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CEO prescription for health care

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The government has implemented reimbursement reforms under the Affordable Care Act that aim to cut costs, but with private employers and their workers footing the bill for nearly half of the nation's $2.7 trillion in health-care spending, the council CEOs think that by working together companies can leverage their market power to do more.

"We can all make these incremental changes that we've all made, we can continue the wellness plan, but the question is really with long-term thinkinghow do we drive to a long-term change?" said council member Brian Moynihan, CEO of Bank of America.

The CEOs are challenging business leaders not just to improve care for their companies, but their communities and the nation's health system.

Telecom provider Verizon, which spends $3.5 billion a year to provide coverage for 740,000 workers, retirees and dependents, is focused on leveraging mobile and interactive technology to widen access to lower-cost care both for its employees and for community health programs.

Read MoreWhy your boss wants you to see online doctors

"We need to use the power of that technology to transform health care. Things like telemedicine, electronic health records," said Verizon Co-Chair and CEO Lowell McAdam. "All of these innovations can help people take charge of their health and improve their quality of health and their lives."

Not coincidentally, health IT is in an increasing part of the telecom giant's business. Verizon was one of the contractors that worked on the federal HealthCare.gov insurance exchange last year.

For Walgreen President and CEO Greg Wasson being a health-care provider means having a better perspective about what really works to improve the health of both the company's employees and its customers. His strategy starts with an incentive to change.

"Proactive benefit designs that encourage healthy behaviortrying to mitigate cigarette smoking, help people with weight losswhich are the top two causes of disease in this country," said the drugstore chain chief.

While Walgreen promotes smoking cessation, Wasson and the company's board have so far resisted calls from health advocates to stop selling tobacco products in its drug stores. Rival CVS Health stopped selling tobacco earlier this month.

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CEO prescription for health care

Jim Landers: Health care overhead is costing us big bucks

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WASHINGTON Americans spend more than $9,000 apiece on health care every year. Ouch, you say. But how does it feel to know that more than $1,000 of that sum goes to administrative costs? Or that Americans spend more than $210 billion a year on the health insurance claims system?

Needless back-office spending is one of the biggest sources of waste in health care, according to health insurers, providers and academics alike.

In a recent Health Affairs article, the authors estimated that administrative expenditures account for 25.3 percent of the average American hospitals annual spending. No other developed nation comes close. The next highest, the Netherlands, spends 19.8 percent on administration.

Its getting worse, said Dr. David Himmelstein, an internist who teaches at Hunter College in New York and Harvard Medical School. Himmelstein was the lead author of the article.

Its because were running health care more and more like a business. What that means is, if you think you can make $101, its worth spending $100 to do it. Hospitals are saying, gee, if we hired another financial person here they might help us bring in just a little more than their salary. Theres a whole variety of games you can play.

Any business with 25 percent of its spending going to administration should be trying to cut, not add, to that burden. Hospitals, physicians and insurers all say thats what theyre doing.

Were continuously looking at administrative costs and looking for ways to reduce the costs, Wendell Watson, director of public relations with Texas Health Resources, wrote in an email.

Over the last 10 years, weve consolidated many administrative functions to gain efficiencies and economies of scale and improved our processes to reduce costs where we can.

Texas Health Resources owns 25 hospitals in North Texas. In the 12 months ending May 31, 2013, Texas Health Presbyterian Hospital of Dallas spent $119.8 million on administrative costs, or 20.3 percent of its expenditures that year. The figures come from Medicare reports sifted by American Hospital Directory, which compiles statistics on more than 6,000 hospitals.

Much of the administrative expense in American health care is due to the complexity of billing. There are many insurance companies and hundreds of thousands more companies that self-insure their employees with their own nuanced health plans. A hospital or physicians office has to find the policy that matches the patient and send in a bill.

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Jim Landers: Health care overhead is costing us big bucks

Joan Christensen, First Data, Discusses Innovations in Health Care Payments – Video

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Joan Christensen, First Data, Discusses Innovations in Health Care Payments
In this segment, Joan Christensen, VP, Health Services, First Data, and the hosts discuss the changing world of health care payments. We need to find creative and innovative ways to automate...

By: HealthCare Consumerism Radio

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Joan Christensen, First Data, Discusses Innovations in Health Care Payments - Video

Health Benefits Home – U.S. Department of Veterans Affairs

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If you served in the active military, naval or air service and are separated under any condition other than dishonorable, you may qualify for VA health care benefits.

Many Veterans qualify for cost-free health care services based on a compensable service-connected condition or other qualifying factors.

VA strives to ensure that you have access to all of your needed services wherever you receive your VA health care. This may be on-site during inpatient hospitalization, at one of our primary or specialty care clinics, at a Community Based Outpatient Clinic (CBOC), in a Community Living Center (formerly known as a VA nursing home), or in a residential care facility. However, all services may not be available at every location.

March 24, 2014

WASHINGTON The Department of Veterans Affairs (VA) is eliminating the annual requirement for most Veterans enrolled in VA's health care system to report income information beginning in March 2014. Instead, VA will automatically match income information obtained from the Internal Revenue Service and Social Security Administration.

"Eliminating the requirement for annual income reporting makes our health care benefits easier for Veterans to obtain," said Secretary of Veterans Affairs Eric K. Shinseki. "This change will reduce the burden on Veterans, improve customer service and make it much easier for Veterans to keep their health care eligibility up-to-date."

Some Veterans applying for enrollment for the first time are still required to submit income information. There is no change in VA's long-standing policy to provide no-cost care to indigent Veterans, Veterans with catastrophic medical conditions, Veterans with a disability rating of 50 percent or higher, or for conditions that are officially rated as "service-connected."

VA encourages Veterans to continue to use the health benefits renewal form to report changes in their personal information, such as address, phone numbers, dependents, next of kin, income and health insurance.

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Health Benefits Home - U.S. Department of Veterans Affairs

Health-care Sector Surges in Sacramento

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Sept. 15--Sacramento has long been known as a state worker town. These days, it's just as accurate to call it a health worker town.

The health care sector in the four-county Sacramento region has grown steadily and significantly for more than a decade, according to the California Employment Development Department. While most other sectors shed jobs during the recession, hospitals, doctor's offices and nursing homes held strong, adding 10,000 workers between 2008 and 2014.

As a result, roughly 83,000 health care workers live in the region, up nearly 60 percent since 2000. The Sacramento region now has about as many health workers as it does state civil-service employees.

It also has more registered nurses than waiters; more dental assistants than bartenders; more nursing assistants than baristas.

"It's been a source of strength in the Sacramento economy," said Jeffrey Michael, director of the Business Forecasting Center at the University of the Pacific. "It continues to be a growing area."

The sector is growing largely because of demand: The region's baby boomers are growing older and need more health care services, Michael and others said. Health advances also keep elderly seniors -- those over age 85 -- alive longer.

"If we continue to see the growth in retirees, we may see that increase in services continue," said Tim Maurice, chief financial officer for the UC Davis Health System. UC Davis added 400 medical staff members during the last three years, he said.

The Affordable Care Act requiring Americans to obtain health insurance is another factor driving job growth, medical officials said. Californians with insurance are more likely to seek medical care.

"We have to meet that demand so we are expanding our footprint dramatically," said Dr. Joseph Jasser, president and CEO of Dignity Health Medical Foundation, which operates scores of medical offices across the state. The foundation hired more than 100 new physicians last year and expects to hire another 150 this fiscal year.

Health workers tend to be well-paid and educated. When they spend their earnings, they support other sectors of the economy.

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Health-care Sector Surges in Sacramento

How to save on health care in retirement

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And while trying to stay healthy, McClanahan advises her clients to pay attention to their health care consumption habits. Figuring out what McClanahan calls your "health-care mindset" will help you budget for the medical care you need, which is critical for many of today's retirees on fixed incomes who don't have the luxury of a pension.

"People who go to the doctor for everything are going to have higher medical costs," said McClanahan. "So if you're seeing every doctor under the sun, you need to save more money."

Take especial care if you tend to rely on holistic medicine, McClanahan added, as that's not covered under most medical plans and can be quite expensive.

Read MoreFinding your 'magic number' for retirement savings

But even if you're not going for homeopathic remedies, it's important to understand your health insurance. Just 7 percent of people between the ages of 55 and 64 felt knowledgeable about Medicare coverage options, according to the Merrill Lynch study.

Knowing what your plan does and does not cover can help you decide whether it's worth signing up for supplemental insurance or paying into a long-term care insurance plan.

While thinking about what you'll need in the event of long-term care, you should also go ahead and have frank discussions with your loved ones, McClanahan said. That means figuring out what you'll want medically when the situation takes a turn for the worst. For instance, will you seek aggressive treatment or would you prefer hospice?

"It's really important to have good directives in life," McClanahan advised. "Make clear with your family what type of lifestyle is desirable."

Doing so will not only save your loved ones much agony but will also help protect them from over-spending and having to dip into their own pockets for what might be unnecessary treatment.

Nearing 60? 5 easy ways to boost your nest egg

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How to save on health care in retirement

Health care hurdles predicted

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WASHINGTON Potential complications await consumers as President Barack Obamas health care law approaches its second open enrollment season, just two months away.

Applicants lined up during a health care enrollment event in Commerce, Calif., in March. Potential complications await as the health care law approaches its second open enrollment season.(The Associated Press)

Dont expect a repeat of last years website meltdown, but the new sign-up period could expose underlying problems with the law itself that are less easily fixed than a computer system.

Getting those who signed up this year enrolled again for 2015 wont be as easy as it might seem. And the laws interaction between insurance and taxes looks like a sure-fire formula for confusion.

For example:

For the roughly 8 million people who signed up this year, the administration has set up automatic renewal. But consumers who go that route may regret it. They risk sticker shock by missing out on lower-premium options. And they could get stuck with an outdated and possibly incorrect government subsidy. Automatic renewal should be a last resort, consumer advocates say.

An additional 5 million people or so will be signing up for the first time on HealthCare.gov and state exchange websites. But the Nov. 15-Feb. 15 open enrollment season will be half as long the 2013-2014 sign-up period, and it overlaps with the holiday season.

Of those enrolled this year, the overwhelming majority received tax credits to help pay their premiums. Because those subsidies are tied to income, those 6.7 million consumers will have to file new forms with their 2014 tax returns to prove they got the right amount. Too much subsidy and their tax refunds will be reduced. Too little, and the government owes them.

Tens of millions of people who remained uninsured this year face tax penalties for the first time, unless they can secure an exemption.

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Health care hurdles predicted

How to save on health care when planning retirement

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And while trying to stay healthy, McClanahan advises her clients to pay attention to their health care consumption habits. Figuring out what McClanahan calls your "health-care mindset" will help you budget for the medical care you need, which is critical for many of today's retirees on fixed incomes who don't have the luxury of a pension.

"People who go to the doctor for everything are going to have higher medical costs," said McClanahan. "So if you're seeing every doctor under the sun, you need to save more money."

Take especial care if you tend to rely on holistic medicine, McClanahan added, as that's not covered under most medical plans and can be quite expensive.

Read MoreFinding your 'magic number' for retirement savings

But even if you're not going for homeopathic remedies, it's important to understand your health insurance. Just 7 percent of people between the ages of 55 and 64 felt knowledgeable about Medicare coverage options, according to the Merrill Lynch study.

Knowing what your plan does and does not cover can help you decide whether it's worth signing up for supplemental insurance or paying into a long-term care insurance plan.

While thinking about what you'll need in the event of long-term care, you should also go ahead and have frank discussions with your loved ones, McClanahan said. That means figuring out what you'll want medically when the situation takes a turn for the worst. For instance, will you seek aggressive treatment or would you prefer hospice?

"It's really important to have good directives in life," McClanahan advised. "Make clear with your family what type of lifestyle is desirable."

Doing so will not only save your loved ones much agony but will also help protect them from over-spending and having to dip into their own pockets for what might be unnecessary treatment.

Nearing 60? 5 easy ways to boost your nest egg

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How to save on health care when planning retirement

Is The Variation In Health Care Spending Among The States A Myth?

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One of the most influential ideas in all of health policy comes from researchers at Dartmouth, who have shown year after year that there are large variations in Medicare spending across the states, with no apparent effects on health outcomes. The implication: if doctors in the high spending states could learn how to practice medicine the way it is practiced in the low spending states, we could save billions of dollars with no adverse effects on the health of the patients.

For example, when he was director of the Office of Management and Budget (OMB), Peter Orszag wrote an editorial on this very subject in the Wall Street Journal. Referring to the Dartmouth work, Orszag noted:

If we can move our nation toward the proven and successful practices adopted by lower-cost areas and hospitals, some economists believe health-care costs could be reduced by 30% or about $700 billion a year without compromising the quality of care.

Sounds great. But what if it isnt true?

Louise Sheiner of the Brookings Institution has produced a study that challenges the Dartmouth way of thinking from top to bottom. And if the study stands up to academic scrutiny (as I think it will), the entire health policy community is going to have to change the way it has been thinking about health care.

Missing from the Dartmouth analysis, according to Sheiner, is a full appreciation for the way in which states differ. For example, some states are healthier than others and this clearly has an effect on health spending. (See the figure.) Also, states that have a larger portion of the population uninsured or on Medicaid are more likely to shift the fixed costs of an MRI scanner and other equipment to Medicare. Sheiner writes:

places with poor health, high rates of uninsurance, and a large black populationlike Mississippi and Louisianahave high Medicare spending and low non-Medicare spending. Conversely, places with the opposite characteristicslike Vermont and Minnesotahave relatively high non-Medicare spending and low Medicare spending.

So what happens when we adjust for these important differences among the states? A lot of what we thought we knew turns out to be wrong:

Many states that appear to be high-cost, like New York and New Jersey, no longer are once the price, demographic and health variables are included; similarly, Colorado and Montana, which are on the low end of the distribution of unadjusted Medicare spending, appear to be relatively high spenders once the adjustments have been taken into account. [These results] suggest that the cross-state variation in Medicare spending is tightly associated with the characteristics of state populations, and that, once these characteristic are controlled for, the variation in spending is fairly small.

The Sheiner study is similar to an earlier study by Andrew Rettenmaier and Thomas Saving (a former trustee of Medicare). That study found that 80 percent of the variation in Medicare spending per enrollee could be explained by demographics (age, race, sex, etc.), income, and the uninsured rate. After making adjustments for these variables, the study asked how much money Medicare could save if every state matched the performance of the five lowest-spending states? The answer: about 10 percent. For all health care spending, how much could be saved if every state matched the performance of the five lowest-spending states? Answer: about 5 percent.

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Is The Variation In Health Care Spending Among The States A Myth?

Health care worker accused of stealing from patient

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Published: Monday, September 15, 2014 at 3:59 p.m. Last Modified: Monday, September 15, 2014 at 3:59 p.m.

NORTH PORT - A home health care worker has been arrested for stealing more than $5,000 from an 87-year-old Venice woman with dementia.

Michelle Horton home health care worker arrested for stealing from elderly Venice woman.

According to the Sarasota County Sheriffs Office:

Michelle Horton began taking care of the victim and her now-deceased husband last June.

Detectives found that in November 2013, Horton brought the victim to the Venice Department of Motor Vehicles and had her sign over the title to her 2003 Honda. A few months later, Horton had the victim pay nearly $1,200 to Sears for auto repairs on the car and also used the victims bank account to make a $202 payment on another vehicle Horton owned.

Horton was employed by Almost Family, Inc., which paid her to care for the victim. At the same time, the victim wrote eight personal checks to Horton for her services, not realizing that she was already paying Almost Family to pay Horton.

Michelle Horton, 42, of 5127 Gailbreath Road, North Port, was charged with Exploitation of the Elderly and is being held on $20,000 bond.

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Health care worker accused of stealing from patient

Nurses need education on advance health care directives, reports Journal of Christian Nursing

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15-Sep-2014

Contact: Connie Hughes Connie.Hughes@wolterskluwer.com 646-674-6348 Wolters Kluwer Health @WKHealth

September 15, 2014 An educational program for nurses can help address knowledge gaps related to advance health care directives (AHCDs)thus helping to ensure that patients' wishes for care at the end of life are known and respected, reports a paper in the October/December Journal of Christian Nursing, official journal of the http://www.ncf-jcn.org/">Nurses Christian Fellowship. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Maureen Kroning, EdD, RN, of Nyack (N.Y.) College and Good Samaritan Hospital presents her hospital's experience with developing an inservice educational program to provide nurses with needed information on advance directives. She writes, "It is vital to recognize and address problems associated with AHCD so nurses can provide competent and compassionate care."

Program Meets Nurses' Need for Knowledge on Advance Directives

Research shows that, while most adults want their wishes for end-of-life care response, only about one-third have completed AHCDs. Despite the growing need for advance care planning, many health care professionals lack the knowledge to teach patients about advance directives.

At the study hospital, there was a "recognized problem" with AHCD education. On admission, patients were provided with an AHCD information packet and told to ask a nurse if they had any questions. "However," Maureen Kroning writes, "nurses expressed not fully understanding AHCDs, feeling incompetent to educate patients, nor did they believe AHCD education was an important part of their role."

A subsequent survey of 49 nurses found significant deficits in knowledge regarding AHCDs, especially among less-experienced nurses. Nurses "specifically and repeatedly" addressed the need for more AHCD education.

In response, the hospital developed an AHCD inservice education program, specifically addressing the knowledge gaps uncovered by the survey and tailored to the needs of adult learners. The two-hour program included information on AHCDs and living wills, and relevant federal and state laws. In addition to lecture and discussion, the program included role-playing opportunities and questions and answers. The online version of the article includes links to the author's lecture slides and an AHCD patient booklet.

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Nurses need education on advance health care directives, reports Journal of Christian Nursing


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