By Ricardo Alonso-Zaldivar, The Associated Press

WASHINGTON - President Barack Obama's new budget offers Medicare cuts to entice Republicans into tax negotiations, while plowing ahead to cover the uninsured next year under the health care law the GOP has bitterly fought to repeal.

But the biggest health consequences of any new proposal in Obama's plan could come from nearly doubling the federal tobacco tax. If enacted by Congress, it could make young people think twice about the cigarette habit.

Unveiled Wednesday in a flurry of numbers and details, the health care provisions of the 2014 spending plan will touch every American family, and businesses large small throughout the economy.

The budget for the Health and Human Services department would rise 5.4 per cent to nearly $950 billion, roughly one-fourth of all federal spending. Aging baby boomers swelling the Medicare rolls and coverage for the uninsured under Obama's signature law keep pushing health care spending higher.

On Medicare, the president sought to tap the fiscal brakes. His plan offered about $400 billion over 10 years in cuts, a bid to draw Republicans into negotiations to reduce government debt. It amounted to single-digit percentage points trimmed from Medicare spending, but for seniors individually and for businesses like hospitals and drug companies, there could be substantial consequences.

Obama has previously offered most of the Medicare cuts, but failed to gain political traction. Some proposals such as hiking premiums for upper-income beneficiaries clearly enjoy Republican support. But it's uncertain how far Obama can get. The president has said he won't ask beneficiaries to pay more without tax hikes on upper-income earners that Republicans are loathe to concede.

Powerful advocacy groups like AARP, along with most congressional Democrats, are dead set against cutting Medicare benefits.

Upper-middle class and well-to-do seniors would pay higher monthly premiums for outpatient and prescription drug coverage, a significant expansion of a policy already in effect. The current premiums would be boosted, and the share of beneficiaries exposed to the higher rates would keep growing until it reaches one-fourth of all those in the program. Now, only about 6 per cent of Medicare recipients pay higher "income related" premiums.

Newly joining Medicare beneficiaries would face several charges that will not apply to established retirees. These include a $100 copayment for home health services not preceded by an in-patient stay.

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Obama health care budget: cover uninsured, trim Medicare, hike tobacco taxes

ANN ARBOR, Mich.--(BUSINESS WIRE)--

National health care spending in February 2013 grew 3.9 percent relative to February 2012, a falling rate that returns it to the record low levels seen annually in 2009 2011, and below our estimate of 4.3 percent for 2012. Meanwhile, despite the recent pattern of historically low spending growth, the health sector now accounts for nearly 1 in 9 total U.S. jobs, a new all-time high at 10.74 percent.

While health care price growth rose to 1.7 percent in February 2013 compared to February 2012, two-tenths above the January 2013 reading, this was still the second lowest rate since 1.3 percent growth recorded in December 1997. The 12-month moving average price growth at 1.9 percent in February 2013 is the lowest since the same figure recorded in November 1998.

Health care employment rose by 23,000 jobs in March 2013, barely below the 24-month average of 24,000, but economy-wide employment rose by a disappointing 88,000, well below forecasts of approximately 200,000.

These data come from the April Health Sector Economic IndicatorsSM briefs released by Altarum Institutes Center for Sustainable Health Spending. The briefs, covering health care spending, utilization, prices, and employment are at http://www.altarum.org/HealthIndicators.

Health spending has remained at about 18 percent of gross domestic product since mid-2009, but health employment continues to slowly increase as a share of total employment, said Charles Roehrig, director of the Center. Expanded coverage under the Affordable Care Act should push these figures upward, but an improving economy will push in the other direction as non-health spending and jobs accelerate. We look forward to tracking how these forces play out.

The health spending share of the gross domestic product was steady at 18.0 percent in January 2013, up from 16.4 percent at the start of the recession in December 2007. Implicit per capita health care utilization averaged 1.3 percent growth over the last 12 months.

Altarum Institute (www.altarum.org) integrates objective research and client-centered consulting skills to deliver comprehensive, systems-based solutions that improve health and health care. Altarum employs more than 400 individuals and is headquartered in Ann Arbor, Mich., with additional offices in the Washington, D.C., area; Atlanta, Ga.; Portland, Maine; and San Antonio, Texas.

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Health Care Spending Growth Back below 4 Percent; Nearly One in Nine Jobs Lie in Health Sector

As Congressional budget battles heat upor roll along, depending on your time perspectivethe cost of health care in America receives a lot of attention. Unfortunately most of the discussion is largely off the mark about where the preventable, unnecessary costs really are. Yes, there is certainly over treatment, particularly of people in their last days of life. Yes, doctors under a fee-for-service arrangement do have financial incentives to do too much, and the fear of malpractice can lead to overtesting and overtreatment. As the recent article in Time by Steven Brill illustrated, pricing of medical care is neither invariably transparent nor sensible. And it would certainly be nice if care were better coordinated across functional specialties.

But the thing that few people talk about, and that no serious policy proposal attempts to fixthe arrangement that accounts for much of the difference between health spending in the U.S. and other placesis the enormous administrative overhead costs that come from lodging health-care reimbursement in the hands of insurance companies that have no incentive to perform their role efficiently as payment intermediaries.

More than 20 years ago, two Harvard professors published an article in the prestigious New England Journal of Medicine showing that health-care administration cost somewhere between 19 percent and 24 percent of total spending on health care and that this administrative burden helped explain why health care costs so much in the U.S. compared, for instance, with Canada or the United Kingdom. An update of that analysis more than a decade later, after the diffusion of managed care and the widespread adoption of computerization, found that administration constituted some 30 percent of U.S. health-care costs and that the share of the health-care labor force comprising administrative (as opposed to care delivery) workers had grown 50 percent to constitute more than one of every four health-sector employees.

What remains missing even in the discussion of the enormous administrative burden is not just how large, both in absolute dollars and as a percentage of health costs, it is, but also how few incentives there are for insurance companies to stop wasting their and everyone elses time. Most large employers, including mine, Stanford University, are self-insured, which means they pay for their own medical claims. These large employers invariably hire health insurance companies to administer their health-care dollars, doing things such as paying claims. Employers typically reimburse the insurers the amount of money they pay out to health-care providers plus a percentage of these costs. In Stanfords case, we pay Blue Shield 3 percent of the amount, about $3 million a year. (Note that the overhead costs of Medicare are less than one-third as much at slightly less than 1 percent.)

Because insurers are paid a fixed percentage of the claims they administer, they have no incentive to hold down costs. Worse than that, they have no incentives to do their jobs with even a modicum of competence. To take one small personal example, I have reached the age of Medicare eligibility but, because I continue to work full time, have primary health insurance coverage through my employer. Blue Shield, of course, wants to be sure it doesnt pay for any claim it doesnt have to, so I was asked to attest to the fact that I have no other insurance. No problem there, except such attestations seem to be required on almost a monthly basisrequiring my time on the phone (and on hold) with Blue Shields customer service, an oxymoronic term if there ever was one, and also requiring my doctor and laboratory to call me, call Blue Shield, or both, and thus also waste their time and resources.

This story and the many others of the same sort but even worse, magnified across the millions of people subjected to private health insurance companies, is why American health care costs so much and delivers so little. Unless and until we as a society pay attention to the enormous costs and the time wasted by the current administrative arrangements, we will continue to pay much too much for health care.

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The Reason Health Care Is So Expensive: Insurance Companies

For same-sex couples, whose marriages aren't recognized by the federal government, the costs of getting health care add up quickly.

Mike Bosia and Steven Obranovich, of Hardwick, Vt., were married three years ago after Vermont legalized same-sex marriage. As Bosia's spouse, Obranovich is entitled to health insurance through Bosia's employer,Saint Michael's Collegein Colchester.

But that coverage comes at a cost.

The couple estimates that they have had to pay $4,500 in additional federal income tax and filing-related expenses because thefederal government is prohibited by the Defense of Marriage Act from recognizing same-sex marriages. Bosia, 51, has to pay that tax on the value of the health coverage he gets for Obranovich, 45.

Bosia says the difference in tax treatment at the state and federal levels creates headaches for the couples accountant at tax filing time.

Dealing with the different rules, he says, "takes more time and costs more."

According to areport published by two think tanks, the Center for American Progress and the Williams Institute, which conducts research on gender identity and sexual orientation, an employee who buys health insurance for a domestic partner of the same or opposite sex pays $1,069 more a year in federal taxes, on average, than a worker in a heterosexual marriage would pay for the same coverage.

Nine statesand the District of Columbiacurrently permit same-sex marriage, according to the National Conference of State Legislatures.

Last month, the Supreme Court heard oral arguments in two cases that relate to same sex marriage. In addition to the challenge to DOMA, thecourt considered a California-based case challenging whether states can ban same-sex marriages.

The rulings are unlikely to have a direct impact on same-sex couples in domestic partnerships or civil unions, says Tara Borelli, a staff attorney at Lambda Legal, an advocacy organization for lesbian, gay, bisexual and transgender people.

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The Hidden Cost of Health Care for Same-Sex Couples

WESTERVILLE, Ohio, April 9, 2013 /PRNewswire/ --Laurel Health Care Company (Laurel), a leading long-term care organization, has selected Daylight IQ, the COMS Interactive (Clinical Outcomes Management System or COMS) product suite, as a key component of its disease management program. The team will be deploying Daylight IQ at thirty-three facilities in the several states/communities in which Laurel serves.

A Software as a Service (SaaS) product, Daylight IQ features integrated, disease-based clinical protocols that significantly empower each facility's clinical team by identifying changes in condition at the point of care. Daylight IQ highlights abnormal findings and provides the Laurel nursing staff with appropriate interventions and/or physician communication.

"The primary focus of our disease management strategy is to provide the best possible care and reduce unnecessary hospital re-admissions for our residents," noted Roger Obenauf, Vice President, Business Development. "As a leader in the long-term care market, we have a responsibility to continually identify methods to enhance care and improve the quality of life enjoyed by our residents. Fortified with Daylight IQ, we are able to more completely achieve this objective."

The Daylight IQ product suite focuses upon improving quality of care by closely tracking changes in condition and initiating appropriate clinical interventions. Key components of the product suite include an Automated Disease Care Guide Library, a Dynamic Nursing Assessment and Compare Module, all of which work in conjunction with each resident's disease profile. It's important to note that utilizing Daylight IQ reduces 30-day hospital readmissions and premature mortality by more than 50%.

"Given the current state of the healthcare industry, hospitals are partnering with progressive facilities to extend superior care for patients," noted Edward J. Tromczynski, Chief Executive Officer, COMS Interactive, LLC. "Recognized as a thought leader, Laurel Health Care continues to improve clinical outcomes, and COMS is pleased to partner with Laurel on this initiative."

Industry data shows that the average nursing home resident has a complicated health profile, including one primary disease and up to eight secondary diseases or afflictions. Over 70% of re-hospitalizations from a skilled nursing facility are due to a secondary or new disease progression. By providing early detection of an individual's change in condition, Daylight IQ highlights potential problems and offers caregivers the opportunity to respond, preventing further progression of the illness or affliction.

About Laurel Health Care CompanyLaurel Health Care Company is a national provider of skilled nursing, rehabilitation, sub-acute and assisted living services dedicated to one simple principle - achieving the highest standards of care and caring. Laurel achieve this goal in partnership with residents and families, their associates and the communities they serve.

At Laurel Health Care, caring is more than providing excellent medical and resident services - it's also treating each resident with the utmost dignity, respect and compassion. The Laurel skilled nursing and rehabilitation centers provide both short-term and long-term residents with comprehensive health-care services in a comfortable, home-like environment that promotes the highest level of independence and life quality. For additional information, contact Laurel Health Care at 614.794.8800 or at http://www.laurelhealth.com.

About COMS Interactive, LLCCOMS Interactive, LLC partners with twelve state health care associations in deploying processes and systems that stabilize and improve resident health while improving financial outcomes for skilled nursing facilities. The Daylight IQ Software as a Service (SaaS) product combines business administration, disease management and long-term healthcare knowledge to empower the nursing team, reduce medical errors, more efficiently address resident healthcare needs and increase facility revenues. This combination of clinical and technical processes can save millions of dollars a year in preventable hospital re-admissions. Additional information regarding COMS Interactive and Daylight IQ is available at http://www.comsllc.com or by contacting a COMS representative at #330.650.9900.

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Laurel Health Care to Deploy COMS Interactive Disease Management Program

The Bayada Home Health Care office in Frisco looks like a typical office there are desks, computers, printers, copy machines. One room, however, is a little different. Instead of a workstation, it holds a bed, complete with pillows, comforter and a stuffed animal. There's a nightstand with a lamp, a box of tissues and glasses, and a closet in the far corner.

This isn't a room for employees looking for a nap after lunch, it's a training center. Bayada, a national organization, is bringing home health care services to Summit and Eagle counties. Its Frisco office, opened in January, plans to offer nursing care and assisted care services to people within the mountain community.

We want to try to help everybody in our little mountain area here, said Diane Ream, Bayada office director.

Headquartered in Philadelphia, Bayada originated in 1976 and has since grown to include more than 250 offices in 25 states.

Maybe they have mobility issues, or they have memory care issues, or they're very elderly and just need a little bit of help, we do all that, Ream said.

Much of the care given by the nurse's aids is for activities of daily living, such as bathing, dressing and meal preparation. They can also assist in transportation, bringing clients to and from appointments, both medical or errand-related, such as to a hairdresser.

Skilled level of care is available from the nurses, who might be called to sit up overnight with an elderly relative, perform procedures such as an IV infusion or simply provide end-of-life care.

All of our services happen in the client's home, wherever their home might be, Ream said. Even if they're here vacationing and are in a condo, or in a hotel, and they need us, we can go there.

While the focus of Bayada's Frisco office is primarily Summit and Eagle county residents, people on vacation can also benefit from home service care, Ream said. It could be anything from lending transportation for a wheelchair-bound relative to assisting with care of broken bones or illness in general.

There is no other private-duty home care up here and there are no nursing homes or assisted living facilities, she explained. So what do you do when you've moved up here to the beautiful mountains and you find yourself convalescing, or getting a little up there in years, and maybe you or a loved one needs some help? What do you do? We didn't want anybody to have to move all the way back to Denver. ... We wanted it to be something that people could have up here and since there was none, that's what we're here for, to provide that need.

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Health care at home in Summit County

WASHINGTON - Millions of people who take advantage of government subsidies to help buy health insurance next year could get stung by surprise tax bills if they don't accurately project their income.

President Barack Obama's new health-care law will offer subsidies to help people buy private health insurance on state-based exchanges, if they don't already get coverage through their employers. The subsidies are based on income. The lower your income, the bigger the subsidy.

But the government doesn't know how much money you're going to make next year.

And when you apply for the subsidy, this fall, it won't even know how much you're making this year. So, unless you tell the government otherwise, it will rely on the best information it has: your 2012 tax return, filed this spring.

What happens if you or your spouse gets a raise and your family income goes up in 2014?

You could end up with a bigger subsidy than you are entitled to. If that happens, the law says you have to pay back at least part of the money when you file your tax return in the spring of 2015.

That could result in smaller tax refunds or surprise tax bills for millions of middle-income families.

No warning

"That's scary," says Joan Baird of Springfield, Va. "I had no idea, and I work in health care."

Baird, a health-care information management worker, is far from alone. Health-care providers, advocates and tax experts say the vast majority of Americans know very little about the new health care law, let alone the kind of detailed information many will need to navigate its system of subsidies and penalties.

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Health care credits could trigger surprise tax bills

SARANAC LAKE - Adirondack Health administrators and doctors spoke openly for the first time Thursday about their plan to convert the 24-hour-a-day emergency department at Adirondack Medical Center-Lake Placid into a 12-hour urgent care clinic.

During a 90-minute interview with the Enterprise, Adirondack Health President and CEO Chandler Ralph, Chief Medical Officer Dr. John Broderick and Emergency Department Medical Director Dr. Anthony Dowidowicz said the proposal makes sense from both a medical and a financial standpoint.

They said their Lake Placid ER doesn't have CT scan machines and other modern medical technology, and that most seriously ill patients already bypass it and are taken to the more state-of-the-art emergency department 10 miles away at AMC-Saranac Lake. They also say the low volume of patients at the Lake Placid ER doesn't justify keeping it open around the clock, and that converting it to an urgent care facility would still provide a valuable service to the community while saving the hospital an estimated $1 million.

Dr. John Broderick, right, Adirondack Healths chief medical officer, talks about the proposed conversion of the Adirondack Medical Center-Lake Placid emergency room to an urgent care center Thursday at AMC-Saranac Lake as the organizations communications director, Joe Riccio, listens. (Enterprise photo Chris Knight)

Dowidowicz said health care reform is pushing organizations like Adirondack Health to use its resources more efficiently.

"There are a lot of silos in medicine that are these hard and concrete structures that people cling onto that really don't fit with change," he said. "A lot of people don't want to give up what they've held onto for a long time. In order to survive in the future with the way things are going, you need to adapt."

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By the #s

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Visits to the emergency room at AMC-Lake Placid

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Health care in transition

Back in 1979, when the belief that government could and should beneficially control the prices of goods and services was popular, New Hampshire passed a Certificate of Need (CON) law. It forbade hospitals and other health care providers from buying expensive new equipment, or offering certain new services, without prior state approval.

The law "promotes rational allocation of health care resources in the state," it stated. Rational allocation. By the state. Let that sink in.

The next year, Jimmy Carter was defeated in a landslide, and in the years that have followed the public and policymakers have learned a great deal about economics and price controls. Here is what some of the official U.S. government studies have found.

A 1988 Federal Trade Commission study "finds that hospital costs are not lower in states that subject a larger proportion of proposed hospital expenditures to CON review. The study thus finds no evidence that CON programs have led to the resource savings they were designed to promote but rather indicates that reliance on CON review may raise hospital costs."

In 2004, the FTC and the U.S. Department of Justice revisited the CON issue. "The Agencies believe that, on balance, CON programs are not successful in containing health care costs, and that they pose serious anti-competitive risks that usually outweigh their purported economic benefits," the report concluded. "Market incumbents can too easily use CON procedures to forestall competitors from entering an incumbent's market."

(The 2004 study and several others are summarized nicely in a report issued last year by the Josiah Bartlett Center.)

Educated by such research, New Hampshire legislators voted in the last session to repeal the state's CON law. Incredibly, the state House of Representatives voted on Wednesday to reinstate the law before the positive effects of its repeal could be felt.

Why would New Hampshire, having just abolished a law that restricts the supply and increases the cost of health care services, bring it back? There are only two possible reasons. One, large hospitals, which benefit from the higher prices and reduced competition CON laws generate, have pressured politicians to revive the law. Or two, politicians don't want to give up the power CON laws give the state.

The CON law revival was part of the House budget. The Senate should strike that part and make clear that it will not find its way into any committee of conference report.

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CONned again Raising NH health care prices

Wayne Allen

PDT Staff Writer

On Thursday, the group Advocates for Ohios Future released a fact sheet showing the potential impact of extending health care coverage in the state budget, if approved by legislators.

The fact sheet states, Scioto Countys economy is stronger when everyone can participate in the economy. Healthy children become productive citizens, healthy citizens build strong communities, and health workers strengthen Ohios economy. If Ohio extends health coverage in the state budget 3,766 Scioto County uninsured 19-64 year olds are projected to gain health coverage by 2015.

According to 2010 figures the group estimated there are 5,422 eligible uninsured adults in Scioto County.

The fact sheet states that if Ohio extends its medicaid coverage, by 2015, only two percent of Scioto County would remain uninsured. Based on 2010 figures that would represent a 69 percent decrease.

In February the the Scioto County Health Coalition unanimously voted to endorse Gov. Kasichs plan to expand Medicaid in Ohio.

Kasich released his plan with this proposal for a $63.3 billion 2014-2015 state budget.

Kasichs plan would expand Medicaid eligibility to Ohioans earning up to 138 percent of federal poverty level (about $15,400 per person). But the extension comes with a condition: If the federal government fails to cover the bulk of the costs, as it has promised, the state will reverse course.

For a number of years weve lived with the reality that some of the unhealthiest folks in our community are unable to access health care services because they are uninsured. The Medicaid expansion will create a pathway for them to be able to access what we think is a very well developed system in our community, between primary care, hospitals and clinics that are available, Ed Hughes of Compass Community Health said. There is likely 20 percent of our citizens that can not access the services we have and this Medicaid expansion will create that opportunity.

Continued here:

Group says health care expansion positive for Scioto County

Shainah Hughes knows shell find a job and support her family when she graduates.

Job security is one of the big reasons the 29-year-old student at Western Technical College is pursuing a degree in electronics and computer engineering.

When I graduate, theres going to be a need for that, Hughes said.

Health care, accounting and technology are big draws for grads who want to live locally, but college officials agree theres no hard and fast trend.

Job security is huge for todays graduates, said Beth Dolder-Zieke, director of career services at Viterbo University.

Many started college on the eve of the recession.

They heard you go to college, you do really well, get a job, Dolder-Zieke said. And then they go to college, and for those of them who were aware of what was going on, it was very discouraging.

College grads have high expectations from their first job. Nationally, they expect a salary approaching $50,000 and want opportunities for future growth, Dolder-Zieke said.

For that, many are looking to health care.

More than 160 students graduated from Viterbos un-dergraduate nursing and nursing-completion programs last year. Western, UW-L, Winona State University and Minnesota State College-Southeast Technical in Winona all offer degrees in health care, too.

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Health care , accounting, tech are hottest fields for Coulee Region graduates

SACRAMENTO, Calif., April 4, 2013 /PRNewswire/ --According to the White House, the U.S. spends $2.2 trillion each year in health care, and Americans spend more on health care than on food or housing. An upward trend in health care cost is projected over the period of 2015-2021 at an average rate of 6.2 percent annually, reflecting the net result of the aging of the population, several provisions of the Affordable Care Act, and generally improving economic conditions reported by the Centers for Medicare and Medicaid Services.

Many experts believe that broadband enabled health may be a critical answer to controlling costs, while enhancing quality health care, and is being considered by many to be the next great frontier of American medicine. A recent study by U.S. Telecom suggests that health care expenditures could be cut by $200 billion over the next 25 years using broadband. High-speed transmission capability has generated efficiencies such as faster patient diagnoses, reduced medical errors, and additional control over skyrocketing patient care costs. Successful broadband adoption requires implementation of broadband-dependent applications that add value to health care organizations, businesses and consumers. This requires that clinicians and consumers are broadband technology-literate.

These trends were the catalyst for the California Community Colleges' Health Workforce Initiative (HWI) that led to the development of a new broadband enabled health care course for California nurses. HWI Director Linda Zorn said, "This is such a timely course given all of the health care changes and trends taking place in California. We were fortunate to have received a grant from the University of California Davis eHealth Broadband Adoption Project, so that we can offer this course at no charge to nurses for a limited time."

The self-paced, online course provides six contact hours for California nursing continuing education units and includes topics such as: a) The Importance of Broadband for Health Care Delivery; b) The Future is Now: New Technologies for Better Health; c) eHealth; d) Consumer Focused Applications and Devices; e) Clinical Health Informatics: An Overview for Nurses; and f) Nursing Considerations and the Future of Telehealth.

To learn more about the course or to register, go towww.freeRNceus.org.

The available funding used to offer the course at no charge for California registered nurses ends 6/30/13.

The Health Workforce Initiative is part of the California Community Colleges Economic and Workforce Development program. Course materials were developed through funding from the University of California Davis Health System award No. 06-43-B10584 from the National Institute of Standards and Technology (NIST), U.S. Department of Commerce. The statements, findings, conclusions, and recommendations are those of the author(s) and do not necessarily reflect the views of NIST or the U.S. Department of Commerce.

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Grant-Funded Broadband Enabled Health Care Online Course Released For California Nurses

NEWARK, N.J.--(BUSINESS WIRE)--

As brokers and employers get ready to meet the benefits challenges posed by health care reform, many American workers have concerns about how the reforms will affect their worksite benefits. According to Health Care Reform: The Waiting Is Over, the third in a series of research briefs based on The Prudential Insurance Company of Americas (Prudentials) Seventh Annual Study of Employee Benefits:Today & Beyond, nearly half (46%) of employees believe it is likely that the cost of health insurance will increase overall and nearly a third (31%) say its likely that fewer employers will offer health insurance coverage.

Brokers and employers both anticipate consequences from health care reform, with brokers expecting a larger impact. Both groups agree that benefits funding will be most affected. Among their top concerns, brokers expect the number of employee benefits offered (80%) and benefit communications (78%) to be highly impacted, while employers note benefits service and support (56%), as well as number of benefits offered (55%) as their top concerns.

Seventy-two percent of brokers say that expertise and thought leadership on health care reform from insurers is either critical or very helpful.

Brokers tell us that helping clients navigate heath care reform and lowering clients benefits costs are their most critical priorities, says Vishal Jain, vice president, Strategy and Planning for Prudential Group Insurance. They are looking to us, the carriers, to provide the marketing, education, and communications that will help employers to continue to deliver strong benefit offerings.

Mid-size employers (500 to 9,999 employees) anticipate a greater impact on all aspects of employee benefits compared to small or large companies. Sixty-eight percent say that health care reform will have a significant impact on employee benefits funding, and 61% say it will have a significant impact on employee benefits communications. Large companies (10,000+ employees) were less likely to say that the number of employee benefits offered will be impacted.

Twenty-nine percent of employers say they are at least somewhat likely to cease providing health care benefits to their employees. Those companies who say they are leaders in health care reform adoption are most likely to say they are not considering scaling back on benefits offerings.

Our survey has given us insights into the concerns of employers and brokers alike as the employee benefits landscape undergoes significant changes, notes Jain. As a carrier, our role is to help both groups meet the challenges ahead by providing consultative expertise, as well as access to an array of voluntary benefits and services, to help employers continue to offer benefit programs that attract and retain employees, even as they potentially implement significant changes to healthcare benefits.

Health Care Reform: The Waiting Is Over is the third in a series of five research briefs that highlight the major findings from Prudentials Seventh Annual Study of Employee Benefits: Today & Beyond. The research was conducted via the Internet during July 2012, and consisted of three distinct surveys of plan sponsors, plan participants, and broker/consultant audiences.

Prudential Group Insurance manufactures and distributes a full range of group life, long-term and short-term disability and corporate and trust-owned life insurance in the U.S to institutional clients primarily for us in connection with employee and membership benefits plans. The business also sells accidental death and dismemberment, and other ancillary coverages and provides plan administrative services in connection with its insurance coverages.

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Health Care Reform Is Prompting Changes In Employee Benefits

retirement

Retirement Health Care For Retirees

It's not your father's retirement, thanks to health care costs.

Once they retire, workers today are less likely than their parents or grandparents to enjoy the standard of living that they did while they worked.

What's going to spoil the party? Health care costs are rising faster than wages. That's the key finding in a report from the Urban Institute and AARP Public Policy Institute. Retiree income is projected to fall from 80 percent of average career earnings for current retirees to 73 percent for future retirees, according to the report. Take into account health care costs and the figure drops further, to 55 percent of average career earnings. And these estimates assume no changes to future Social Security benefits.

Source: Report from AARP Public Policy Institute and Georgetown University.

In 2010, national health care spending averaged $8,402 per person. That's 72 percent higher than 10 years earlier, when it was $4,878, and nearly three times the 1990 level of $2,854, according to a study by the AARP Public Policy Institute and Georgetown University.

If only the economy were growing as much as health care spending. Between 2000 and 2010, health care spending per person grew at an average rate of nearly 6 percent a year -- much higher than the 2.4 percent inflation rate.

People 65 and older are the hardest hit. Future retirees are expected to spend 18 percent of their household income on health care expenses, compared to 8 percent for current retirees, according to the report.

The trend is delaying retirement for many. A recent survey from the Employee Benefit Research Institute found that overall, 53 percent of workers said they'd like to tear up their time cards for good, but they'll likely have to continue to punch the clock because they need to keep their employer-sponsored health insurance.

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Health care for retirees

Health Care REIT Inc. (HCN), which operates senior housing and health care real estate, received a rating upgrade from Standard & Poors Ratings Services. The company now enjoys a corporate credit rating to BBB from BBB- with a stable outlook.

The uptick in rating came on the back of Health Care REITs diversified and quality portfolio. Moreover, the rating agency acknowledged the companys capacity to produce a stable cash flow as well as improve its credit metrics.

The rating upgrade of Health Care REIT is encouraging. In fact, this plays a major role in preserving investor confidence in the stock and helps boost its creditworthiness in the market.

In February, Health Care REIT reported fourth-quarter 2012 normalized FFO (funds from operations) of 85 cents per share, in line with the Zacks Consensus Estimate. Being one of the largest and oldest healthcare REITs in the U.S, the company boasts a strong portfolio of senior housing, long-term care and medical office facilities.

Moreover, the completion of the acquisition of Sunrise Senior Living facility further boosted the companys high-quality senior housing portfolio and extended its reach in the high-barriers-to-entry affluent markets.

Also, the healthcare sector is relatively immune to the downturn in the economy and provides a steady source of income that insulates the company from short-term market volatility. Thus, we expect Health Care REIT to maintain its growth curves through strategic investments and simultaneously benefit the shareholders by raising dividends.

Yet, with a large portion of revenues being determined by government payout rates, forces beyond the companys control could negatively affect revenue and operator coverage ratios.

However, Health Care REIT currently holds a Zacks Rank #4 (Sell). Nevertheless, a number of other REITs that are performing better and are worth a look include Federal Realty Investment Trust (FRT), Simon Property Group Inc. (SPG) and Cousins Properties Incorporated (CUZ), all carrying a Zacks Rank #2 (Buy).

Note: FFO, a widely accepted and reported measure of the performance of REITs, is derived by adding depreciation, amortization and other non-cash expenses to net income.

Read the Full Research Report on HCN

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It's not your father's retirement, thanks to health care costs.

Once they retire, workers today are less likely than their parents or grandparents to enjoy the standard of living that they did while they worked.

What's going to spoil the party? Health care costs are rising faster than wages. That's the key finding in a report from the Urban Institute and AARP Public Policy Institute. Retiree income is projected to fall from 80% of average career earnings for current retirees to 73% for future retirees, according to the report. Take into account health care costs and the figure drops further, to 55% of average career earnings. And these estimates assume no changes to future Social Security benefits.

Source: Report from AARP Public Policy Institute and Georgetown University.

In 2010, national health care spending averaged $8,402 per person. That's 72% higher than 10 years earlier, when it was $4,878, and nearly three times the 1990 level of $2,854, according to a study by the AARP Public Policy Institute and Georgetown University.

If only the economy were growing as much as health care spending. Between 2000 and 2010, health care spending per person grew at an average rate of nearly 6% a year -- much higher than the 2.4% inflation rate.

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Health Care Costs Can Make You Sick in Retirement

PHILADELPHIA, PA--(Marketwired - April 03, 2013) - Independence Blue Cross (IBC), Penn Medicine and DreamIt Ventures today announced the 10 health care startup companies selected to participate in DreamIt Health, the first-ever Philadelphia-based health care accelerator. The 2013 DreamIt Health inaugural class will enter a four-month boot camp, beginning this Monday, April 8, to help rapidly advance the development of their innovative health care solutions and business models.DreamIt Health will be hosting a Kickoff Weekend Reception for the Philadelphia entrepreneurial community at Venturef0rth on Friday, April 5, 2013 at 6 p.m. to welcome the 10 companies and celebrate the program launch.

Sponsored by IBC and Penn Medicine, DreamIt Healthlaunched in December 2012 with a nationwide search for unique health care startups who apply technology to the challenges of keeping people healthy and providing more effective and affordable interventions at the point of care.

IBC, Penn Medicine, and DreamIt Ventures selected the 10 participating companies based on the strength of their founders and their entrepreneurial passion, and the level of innovation in their products or services. Each startup will receive a stipend of up to $50,000. During the four-month boot camp, they will receive in-depth mentoring and coaching from experienced entrepreneurs and health care executives, and access to information and guidance from IBC, Penn Medicine, and others to help develop their products. Additionally, the companies will be provided workspace at Venturef0rth in Philadelphia and have an opportunity to test their business models with potential customers.

"At IBC, we believe that innovation is the key to bringing fresh ideas into health care, and are working to transform the Philadelphia region into a national magnet for health care innovation, investment, and employment. We must continue pushing the envelope and providing opportunities for the brightest minds to create solutions for unmet health care needs," said Daniel J. Hilferty, president and CEO of IBC.

"Both IBC and DreamIt Ventures share our passion for health care innovation, which is why it was such a great match for us to work together to launch Philadelphia's first health care accelerator," noted Ralph Muller, CEO of University of Pennsylvania Health System. "Through this program, these 10 entrepreneurs have access to unique resources to develop and execute innovative business models that will advance and benefit the health care industry as a whole. I am excited to see what the future holds for these companies."

The 10 selected companies are:

"DreamIt Health has found the working relationship with Penn Medicine and IBC to be highly collaborative and engaging.We are looking forward to working with the selected teams and know that the DreamIt framework and collaborative partners will be effective in developing these selected companies," said Karen Griffith Gryga, Managing Partner of DreamIt Ventures.

Supporting sponsors of DreamIt Health include Towers Watson, a leading global professional services company, as well as law firms, Morgan Lewis and Pepper Hamilton. More information about the Towers Watson partnership can be found here.

About Independence Blue Cross

Proudly celebrating its 75th anniversary in 2013, Independence Blue Cross is the leading health insurer in southeastern Pennsylvania. With our affiliates, we serve more than seven million people nationwide. We are enhancing the health and wellness of the people and communities we serve by delivering innovative and competitively priced health care products and services; pioneering new ways to reward doctors, hospitals, and other health care professionals for coordinated, quality care; and supporting programs and events that promote wellness. To learn more about how we're changing the game, visit http://www.ibx.com. Connect with us on Facebook at ibx.com/facebook and on Twitter at @ibx. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.

Excerpt from:

Ten Startups Selected for DreamIt Health , Philadelphia's First Health Care Accelerator

DEERFIELD, Ill.--(BUSINESS WIRE)--

Access to health care services is an ongoing challenge to the U.S. health care system. With a physician shortage, aging population, a growing prevalence of chronic diseases and up to 30 million people projected to gain insurance coverage in 2014 through the Affordable Care Act, the issue will become even more critical and may further impact both patients and the health care system at large.

To help meet the need for greater access to affordable health services and bridge gaps in patient care, while also improving care coordination, Walgreens (WAG) (WAG) today announced its Take Care Clinics are expanding the scope of health care services offered. The new services, now available at the more than 330 Take Care Clinics located at select Walgreens (excludes clinics in Missouri), include assessment, treatment and management for chronic conditions such as hypertension, diabetes, high cholesterol, asthma and others, as well as additional preventive health services.

With this service expansion, Take Care Clinics now provide the most comprehensive service offering within the retail clinic industry, and can play an even more valuable role in helping patients get, stay and live well, said Dr. Jeffrey Kang, senior vice president of health and wellness services and solutions, Walgreens. Through greater access to services and a broader focus on disease prevention and chronic condition management, our clinics can connect and work with physicians and other providers to better help support the increasing demands on our health care system today.

Service Expansion

Under the new service expansion,in addition to chronic condition management, Take Care Clinic providers can evaluate, recommend and order preventive health services, such as screenings or lab tests, based on a patients age, gender and family history.

Retail clinics have continued to gain greater consumer acceptance, popularity and recognition for delivering quality care. A recent Rand Corporation study showed the use of walk-in retail clinics is on the rise increasing 10-fold over the past two years.1 Studies have also found that retail clinics provide care for routine illnesses at a lower cost and similar quality as physician offices, urgent care centers or emergency rooms.2

Retail clinic industry estimates show that more than one in three patients do not have a regular physician.3 Walgreens and Take Care Health strongly encourage all patients to have a designated primary care physician and medical home for ongoing medical needs and routine exams, and under this new service expansion will continue to work collaboratively with providers to support and complement a patients physician care plan.

The existing gaps in patient care and demands on an already overburdened health care system are all projected to worsen with an influx of new patients under health care reform, said Heather Helle, divisional vice president, consumer solutions group, Walgreens. Walgreens is stepping up to be part of the solution. As innovative care delivery models emerge, we are uniquely positioned to play an integral role in addressing the needs of patients, payers, and providers and to help shape the future of health care delivery in the U.S.

Take Care Clinics are open seven days a week, with extended evening and weekend hours, and offer walk-in availability as well as same-day online appointment scheduling. Take Care Clinics accept most major insurance plans including Medicare and Medicaid, and offer affordable, transparent pricing for those without insurance coverage. Take Cares board-certified nurse practitioners and physician assistants deliver patient-centric care, driving patient satisfaction rates that are consistently greater than 90 percent. Take Care providers use nationally accepted, evidence-based clinical guidelines to ensure quality care delivery.

Originally posted here:

Take Care Clinics Expand Scope of Health Care Services to Include Chronic Condition Management and Additional ...

ABN Sting Operation on Scam In Retro Health Care PVT.LTD

By: abntelugutv

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ABN Sting Operation on Scam In Retro Health Care PVT.LTD - Video

1:00 AM Some Americans will be asked to estimate their 2014 earnings and could end up owing money.

The Associated Press

WASHINGTON - Millions of people who take advantage of government subsidies to help buy health insurance next year could get stung by surprise tax bills if they don't accurately project their income.

click image to enlarge

Barack Obama signs the Affordable Care Act into law March 23, 2010 in this file photo. The law requires people to pay back part of a subsidy if their income estimation is off.

The Associated Press

President Obama's new health care law will offer subsidies to help people buy private health insurance on state-based exchanges, if they don't already get coverage through their employers. The subsidies are based on income. The lower your income, the bigger the subsidy.

But the government doesn't know how much money you're going to make next year. And when you apply for the subsidy, this fall, it won't even know how much you're making this year. So, unless you tell the government otherwise, it will rely on the best information it has: your 2012 tax return, filed this spring.

What happens if you or your spouse gets a raise and your family income goes up in 2014? You could end up with a bigger subsidy than you are entitled to. If that happens, the law says you have to pay back at least part of the money when you file your tax return in the spring of 2015.

That could result in smaller tax refunds or surprise tax bills for millions of middle-income families.

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Health care subsidies carry tax risk