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Leveraging Stealth Networking to Facilitate HIPPA Compliance

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As communication technologies continue to evolve, many previously independent systems are now networked and operate in highly regulated environments. A prime example is a health care environment, where the protection of personal medical records and data is mandated by government. The Health Insurance Portability and Accountability Act (HIPAA) places specific obligations on businesses operating in these environments. HIPAA applies to Protected Health Information (PHI), which relates to a specific… Reported by bizjournals 7 hours ago.

How Will Scott Walker Pay For His Plan To Replace Obamacare? It's Largely Unclear

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Today in Minnesota, Wisconsin Gov. Scott Walker (R.) will put forth his plan to repeal and replace Obamacare. The plan offers sizable health insurance subsidies that every American would be eligible for, regardless of income. It would increase Medicare spending by more than $800 billion over ten years. But there’s one key question that Walker’s plan barely tries to answer: how it will keep all those promises without increasing the deficit. Reported by Forbes.com 5 hours ago.

GOP hopeful Scott Walker offers health plan with tax credits

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MINNEAPOLIS (AP) — Republican presidential candidate Scott Walker's plan for replacing President Barack Obama's health care law would extend refundable tax credits to help pay for private health insurance based on age instead of income, restructure Medicaid and allow people to shop for insurance across state lines. The Wisconsin governor provided details of his proposal to The Associated Press in advance of a Tuesday speech in suburban Minneapolis where he was to outline his first major policy initiative of the presidential campaign. For the period from April to June of this year, 11.4 percent of U.S. adults were uninsured, which translates to about 16 million people gaining coverage since the rollout of Obama's health care law in 2013. The Supreme Court in June upheld a key portion of the Affordable Care Act allowing for federal subsidies to defray the cost of coverage, a major defeat for opponents of the law. Walker would also change one of the most popular parts of the current law requiring insurance companies to allow people up to age 26 to stay on their parents' plan. Other elements of the plan would include extending a $1,000 refundable tax credit for anyone who signs up for a health savings account, allowing people to shop for health insurance across state lines, reorganizing Medicaid into smaller programs, and giving states more regulatory authority. Reported by SeattlePI.com 7 hours ago.

Zipari Announces the Launch of Scout: The Latest Release in Their Enterprise Suite of Products that Empower and Engage the Healthcare Consumer

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Healthcare technology start-up addresses gap between the quality and type of experiences consumers demand from brands in the retail space and those they could expect in the health insurance market.

Brooklyn, NY (PRWEB) August 18, 2015

Today Zipari, a healthcare software startup disrupting the insurance and benefits market announced its latest offering, Scout: Provider Search, a first-of-its-kind white-label doctor and facility search for health insurance carriers leveraging Zipari’s first-of-its-kind CX Customer Experience platform launched earlier this year.

Scout Provider Search allows health insurance carriers to offer consumers an easy, personalized experience when searching for doctors and medical facilities. Scout’s game-changing, mobile-first technology replaces existing legacy doctor searches that were never designed for the consumer market. Zipari’s solution pays for itself by generating leads from consumer prospects, and guiding prospective buyers to shop and buy insurance. The net is a modern consumer-friendly product that pays for itself with new customer acquisition.

In 2014, the Zipari founding team identified a major gap between the quality and type of experiences consumers demanded from brands in the retail space and those they could expect in the health insurance market. Unlike user-friendly sites like Amazon, the health insurance market wasn’t tailored to be consumer-facing at all, hence health insurance has long maintained very low customer satisfaction, and brand loyalty is nearly a foreign concept. This problem became especially rampant after the Affordable Care Act or 2013 caused payers and employers to shift much of the burden of cost onto the healthcare consumer. Seeing as there is a huge surge of consumers actively participating in the healthcare decision making process—it’s estimated that they will decide over $650 billion of health insurance buying decisions by 2018—Zipari decided to create a solution: Scout.

Scout is already available for all carriers to purchase and install in preparation for 2016 open enrollment period starting on November 1, 2015. Health Republic Insurance of New Jersey has deployed Scout to over 60,000 members so they can quickly find doctors and facilities,

“Zipari’s innovative provider search solution allows members to have the best possible experience while at the same time encouraging prospects to shop and enroll,” said Catherine Ann Sauner, COO of Health Republic Insurance of New Jersey.

The Scout solution allows prospective buyers of Health Republic Insurance of New Jersey to start researching their primary care physicians and specialists in preparation for purchasing insurance during open enrollment.

With Scout, carriers will provide their members with a highly intuitive, mobile-friendly solution for researching and managing their favorite doctors and facilities. At the same time, payers will be able to understand consumer sentiment at every step of the way by observing what doctors and facilities are viewed, contacted and saved. This information is segmented by consumer personas similar to modern retail sites such as Amazon or Yelp resulting in highly personalized experiences. Zipari’s CX Consumer Experience platform captures this information so that payers can view customer behavior and manage workflow in Customer Relationship Management (CRM) products such as Salesforce. This allows carriers to tune their offerings based on personas and personalized information, resulting in higher customer satisfaction and increased member renewals.

“Zipari was founded on the mission of making healthcare understandable for all consumers,” said Mark Nathan, co-founder and chief executive officer at Zipari. “Empowering consumers to make intelligent doctor and facility decisions to meet their individual healthcare needs, while helping carriers understand their customers and deliver optimal recommendations through an easy-to-use mobile-friendly interface, is an important step in this mission.”

Introducing Scout: Provider Search
Deployable in two to six weeks, Zipari’s Scout: Provider Search is an elegant solution that allows consumers to easily lookup healthcare providers covered by their health plan, compare doctors and facilities, and select physicians who meet their specific health needs. For carriers, the platform gives insurance professionals data-driven insights into the consumer decision-making process as it relates to finding and selecting a provider. In doing so, Zipari’s solution allows carriers to provide personalized provider recommendations, improve customer satisfaction and boost member retention throughout the process. Zipari makes this possible with the following custom-built features:· Mobile-first platform – designed with a mobile-first approach, Scout’s intuitive, easy-to-use technology platform allows carriers to engage with consumers through the channel they’re using most: their phone. With doctor’s details, like contact information and directions, combined with geolocation capabilities built directly into the solution, Scout’s mobile-friendly platform allows consumers to locate covered providers in their proximity whenever and wherever they are looking for doctors and facilities.
· Intelligent recommendations and decision support – combined with Zipari’s CX platform, Scout gives carriers data-driven insights into the actual healthcare needs of their constituencies and creates personas based on these needs. With these personas, Scout allows carriers to create intelligent, highly tailored, personalized healthcare provider recommendations for consumers.
· Provider comparisons – with Scout, consumers can easily compare different healthcare providers, filtering them by where they went to school, when they graduated, what languages they speak and specialties. Consumers can easily save these comparisons to a favorites list and share them via email.

Targeted, rich email campaigns – Scout allows carriers to identify potential leads, differentiate between regular and ‘hot’ leads, and create highly targeted, effective email campaigns to attract potential customers. Since most consumers begin looking for a new plan by identifying if their doctors are covered, carriers can utilize Scout to capture leads as prospects search for their doctors, and then follow up with tailored email campaigns highlighting the best plans for the consumer.

About Zipari
Zipari is disrupting the healthcare industry with its proprietary CX Customer Experience platform. Zipari streamlines processes, improves efficiency and integrates with major CRM solutions. The result is increased conversions, reduced acquisition costs and improved member satisfaction. Zipari is passionate about utilizing its extensive healthcare experience and technology to improve consumer satisfaction. Based in Brooklyn, New York, Zipari's primary investor is Vertical Venture Partners, a venture capital firm focused on investments in vertical markets. For more information, visit http://www.zipari.com.

About Health Republic Insurance of New Jersey
Based in Newark, NJ, Health Republic Insurance of New Jersey is a non-profit, Consumer Operated and Oriented Plan (CO-OP) that provides cost-effective and comprehensive healthcare coverage to individuals and small employer groups in New Jersey. HRINJ is a mission-and–health-based organization built to serve the best interests of its members. With no private shareholders, surplus revenues go towards ensuring individuals and small businesses served get the healthcare they need while providing ample services and reduced premiums.

HRINJ is one of 21 CO-OPs in the U.S. that resulted from the Affordable Care Act when it became law. The company provides a voice for individuals and businesses who want to take part in their health and the healthcare process. By 2016 the majority of its board of directors will be members of the plan, offering opportunities for input about the best way for HRINJ to deliver healthcare and attain optimal outcomes for members. Reported by PRWeb 7 hours ago.

First Draft: Scott Walker’s Health Care Plan Relies on Tax Credits to Buy Coverage

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Gov. Scott Walker’s health care plan makes a full repeal of Obamacare his top priority, then proposes a system of tax credits that would allow Americans who do not get health insurance through their employers to buy individual plans. Reported by NYTimes.com 6 hours ago.

Health Plan: Rubio Get's It Right

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So far it’s just an editorial. But it is an editorial that proposes two bold ideas that no other Republican presidential candidate has been willing to endorse: (1) tax relief for the purchase of health insurance should be the same for everyone – whether insurance is acquired at work, in [...] Reported by Forbes.com 4 hours ago.

Republican Policies Show The Party Doesn't Care About Children

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During the Republican debates, Cruz, Huckabee and Rubio made the case for defunding Planned Parenthood, even though the organization did not break any laws and doesn't receive any federal money towards providing abortions. Fetal tissue research was supported by GOP lawmakers up until recently. Mike Huckabee, whose small government vision includes using the National Guard to prevent women from having abortions, said that as a nation, we must protect children by banning abortion.

Republican politicians claim that as the party that advocates for children, it's alright for them to terminate crucial health services for millions of women. We shouldn't believe though that the Republican party actually cares about children. If they did, they wouldn't have spent months trying to prevent the unaccompanied minors on the border--as Rubio referred to them during the debates--from entering the country.

Conservatives make pro-child claims as one of their central points against gay marriage. While arguing against same sex marriage in Missouri, the conservative defendant argued that all children would experience "substantial risks" if gays could marry because it would diminish the value of heterosexual marriage, supposedly resulting in a grave decline in straight couples marrying. Never mind the children who will benefit from their gay parents marrying, or all those adopted by same-sex couples, as Justice Kagan pointed out during the Supreme Court hearing Obergefell v. Hodges, conservatives claim the right to discriminate for the sake of all children.

How can anyone earnestly believe that gay marriage will keep any straight couples from marrying, beyond that one Australian couple? But many opponents have argued in court that the heterosexual union will be so greatly de-sanctifying by gay marriage that fewer straight couples will bother having children anymore either, and conservatives need to think about birthrates in their states! This will also lead to an increase in single parenthood, and the resulting influx of single parenthood will cause parents to become selfish, which will not only burden their offspring but also the state!

In the Supreme Court case, conservative John Bursch even went so far as to incredulously claim that same sex-marriage, not failed abstinence-only policies, leads to teenage pregnancy. If only gay marriage were banned, this would reverse the national rise in out-of-wedlock births! Gay marriage is clearly what is causing teenage pregnancy as opposed to abstinence-only education, another signature GOP platform. In 2011, 80,000, or 40 per cent, of babies born in Florida were born to unmarried mothers. This must be because of gay marriage, which wasn't even legal there until 2015, and not because of statewide poverty rates or because Jeb Bush gutted Planned Parenthood in the state. (As a result, 20 per cent of Floridian women now lack access to a doctor.)

Or take Texas, where conservatives took funding from HIV prevention to put even more money towards abstinence-only education, an approach that has been demonstrated time and time again increase teen pregnancy rates and that children born to teenage mothers are more likely to live in poverty and to experience abuse and neglect. But it seems like Planned Parenthood harms children, instead of the party whose presidential contenders think that 11-year-old rape victims should be forced to give birth and who will not prevent young people from catching HPV and other preventable communicable diseases. And who cares about HIV infection in the state with the nation's third highest transmission rate per capita, right?

Because no party is a greater champion for children than the GOP. While raising the minimum wage to $10.10 per hour would help 14 million children living in poverty, Republicans Senators blocked a minimum wage hike. The party has better ideas for bringing millions of low-income American children and their families out of poverty. The official GOP website considers that these families would be better off without health insurance, despite Obamacare having increased coverage for millions of Americans, including 17 million children with preexisting conditions who can no longer be denied coverage. Because what could be better than their families experiencing medical bankruptcy?

Another of the website's suggestions for families living in poverty? Marrying someone with a job. After all, who needs a living wage when maybe you can marry someone with (hopefully living wage) a job? Just like the Koch brothers claiming they are pro-poor by trying to prevent an increase in the minimum wage and access to healthcare, the GOP renouncing Obamacare and keeping wages at standstill poverty levels is decidedly the opposite of pro-child.

Speaking of a champion for children, George W. Bush made Iraq one of the worst countries in the Middle East for children, including for hunger. The party does not mind increasing the number of hungry children in the U.S. either. In 2013, Republican Senators defunded SNAP food assistance by $5 billion, which impacted 48 million children, elderly, and low-income people. What if Republicans had an idea about how toxic the stress of living in poverty is on children's brains, posing the risk of lifelong physical and mental health problems? Despite the research on children and malnutrition in the U.S., conservative commentator guru Bill Kristof deemed "not the end of the world."

During the Republican debate, Marco Rubio alleged, "This is the most generous country in the world when it comes to immigration...There are a million people a year who legally immigrate to the United States, and people feel like we're being taken advantage of. We feel like despite our generosity, we're being taken advantage of." Similarly, Donald Trump posted on his website about immigration, "We will not be taken advantage of anymore." Yes, the United States, and more specifically, the Republican party, is so generous, that GOP Senators tried to get the children deported even more quickly.

President Obama has not been commendable on this issue either, but nothing pales in comparison to the wretched cold heartedness displayed by the GOP. The party has withheld funds for the minors to receive legal representation, making it much more likely that they be returned to the country they fled. They did this under the guise of being humane, despite evidence that children were killed after the U.S. government deported them back to their country of origin.

Marco Rubio doesn't want to help children fleeing for their lives. The type of immigrant Rubio generously thinks should be in the U.S. are, "Who never gets talked about in these debates... They've paid their fees, and they hired a lawyer, and they can't get in." Why should children fleeing the violent societies our government established be let into the U.S., when Rubio has rich foreign-born constituents who can pay for an attorney?

If the Republican party actually cared about protecting children, it would not have refused to help the undocumented minors, that fled by the hundreds of thousands to the U.S. Last summer, instead of passing legislation to address the deteriorating situation in Central America and the humanitarian crisis on the border, Republicans in Congress left D.C. for their vacations. Rather than help the unaccompanied minors, the GOP blamed President Obama for the hundreds of thousands of children fleeing for their lives. But President Obama did not create the unaccompanied minor migration influx; Republican Party hero Ronald Reagan did.

The Nation recently demonstrated how U.S. involvement in El Salvador set the stage for the incredible violence that many of the unaccompanied minors are fleeing. In the 1980s, the Reagan Administration gave El Salvador's then president José Duarte a billion dollars to buy weapons, propelling 12 years of civil war. Ronald Reagan sent no fewer than 55 U.S. officials to train the Salvadorian military and turned a blind eye to widespread allegations that the government was torturing and murdering civilians.To prevent El Salvador from "becoming another Cuba", Reagan supported a government that killed 75,000 of its civilians.

The vast majority of the unaccompanied minors, some who are as young as 5 years old, are from El Salvador, Guatemala, and Honduras. Honduras is currently the most dangerous country in the world. El Savador falls second and Guatemala is also one of the most violent. In Guatemala, President Reagan and U.S. conservative Christians supported General Efraín Ríos Montt, whose troops murdered, raped and tortured Mayan Indians and maintained rule through death squads, torture and "disappearing" political opponents. Even today the U.S. is supporting a brutal police force in Honduras; this is merely a continuation of U.S. sanctioned state violence that has lasted for for several decades.

If the Republicans really care about children, it should stop trying to defund Planned Parenthood and focus on how its policies. The party would support anti-gun legislation so that children can go to school and movie theaters and be at home without being executed, instead of letting 9 U.S. youths be gunned down per day.

Instead, it is a party whose platforms regarding children range from indifference, to cluelessness, and to actively cruel. Given this record, Republican lawmakers have a lot more to worry about in terms of child welfare than highly fabricated Planned Parenthood tapes.

-- 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 4 hours ago.

California lawmakers renew push to pass right-to-die bill

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SACRAMENTO, Calif. (AP) — California lawmakers announced Tuesday that they are making a new push to allow terminally ill patients to legally end their lives after opposition from religious groups and hesitance from fellow Democrats helped stall efforts earlier this year.

The bill allowing doctors to prescribe life-ending drugs was renewed by legislators in a special session on health care convened by Gov. Jerry Brown. It comes after at least two dozen states have introduced aid-in-dying legislation this year, though none has passed a bill. Doctors already are allowed to prescribe life-ending drugs in Oregon, Washington, Vermont and Montana.

The right-to-die movement has been galvanized by the highly publicized case of 29-year-old Brittany Maynard, a California woman with brain cancer who moved to Oregon to legally take her life. She argued in widely viewed online videos that she should have been able to access life-ending drugs in her home state.

"Californians should have more options available to those suffering constantly other than moving to other states or living in constant pain," Assemblyman Luis Alejo, D-Watsonville, said Tuesday at a press conference.

Religious groups and advocates for people with disabilities opposed a nearly identical California bill this year, saying it goes against the will of God and put terminally ill patients at risk for coerced death. The measure passed the state Senate but stalled in the Assembly.

Debbie Ziegler, Maynard's mother, criticized religious groups, including the Catholic Archdiocese of Los Angeles, that have been lobbying against the bill.

"What right does anyone of a specific religious faith have to say I should act in accordance with their fate in my death?" she said.

Advocates also have turned to courts, where they faced recent defeats in New Mexico and San Diego, where the judge said the issue should be resolved by state lawmakers.

Elizabeth Wallner, a single mother with Stage 4 colon cancer who filed the San Diego lawsuit, urged lawmakers to allow people like her to have a peaceful death at home.

"I don't want my son's last image to be of me struggling and in pain," she said.

The earlier California bill stalled in the Assembly Health Committee. Sens. Lois Wolk of Davis and Bill Monning of Carmel could not get support from fellow Democrats on the panel who lost parents to cancer and who were uncomfortable with allowing patients to kill themselves.

The new bill would bypass that committee. Brown called the special session to address funding shortfalls for programs providing health insurance to the poor and home health aides, but lawmakers are using the session to advance other contentious legislation related to health care.

The right-to-die advocacy group Compassion and Choices has said it would attempt to qualify a 2016 ballot measure if they lose in the Legislature.

___

Follow Fenit Nirappil on Twitter at www.twitter.com/FenitN .

Join the conversation about this story » Reported by Business Insider 4 hours ago.

Ohio Gov. Kasich on his ideas to replace Obamacare

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He said his plan includes doing away with the individual mandate, which requires every American to have health insurance Reported by CBS News 4 hours ago.

ACHC Behavioral Health Accreditation Accepted by Highmark Health

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Accreditation Commission for Health Care’s Behavioral Health Accreditation program recently received acceptance by Highmark Health, an independent licensee of the Blue Cross and Blue Shield Association. Effective August 2015, the Highmark Health approval permits ACHC-accredited behavioral health providers in Pennsylvania, Delaware, and West Virginia to access the network.

Cary, NC (PRWEB) August 18, 2015

Accreditation Commission for Health Care’s Behavioral Health Accreditation program recently received acceptance by Highmark Health, an independent licensee of the Blue Cross and Blue Shield Association. Effective August 2015, the Highmark Health approval permits ACHC-accredited behavioral health providers in Pennsylvania, Delaware, and West Virginia to access the network.

Highmark Health is among the 10 largest health insurers in the United States, and is the fourth-largest Blue Cross and Blue Shield-affiliated company. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware, and West Virginia that serve 5.3 million members. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

“ACHC is committed to partnering with behavioral healthcare providers to deliver the highest quality of care. Our Behavioral Health Accreditation program offers a range of service-specific standards that align with the individual needs of providers,” said Teresa Harbour, Associate Clinical Director, Home Health, Hospice, Private Duty, and Behavioral Health. “Recognition by Highmark Health allows behavioral health providers in Pennsylvania, Delaware, and West Virginia the flexibility to choose an accreditation organization that compliments the goals of their business.”

ACHC offers a patient-focused approach to Behavioral Health Accreditation with principles that were developed with direct input from industry professionals to ensure relevant and realistic standards. In order to remain flexible to the needs of providers, ACHC’s Behavioral Health Accreditation program offers standards specific to over 15 different services. The organization’s consultative approach to accreditation is designed to facilitate a higher quality of patient care while enhancing business efficiencies.

ACHC is a not-for-profit accreditation organization that has stood as a symbol of quality and excellence since 1986. The organization has CMS Deeming Authority for Home Health, Hospice, and DMEPOS and a Quality Management System that is certified to ISO 9001:2008. ACHC’s broad range of accreditation programs also includes Pharmacy, Private Duty Nursing, and Sleep. ACHC is the provider’s choice for accreditation because of its personal Account Advisors, relevant and realistic standards, competitive pricing, and consultative approach to accreditation. Accreditation by ACHC reflects an organization’s dedication and commitment to meeting standards that facilitate a higher level of performance and patient care.

For more information on ACHC’s accreditation programs and educational resources, or to download ACHC Accreditation Standards, please visit http://www.achc.org or contact them at customerservice(at)achc(dot)org or 855-937-2242. Reported by PRWeb 3 hours ago.

Scott Walker And The Trouble With Obamacare 'Replacement' Plans

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Very near the beginning of Scott Walker's new proposal to "repeal and replace" the Affordable Care Act, he bemoans that Obamacare forced so many people to give up the insurance they once had.

Walker, the Republican governor of Wisconsin and one of many GOP presidential hopefuls, then goes on to outline an alternative plan that would do the exact same thing.

By scrapping President Barack Obama's 2010 health care overhaul, Walker's plan -- which the governor announced this week -- would take away health coverage from some unknowable share of the millions of people who have gained it under Obamacare. It promotes benefits like less regulation and less federal spending on health insurance, as well as cheaper coverage for some young and healthy people. But like all the other Republican “repeal and replace” plans that have appeared in the last few years, Walker's proposal never acknowledges the trade-offs and consequences of these changes.  

This is the crux of the dilemma facing Obamacare opponents, now that the law has taken hold in the real world: Their proposals would also create winners and losers, albeit different ones from those created by the Affordable Care Act. There's a pretty significant gap between campaigning against the president's signature law and governing with it in place, and talking points -- no matter how appealing they sound -- often don't meet up with reality.

Forced to reconcile their pledges to repeal Obamacare with the political fallout that could come from upending people's health coverage, candidates have mostly chosen either to downplay the negatives or promise what they can't deliver. Obama experienced the consequences of this in the fall of 2013, when insurers canceled policies that didn’t conform to the new law’s regulations -- thereby violating Obama’s oft-repeated pledge that "if you like your plan, you can keep it." Any White House hopeful seeking a better understanding of how bruising it is to carry out big changes to health policy need only ask the building's current occupant.

Obamacare isn't overwhelmingly popular, but it's now integrated into the health care system and has been responsible for a historic expansion of health insurance coverage. That's the starting point for whatever plans Republicans propose, and GOP candidates must reckon with this reality.

By rolling back Obamacare's new spending and regulation, both of which Republicans oppose on ideological principle, any GOP “replacement” proposals would almost certainly leave people far more exposed to crippling medical bills. That's true for Walker's plan and for those touted by his rival candidates within the party (Florida Sen. Marco Rubio published a rough outline of his plan Monday, and Louisiana Gov. Bobby Jindal issued a paper on health care reform in April 2014). Walker issued his plan Tuesday and spoke about it during a visit to a Minneapolis factory.

"We aim for an easy transition," Walker's plan says. It doesn't say how.

And in a reflection of just how much the Affordable Care Act is now enmeshed with the health care system -- and how certain components of the law, like guaranteed coverage of pre-existing conditions, remain popular even though "Obamacare" isn't -- Walker's plan appears to accept many of the ACA's premises.

Walker would still provide financial assistance to some people, for example. He would keep some adults without children or disabilities on Medicaid, and he'd provide some form of fallback option for people with pre-existing conditions. These goals are superficially similar to those of the Affordable Care Act, but how Walker proposes to achieve them is vastly different.

Walker would rescind the Affordable Care Act’s regulations on the policies that insurers sell and the prices they charge for those policies. The Walker campaign does not specify precisely how it would go about this, or exactly which regulations it would end. But similar plans that have been circulating in conservative circles -- like a plan from the so-called 2017 Project, a conservative think tank based in Washington -- have called for allowing insurers more leeway to adjust premiums based on age, and eliminating requirements that all policies include a set of “essential” health benefits.

What sort of effects would a plan like this have? It seems safe to assume that insurers would start charging older Americans much higher premiums for comprehensive coverage, or simply stop offering such policies altogether. Younger and healthier people could go back to buying the type of cheap, skimpy policies that many had before Obamacare. But others would lose the comprehensive coverage they have now, leaving them exposed to higher medical expenses.

Walker's plan would offer financial assistance to people buying coverage on their own -- just as the Affordable Care Act has done -- but it would use a very different formula for calculating that assistance. Instead of offering tax credits that vary based on income and the price of insurance in a given locale, Walker’s plan would offer tax credits that vary only by age. And while Obamacare also offers lower-income people additional financial assistance that reduces out-of-pocket costs, Walker's plan calls for no such protection. Instead, it would provide more tax incentives for setting aside money in “health savings accounts” -- a form of tax-preferred savings that people can use to cover medical expenses.

This would tend to work out well for some middle- and upper-income people, because right now they don’t qualify for much -- or any -- financial assistance for the government. But less affluent people would lose assistance, to the point that large numbers of Americans would no longer be able to afford comprehensive coverage at all, and those who could afford it would face much more punishing bills.

Walker would convert Medicaid into a “block grant” for beneficiaries who don't have disabilities or are younger than 65. This would be a huge change, and in some ways would be the most consequential part of his proposal -- although it may get the least attention from the press.

Medicaid guarantees a comprehensive set of benefits to anybody who meets the program’s income criteria. In states that have expanded the program as the Affordable Care Act envisions, those criteria now include anybody in a household where income is below 133 percent of the poverty level -- or $26,720 a year for a family of three.

Walker would remake the program from scratch. Under his plan, the federal government would give states a fixed sum of money based on a pre-existing formula, rather than allow funding to rise and fall depending on need. The feds would also give states much more leeway to determine what kind of insurance to provide. What would almost certainly happen as a result, given the fiscal constraints Republicans typically impose on these plans, would be a loss of insurance for millions of people as states cut back on eligibility, benefits or both.

Of course, that doesn’t mean any of Walker's policies are likely to become law if he's elected president.

Versions of these ideas have been appearing in Republican campaign platforms at least as far back as President George W. Bush's 2004 re-election campaign. Sen. John McCain (Ariz.) and former Massachusetts Gov. Mitt Romney ran as GOP presidential nominees on similar platforms in 2008 and 2012, respectively. And Republican lawmakers have introduced numerous bills in recent years that have included features resembling these campaign plans.

And therein lies the problem with Walker's and Rubio's and Jindal's plans, which have nothing to do with their substance: When in power, Republicans have never made a strong push to enact those plans. This was true in the 1990s when the GOP fought President Bill Clinton's reforms, it was true after 2010 when they took over the House and it's been true since last year when they took over the Senate. Despite dozens of votes in the House to repeal Obamacare, the Senate has failed even to get that far, and the GOP leaders in both chambers have never coalesced around a replacement plan.

The Republican 2016 contenders want voters to believe things will be different this time, that Obamacare will be easier to repeal and replace than it has been thus far, and that GOP leaders care enough about health care to go beyond vilifying Democratic policies and put some of their own in place. If history is any guide, voters eager for that outcome will have to go on waiting.

-- 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 hours ago.

HUFFPOST HILL - Something Terrific!

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A small child failed to catch a football thrown by Marco Rubio, proving once again that children are not the future. Republican candidates are questioning birthright citizenship, because nothing says "Party of Lincoln" quite like the Dred Scott decision. And Scott Walker proposed a healthcare plan that's making Donald Trump's idea to replace Obamacare with "something terrific" look pretty smart. This is HUFFPOST HILL for Tuesday, August 18, 2015:

*YOU SAY "XENOPHOBIA" LIKE IT'S A BAD THING* -- HuffPost's Amanda Terkel reports the U.S. approaching a new low-point in its treatment of furriners: "Prominent figures in the Republican Party in recent days have expressed renewed interest in repealing the 14th Amendment to the Constitution, which would take away the automatic right of those born in the United States to become citizens of the country… But *rescinding birthright citizenship privileges would return the U.S. to some of its darkest chapters, when politicians tried to deny citizenship rights to black people and when the country was overtaken by anti-Chinese xenophobia*. Walter Dellinger has been trying to push back against the anti-birthright citizenship movement since the mid-1990s, when he served as a top legal official in President Bill Clinton's administration and testified against such an effort before a House committee. He told The Huffington Post Tuesday that *the country is at a 'critical moment' in this debate, when a major political party may nominate as its presidential candidate someone who embraces the end of birthright citizenship.* 'It would fundamentally change the identity of America,' Dellinger said, 'to create a permanent caste that was excluded from citizenship generation after generation.'" [HuffPost]

*Candidates who are wobbly on the 14th Amendment:* Donald Trump, John Kasich, Rand Paul, Rick Santorum, Bobby Jindal, Lindsey Graham, Chris Christie, Scott Walker. [HuffPost]

*IRAN, IRAN SO FAR AWAY* -- The Associated Press: "President Barack Obama has '*a great likelihood of success*' in his showdown with congressional Republicans on the Iran nuclear deal, Senate Majority Leader Mitch McConnell grudgingly acknowledged on Monday. The GOP-led Senate and House are expected to turn down the deal next month, with the Kentucky Republican calling it flawed and House Speaker John Boehner criticizing the accord… Obama has pledged to veto a congressional resolution of disapproval. The question then becomes whether opponents of the accord can muster the votes to override the president." Spoiler alert: Probably not. [AP]

*WHAT ABOUT BOB?* Jessica Schulberg reports that New Jersey's senior Democratic senator plans to vote against the Iran deal: "Sen. Bob Menendez (D-N.J.) on Tuesday formally announced his opposition to the nuclear agreement with Iran, claiming that the Obama administration could renegotiate a better deal and wrest more concessions from Iran if Congress rejects the current accord. *'I have looked into my own soul and my devotion to principle may once again lead me to an unpopular course, but if Iran is to acquire a nuclear bomb, it will not have my name on it,'* Menendez told an audience of approximately 400 students, faculty, and constituents at Seton Hall University in New Jersey. 'It is for these reasons that I will vote to disapprove the agreement and, if called upon, would vote to override a veto.' An ideal agreement, the senator said, would be one that required Iran to completely surrender its nuclear program, rather than simply downsizing it and opening it up to inspections. Secretary of State John Kerry has called this an unrealistic goal." [HuffPost]

Here's our whip count.

*BLM-GHAZI* -- Marina Fang: "Newly released video of Democratic presidential candidate Hillary Clinton's private meeting with Black Lives Matter activists in New Hampshire last week shows a testy exchange between Clinton and the activists. In one of two clips of the meeting posted by Good Magazine on Monday, Clinton suggests that the activists need to have strong policy goals if they want to create real change, using the women's and gay rights movements as a comparison. One of the activists takes issue with her comments. 'This is and has always been a white problem of violence. There's not much that we [black people] can do to stop the violence against us,' Julius Jones of Black Lives Matter tells Clinton. Clinton pushes back: 'Respectfully, if that is your position, then I will only talk to white people about the very real problems.' [HuffPost]

*HAIRCUTS:* Igor Bobic, Eliot Nelson.

*DAILY DELANEY DOWNER* - This piece by Jon Hilsenrath and Nick Timiraos made the rounds today: "As the U.S. economic expansion ages and clouds gather overseas, policy makers worry about recession. Their concern isn’t that a downturn is imminent but whether they will have firepower to fight back when one does arrive…. The U.S. generally injects cash into the economy through interest-rate cuts, tax cuts or ramped-up federal spending. Those tools could be hard to employ when the next dip comes: Interest rates are near zero, and fiscal stimulus plans could be hampered by high levels of government debt and the prospect of growing budget deficits to cover entitlement spending on retired baby boomers." [WSJ]

Does somebody keep forwarding you this newsletter? Get your own copy. It's free! Sign up here. Send tips/stories/photos/events/fundraisers/job movement/juicy miscellanea to huffposthill@huffingtonpost.com. Follow us on Twitter - @HuffPostHill

*THE GAS WE PASS* -- Obama wants to cut down on methane leaks … in the oil and gas sector: "The Obama administration on Tuesday proposed new standards limiting methane emissions from oil and gas drilling operations, a significant contributor to climate change. The Environmental Protection Agency released four separate proposals that aim to reduce emissions that escape from oil wells, as well as natural gas processing and storage facilities. The methane proposal would cut releases from drill sites and infrastructure 20 to 30 percent nationally in the next 10 years, the agency said. The agency described the standards as a 'flexible approach' to reducing a major contributor to climate change." [HuffPost]

The Washington Post's David Fahrenthold chronicles 20 times Donald Trump has changed his mind since June.

*THE TROUBLE WITH OBAMACARE REPLACEMENTS* - Obamacare currently exists, you know? It's like, there. Jeffrey Young and Jonathan Cohn: "Very near the beginning of Scott Walker's new proposal to 'repeal and replace' the Affordable Care Act, he bemoans that Obamacare forced so many people to give up the insurance they once had. Walker, the Republican governor of Wisconsin and one of many GOP presidential hopefuls, *then goes on to outline an alternative plan that would do the exact same thing*. By scrapping President Barack Obama's 2010 health care overhaul, Walker's plan -- which the governor announced this week -- would *take away health coverage from some unknowable share of the millions of people who have gained it under Obamacare*. It promotes benefits like less regulation and less federal spending on health insurance, as well as cheaper coverage for some young and healthy people. But like all the other Republican 'repeal and replace' plans that have appeared in the last few years, Walker's proposal never acknowledges the trade-offs and consequences of these changes." [HuffPost]

*BOBBY JINDAL MANFULLY PANS WALKERCARE* - Igor Bobic: "In a sharply worded statement following Walker's remarks, Jindal accused the Wisconsin governor of endorsing the 'fundamental underpinning of Obamacare.' '*In Governor Walker’s plan, a new entitlement is created for every single American human being from the time they are born right up until they grow old and become eligible for Medicare*,' Jindal said. 'It is frankly shocking that a Republican candidate for President would author a cradle to grave plan like this.'" [HuffPost]

Dirtbag Karl Marx: WHY DON’T YOU MAKE LIKE THE RULING CLASS IN THE WAKE OF POPULAR UPRISINGS AND GET OFF MY BACK

*WHITE HOUSE HIRES FIRST OPENLY TRANSGENDER STAFFER* - Dayana Morales Gomez: "President Barack Obama's administration has appointed the first-ever transgender White House staffer. *Raffi Freedman-Gurspan, a transgender woman, is the outreach and recruitment director for presidential personnel in the White House Office of Presidential Personnel*. She started her new job Tuesday.Previously, Freedman-Gurspan was a staff member at the National Center for Transgender Equality, where she served as policy adviser for the organization's Racial and Economic Justice Initiative." [HuffPost]

*TODAY IN SPORT:*


I could watch Marco Rubio smoking this kid in the face with a football all day. pic.twitter.com/eH0LvWf4Ie

— The Taco (@ElTaco_TFM) August 18, 2015



Here's a GIF of yet another child falling to the ground after Marco Rubio gives him a football. pic.twitter.com/2X8ACralX5

— Mudacris (@moody) August 18, 2015
*BECAUSE YOU'VE READ THIS FAR* - Tiny baby befriends giant pitbull

*LINDSEY GRAHAM SICKENED BY INSUFFICIENT DEATH* - Andrew Kaczynski: "South Carolina Sen. Lindsey Graham says the Connecticut Supreme Court decision that the death penalty violates the state’s constitution -- sparing the perpetrators of a horrific 2007 home invasion and murder from execution -- makes him physically ill. Steven Hayes and Joshua Komisarjevsky were both sentenced to death for killing and setting on fire Jennifer Hawke-Petit and her daughters Hayley, 17, and Michaela, 11. '*Makes me want to throw up. Makes me want to throw up when I hear that putting these two guys to death for what they did to that family is somehow outside of the standards of decency*,' Graham stated Monday to radio host Michael Medved." [BuzzFeed]

*COMFORT FOOD* by @dmoralesgomez & @yujia_pan

- Blue whale tells BBC “I’M RIGHT HERE”

- These raccoons are loco for Doritos

- Raccoon rides a bike

*TWITTERAMA*

@jondaly: When your dog farts you should be happy. They're relaxed because you're a good friend.

@JRLbako: @FauxJohnMadden Marco Rubio hit kid in face with football; Jets offer him starting QB job.

@mattytalks: In life most people are afraid to ask the tough questions, but not me. Is a pancake just a fat crepe? Find out tonight at 10pm on MSNBC

*Got something to add? Send tips/quotes/stories/photos/events/fundraisers/job movement/juicy miscellanea to Eliot Nelson (eliot@huffingtonpost.com) or Arthur Delaney (arthur@huffingtonpost.com). Follow us on Twitter @HuffPostHill (twitter.com/HuffPostHill). Sign up here: http://huff.to/an2k2e*

-- 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 minutes ago.

Democrats draw attention to Medicaid expansion with personal stories

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Salt Lake City, Utah- (ABC 4 Utah) – This week the legislature is turning its attention to the prison, but Utah democrats say the focus should be on a much bigger crises.

They say a solution to the Medicaid coverage gap is long overdue.

That's why they rallied at the Capitol to put a face to the struggles.

More than 50,000 people in our state have no option for health insurance.

Working mother, Grisel Guadarrama is one of them.

Tuesday, she is spoke publicly about the daily challenges.

"Not paying bills on time, because I know I have to pay for medication. Canceling Eric's appointments all the time, because we can't afford it," said Guadarrama.

She is joining forces with democratic leaders to call for a solution.

"We need to get something done, people are losing their lives. We need to send the message that we care about our citizens, not just about the bottom line," said Utah Democratic Party Chair, Peter Corroon.

Six republican lawmakers are working on a plan to bridge the gap.

Last month they announced they agree on a concept, but missed a self imposed deadline to roll it out.

Democrats say it's unacceptable.

"They are not lazy, they just need a helping hand to get back on their feet. And I'll tell you, the biggest cure to homelessness that we could implement now in our state is to have Medicaid expansion," said Scott Howell, Pioneer Park Coalition Chair.

For Brent Frisby's wife, Carol who passed away this summer it's too late, but in her honor he pushes forward.

"She is here in spirit. She is going to see this through, so that other people don't have to suffer," said Frisby.

House republicans are concerned about sustainability and making sure the state doesn't get stuck with unexpected costs.

The plan the Gang of Six is considering would shift the cost to those that would benefit from Medicaid dollars, like hospitals and pharmacies.

In response to this rally Republican Party Chair, James Evans says democrats are using emotion to manipulate and advance the cause of big government.

He says he's confident republican leaders will find a fiscally responsible solution. Reported by abc4 1 day ago.

Ron Paul On The Seamless Web Of Liberty

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Ron Paul On The Seamless Web Of Liberty Submitted by Ron Paul via The Ron Paul Institute for Peace & Prosperity,

Many people think the Internal Revenue Service was violating civil liberties when it harassed tea party groups. After all, the groups were targeted because they wanted to exercise their civil liberty to challenge government policies. However, the specific issue in the IRS case was the groups’ application for tax-exempt status, which seems to be an aspect of economic liberty. *In fact, the IRS case demonstrates that there is no meaningful distinction between civil and economic liberties. A true friend of the free society defends both civil and economic liberties.*

Many “civil libertarians” who oppose government laws interfering in the personal choices of consenting adults support laws preventing consenting adults from working for below the minimum wage. Other civil libertarians support government programs forcing consenting adults to purchase health insurance. Many liberals who join libertarians in opposing the NSA’s warrantless wiretapping fail to protest Obamacare’s assault on medical privacy. Even worse are those “First Amendment defenders” who cheer on government actions preventing religious individuals from operating their businesses in accord with the teachings of their faith.

*The hypocrisy of left-wing civil libertarians is matched by the hypocrisy of many “economic conservatives.”* Too many conservatives combine opposition to high taxes and Obamacare with support for authoritarian measures aimed at stopping individuals from engaging in “immoral" behavior. These conservatives do not understand that using force to stop people from engaging in nonviolent activities that some consider immoral is just as wrong as using force to make people purchase health insurance. Obamacare and the drug war both violate individual rights, and neither has any place in a free society.

*In a free society, individuals must respect the right of others to make their own choices free from government coercion.* However they do not have to approve of those choices. Individuals are free to use peaceful persuasion to stop others from engaging in immoral or destructive behavior. They can also avoid associating with individuals or businesses whose actions they find immoral or simply distasteful.

*Many civil and economic libertarians also mistakenly believe that they can defend liberty while supporting an imperialist foreign policy.* It is impossible to be a true civil libertarian, or a true fiscal conservative, and support the warfare state.

America’s imperialist foreign policy is the underlying justification for the rise of the modern surveillance state, and the reason Americans cannot board an airplane without being harassed and humiliated by the Transportation Security Administration. The warfare state is also the justification for the government’s greatest infringement on personal liberties: the military draft.

*The United States government’s militaristic foreign policy costs taxpayers over $1 trillion a year. The costs of empire are major drivers of the American debt. Yet many of the most fervent opponents of domestic spending oppose even minuscule cuts to the defense budget. The government’s budget will never be balanced until conservatives give up their love affair with the welfare state and military Keynesianism.*

Scholars, commentators, and other public figures who defend liberty in some areas and authoritarianism in other areas - or combine a defense of economic or civil liberty with a defense of the warfare state - undermine the case for the liberties they claim to cherish. *Restoring the link between economic liberty, civil liberty, and peace is a vital task for those seeking to restore a society of liberty, peace, and prosperity.* I examine the link between an interventionist foreign policy and a loss of our civil and economy liberties in my new book Swords into Plowshares. Reported by Zero Hedge 1 day ago.

Bernie Sanders Exaggerates Health Care Spending

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The following post first appeared on FactCheck.org.Sen. Bernie Sanders said that the United States spends “almost twice as much per capita on health care as do the people of any other country.” He’s wrong about that.

The U.S. spends more than twice as much per capita as the average amount spent by other developed nations, but it doesn’t spend twice as much as every one of them.

Sanders, an independent who is running for the Democratic presidential nomination, made the claim during his soapbox speech at the Iowa State Fair on Aug. 15.

He said that despite the Affordable Care Act, there are still millions of U.S. residents who lack health insurance, even though the country spends almost double what any other nation does for health care. (Jump to 10:55 in the video to hear his statement.)



*Sanders, Aug. 15:* It makes no sense to me that despite the gains of the Affordable Care Act, we continue to have 35 million people uninsured. And many of you are under-insured, right? High deductibles, high copayments. And yet, after all of that, we end up spending almost twice as much per capita on health care as do the people of any other country. That’s wrong. That has got to change.



But it’s Sanders who needs to change his talking point.

We contacted the senator’s campaign to get his source, but haven’t received a response.

The U.S. spent $8,713 per capita in 2013, according to the most recent data from the Organisation for Economic Co-operation and Development. That’s far more than most other developed nations, and also more than double the OECD average of $3,453 per capita.

So Sanders has a point that the U.S. spends a lot more on health care than other nations. But he went too far in saying it spends twice as much as any other country.

After the U.S., Switzerland ($6,325 per capita) and Norway ($5,862 per capita) spent the most on health care in 2013, and the U.S. didn’t spend 100 percent more than either nation. The U.S. also didn’t spend twice as much as the Netherlands ($5,131 per capita), Sweden ($4,904 per capita) or Germany ($4,819 per capita).

We wrote about a similar claim from Barack Obama in 2008, when he was running for president. Obama was wrong then, and Sanders is wrong now.

— D’Angelo Gore

-- 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.

InsureMonkey Ranks No. 79 on Inc. Magazine’s 5000 Fastest Growing Companies

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InsureMonkey Ranks No. 1 in Nevada, No. 79 in the U.S., and No. 9 Among Software Companies

(PRWEB) August 18, 2015

InsureMonkey, one of the nation’s leading providers of private exchange technology for the healthcare industry, announced today that Inc. Magazine ranked the company number 79 on its annual 5000, an exclusive ranking of the nations fastest growing private companies. InsureMonkey also ranks number 1 in Nevada and number 9 among software companies in the U.S.

The list represents the most comprehensive look at the most important segment of the economy—America’s independent entrepreneurs. Companies such as Intuit, Zappos, Under Armour, Microsoft, Oracle, and many other well-known names gained early exposure as members of the Inc. 5000.

“We are honored to be included on this prestigious list and ranked among great innovators and forward-thinking companies that are changing industries,” said Alex Rivlin, Chief Executive Officer of InsureMonkey. “The demand for private health insurance exchange technology continues to grow and we are committed to helping more companies deliver personalized consumer experiences in healthcare.”

The 2015 Inc. 5000 (available on newsstands August 18 to September 22) is the most competitive crop in the list’s history. The average company on the list achieved a mind-boggling three-year growth of 490%. The Inc. 5000’s aggregate revenue is $205 billion, generating 647,000 jobs over the past three years. Complete results of the Inc. 5000, including company profiles and an interactive database that can be sorted by industry, region, and other criteria, can be found at http://www.inc.com/inc5000.

"The story of this year’s Inc. 5000 is the story of great leadership. In an incredibly competitive business landscape, it takes something extraordinary to take your company to the top,” says Inc. President and Editor-In-Chief Eric Schurenberg. “You have to remember that the average company on the Inc. 5000 grew nearly six-fold since 2012. Business owners don’t achieve that kind of success by accident."

The 2015 Inc. 5000 is ranked according to percentage revenue growth when comparing 2011 to 2014. To qualify, companies must have been founded and generating revenue by March 31, 2011. They had to be U.S.-based, privately held, for profit, and independent--not subsidiaries or divisions of other companies--as of December 31, 2014. (Since then, a number of companies on the list have gone public or been acquired.) The minimum revenue required for 2011 is $100,000; the minimum for 2014 is $2 million. As always, Inc. reserves the right to decline applicants for subjective reasons. Companies like InsureMonkey on the Inc. 500 are featured in Inc.'s September issue. They represent the top tier of the Inc. 5000, which can be found at http://www.inc.com/5000.

About InsureMonkey, Inc.

InsureMonkey is a leading provider of private health insurance exchange technology. Its cloud-based software platform enables insurers to power their own branded online exchanges, delivering a personalized, anywhere/anytime consumer experience and redefining consumer value. It mitigates some of the industry’s toughest data challenges, integrating seamlessly with existing insurer systems and measurably reducing administrative costs. With its state-of-the-art solutions, insurers can enable new models to maximize the member experience, promote better health outcomes, and lower the cost of care.

InsureMonkey is a privately held company based in Las Vegas. To learn more, visit InsureMonkey.com.

CONTACT:
Mark Jolley
InsureMonkey
(702) 336-1100
mark(at)insuremonkey(dot)com

About Inc. Media

The Inc. 500|5000 is a list of the fastest-growing private companies in the nation. Started in 1982, this prestigious list of the nation's most successful private companies has become the hallmark of entrepreneurial success. The Inc. 5000 Conference & Awards Ceremony is an annual event that celebrates their remarkable achievements. The event also offers informative workshops, celebrated keynote speakers, and evening functions.
For more information on Inc. and the Inc. 5000 Conference, visit http://www.inc.com/. Reported by PRWeb 23 hours ago.

All Along the Border

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The Texas-Mexico border confounds politicians and overwhelms sociologists. Population growth and a merging of cultures and economies do not make for simple solutions to problems. In Texas, the border is often an afterthought for policy-makers in Austin, which means funding and legislation to drive equality of government services historically lags in delivering benefits that are afforded the rest of the state.

Resources deployed to the Texas-Mexico border have often been provided with the expressed purpose of stopping illegal immigration into the U.S., and confronting drug cartels. Social services for residents, especially health care, tend to get secondary treatment. In fact, Texas Governor Greg Abbott expects to fund 500 new Department of Public Safety troopers to increase security on the Rio Grande and elsewhere in the state even as other, arguably, more essential border challenges go ignored.

The federal government cannot exactly be accused of largesse, either, with regards to the border. Critical needs are often dramatically underfunded by Washington, which can lead to compounding crises.

"Of the 141, veterans' hospitals in the U.S., we rank 141 for access to mental health care here in El Paso," said Congressman Robert F. "Beto" O'Rourke of El Paso. "There are always dangers that troubled vets might do harm to themselves and their families, and we need to provide treatment, right away. We are coming up with a plan for turning around access to health care for veterans in El Paso, especially mental health care, and I believe El Paso can serve as a model for the V.A. nationally."O'Rourke was speaking at the recent 10th annual gathering of the Border Health Conference sponsored by the Border Health Caucus (BHC) on the campus of the University of Texas at El Paso. The BHC is sponsored by the Texas Medical Association (TMA.) TMA physicians and member groups created the organization in an attempt to raise awareness of critical health care issues along the Texas-Mexico border, and provide leadership for positive change. This is the second time the conference has been held on the border instead of in Washington, D.C. The BHC consistently gets bi-partisan support and this year's attendees included, in addition to Congressman O'Rourke, a Democrat, fellow Democratic Congressman Filemon Vela of Brownsville, and Republicans Will Hurt of Helotes and Dr. Michael Burgess from North Texas.

Health care has grown infinitely more challenging as the border region's population has doubled to around six million people over the last 20 years, according to the latest U.S. Census figures.

"We have to continue to lead the search for solutions to these problems," Dr. Tom Garcia, president of the TMA told the caucus attendees. "We know the border has more poverty and a much less robust health infrastructure than the rest of Texas, and the rest of the country. And we are here to take care of people, not garner votes."

And there is an abundance of people that need care, not just military veterans. Texas is estimated to have about 2300 colonias along the border, which are unincorporated communities that often lack running water, sewers and electricity. The state legislature has not comprehensively dealt with colonia issues even though unscrupulous developers first created them back in the 1950s for migrant workers. The state's "highest health risk" remains among 45,000 people living in 350 colonias, which means being a physician or caregiver along the Texas-Mexico border is both a health care and political challenge.

The Texas legislature, after decades of political wrangling, finally funded a university and medical school in the Rio Grande Valley of South Texas, which will begin to have an impact on border health, including a first class in 2016 that will focus on health issues related to colonias.

The discussions in Washington are often more frustrating for physicians and the TMA.

"We spend a lot of time educating congressmen and women and their staff about unique health care issues we face each day in our practices," said Linda Villareal, MD, an Edinburg, Texas internist and TMA trustee. "We were not shy about expressing our opinion [to elected officeholders] that politics as usual during this trying time is not acceptable, nor is it acceptable for Congress to use physicians and our patients as a political football between the House and Senate."

The border suffers along with the rest of Texas for a failure by the state to adopt Medicaid expansion under the Affordable Care Act (ACA.) An estimated $22 billion of federal tax money will end up in other states instead of being used to deliver health care in Texas through 2022. Sign-ups for Medicaid in California increased 35 percent under the ACA, 28 percent in Arizona, and 53 percent in New Mexico through expanded eligibility and increased federal funding. In Texas, however, which has refused the coverage, Medicaid and Children's Health Insurance Program sign-ups rose only 4 percent. The state legislature and the governor refused Medicaid expansion even though the health department estimates one out of every four Texas residents lacks health care coverage.

The Texas Medical Association also launched the federal government's Healthy Border 2020 Initiative for bi-national solutions by creating the U.S.-Mexico Border Health Commission. The 2020 initiative is developing a strategy to address infectious disease, mental health and addiction, chronic and degenerative disease, obesity, injury prevention, research, access to care, and critical planning.

Unfortunately for the border, problems persist, in part, because politicians in Washington and Austin appear more worried about walls and guns and security instead of medicine and care giving. While veterans living on the border wait almost interminably for access to a hospital or a doctor, 41,500 positions inside of the VA remain unfilled, and construction of a vets' hospital in Denver runs $1 billion over budget.

There is likely a better way to do things. But someone still needs to find it. And soon.

Also at: Texas to the World

-- 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.

Fit4D Raises Series A Funding From SJF Ventures, Sovereign Health System and Blue Cross and Blue Shield of Nebraska

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Supports Rapid Expansion of Fit4D’s Scalable Diabetes Platform across Pharmaceutical, Payer and Provider Distribution Channels

New York, New York (PRWEB) August 19, 2015

Fit4D© (http://www.fit4d.com), a digital health company that is improving the health of people with diabetes, announced today that it has secured Series A funding from SJF Ventures, Sovereign Health System and Blue Cross and Blue Shield of Nebraska. The funding will enable the company to expand distribution of its innovative diabetes platform across new customer channels and to leverage the platform to improve health outcomes for other chronic diseases.

For pharmaceutical companies with a branded diabetes drug or device, Fit4D optimizes the mix between technology and diabetes-expert clinicians, also known as Certified Diabetes Educators (CDEs), to improve adherence to the drug or device in an affordable manner. The platform works with intelligent-scripting algorithms that enable diabetes expert clinicians to more than triple their capacity to deliver personalized care. Unlike apps or call centers, Fit4D offers a high-touch, personalized experience for patient populations that leverages proprietary technology and methodologies to demonstrably improve adherence in manner that provides over a 3x payback for customers.

For Payers seeking to improve quality measures, Fit4D utilizes the diabetes platform to reduce the HbA1c values of members at highest risk while increasing member engagement with their personal CDE.

Managing diabetes is complicated. Effective diabetes management involves motivating patients to take their prescribed medications, integrating healthy lifestyle (nutrition, exercise, weight management etc.), coping with the ongoing emotional stresses of the disease, and using measurement tools such as blood glucose meters and lab tests. Achieving positive health outcomes is made more challenging as every patient starts in a different place, continues on their own unique journey, responds differently to messaging and has distinct and varied hurdles. The challenge of providing effective and on-going support is compounded for most healthcare professionals who have limited time during appointments.

Fit4D uses multi-channel communication technology and intelligent scripting algorithms to segment patient populations enabling Certified Diabetes Educators (CDEs) to deliver personalized care with increased member volumes. By empowering every CDE with a data-driven approach to improve health measures, Fit4D increases each CDE’s patient capacity by over 3x from 120 to 400.

The Fit4D platform provides electronic interactions in patient-preferred modalities (e.g. phone, email, text, web, video, etc.) that address patient-specific issues (e.g. overwhelmed, fear of needles, language barriers, etc.), in the patient’s preferred format (e.g. articles, videos, webinars, etc.) and at the patient’s preferred time of day (after putting children to bed, before work in the morning, etc.)

“Fit4D has the opportunity to transform the way our health system treats real people suffering from diabetes and other chronic diseases,” said Cody Nystrom, Managing Director at SJF Ventures. “Fit4D’s history in diabetes education provided the necessary experience and domain expertise to create a proprietary medical adherence solution built, tested and proven to work for real patients engaged through pharmaceutical and payer clients. Fit4D has the potential to impact millions of people with diabetes and other chronic diseases by providing personalized clinical support made scalable through the use of technology.”

“Providers are always seeking innovative solutions to improve medication adherence and health outcomes,” said Dr. Joann Schaefer, Chief Medical Officer and senior vice president for Blue Cross and Blue Shield of Nebraska. “Fit4D brings a personalized experience to members while providing value-based services to providers.”

“Sovereign Health System enhances patient health by delivering evidence-based, cost-efficient care that utilizes clinical data to individualize treatment to optimal effect. Given Fit4D's data-driven approach to improving the health of people with diabetes, this is a very natural and strategic investment for our organization," said John Hajjar, MD, FACS, MBA, founder, chairman and CEO of Sovereign Health System.

Fit4D’s mission is to improve the health of people with diabetes everywhere in the world,” said David Weingard, Fit4D Chief Executive Officer. “We are excited to partner with our investors to achieve this mission and will continue to leverage technology to scale the reach of our diabetes-expert clinicians. We will also customize the Fit4D platform to improve medication adherence and health outcomes for patients with other chronic diseases. Everyone on the Fit4D team is passionate about helping patients and positively impacting the healthcare landscape.”

About Fit4D
Fit4D’s mission is to improve the lives of people living with diabetes worldwide. Fit4D delivers scalable and effective patient programs through an optimized mix of its technology platform and human-based touch points. The Fit4D clinical team, comprised of dietitians, exercise physiologists, nurses, and social workers, many of whom are also certified diabetes educators (CDEs), focuses on empowering people with diabetes to live rich, healthy and fulfilling lives.

Fit4D’s Fortune 500 clients include pharmaceutical, payer, provider and wellness companies. Fit4D has also engaged in numerous joint initiatives with the Juvenile Diabetes Research Foundation, American Diabetes Association, and Diabetes Research Institute.

Fit4D is also a member of the StartUp Health Academy, a network of digital health companies dedicated to innovation across the globe.
Contact: Sherri Isaak, sisaak(at)fit4d(dot)com

About SJF Ventures
SJF Ventures is a venture capital fund with offices in Durham, NC, New York and San Francisco. SJF has a 16-year successful record of assisting visionary and talented management teams in building industry-leading firms providing meaningful societal impact. SJF provides strong expertise and networks in the technology-enhanced services sectors of energy, infrastructure, health and education. For more information visit http://www.sjfventures.com.
Contact: Cody Nystrom, 804-230-1910, cnystrom(at)sjfventures(dot)com

About Sovereign Health System
Sovereign Health System (http://www.sovereignhealthsystem.com) is a fully integrated multi-specialty community healthcare system serving the people of the New York City metropolitan area through its network of primary care and specialty physicians, laboratory facilities, urgent care clinics, outpatient surgery centers, and outpatient cancer-treatment centers.
Contact: Kevin Kiel, 973-216-1633, kkiel(at)sovms(dot)com

About Blue Cross and Blue Shield of Nebraska
Blue Cross and Blue Shield of Nebraska is a community-based, member-owned health insurance company serving approximately 700,000 people. For more than 75 years, BCBSNE has been committed to protecting Nebraska families and delivering the health and wellness solutions Nebraskans value most. Recent honors include the Platinum Well Workplace Award from the Wellness Councils of America and the Better Business Bureau's Integrity Award. Blue Cross and Blue Shield of Nebraska is an independent licensee of the Blue Cross and Blue Shield Association.
Contact: Marcia Cady, 402-982-8242, Marcia.cady(at)nebraskablue(dot)com Reported by PRWeb 14 hours ago.

AIS Newsletter Offers Analysis of New ACA-Created Health Programs in Minnesota, New York

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The August 2015 issue of Inside Health Insurance Exchanges offers analysis of Basic Health Program plans, a very under-utilized provision of the Affordable Care Act.

Washington, DC (PRWEB) August 19, 2015

Late last month, the New York Department of Financial Services announced the launch of a new insurance plan — the Essential Plan — that would be available to that state’s poorest residents for the 2016 plan year. The Essential Plan was created under the little-used Basic Health Program (BHP) provision under the Affordable Care Act (ACA); so little-used that it’s only the second BHP in existence. The August 2015 issue of Atlantic Information Services, Inc.’s (AIS) Inside Health Insurance Exchanges (HEX) offers analysis of these two plans, in New York and Minnesota, including eligibility details.

Although BHPs were called for by the ACA, which was signed into law in 2010, final guidance on them wasn’t issued until this February, according to HEX. The ACA allows states to install a BHP for individuals earning between 133% and 200% of the federal poverty level who are not otherwise eligible for Medicaid, the Children’s Health Insurance Program, other government programs or employer-sponsored insurance.

New York and Minnesota “are unique at this point in time, and they have a set of circumstances where the BHP makes sense for them,” says Deborah Bachrach, a former New York Medicaid director, now a partner in the law firm Manatt, Phelps & Phillips, LLP. Adding a BHP allows for New York to use federal funds to provide health care for low-income legal immigrants in an existing health care program and its state Medicaid program, she explains. Minnesota already had a program similar to a BHP, called MinnesotaCare, and lawmakers spent much of 2014 bringing it in line with the new requirements, the state said. The federal government took over half the cost for most adults without children on MinnesotaCare in August 2011 as part of the bridge to the ACA and the BHP funding opportunity. Moving some of those beneficiaries into a BHP allows federal dollars to cover 95% of the costs, according to HEX.

While other states might consider offering a BHP, Bachrach suggests they are more likely to wait until 2017, when they can apply for a State Innovation Waiver, which was also created by the ACA. State Innovation Waivers would allow a state to develop a BHP-esque program and receive 100% of the federal funds available, as opposed to the 95% allowed by the BHP provision.

Visit http://aishealth.com/archive/nhex0815-04 to read the article in its entirety, including more details on New York and Minnesota’s BHPs.

About Inside Health Insurance Exchanges
Inside Health Insurance Exchanges provides hard-hitting news and strategies on public and private health insurance exchanges, written for business leaders with health plans, pharma companies, hospitals and health systems, brokers and agents, and exchange managers and vendors. The newsletter delivers reliable intelligence on this critical cornerstone of health reform — the players and their partners, product designs and enrollment results, employer perspectives and much more. Visit http://aishealth.com/marketplace/inside-health-insurance-exchanges 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 12 hours ago.

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