increased vigilance in our health system are patients suffering from chronic disease or recovering from surgery. From the perspective of optimizing health outcomes and preventing frivolous costs, the attention needs to shift to vulnerable populations stressing the system. Furthermore, some insurance companies incentivize members by providing mobile apps under the moniker of "mHealth;" this terminology runs the risk of misleading individuals into skipping preventive care visits with their doctor. These apps should optimize medical management in the appropriate clinical context through physician supervision with appropriate FDA regulation as an "mCare" effort instead. The FDA already applies a risk-based approach for assessing mobile medical apps considered accessory to regulated medical devices or transformational into a regulated medical device. More of this patient-centered innovation is needed to solve our system's real issues.
Third, we fail to play to the strengths of smartphones in medicine. Smartphone technology is fundamentally advantageous because users have the freedom to move and communicate without restriction. Given that outcome metrics for the fields of orthopaedic surgery and rheumatology are predicated on physical mobility and patient-reported response to interventions, smartphone technologists should target these specialties first to realize benefits of afflicted patients in real-time. Joint replacement is one of the most common surgical interventions in the world, and being able to track steps taken, or the steps not taken, using the phone's native pedometer has the potential to alert a surgeon of post-operative complications in advance. The current strategy is focused on creating the best apps for the fittest individuals, but the most impactful technologies would be directed towards streamlining assurances of patient safety and physical activity for those with musculoskeletal conditions.
Finally, collaboration is lacking. Smartphones track and store the "small data" of millions of potential patients. When put together, the data tells a greater story. Numerous insidious diseases, from major depression to ovarian cancer, could be detected earlier and managed better when sharing our stored mobile data. While there do exist standout organizations like Fitbit which offer an open developer API, the current landscape is not set up to exchange user data. One such organization that recognizes the meaningful macroscopic conclusions that can be drawn from sharing mobile data is Open mHealth. Founded on the value of facilitating the sharing, storage, and processing of mobile data using an open infrastructure, Open mHealth has already made great strides among individuals with diabetes and veterans with PTSD.
Today, the smartphone is one of the greatest commercially available technologies. With emerging wearable devices like Apple Watch and Jawbone, who knows what our go-to device will be tomorrow? Thus, validation of mobile technology in medicine cannot hinge on today's version of devices. The evidence supporting application of mobile technologies to the medical workflow must maintain modularity and iterative capacity. One example of modular capacity is Apple's open source ResearchKit. Though in a perfect world Apple and Google would have partnered to cover nearly all smartphone users, ResearchKit has the laudable benefit of availability across all current and future iOS devices. Thus, validation is needed just once for survivorship of mobile technology in medicine to be ensured.
The potential for mobile technology in medicine is great, but the current landscape is not yet set up to transform the health care industry. There exists no reliable winner in the marketplace because either our goals are misaligned or our focus has been misplaced. If the objective is to help the well become more well, then we are thriving. However, if we choose to unbridle the capability of mobile technology in medicine by remembering the end user, helping the suffering, playing to the strengths of our resources, and enabling collaboration, we are on the precipice of a truly transformational era in modern medicine.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 15 hours ago.
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Colorado health insurance premium requests are too high, group says
A Colorado consumer advocacy group says insurance companies proposing 20 percent to 30 percent price hikes on 2016 health benefit plans can't justify them.
Reported by Denver Post 14 hours ago.
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Humana, Aetna set termination fees for deal
(Reuters) - Health insurer Humana Inc and buyer Aetna Inc set fees to be paid in the event of a failure of the largest deal in the health insurance industry.Aetna, which said last week it would buy Humana for about $37 billion in cash and stock, has to pay a termination fee of $1.69 billion, Humana said in a regulatory filing on Tuesday (http://1.usa.gov/1JSxWVr)
Humana would pay the larger rival $1.31 billion if the deal is terminated.
The deal faces antitrust issues as the authorities scrutinize how the combination will affect competition for each line of insurance: Medicare, Medicaid for the poor, individual insurance, commercial insurance for small and large businesses and the large employer business. (http://reut.rs/1LLQn1n)
Wall Street analysts and some antitrust experts have said that they expect the combination to be approved, although regulators may insist on some divestitures.
Aetna's chief executive said on Monday that he was confident about an antitrust approval for the deal to close by June 30, 2016. The company had already prepared for possible divestitures to address overlaps with Humana's business, he added.
Aetna is also required to pay Humana $1 billion if the deal is not closed by June 30, 2016, according to Tuesday's filing.
(Reporting by Rosmi Shaji in Bengaluru)
Join the conversation about this story » Reported by Business Insider 12 hours ago.
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New report stirs debate over Medicaid expansion in Utah
Salt Lake City, Utah- (ABC 4 Utah) – An estimated 66,000 Utahns have no option for health insurance right now.
Reported by abc4 13 hours ago.
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AmeriLife Welcomes College Interns
CLEARWATER, Fla., July 7, 2015 /PRNewswire/ -- AmeriLife®, the nation's premier annuity, life and health insurance marketing organization, brought aboard three exceptional college students for summer employment internships as part of a novel program designed to identify and cultivate...
Reported by PR Newswire 13 hours ago.
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NBA Union Likely To Soon Start Paying Ex-Players’ Health Care Costs
Tired of hearing stories of former players not being able to afford medical care, National Basketball Players Association executive director Michele Roberts and the union’s executives are readying a proposal for the league's player representatives that would pay for retired NBA players’ health care costs.
NBPA director of communications Tara Greco confirmed to The Huffington Post that the proposal will be discussed at a July 20 membership meeting but could not comment the likelihood of it being adopted. But league sources have told Yahoo’s Adrian Wojnarowski that the plan is expected to pass through “with ease.”
The plan will reportedly cost up to $15 million per year and come out of the gobs of money that the league and players will start to pull in as a result of a highly lucrative television deal beginning in the 2016-17 NBA season. The NBPA has already begun the process of tracking down former players who will benefit from the plan.
“This is what a union should do -- help take care of its members, past and present,” NBC Sports’ Kurt Helin wrote of the proposal. “These are the guys who helped build the foundation that the very lucrative NBA was built upon.”
Sports Illustrated shocked the sports world in 2009 when it estimated that roughly 60 percent of NBA players face financial stress within just five years of retiring from the league. Since then, a number of efforts have sprouted up to help the former players, including a partnership with a group of doctors who provide free care to some athletes and the imposition of a plan meant to force NBA players to save for retirement.
Stories of beloved players -- including Hall of Famer Earl Monroe -- struggling to afford health insurance in post-NBA life have popped up numerous times in recent years. But Deadspin’s Kevin Draper wonders whether this relatively small gesture is also a political move meant to engender sympathy for the players ahead of upcoming labor negotiations, which some fear might lead to a lockout or strike.
Of course, there's also the possibility it could be both a cynical ploy and a genuinely sympathetic gesture. After all, all players will be former players someday.
-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 13 hours ago.
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Defiant Oklahoma Governor Says Ten Commandments Monument Will Stay On State Capitol Grounds
WASHINGTON -- Oklahoma Gov. Mary Fallin (R), apparently defying a state Supreme Court ruling, has ordered that a monument to the Ten Commandments remain on the grounds of the state capitol.
Fallin on Tuesday said the monument was staying while the state attorney general appeals last week's 7-2 decision declaring that the monument was unconstitutional because public property cannot be used for religious purposes. Legislators opposed to the ruling are considering amending the state constitution to allow the monument to stay.
"Oklahoma is a state where we respect the rule of law, and we will not ignore the state courts or their decisions. However, we are also a state with three co-equal branches of government," Fallin said in a statement.
The American Civil Liberties Union, which brought the lawsuit challenging the monument and pursued it to the state Supreme Court, shrugged off Fallin's comments. Daniel Mach, director of the ACLU's Program on Freedom of Religion and Belief, told The Huffington Post he doesn't think the governor's statement disobeys the court decision.
"We fully expect the state to respect the rule of law and comply with the court's decision," Mach said.
Brady Henderson, legal director of the ACLU of Oklahoma, said if Fallin defies the court decision, it would amount to "chaos."
"She hasn't violated her oath yet, but she has made a statement that she's willing to do so," Henderson said. "The highest elected official in the state is essentially saying, 'I am willing to break the law.' My hope is very much that this is political grandstanding."
For Fallin to actually defy the decision, she would have to issue an executive order, because the Capitol Preservation Commission controls the capitol grounds, and the lawsuit concerned the commission, not the governor's office or the state legislature, Henderson explained.
"At the end of the day, I don't think it's the governor's decision," Henderson said.
The American Humanist Association, which advocates for the separation of church and state, denounced Fallin's statement.
"It's deeply disturbing that Gov. Fallin would break the law, brazenly defying the state's highest court in order to further her personal religious agenda," executive director Roy Speckhardt said in a statement to The Huffington Post. "The display of such an overtly religious monument violates the Constitution and makes individuals of minority faiths and philosophies feel like second-class citizens in their own state."
The controversial Ten Commandments monument was donated by state Rep. Mike Ritze (R) and installed in 2012. It has been the subject of many debates over the separation of church and state.
The Oklahoma constitution says that "no public money or property shall ever be appropriated, applied, donated, or used, directly or indirectly, for the use, benefit, or support of any sect, church, denomination, or system of religion, or for the use, benefit, or support of any priest, preacher, minister, or other religious teacher or dignitary, or sectarian institution as such."
State Rep. John Paul Jordan (R), who supports a constitutional amendment that would repeal this provision, told a local television station that the provision was "toxic."“It was written with discrimination in mind, and like a malignant tumor, needs to be removed completely," he said.
Jordan claimed the constitutional provision jeopardizes other commemorative items in the state capitol building, such as Native American artwork. He suggested it applies to people who have purchased health insurance under the Affordable Care Act and who receive health care at religious hospitals.
"It could possibly lead to the Native American artwork in the Capitol and State Supreme Court buildings being removed, as much of it is religious in nature," Jordan said. "In addition, it could lead to individuals on state funded insurance programs being unable to receive medical care as a large portion of hospitals in Oklahoma are supported by a religious affiliation."
Henderson accused the legislators of waging what he called a "campaign of disinformation."
"Right now, in the heat of the moment, it's easy for people to believe those outlandish things," he said.
Oklahoma voters would have to approve or reject the constitutional amendment if it moves forward in the legislature. That vote would not occur until November 2016, because the legislature's next session begins in February. Henderson said he hopes that if the amendment comes up for a vote, voters would have time to become more informed about the issue and the constitutional provision.
Meanwhile, the state attorney general has asked the state Supreme Court to rehear the case.
Mach said he doubted the court would grant the appeal. "The court got it right the first time, and there's no reason to think that it would change its mind," he said.-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 12 hours ago.
Fallin on Tuesday said the monument was staying while the state attorney general appeals last week's 7-2 decision declaring that the monument was unconstitutional because public property cannot be used for religious purposes. Legislators opposed to the ruling are considering amending the state constitution to allow the monument to stay.
"Oklahoma is a state where we respect the rule of law, and we will not ignore the state courts or their decisions. However, we are also a state with three co-equal branches of government," Fallin said in a statement.
The American Civil Liberties Union, which brought the lawsuit challenging the monument and pursued it to the state Supreme Court, shrugged off Fallin's comments. Daniel Mach, director of the ACLU's Program on Freedom of Religion and Belief, told The Huffington Post he doesn't think the governor's statement disobeys the court decision.
"We fully expect the state to respect the rule of law and comply with the court's decision," Mach said.
Brady Henderson, legal director of the ACLU of Oklahoma, said if Fallin defies the court decision, it would amount to "chaos."
"She hasn't violated her oath yet, but she has made a statement that she's willing to do so," Henderson said. "The highest elected official in the state is essentially saying, 'I am willing to break the law.' My hope is very much that this is political grandstanding."
For Fallin to actually defy the decision, she would have to issue an executive order, because the Capitol Preservation Commission controls the capitol grounds, and the lawsuit concerned the commission, not the governor's office or the state legislature, Henderson explained.
"At the end of the day, I don't think it's the governor's decision," Henderson said.
The American Humanist Association, which advocates for the separation of church and state, denounced Fallin's statement.
"It's deeply disturbing that Gov. Fallin would break the law, brazenly defying the state's highest court in order to further her personal religious agenda," executive director Roy Speckhardt said in a statement to The Huffington Post. "The display of such an overtly religious monument violates the Constitution and makes individuals of minority faiths and philosophies feel like second-class citizens in their own state."
The controversial Ten Commandments monument was donated by state Rep. Mike Ritze (R) and installed in 2012. It has been the subject of many debates over the separation of church and state.
The Oklahoma constitution says that "no public money or property shall ever be appropriated, applied, donated, or used, directly or indirectly, for the use, benefit, or support of any sect, church, denomination, or system of religion, or for the use, benefit, or support of any priest, preacher, minister, or other religious teacher or dignitary, or sectarian institution as such."
State Rep. John Paul Jordan (R), who supports a constitutional amendment that would repeal this provision, told a local television station that the provision was "toxic."“It was written with discrimination in mind, and like a malignant tumor, needs to be removed completely," he said.
Jordan claimed the constitutional provision jeopardizes other commemorative items in the state capitol building, such as Native American artwork. He suggested it applies to people who have purchased health insurance under the Affordable Care Act and who receive health care at religious hospitals.
"It could possibly lead to the Native American artwork in the Capitol and State Supreme Court buildings being removed, as much of it is religious in nature," Jordan said. "In addition, it could lead to individuals on state funded insurance programs being unable to receive medical care as a large portion of hospitals in Oklahoma are supported by a religious affiliation."
Henderson accused the legislators of waging what he called a "campaign of disinformation."
"Right now, in the heat of the moment, it's easy for people to believe those outlandish things," he said.
Oklahoma voters would have to approve or reject the constitutional amendment if it moves forward in the legislature. That vote would not occur until November 2016, because the legislature's next session begins in February. Henderson said he hopes that if the amendment comes up for a vote, voters would have time to become more informed about the issue and the constitutional provision.
Meanwhile, the state attorney general has asked the state Supreme Court to rehear the case.
Mach said he doubted the court would grant the appeal. "The court got it right the first time, and there's no reason to think that it would change its mind," he said.-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 12 hours ago.
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Taj union says many still lack health coverage
ATLANTIC CITY - Hundreds of workers at the Trump Taj Mahal casino still have no health insurance six months after their employer ended health-care coverage and gave them a stipend to buy insurance on their own, their union says.
Reported by philly.com 5 hours ago.
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AIS Newsletter Examines Potential Fixes to Massachusetts Medicare-Medicaid Duals Demo
In the wake of Fallon Total Care’s announcement that it will exit the Massachusetts Medicare-Medicaid dual-eligibles demo, Atlantic Information Services’ Medicare Advantage News takes a look at what CMS might do to make duals demos more viable.
Washington, DC (PRWEB) July 08, 2015
Last month, Fallon Total Care announced that it would leave the Massachusetts Medicare-Medicaid dual-eligibles demonstration program, or demo, raising doubts about the viability of the program. The Centers for Medicare & Medicaid Services (CMS) would not comment on the Fallon departure, but CMS’s Medicare-Medicaid Coordination Office (MMCO) and the agency as a whole are known to be actively seeking ways to help demo plans succeed, Atlantic Information Services, Inc.’s (AIS) Medicare Advantage News (MAN) reports in its July 2 issue, which examines some of the specific changes that have been made and could be made in the future to the duals program.
Actions being considered include streamlining reporting requirements, implementing administrative changes, and perhaps even changing the current risk-adjustment system, which lumps full duals served by the demo in the same category as less-expensive partial duals served by other plans for payment purposes.
One major fix could be continuing risk-protection programs such as risk corridors. Kit Gorton, M.D., president of the public plans division of Tufts Health Public Plan, notes to MAN that MMCO has extended risk corridors to the second and third years, which has the effect of boosting pay for the demo plans. But Lois Simon, the president of Commonwealth Care Alliance (CCA), tells MAN that she would like to see it extended through the whole length of the duals initiative. Tufts Health and CCA are the two plans remaining in the Massachusetts duals demo.
Another specific problem Gorton cites is having to submit encounter data in two different formats, one for CMS and one for Massachusetts. There are also two sets of regulations for handling appeals and grievances, two sets of timelines to meet, and the continuation of a system where the Medicare claim must be paid before Medicaid pays the balance.
Visit http://aishealth.com/archive/nman070215-01 to read the article in its entirety, which includes a table counting Massachusetts duals-demo enrollment as of May 1.
About Medicare Advantage News
Medicare Advantage News is the health care industry’s #1 source of timely news and business strategies about Medicare Advantage plans, product design, marketing, enrollment, market expansions, CMS audits, and countless federal initiatives in this hotly contested area of health insurance. Published biweekly since 1994 (when it was Medicare+Choice), the newsletter exists to help plans boost revenues, increase enrollees, cut costs and improve outcomes in Medicare Advantage and Medicaid managed care. Visit http://aishealth.com/marketplace/medicare-advantage-news for more information.
About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.
Contact
Jill Brown, Executive Editor
Atlantic Information Services, Inc.
(202) 775-9008, ext. 3058
jbrown(at)aishealth(dot)com Reported by PRWeb 2 hours ago.
Washington, DC (PRWEB) July 08, 2015
Last month, Fallon Total Care announced that it would leave the Massachusetts Medicare-Medicaid dual-eligibles demonstration program, or demo, raising doubts about the viability of the program. The Centers for Medicare & Medicaid Services (CMS) would not comment on the Fallon departure, but CMS’s Medicare-Medicaid Coordination Office (MMCO) and the agency as a whole are known to be actively seeking ways to help demo plans succeed, Atlantic Information Services, Inc.’s (AIS) Medicare Advantage News (MAN) reports in its July 2 issue, which examines some of the specific changes that have been made and could be made in the future to the duals program.
Actions being considered include streamlining reporting requirements, implementing administrative changes, and perhaps even changing the current risk-adjustment system, which lumps full duals served by the demo in the same category as less-expensive partial duals served by other plans for payment purposes.
One major fix could be continuing risk-protection programs such as risk corridors. Kit Gorton, M.D., president of the public plans division of Tufts Health Public Plan, notes to MAN that MMCO has extended risk corridors to the second and third years, which has the effect of boosting pay for the demo plans. But Lois Simon, the president of Commonwealth Care Alliance (CCA), tells MAN that she would like to see it extended through the whole length of the duals initiative. Tufts Health and CCA are the two plans remaining in the Massachusetts duals demo.
Another specific problem Gorton cites is having to submit encounter data in two different formats, one for CMS and one for Massachusetts. There are also two sets of regulations for handling appeals and grievances, two sets of timelines to meet, and the continuation of a system where the Medicare claim must be paid before Medicaid pays the balance.
Visit http://aishealth.com/archive/nman070215-01 to read the article in its entirety, which includes a table counting Massachusetts duals-demo enrollment as of May 1.
About Medicare Advantage News
Medicare Advantage News is the health care industry’s #1 source of timely news and business strategies about Medicare Advantage plans, product design, marketing, enrollment, market expansions, CMS audits, and countless federal initiatives in this hotly contested area of health insurance. Published biweekly since 1994 (when it was Medicare+Choice), the newsletter exists to help plans boost revenues, increase enrollees, cut costs and improve outcomes in Medicare Advantage and Medicaid managed care. Visit http://aishealth.com/marketplace/medicare-advantage-news for more information.
About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.
Contact
Jill Brown, Executive Editor
Atlantic Information Services, Inc.
(202) 775-9008, ext. 3058
jbrown(at)aishealth(dot)com Reported by PRWeb 2 hours ago.
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Retirement: Where Will You Be When The Music Stops?
Lately, I view everything through the prism of retirement. If we vacation in a new place, I envision what it would be like to live there after I retire. When I contemplate buying new clothes for work, I immediately amortize their value against the knowledge that I'll never wear them once there is no office to go to every day. I even question if the bag of fancy pistachio nuts in my grocery cart is an indulgence that I should probably start weaning myself from. Retirement, for me, won't include much wiggle room for luxuries like gourmet pistachios.
Then I give myself a "Moonstruck" slap and snap out of it. Retire? Who am I kidding? Retirement will be the time between when they wheel me out of the office on a gurney and the final bugle sounds. But you know what? I'm fine with that.
Work for me has never been a four-letter word. I love what I do, which is write for a living. In my current incarnation, I write a lot about what it's like to be a baby boomer at this particular crossroad of our lives -- the crossroad where we contemplate retirement, trying it on like a new pair of shoes and seeing whether it feels good to us. Eventually, we all need new shoes, right? And eventually, we all do stop work. The big question is "when?"
If I've learned anything covering retirement, it's this: No two of us feel the same about it -- and how we feel about retirement generally depends on how we feel about our jobs, assuming we still have them.
There is a lucky swath of us who found a way to turn our passions into a livelihood and for whom going to work each day has been a gift, not a chore. I'm solidly in this group. We see retirement as an event far down the road -- something that will find us, not something we are planning to do any time soon.
Then there are those who work to pay the bills and live for their days off. I'd lump my husband in here. Before he retired, he spent 32 years as an editor at a major daily newspaper. But his heart always belonged to the ponies. Even before he retired from newspapering, he had built a small stable of racehorses and was spending time learning the racing business. He has now retired from that second career as well, thanks in part to the IRS' insistence that horse-racing is a gentleman's hobby and not actually a career. Hard to argue that one.
I also know people for whom work isn't about the satisfaction or salary; it's about the benefits. Now in their early 60s, they are finally fully funding their 401ks and squirreling away vacation days to be able to cash them out when the big R rolls around. They work for health insurance and a prescription drug plan. They work for paid sick leave and paid dental coverage. With an eye on their retirement, they get every annually suggested medical test on time and stockpile their expensive medications, gearing up for when those things will cost them plenty out of pocket. They know the precise day they are eligible to get new glasses and are at the optometrist's wondering if this will be the last pair that someone else pays for. For them, the devil is in the employer-paid benefits. They are anchored to their jobs because they are either ineligible or can't afford those things on the open market.
Then of course there are those for whom a job is elusive. They lost their footing in the recession and have since bounced from one gig to another. This group struggles mightily and the sand has run through their hour glasses. Their skill sets may be hopelessly out of date or they may have wasted precious years chasing new jobs in the same dying industries that laid them off. They are living off their savings and know that it won't likely last as long as they need it to. This is retirement at its worst -- forced and inadequately planned for because nobody ever anticipates losing their job in their 50s. This group is counting the days until Social Security kicks in.
It often feels to me that figuring out when to retire is like playing a giant game of musical chairs. The financial quality of our active retirement years will depend on where we are when the music stops. If you own a home and it's paid off, you are sitting pretty. If you own a home that still requires your weekly paycheck to support, you likely will have moving boxes in your near future. And if you've been a renter your whole life, I pray that you've invested in something other than hedonistic pleasures because you haven't accrued the equity that you'll need to live off of.
And for those of us who remain gainfully employed at something we love, we just hope that the band keeps playing.Like Us On Facebook |
Follow Us On Twitter |
Earlier on Huff/Post50:-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 2 days ago.
Then I give myself a "Moonstruck" slap and snap out of it. Retire? Who am I kidding? Retirement will be the time between when they wheel me out of the office on a gurney and the final bugle sounds. But you know what? I'm fine with that.
Work for me has never been a four-letter word. I love what I do, which is write for a living. In my current incarnation, I write a lot about what it's like to be a baby boomer at this particular crossroad of our lives -- the crossroad where we contemplate retirement, trying it on like a new pair of shoes and seeing whether it feels good to us. Eventually, we all need new shoes, right? And eventually, we all do stop work. The big question is "when?"
If I've learned anything covering retirement, it's this: No two of us feel the same about it -- and how we feel about retirement generally depends on how we feel about our jobs, assuming we still have them.
There is a lucky swath of us who found a way to turn our passions into a livelihood and for whom going to work each day has been a gift, not a chore. I'm solidly in this group. We see retirement as an event far down the road -- something that will find us, not something we are planning to do any time soon.
Then there are those who work to pay the bills and live for their days off. I'd lump my husband in here. Before he retired, he spent 32 years as an editor at a major daily newspaper. But his heart always belonged to the ponies. Even before he retired from newspapering, he had built a small stable of racehorses and was spending time learning the racing business. He has now retired from that second career as well, thanks in part to the IRS' insistence that horse-racing is a gentleman's hobby and not actually a career. Hard to argue that one.
I also know people for whom work isn't about the satisfaction or salary; it's about the benefits. Now in their early 60s, they are finally fully funding their 401ks and squirreling away vacation days to be able to cash them out when the big R rolls around. They work for health insurance and a prescription drug plan. They work for paid sick leave and paid dental coverage. With an eye on their retirement, they get every annually suggested medical test on time and stockpile their expensive medications, gearing up for when those things will cost them plenty out of pocket. They know the precise day they are eligible to get new glasses and are at the optometrist's wondering if this will be the last pair that someone else pays for. For them, the devil is in the employer-paid benefits. They are anchored to their jobs because they are either ineligible or can't afford those things on the open market.
Then of course there are those for whom a job is elusive. They lost their footing in the recession and have since bounced from one gig to another. This group struggles mightily and the sand has run through their hour glasses. Their skill sets may be hopelessly out of date or they may have wasted precious years chasing new jobs in the same dying industries that laid them off. They are living off their savings and know that it won't likely last as long as they need it to. This is retirement at its worst -- forced and inadequately planned for because nobody ever anticipates losing their job in their 50s. This group is counting the days until Social Security kicks in.
It often feels to me that figuring out when to retire is like playing a giant game of musical chairs. The financial quality of our active retirement years will depend on where we are when the music stops. If you own a home and it's paid off, you are sitting pretty. If you own a home that still requires your weekly paycheck to support, you likely will have moving boxes in your near future. And if you've been a renter your whole life, I pray that you've invested in something other than hedonistic pleasures because you haven't accrued the equity that you'll need to live off of.
And for those of us who remain gainfully employed at something we love, we just hope that the band keeps playing.Like Us On Facebook |
Follow Us On Twitter |
Earlier on Huff/Post50:-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 2 days ago.
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