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Bizarro World: Some Republicans Now Defending "Failing" ObamaCare

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Bizarro World: Some Republicans Now Defending Failing ObamaCare For months now we've warned, as have many prominent Republican legislators, that Obamacare is on the verge of collapse (see "Obamacare On "Verge Of Collapse" As Premiums Set To Soar Again In 2017"). 

It's not that shocking really as the fundamental concept behind the legislation made it doomed from the start.  *The idea was that, out of an abundance of compassion for their elders, young, healthy millennial families would fork up $10s of thousands of dollars each year to purchase health insurance they didn't really need.*  Those premiums would then be used to subsidize care for the elderly who consume more than their "fair share," to quote Obama.

Unfortunately, the basic math skills of our young millennials turned out to be better than the Obama administration had planned for and they figured out they were better off just paying the Obamacare tax to the IRS than paying the larger Obamacare 'tax' associated with buying a service they never use.  *This "adverse selection bias" left risk pools way worse than insurers planned, which drove premiums even higher, which forced even more young people to ditch their insurance and the cycle will continue until the system ultimately fails.*

In fact, as we pointed out last week, Knoxville, TN could be ground zero for the Obamacare explosion as it's 40,000 residents live in a county that has been left with no healthcare options for the 2018 plan year after Humana pulled out of exchanges there.

And, with the fate of Obamacare all but sealed, you can imagine our shock to learn that several House Republicans are now apparently warming up to the legislation.

One such person is Patrick McHenry of North Carolina who says that any efforts of the Trump administration to lure votes from the Freedom Caucus by relaxing rules to allow insurance providers to charge people with pre-existing conditions higher premiums would be a "bridge too far" for some more moderate Republicans.  Per The Hill:



Rep. Patrick McHenry (R-N.C.), the GOP’s chief deputy whip, said Wednesday that the Freedom Caucus's calls for states to be able to apply for waivers to repeal pre-existing condition protections are *“a bridge too far for our members.”*

 

Those ObamaCare protections include what is known as community rating, which prevents insurers from charging higher premiums to people with pre-existing conditions, and guaranteed issue, which prevents insurers from outright denying coverage to them.

 

McHenry spoke in personal terms about the importance of keeping in place those Affordable Care Act (ACA) provisions, contained in Title I of the law.

 

“If you look at the key provisions of Title I, it affects a cross section of our conference based off of their experience and the stories they know from their constituents and their understanding of policy,” McHenry said.

 

*“My family history is really bad, and so my understanding of the impact of insurance regs are real, and I believe I'm a conservative, so I look at this, understand the impact of regulation, but also the impact of really bad practices in the insurance marketplace prior to the ACA passing,”* he continued. *“There are a lot of provisions that I've campaigned on for four election cycles that are part of the law now that I want to preserve.”*



Meanwhile, other Republicans are also supporting ObamaCare's expanion of Medicaid and the so-called "minimum coverage" mandate that, among other things, *requires men to pay for maternity benefits*...*and while it may now be customary for our snowflakes to "choose" their own gender, we're pretty sure that biology doesn't actually work that way.  *



Many Republicans from states that accepted ObamaCare’s expansion of Medicaid are supporting keeping it.

 

A group of Republican senators, including Sen. Cory Gardner (R-Colo.), the chairman of Senate Republicans’ campaign arm, last month *objected to a draft of the House GOP repeal bill because it did not “provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states.”*

 

The House bill would effectively end the Medicaid expansion starting in 2020. Rep. Chris Smith (R-N.J.) warned that change “affects so many of our disabled individuals and families, and the working poor.”

 

Republicans had long derided ObamaCare’s “essential health benefits,” which mandate 10 health services that insurance plans must cover. They have said, for example, that men should not be forced to pay for plans that cover maternity care.

 

But now some Republicans are speaking up in favor of those requirements, including the chairman of the powerful Appropriations Committee, Rep. Rodney Frelinghuysen (R-N.J.).

 

*“In addition to the loss of Medicaid coverage for so many people in my Medicaid-dependent state, the denial of essential health benefits in the individual market raise serious coverage and cost issues,”* Frelinghuysen wrote in a statement last month announcing he would oppose the House GOP repeal bill.

 

House Republicans even touted an amendment on Thursday that they said would bring down premiums by the government helping to pay for the costs of high-cost enrollees. That program is very similar to one that already existed in ObamaCare, called “reinsurance.”



Of course, it's looking increasingly likely that former House Speaker John Boehnor was right about Republicans and healthcare all long when said that the idea of a quick repeal and replace was just *"happy talk....Republicans never ever agree on health care."* Reported by Zero Hedge 3 days ago.

Worries of an Anthem exit add to Western Slope’s health care woes

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Reports that health insurance giant Anthem is considering pulling out of many Affordable Care Act exchanges in 2018 is another blow for Colorado's Western Slope, which already pays some of the highest health insurance rates in the country and would be left with only one or no options on the state's exchange if Anthem left. Reported by Denver Post 2 days ago.

EZ4Ucare Brings Convenient Access and Affordability to Healthcare

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After several years in development, EZ4Ucare has launched its healthcare provider services with initial coverage in the states of Illinois and Missouri. EZ4Ucare is a part of the rapidly expanding $30 billion telehealth industry that is addressing two of the fundamental weaknesses in the current healthcare system: 1.) convenient access and 2.) affordability.

O'Fallon, Missouri (PRWEB) April 10, 2017

After several years in development, EZ4Ucare has launched its healthcare provider services with initial coverage in the states of Illinois and Missouri. EZ4Ucare is a part of the rapidly expanding $30 billion telehealth industry that is addressing two of the fundamental weaknesses in the current healthcare system: 1.) convenient access and 2.) affordability.

With the rising cost of health insurance, co-pays, deductibles and healthcare delivery, EZ4Ucare provides a smart solution that, with minimal cost, subscribers can access quality healthcare that addresses over 70% of the most common health conditions for which individuals seek professional medical advice and care. In the face of challenges to the repeal and replacement of the Affordable Care Act, many Americans may well likely be facing challenges to be able to access a healthcare provider for common, non-life threatening health conditions. Subscribers to EZ4Ucare can access the system that after placing a phone call, or going online to the ez4ucare.com website, consumers are able to conduct a virtual visit with a licensed medical professional in less than 15 minutes.

Speaking to the value delivered by EZ4Ucare is founder Kelly Cox, MD, FACEP, a board-certified emergency room physician. “Back nearly a decade ago, I began wrestling with the issue of coming up with a better alternative to the current healthcare delivery system. At the time, we were and are continuing to see significant advancements in technology and medicine that physicians and healthcare professionals were not fully tapping for the benefit of our patients. So, I set out to create a solution that promises to improve the delivery of healthcare that is truly patient focused both in terms of convenient access, while at the same time lowering the cost of healthcare delivery. I’m proud to say that EZ4Ucare delivers on both promises in a far superior way than does the traditional healthcare system.”

Since launching EZ4Ucare, the firm is finding success in working with small business owners that under the current terms of the Affordable Care Act (ACA) are bound to provide healthcare coverage for their employees. Although EZ4Ucare as a subscription service does not cover all an individual’s needs with respect to medical care, the service effectively addresses over 70% of the most common health ailments such as asthma, bladder infections, cold & flu, ear aches, allergies, bronchitis, migraines, eye infections, etc. For employers, EZ4Ucare provides another layer of healthcare for employees that can save the employer and the employee hundreds of thousands of dollars per year in lost productivity because of employee time away from work to visit an Emergency Room (ER) or Urgent Care facility to address a common health ailment.

According to the World Health Organization, healthcare expenditures in the U.S. represent 17.1 percent of our country’s overall gross domestic product and if unchecked, will in the future face ever increasing drain on the overall economy and on the budgets for every American household. There is little doubt that more innovative healthcare solutions will come to the fore that leverages both technology advancements and medical science. We believe that EZ4Ucare is already having an impact by making a difference in the way healthcare is delivered both in terms of providing convenient access while lowering cost. In the end, we are keeping our focus on the care and wellbeing of our patients that is making a positive difference in the lives of the people it serves.

About EZ4Ucare

EZ4Ucare is a telehealth services provider delivering quality medical advice and care for our member patients from the comfort, convenience and security of their homes, offices, and colleges/universities, 24/7, 365 days a year. EZ4Ucare employs highly qualified and experienced healthcare professionals (Physicians and Nurse Practitioners) who are U.S. trained and board certified with combined years of experience in family practice, urgent care, and emergency medicine. Accessing the healthcare provider resources of EZ4Ucare results in elimination of lengthy wait times in emergency rooms and urgent care facilities, while delivering high quality medical care and advice whenever and wherever a patient needs it, saving both time and money in the process. For more information visit our website at ez4ucare.com. Reported by PRWeb 2 days ago.

PlanTruth.com is the World’s First Health Insurance Ratings Website

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Live on Kickstarter, PlanTruth.com plans to make it easy for customers to fully research health insurances before signing up for a plan.

Brooklyn, NY (PRWEB) April 10, 2017

PlanTruth.com, the world’s first health insurance ratings website, is live on Kickstarter and raising funds to grow and scale the company nationwide.

With dozens of different medical insurance types, companies, plans, deductibles, copayments and so on, patients really need to do their research prior to signing up for a plan. The problem is - there is absolutely no way for patients to actually do that research.

PlanTruth.com will change that by serving as the go-to medical insurance ratings website. For the first time, people will be able to rate and discuss their medical insurance or view what other people (and medical providers) have stated about specific insurance companies and plans. PlanTruth.com is hoping to be the number one destination forum for healthcare plan reviews, rankings, and information.

"I am a practicing cardiologist in Brooklyn, NY. I have been asked a lot of different questions by patients, but the hardest one so far has been: 'Doc, what insurance should I get?,'” says founder and CEO Vladimir Fridman on the inspiration behind the project. “The truth is, nobody really knows the answer to that question. We must have a place for patients to go to in order to obtain information about their healthcare insurance plan options.”

The company launched in February 2017 in New York State, and planning to expand to become the number one source of ratings and information for health insurance plans in the entire United States. The website serves as the definitive resource for health insurance, breaking down the details of every plan available in state with a robust glossary available to help consumers navigate the medical terminology.

"Healthcare reform of any type must start with the consumers/patients. They must have access to information about their healthcare plan options,” adds Fridman. “Government is now focusing on ‘increasing patient options’ as a strategy for healthcare reform. The only way such changes would work is if patients actually understand their options.”

PlanTruth.com is currently live and available to support on Kickstarter: http://kck.st/2ncvmIp

About PlanTruth.com

Plantruth.com is the first and only healthcare insurance plan ratings website. We aim to be the go to website for patients, providers, and all Americans to rate, review, and learn about their healthcare plans and their healthcare plan options.

Plantruth.com is a 100% non-political website. We aim to simplify the constantly changing, extremely complex, healthcare insurance environment and make sure that all Americans know their healthcare plan options.

For more information on PlanTruth.com, please visit http://plantruth.com

### Reported by PRWeb 2 days ago.

Trump Scraps "Phenomenal" Tax Plan, Goes Back To Drawing Board

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Trump Scraps Phenomenal Tax Plan, Goes Back To Drawing Board Remember when Trump promised in early February that he would unveil a "phenomenal" tax plan within two to three weeks? Well, it was just scrapped, because as AP reports, Trump has *scrapped the tax plan he campaigned on and is going back to the drawing board, *hoping to find a plan that will have Republican consensus, something his current proposal has failed to achieve. In doing so, the president threatens the timetable of what many had seen as the primary driver behind his entire first year agenda, which is not in peril, and may not come until early 2018 if not later.

According to the AP, while Trump's first attempt to write legislation is in its early stages and the White House has kept much of it under wraps, it has already sprouted the consideration of a series of unorthodox proposals including a drastic cut to the payroll tax, aimed at appealing to Democrats. Some view the search for new options as a result of Trump's refusal "to set clear parameters for his plan and his exceedingly challenging endgame: reducing tax rates enough to spur faster growth without blowing up the budget deficit."

*The good news: *the ambitious pace to figure out a plan reflects Trump's haste to move quickly past a bruising failure to broker a compromise within his own party on how to replace the health insurance law enacted under President Barack Obama.

*The bad news: *administration officials cited by AP say it's now *unlikely that a tax overhaul will meet the August deadline set by Treasury Secretary Steve Mnuchin. *

Why is the White House, by which we mean Gary Cohn and Goldman Sachs, bypassing Congress and coming up with its own tax plan? One reason proposed is that it is trying to learn the lessons from health care: rather than accepting a bill written by the lawmakers, White House officials are taking a more active role (again: see Gary Cohn).

While administration officials have signaled that they want to pass tax legislation with only Republican votes, yet they've also held listening sessions with House Democrats, in other words there will be concessions for both parties. One problem, however, is how to raise offseting government revenues to make the plan revenue neutral and not add to the budget deficit, something which would lead to further clashes with conservative and even moderate republicans.

White House aides say the goal is to cut tax rates sharply enough to improve the economic picture in depressed rural and industrial pockets of the country where many Trump voters live. *But the administration so far has swatted down alternative ways for raising revenues, such as a carbon tax, to offset lower rates*.

More details: "Trump, who brands himself as a deal-maker, has not said which trade-offs he might accept and he has remained noncommittal on the leading blueprint, from Rep. Kevin Brady, chairman of the Ways and Means Committee."

One notable change: as expected, *the BAT is dead.*

Brady, R-Texas, has proposed a border adjustment system, which would eliminate corporate deductions on imports, to raise $1 trillion over 10 years that could fund lower corporate tax rates. But that possibility has rankled retailers who say it would lead to higher prices and threaten millions of jobs, while some lawmakers have worried that the system would violate World Trade Organization rules. Brady has said he intends to amend the blueprint but has not spelled out how he would do so.

Among the other options are being shopped on Capitol Hill, include changing the House Republican plan *to eliminate much of the payroll tax and cut corporate tax rates*. This would require a new dedicated funding source for Social Security. It would also mean that the Trumpflation trade, and any stock market upside as a result of reduced effective taxes are similarly dead.

As previously reported, *instead of a BAT the administration is currently contemplating a VAT.*



The change, proposed by a GOP lobbyist with close ties to the Trump administration, would transform Brady's plan on imports into something closer to a value-added tax by also eliminating the deduction of labor expenses. This would bring it in line with WTO rules and generate an additional $12 trillion over 10 years, according to budget estimates. Those additional revenues could then enable the end of the 12.4 percent payroll tax, split evenly between employers and employees, that funds Social Security, while keeping the health insurance payroll tax in place.



This approach would give a worker earning $60,000 a year an additional $3,720 in take-home pay, a possible win that lawmakers could highlight back in their districts even though it would involve changing the funding mechanism for Social Security, according to the lobbyist, who asked for anonymity to discuss the proposal without disrupting early negotiations.

While the White House would not comment on the plan, it has recently said a value-added tax based on consumption is not under consideration "as of now."

No matter what final shape Trump's proposal takes, it appears almost inevitable that the president will again face significant internal opposition:



The lack of detail about how to significantly rewrite tax laws for the first time in 30 years may provide Trump some time to build consensus among Republicans. But without Trump laying down his hand, lawmakers appear reluctant to back a plan that will likely stir controversy. "Because there are trade-offs, congressmen need cover from the president to withstand the lobbyists and constituents who are going to complain," said Bill Gale, an economist at the Brookings Institution who worked at the White House Council of Economic Advisers during President George H.W. Bush's administration.

 

The Trump administration appears to have shut out the economists who helped assemble one of his campaign's tax overhaul plans, which independent analyses show would have increased the budget deficit. "It's a little frustrating that they feel they have to write a new tax plan when they have a tax plan," said Steven Moore, an economist at the conservative Heritage Foundation who helped formulate tax policy for the Trump campaign.

 

Sen. Rob Portman, R-Ohio, a member of the Senate Finance Committee, said that all of the trial balloons surfacing in public don't represent the work that's being done behind the scenes. "It's not really what's going on," Portman said. "What's going on is they're working with on various ideas."



Meanwhile, as we showed several weeks ago...

... investors no longer believe Trump can deliver a tax plan, with Goldman's high tax basket having wiped out all gains since the election.

Stocks rallied after his election on the promise of lower taxes and fewer regulations, but the Dow Jones Industrial Average has dipped 1.2 percent over the past month as the path for health care and tax revisions has become muddied.

"The White House is going to need its own clear direction, or it's going to need to defer to Congress, but saying that your plan is forthcoming and then not producing a plan kind of puts everything in stasis," said Alan Cole, an economist at the conservative Tax Foundation. Reported by Zero Hedge 2 days ago.

The uninsured rate just ticked up for the first time in a while during Trump's first quarter in office

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The uninsured rate just ticked up for the first time in a while during Trump's first quarter in office The percentage of Americans that did not have health insurance increased during the first quarter of 2017, according to data from Gallup-Health Ways.

The Well-Being Index found that the percentage of uninsured Americans ticked up to 11.3% in the quarter, an uptick from 10.9% at the end of 2016, which was a record low for the history of the index.

According to Gallup and Health Ways, the recent fight over the repeal and replacement of the Affordable Care Act, or Obamacare, may have been a contributing factor for the increase, as the future of healthcare became murkier.

"The slight rise in the number of uninsured Americans in the first quarter of 2017 could, in part, be attributable to the uncertainty surrounding the long-term future of the Affordable Care Act," the release said. "As such, it will be important to monitor the uninsured trends in the coming months as these events unfold. If coverage options and premiums do change, members of Congress from both parties may show a renewed urgency to address the healthcare issue."

While the increase in the uninsured rate was just the third increase since the start of Obamacare's individual insurance exchanges launched in 2013, the overall rate is still well below its level when Obamacare was instituted.

"Despite an uptick in the uninsured rate in the first quarter of 2017, the number of U.S. adults without health insurance is still 6.7 percentage points lower than it was at its peak in the third quarter of 2013," Gallup-Health Ways. "The uninsured rate reached 18.0% that quarter, just before the health insurance exchanges opened in October 2013."

The survey found that the largest declines since the end of 2013 have come for Americans aged 26 to 34 (a 9.8-percentage point decline), Hispanics (a 10.1-point decline), and households making less than $36,000 annually (a 8.6-point decline).

The Republican plan to repeal and replace Obamacare, the American Health Care Act, was estimated to decrease the number of Americans with insurance by 24 million over 10 years compared to the current baseline under the ACA, according to the Congressional Budget Office.

Insurers have also begun to exit some Obamacare exchanges preemptively, as the future of the exchanges remains in limbo.

*SEE ALSO: One of the nation's biggest health insurers is ditching Iowa's Obamacare exchanges*

Join the conversation about this story »

NOW WATCH: 'CALM DOWN': Watch Sean Spicer spar with reporters over Trump's wiretap claims Reported by Business Insider 2 days ago.

Gilsbar Growing with New Regional Sales Manager

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Lisa Munoz Joins Gilsbar’s Sales Team

Covington, LA (PRWEB) April 11, 2017

Gilsbar is pleased to announce the addition of a new Regional Sales Manager, Lisa Munoz. Working through brokers and consultants, she will lead Gilsbar's sales efforts with mid to large market employers.

Based out of Houston, Texas, Lisa will be responsible for expanding the Gilsbar footprint within the Southwest Central region, consisting of key markets in Texas, Oklahoma, and Arkansas. Ms. Munoz brings 17 years of experience in the employee benefits industry to the Gilsbar team. Prior to joining Gilsbar, Ms. Munoz was in a sales role with wellness company Vitality, worked as an Account Executive at Pacific Life, and served as the Director of Sales for Memorial Hermann Health Insurance Company.

Stephen Cali, Gilsbar’s Director of Sales, stated “Lisa has an unwavering commitment to be a market-driven thought leader, and we’re excited to have her on our team. With existing sales professionals located in the west, central, eastern and now south-central region, Gilsbar is strategically positioned as one of the largest privately-held health and benefit management entities in the country.”

Ms. Munoz attended the University of Texas in San Antonio and has been a member of the Hispanic Chamber of Commerce and the Health Underwriters Association, and has volunteered for 16 years for the Houston Livestock Show and Rodeo, where she is currently a member of the International Committee.

###

About Gilsbar, LLC

Established in 1959, Gilsbar, LLC® is one of the largest privately-held insurance services organizations in the country. Recognized as a catalyst for creating healthy businesses, Gilsbar, LLC® offers self-funded and fully-insured benefit plan management services, along with Wellness, Advocacy, and overall Population Health Management. Gilsbar, LLC’s integrated delivery model improves the health and well-being of its members, resulting in significant health plan savings for its clients.

Gilsbar, LLC® has been honored by Inc. magazine for its sustained growth, Modern Healthcare and Business Insurance magazines as a Best Place to Work, and WELCOA and the American Heart Association for its proven wellness methodology.

For more information, visit http://www.Gilsbar.com. Reported by PRWeb 1 day ago.

UnifyHR Expands Its Services to Include Eligibility Verification Services

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Initially focusing on the complexities associated with the employer mandate requirements of the Affordable Care Act (ACA), its long-term vision has always been to consolidate employee facing administrative solutions in a single unified platform under the UnifyHR banner. Their Eligibility Verification Service is just the first of several anticipated product releases.

Dallas, TX (PRWEB) April 11, 2017

UnifyHR announced today it has expanded its product offerings to include Eligibility Verification Services (EVS). Driven by its flexible rules-based technology, UnifyHR is a leader supporting some of the largest and most complex employers with ACA Compliance Administration. UnifyHR’s vision is to create a platform unifying HR administrative solutions under a single platform. EVS is just the first of several anticipated product releases.

With escalating health insurance premiums, there is increasing pressure on plan fiduciaries to control health benefit costs. The most compelling initiative remains regularly performing Dependent Eligibility Audits.

The UnifyHR management team brings more than a decade of dependent audit experience designing, implementing and delivering effective audit campaigns. Given UnifyHR’s flexible platform design and its leadership team’s prior experience with eligibility verification audits, it naturally made sense to roll out EVS. “We have balanced our tried and true employee communication strategies with an enhanced audit tool which once again positions UnifyHR as the industry innovator with this product,” says Gehrki.

UnifyHR’s experience has demonstrated that faster audit validation reduces the uncertainty faced by employees and their employers. Its technology reduces the risk associated with human data entry errors. Once the dependent information is validated, UnifyHR quickly updates the employee’s status through its secure web portal. Confirmation is then sent by electronic communication notifying the employee that their verification obligation has been met. This significantly reduces the number of employee questions and calls associated with the audit, reducing disruption for the employees.

“Additionally, another key product differentiation is our employee-focused communication materials that help gain employee buy-in to the process,” says Gehrki. UnifyHR’s team spent years perfecting the appropriate messaging to help employees understand why they are being asked for this information, and how their participation will preserve the fiscal integrity of the plan and their own personal finances.

UnifyHR remains committed to providing service excellence. Through its technology, knowledge and experience, the market can expect the same exceptional service that UnifyHR clients have come to expect.

About Us: UnifyHR was founded in 2013 by a group of industry experts and visionaries with a combined history of more than 100 years in benefits and compliance administration. Now, with hundreds of clients that range in size from 150 to more than 150,000 employees, UnifyHR supports over 1.2 million employees annually. Initially focusing on the complexities associated with the employer mandate requirements of the Affordable Care Act (ACA), its long-term vision has always been to consolidate employee facing administrative solutions (e.g. payroll, HRIS, ACA, benefits administration), in a single unified platform under the UnifyHR banner. To learn more, visit us at http://www.unifyhr.com. Reported by PRWeb 1 day ago.

Highmark Teams with Best Doctors, Inc. to Improve Accuracy of Diagnosis through Virtual Second Opinions by Globally Renowned Medical Experts

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As data continues to show the devastating impact of misdiagnosis, the nation's fourth-largest Blue Cross and Blue Shield-affiliated organization partners with Best Doctors to provide virtual expert second opinions for members and their physicians dealing with rare or complex medical conditions.

BOSTON AND PITTSBURGH (PRWEB) April 11, 2017

Highmark, Inc., the nation’s fourth largest Blue Cross and Blue Shield-affiliated organization, and Best Doctors® today announced their partnership to provide virtual expert second opinions for Highmark members and their physicians dealing with rare or complex medical conditions. Best Doctors, the global leader in the effort to assure diagnostic and medical certainty, provides access to more than 53,000 of the world’s brightest minds in over 450 medical specialties, without the need for patients to travel far from home. Data from Best Doctors show that consultation with its experts results in corrected or refined diagnosis in 37 percent of its U.S.-based cases, and corrects or improves treatment in nearly 75 percent of cases.

“Improving the quality and value of care delivery is the mission that drives both our organizations,” noted Peter McClennen, CEO of Best Doctors, Inc. “Best Doctors’ partnership with Highmark is an example on how two companies with a shared vision can work together to transform health care and improve the patient experience.”

“Highmark chose to partner with Best Doctors on second opinions because their process is patient-centric and clinically collaborative,” said Charles DeShazer, M.D., chief medical officer at Highmark. “We like that medical decision-making remains at the local level with the treating physician because this fosters continuity of care.”

With the member’s permission, their Highmark case manager collaborates with a case manager at Best Doctors. Together they gather the member’s complete medical record, avoiding the fragmentation of records which often complicates the diagnostic picture. The information and scans are carefully compiled to help provide a clearer view of the patient’s entire history with the Best Doctors expert. These experts are clinically and academically accomplished, affiliated with national and global centers of excellence, and elected by their peers to the top five percent of U.S. physicians. They then undertake a structured and comprehensive review, devoting many clinical hours to each case, analyzing it from multiple angles in a criterion-based review before preparing their report which is shared with the Highmark member and their doctor.

“Medicine is a collaborative process and doctors learn from each consultation,” DeShazer added. “With Best Doctors, they’re gaining the opportunity to learn from the very best. Members may decline the second opinion, but experience indicates Best Doctors’ recommendations are incorporated into the treatment plan over ninety percent of the time, indicating the high value physicians place on these experts’ opinions.”

Highmark members with complex conditions and multiple comorbidities, elusive diagnosis, multiple hospitalizations and ER visits, and facing decision points in care are the best candidates for the program. Best Doctors will be available for Highmark’s fully-insured customers as well as to Highmark’s Affordable Care Act (ACA) members.

“The uncertainty of not knowing your diagnosis or receiving an incorrect one comes with a tremendous physical, emotional, and financial toll,” added McClennen. “This partnership between Highmark and Best Doctors represents an opportunity to reverse that negative impact and bring peace of mind to many patients simply looking for the right answers.”

ABOUT HIGHMARK
Highmark Inc. and its health insurance subsidiaries and affiliates collectively are among the ten largest health insurers in the United States and comprise the fourth-largest Blue Cross and Blue Shield-affiliated organization. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5 million members and hundreds of thousands of additional members through the Blue Card program. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.
For more information, visit http://www.highmark.com.

ABOUT BEST DOCTORS, INC.
Founded in 1989 by Harvard Medical School physicians, Best Doctors is a medical information services company that connects individuals facing difficult medical treatment decisions with the best doctors, ranked by impartial peer review in over 450 subspecialties of medicine, to review their diagnosis and treatment plans. Best Doctors has grown to over 40 million members worldwide utilizing access to the brightest minds in medicine, analytics and technology to deliver improved health outcomes while reducing costs. For further information, visit Best Doctors at http://www.bestdoctors.com.

To schedule an interview with Best Doctors’ Executive Team, contact Justin Joseph at Ph: 617-359-5522 or jjoseph@bestdoctors.com.

To schedule an interview with Highmark, contact Wendy Morphew at Ph: 412-544-3616, Cell: 917-697-1782 or wendy.morphew(at)highmarkhealth(dot)org

BEST DOCTORS, the STAR-IN-CROSS logo, THE REINVENTION OF RIGHT and CRITICAL CARE INTERCONSULTATION are marks or registered marks of Best Doctors, Inc. Used with permission.
### Reported by PRWeb 1 day ago.

Financial Strategies for Surviving Healthcare Collapse

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The fact is, if Obamacare isn’t available in 2018, or is so expensive no one can afford it, millions of Americans will have no health insurance. Reported by Newsmax 1 day ago.

State employee health insurer GIC to partner with for-profit Iora Health

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The Group Insurance Commission, the quasi-state agency the oversees health insurance for state and some government employees, will partner with Iora Health starting this summer to provide specialized health care to around 2,000 people in an attempt to save the state money. Cambridge-based Iora, a for-profit health system that's been providing primary care to patients over the age of 55 for years, will be available to those members who are enrolled in the UniCare plan through the state and also live… Reported by bizjournals 1 day ago.

The Well Economy: J. Walter Thompson’s Innovation Group Launches Cross-Sector Dive Into Health And Wellbeing

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As wellness becomes a top consumer priority, lifestyle industries meet healthcare providers in a rapidly shifting landscape

New York, NY (PRWEB) April 11, 2017

A new report from J. Walter Thompson’s Innovation Group tackles one of today’s most explosive consumer sectors: health.

“The Well Economy” comes at a time when the definition of “health” is expanding rapidly – as are the industries that cover it. Sectors from retail to beauty are taking cues from wellness branding to realign with consumer priorities. And technology is driving unparalleled changes in healthcare, creating a storm of disruption in the $3 trillion US healthcare industry.

What does it mean to be well? How are health and wellness brands evolving? And most importantly, how can brands reach consumers in this space?

To answer these questions, “The Well Economy” features exclusive interviews with experts in both the healthcare and lifestyle industries. The insights are supported by original data from a survey of 1,007 US consumers conducted by SONAR™, J. Walter Thompson’s proprietary research unit.

Key findings from the report include:· 77% of consumers associate “health” with their physical condition, but nearly as many (75%) include mental health as well
· Millennials look outside of the pharmacy for treatment, preferring non-medicinal options (59%) to over-the-counter (55%)
· Consumers welcome leadership from Silicon Valley: 75% of respondents think startups could improve health insurance
· While 64% of respondents would prefer to track their health from home, a majority (54%) have not found health-tracking apps useful
· Just 37% of consumers would trust consumer brands with their DNA information

Lucie Greene, Worldwide Director of the Innovation Group, said of the new report: “As we expand how we define wellbeing, we’re seeing a more holistic view of health that wraps in body, mind, and more while also creating space for new opportunities for brands.”

The report also includes 14 pages of original infographics that offer a peek at the new visual language of healthcare as well as a preview of revolutionary technologies that will shape health moving forward.

Download “The Well Economy” here. To inquire about receiving press access to the report, please contact innovation@jwtintelligence.com.

# # #

ABOUT THE INNOVATION GROUP
The Innovation Group is J. Walter Thompson’s futures, research and innovation unit.
It charts emerging and future global trends, and consumer change and innovation patterns, and translates these into insight for brands. It offers a suite of consultancy services, including bespoke research, presentations, co-branded reports and workshops. It is also active in innovation, partnering with brands to activate future trends within their frameworks and execute new products and concepts.

The Innovation Group is part of J. Walter Thompson Intelligence, a platform for global research, innovation and data analytics at J. Walter Thompson Company. It houses three key in-house practices: SONAR™, Analytics and the Innovation Group. For more information, please visit http://www.jwtintelligence.com and follow us @JWTIntelligence.

ABOUT J. WALTER THOMPSON COMPANY
J. Walter Thompson Company was founded in 1864 and has been making pioneering solutions that build enduring brands and business for more than 150 years. Today the company has evolved to include several global networks including J. Walter Thompson Worldwide, Mirum and Colloquial. Reported by PRWeb 22 hours ago.

United Airlines, David Dao, And The Way We Blame

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Some years ago I was walking by Croke Park stadium in Dublin immediately after the close of the All-Ireland Hurling Final, in which County Tipperary defeated County Galway. Amidst the sea of jubilant Tipperary supporters in yellow floated disconsolate knots of Galway fans in maroon, and one of these passed close by me, its members grimly silent until one gave name to the depth and nature of their despair: “It’s so bloody predictable; I can’t believe it happened.”

There are some misfortunes that seem so inevitable that their occurrence is a surprise on two levels ― that nothing was done to prevent what happened, and, perversely, that it did not happen sooner. A sports disappointment, however it may feel in the moment, is a trivial but illustrative example; another instance, far more serious, is the violent ejection of Dr. David Dao from a United Airlines flight after he declined to give up his seat so that United personnel could take it, and, in particular, what an element of the public response reveals about how people take sides in disputes.

Dao’s forcible eviction from his seat was not so much a genuine aberration as a grotesque exaggeration of existing phenomena ― overbooking and overselling (neither of which, it should be noted, apply to the flight in question), nebulous rules for denying passengers service, and the general deterioration of the customer experience over years were bound to converge into an ugly incident at some point (though it would have taken a gifted seer indeed to anticipate a passenger badly bloodied while being dragged from a seat for which he had paid and had already occupied.) It is simultaneously surprisingly and sadly predictable.

Equally predictable and perhaps more instructive is a particular element of the public response, one that seeks to excuse or vindicate United Airlines and is prepared to indict Dao in order to do it. While the broad public response has been condemnatory of United Airlines, the airline has its share of apologists and defenders. The first and broadest line of defense are variations on the theme of “What else was United supposed to do?”, as if calling the police to clean up by physical force what was essentially a corporate scheduling error was the only available option (as opposed to, say, raising the offer of compensation for volunteers to take a later flight, or flying their personnel on a different plane.)

The second line of defense is narrower, because it requires time and some degree of investigative skill: smearing Dao, himself. A few media outlets found themselves up to the task, starting with the Louisville Courier-Journal, which had, at least, the (painfully thin) excuse that Dao is a local figure to justify an article on Dao’s legal history from more than a decade ago. Other publications lacked even that pretext, and proceeded anyway. That Dao’s legal history, much less his career as a poker player, are irrelevant to the incident at hand should go without saying. 


Even in this seemingly indisputable set of circumstances, the victim found critics -- unbelievably, and yet predictably.

These defenses of United are not just unsupportable, they are unsettling. They reveal in their users a fundamental refusal, or inability, to comprehend someone else’s perspective, and a need to fortify their belief in a world in which something bad can happen to another person only if that person has done something to deserve it.

For some, a refusal to comply with an order given by an airline (ponder for a moment the absurdity of those words outside of any context other than the prevention or management of an aviation emergency) is sufficient reason to be beaten bloody; for others, Dao must be shown to have been in some other, more personal way deserving of pain and judgment, even if that justification is a decade old and totally irrelevant.

That urge to explain misfortune by finding fault with the unfortunate (almost certainly a relic of white America’s puritan roots, among other things) is hardly limited to cases like this; it occurs across a range of issues, and often follows a similar pattern, with an indictment of the victim’s conduct in the incident in question, followed by a deeper investigation into their past.

This grim two-step is especially familiar in instances of police violence against ethnic minorities (the shooting of Michael Brown comes particularly to mind, with his actions on the day examined in microscopic detail while his past led to the infamous “no angel” article in the “New York Times”); it is probably not a coincidence that we find it now in a case where the man subjected to unwarranted violence by law enforcement, in this case to preserve the convenience of United Airlines, belongs to an ethnic minority.

But this phenomenon also occurs on broader issues of public policy; during the recent debate on health care, Rep. Jason Chaffetz admonished Americans that they may have to choose between getting an iPhone and having health insurance, with the clear implication that people who find themselves without adequate health care do so through their own improvidence, and not because of a health care system that produces medical-debt-related bankruptcies with such frequency and regularity that a casual observer might think that the sole reason for its existence.

These are not majority positions, but if this tendency in public discourse is narrow, the Dao incident shows that it is deep. An airline appealed to law enforcement to forcibly evict a man from a seat for which he had paid, with no justification beyond the airline’s financial and logistical convenience. And yet, even in this seemingly indisputable set of circumstances, the victim found critics ― unbelievably, and yet predictably.

-- 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.

Trump Admin. Position on Healthcare Subsidies Undecided

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The Trump administration has yet to decide whether it will continue to pay subsidies to health insurance companies under the Affordable Care Act, The Hill reported. Reported by Newsmax 17 hours ago.

Starbucks extends health insurance to the parents of workers in China

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The new health-insurance policy is a response to traditional values in China, the company said, as children often care for their parents and grandparents in a society that doesn’t have a comprehensive safety net for the elderly. Reported by Seattle Times 17 hours ago.

Zimbabwe: Rural Folks to Use Livestock As Health Cover

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[The Herald] Cabinet has approved a framework under the proposed National Health Insurance Scheme that will result in people in rural communities using livestock for health cover, a Government official has said. Reported by allAfrica.com 10 hours ago.

What Happens To A Congressman's Health Insurance If Obamacare Goes Down?

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Under the Affordable Care Act, most members of Congress and staff who want to buy health insurance must buy it on the exchange. That requirement is not affected by bills aimed at replacing the ACA. Reported by NPR 8 hours ago.

There are a few simple ways Trump could cause Obamacare to 'explode'

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There are a few simple ways Trump could cause Obamacare to 'explode' Soon after the Republican bill to reform the US healthcare system was pulled from the House floor due to insufficient support from the GOP, President Donald Trump told reporters that the old law is "exploding." He has also said Obamacare's insurance exchanges are "collapsing" and "dead."

Despite the dire predictions, most analysts — from S&P to the Brookings Institution — say the individual marketplace as it currently operates is not going to collapse on its own.

But, Trump could quicken its demise through a range of options, from standing pat on key issues or deciding to use regulatory power to weakening some of the central tenants of Obamacare.

As he Trump said, "The best thing we can do is let Obamacare explode."

*Cost-sharing subsidies*

Perhaps the most significant way Trump could help aid the Obamacare market's explosion would be to halt the payment of the crucial cost-sharing subsidies.

Such payments go to insurers to offset the costs they incur for offering lower deductible and out-of-pocket cost plans to people in the exchanges with income of up to 200% of the federal poverty line. Roughly 58% of the 12.2 million people signed up through the ACA exchanges benefit from these subsidies.

However, the House has argued that since this money was not assigned in an appropriations bill, it constitutes an illegal use of funds. It sued the executive branch under the Obama administration in a case now named House v. Price (referring to current Health and Human Services Secretary Tom Price). A court ruled in favor of the House in May 2016, but the Obama administration appealed the ruling and a judge ordered the payments to continue until the appeal was heard.

The New York Times reported Monday that the Trump administration still has plans to continue the cost-sharing subsidies. The Department of Health and Human Services pushed back on the report on Tuesday, calling it "inaccurate." HHS spokesperson Alleigh Marré said regarding the decision to prosecute the case (emphasis ours):

"The administration is current deciding its position on the matter. We have not been contacted by Democrats to save Obamacare, because they consider Obamacare to be a losing cause. Democrats need to help to solve this failed Obamacare plan. *The report was in reference to the current status of the lawsuit and is not an indication of what will happen in the future. No decision has been made about how the administration will proceed.*"

If Trump and Attorney General Jeff Sessions decide to drop the appeal, the subsidies would cease and cause costs to soar, said Cynthia Cox, associate director at the Kaiser Family Foundation, a nonpartisan health organization.

"If the administration were to drop the case, the fear for insurers is that costs to cover those lowest-income people would soar," Cox said. "These subsidies help insurers provide that coverage and without it, fewer of them would be willing to be in the exchanges."

Even if the companies stayed in the market, insurers would have to increase their premiums substantially in order to make up for the lost payments. Kaiser estimates that average premiums would have to increase 19% on top of current estimates in order to make up for the lost payments.

Additionally, states would see a wide range of premium increases, varying between an extra 9% in North Dakota to an additional 27% in Mississippi.

*Laid-back mandate enforcement*

Another major option the Trump administration has at its disposal would be taking a step back on the tax penalty for people who don't obtain insurance.

The Internal Revenue Service already confirmed in February that if a person did not fill out their tax form indicating they had insurance, called a "silent" return, the agency would still accept it. While the mandate could still come up in an audit, it is a big change from the outright rejection of forms the IRS had outlined, making it easier to avoid the individual mandate.

Cox said the Trump administration could also instruct the IRS not to investigate any instances of a "silent" return for then individual mandate, or easily grant waivers for the mandate penalty, allowing people to get out of paying.

"If the Trump administration were to do either of those things, it would have the same effect as repealing the individual mandate," Cox said.

While the individual mandate is an incredibly unpopular provision of Obamacare, it is designed to get healthier people into the marketplace to bring down costs for those that are older and sicker. It has also proved to help improve insurers' financial performance in the markets.

*Time is running out*

There are also other, smaller ways Trump and his administration could undermine the law, like pulling outreach and advertising for exchange enrollment. The most under the radar move for Trump, however, would be to stay incredibly silent.

During the Obama administration, the department of Health and Human Services attempted to provide as much clarity as possible to insurers in order to get them to participate in the insurance market. Changes to the exchanges were announced early, and there was active engagement from HHS.

If Trump and Price decide to stay mum on any future plans for the ACA, the silence alone could deter insurers from continuing to offer plans.

For instance, on April 4, insurer Wellmark said it was pulling out of Iowa's individual health insurance marketplace. Two days later, Aetna announced it was exiting Iowa. The moves leave 99 counties in the state with only one insurer — and five counties with two. A large portion of this is due to the uncertainty surrounding 2018, Cox said.

"Insurers don't know what the rules are going to be next year, so that is making them uncertain about sticking around in a lot of these markets," she said. "If there isn't more clarity from the Trump administration it's likely that these exits will continue and possibly accelerate."

Cox said Iowa was a relatively stable marketplace before the exits. There were multiple providers in every county, and premiums went up less than the national average for 2017. Despite these positive factors, insurers were worried about sticking around too long.

"Aetna didn't want to be the last one in these markets," Cox said. "A lot of insurers are evaluating there plans for 2018 and don't want to get stuck in a situation where they are the only insurer. This means there are more of these exits to come.

Insurers could be pressured into sticking in markets where there is only one insurer to avoid a gap in coverage, so by leaving early, Aetna made sure it wouldn't get stuck with the bag.

By June 21, insurers have to submit their plans for the 2018 coverage year to be approved in whichever states they wish to participate. If the Trump administration sows the uncertainty until that point, with silence and a lack of clarity, then the explosion he predicted may come to pass.

*SEE ALSO: Trump's next big economic plan is already hitting speed bumps*

Join the conversation about this story »

NOW WATCH: 'CALM DOWN': Watch Sean Spicer spar with reporters over Trump's wiretap claims Reported by Business Insider 3 hours ago.

TRUMP: 'It's been very much misreported that we failed with healthcare'

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TRUMP: 'It's been very much misreported that we failed with healthcare' President Donald Trump said that the fight over healthcare is not finished because the overhaul needs to be done to ensure a "great tax reform" bill.

In an interview with Fox Business' Maria Bartiromo, Trump said that tax reform is going to happen "at some point very soon," but that Republicans need to first repeal and replace Obamacare in order to have the budgetary freedom to pass the tax plan they want.

Additionally, Trump said the death of the American Health Care Act — the House GOP bill to overhaul healthcare — was greatly exaggerated.

"I think we're doing very well on healthcare," Trump said. "It's been very much misreported that we failed with healthcare. We haven't failed, we're negotiating and we continue to negotiate and we will save perhaps $900 billion."

Trump is referring to the Congressional Budget Office report on  the AHCA. The CBO estimated that the bill could cut the federal outlays by $880 billion over the next 10 years, and the deficit could shrink by $337 billion. However, after the most recent additions to the AHCA, the CBO updated this to say the deficit could shrink by only $151 billion with outlays decreasing by $1.15 billion and revenue falling by $999 billion.

While the AHCA had some tax cuts directly baked in, the estimates suggest it would have only slightly lowered the federal budget deficit, largely through Medicaid reductions, potentially allowing for even more tax cuts.

"You know if you look at the kind of numbers we're talking about that's all going back into the taxes and we have to do healthcare first to pick up additional money so that we get great tax reform," said Trump. "So we're going to have a phenomenal tax reform, but I have to do healthcare first."

Trump did admit that the healthcare process is "very,very difficult" but since Obamacare is "failing" something must be done. While most healthcare policy experts argue that the Obamacare individual health insurance exchanges are not failing, they say the Trump administration could still undermine the marketplace.

Additionally, Trump would not commit to the deadline for tax reform laid out by Treasury Secretary Mnuchin, who said Trump will sign a tax reform bill by the congressional recess in August.

"I don't want to put deadlines," the president said. "Healthcare is going to happen at some point. Now, if it doesn't happen fast enough I'll start the taxes. But, the tax reform and the tax cuts are better if i can do healthcare first."

While there has been little clarity so far on tax reform, the other major part of Trump's economic agenda — a promised $1 trillion in infrastructure investment — remains murky as well. The president said that in order to get a second bill on healthcare passed, which would require 60 votes to avoid a Democratic filibuster in the Senate, he may include the infrastructure package.

"I see it, perhaps, as part of the healthcare plan," Trump said. "Because phase two of the healthcare plan in order to get the votes, I need 60% for that and if I put that in the Democrats are actually gong to love the infrastructure plan."

*Watch Trump's comments here via Fox Business:*

Watch the latest video at video.foxbusiness.com

 

*SEE ALSO: There are a few simple ways Trump could cause Obamacare to 'explode'*

Join the conversation about this story »

NOW WATCH: A Navy SEAL explains why you should end a shower with cold water Reported by Business Insider 3 hours ago.

Pekin Life Insurance Completes Final Conversion to LIDP’s Life, Annuity, Health Administration Solution

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Pekin Life Insurance Completes Final Conversion to LIDP’s Life, Annuity, Health Administration Solution WOODRIDGE, Ill.--(BUSINESS WIRE)--LIDP Consulting Services (LIDP), a provider of innovative and proven software solutions and related services designed specifically for the life, annuity and health insurance markets, today announced Pekin Life Insurance Company, a multi-line company and an integral part of the Pekin Insurance® group of companies, is now fully in production with LIDP’s The Administrator solution. After completing six successful conversions, Pekin Life is now operating on a singl Reported by Business Wire 3 hours ago.
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