Daily Archives: June 6, 2020

A top Department ofHealth and Human Services (HHS) official acknowledged that telehealth is here to stay after anexplosion of use due to COVID-19 but hedged on whether new regulatory flexibility on reimbursement is going to stick around.

The cat is out of the bag, so to speak, said Jim Parker, senior adviser for health reform for HHS. We look forward to helping policymakers, congressional leaders and regulators move the interest in telehealth and healthcare consumerism particularly for rural areas forward in a more permanent way.

Parker spoke during a Thursday webinar sponsored by the Bipartisan Policy Center on telehealth and rural healthcare amid the COVID-19 pandemic. His remarks come as the healthcare industry is speculating about the future of telehealth changes after increased use during the pandemic.

The Centers for Medicare & Medicaid Services (CMS) gave providers more flexibility to get Medicare reimbursement for telehealth at the onset of the pandemic a few months ago. Since then, telehealth use has exploded as patients were terrified to head to the doctors office due to the pandemic.

We have one physician who wasnt doing any telemedicine before, said Alan Levine, CEO of Ballad Health, a healthcare system that serves parts of Virginia, North Carolina and Tennessee. Even now that they reopened their practice, 70% of visits [are] still telehealth visits.

RELATED: UnitedHealth exec on telehealth use, reimbursement: 'The genie is out of the bottle'

Levine said on the call that from July 2019 through March the system had 2,400 telehealth visits. From April through May, the system has had 15,000 telehealth visits.

But there are lingering questions about the longevity of the telehealth boom. For one, no one knows whether CMS will continue to offer the same flexibility on reimbursement after the pandemic wanes.

We do face the challenge of where we go from here, Parker said. Consumer expectations are likely changed moving forward.

An open question is whether telehealth increases costs or saves money for Medicare, he added.

We always knew telehealth was an efficient tool for rural health and by saving travel time and expense, as well as providing quicker access to care, Parker said. However, travel time and expense are not covered Medicare expenses.

Parker noted there are some statutory questions that will require action by Congress too on telehealth.

RELATED: Teladoc exec: Why COVID-19 is proving a 'great equalizer' for mental health care

The pandemic is a good opportunity to see what works and what doesnt with telehealth, which should help determine what regulatory changes should become permanent, said Kripa Sreepada, health policy advisor for Sen. Tina Smith, D-Minnesota, on the webinar.

We are seeing a huge uptick in the use of telehealth services, she added. What we need to see is if patients and providers are preferring this as the first step for a visit.

There are larger considerations on the technology infrastructure, especially for rural areas that may lack access to high-speed internet.

Which services should we be providing that are audio-only or by video? Sreepada asked.

CMS said in late April it will grow the number of services it will cover as audio-only telephone visits, including behavioral health and patient education. It also will boost the payment rate for such visits.

See the article here:
HHS official: 'Cat out of the bag' on telehealth but unclear what changes will stick - FierceHealthcare

Science has shown that, Thinking positive, happy, hopeful and optimistic thoughts decreasesCortisol [the bodys stress hormone] and produces Serotonin [the bodys natural anti-depressant], which creates a sense of well-being. This helps the brain function at peak capacity.

The Mental Health Foundations book, Doing Good Does You Good says, Its often said that its better to give than receive, but this is actually backed up by research While its easy to feel too busy or stressed to help others... evidence shows that doing good for others is actually beneficial for your mental health and well being. It can help reduce stress, improve mood, self-esteem, longevity and happiness. From volunteering, to random acts of kindness, your good works can help others and yourself.

With these facts in mind and an awareness that many people are feeling discouraged and helpless during these uncertain times, the longtime friends and bandmates, Katrina Carlson and Jefferson Denim say, [we] felt compelled to create and co-host a podcast that would share the inspiring stories of everyday humans doing crazy amazing things... people who utilize their time, talent and resources to give back, pay it forward and just make a really positive difference.

This resulted in the Crazy Amazing Humans (CAH) podcast, which now consists of seven episodes on YouTube and several other platforms. In the introductory episode, Getting to Know You, Carlson and Denim immediately connect with their audience in a sincere and transparent way. They have an innate ability to create a personal relationship with their listeners and viewers.

It is clear that they themselves are crazy amazing humans who effectively dedicate their skills, talents, and empathetic gifts while drawing from real-life experiences to create a sincere interaction with their podcast guests, bringing inspiration to their audience.

Carlson and Denim are both accomplished professional musicians, singers, and songwriters. Each podcast episode has its own individual song performed by them. Both have strong ties to the Santa Monica community and are involved in several non-profit organizations. Carlson has lived in Santa Monica for over thirty years. She and her family are host to the well-known Santa Monica Halloween House, which is visited, free-of-charge, by an estimated 15,000 people every October.

The CAH podcast episodes, one through seven, span a wide range of guests. From a teenage paralympic track champion who founded a sports organization; to a behind-the-scenes look at the award winning documentary, The Heart of Nuba which follows an American doctor working in a war-torn region of Sudan; to an Oceanscape photographer dedicated to raising blue consciousness.

Every episode ends with inviting listeners to connect and be heard by emailing comments, questions, or sharing their own Crazy Amazing Humans story or experience. Carlson says, Our mission is to find stories of people from all walks of life who are choosing to write their own narratives by becoming a part of solutions. We celebrate choices that make the world a better place, we do so in a way that shows that all of us have this capacity... We want to inspire people and make them feel not alone. We all have our stories and our challenges. We focus on everyday people, not people who are unattainable.

Regarding his own experience in living a life that uplifts and inspires others, Denim says, If you go through rough times you look for people who may be going through rough times too...[and] say, I get it, let's talk, how can I help?

Carlson says, we are on a mission to inspire and remind you that you are Crazy Amazing.

It is as simple as saying, yes and responding to the needs that are right in front of us. Remember that every little kindness has the potential to create Crazy Amazing Human experiences. The podcast can be found at crazyamazinghumans.com.

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Inspiration is Just a Podcast Away The | Corsair - The Corsair

The differences among target date funds (TDFs) can be hard for some plan sponsors and participants to immediately see, but it is moments like the one were in now that can reveal important distinctions between them.

The market volatility caused by the COVID-19 pandemic vividly demonstrates that while risk exposure is important at every point in a TDFs glide path, its particularly impactful for people nearing retirement.

This is not a new point of view, but its newly relevant. Prior to the market declines weve seen since February, investors had enjoyed one of the longest-running bull cycles in U.S. history. That led to impressive equity returns, and with it a heightened focus on asset accumulation.

Subsequently, we believe too much embedded risk crept into many multi-asset class portfolios and remained hidden until now.

Of course, not everyone agrees. There are those who continue to make the case for keeping equity allocations at higher levels near and into retirement. And its worth looking at their arguments. Here are two:

From our perspective, the two most critical factors for TDF portfolios during periods of volatility are time horizon and cash flow. As a result, they impact younger people on the front end of the glide path differently than older people nearing their retirement date.

Generally, TDF investors just starting their career with long time horizons and limited savings can benefit from significant volatility exposure, as this can help them accumulate wealth over time and benefit from the ups and downs of the market through dollar-cost averaging.

As investors accumulate wealth and approach and enter retirement, however, higher levels of equity exposure in volatile markets can work against them. It can cause them significant stress when balances fluctuate, given the larger dollar impact and shorter recovery times before investors need to tap into assets.

Consider how a hypothetical 20% portfolio loss might affect two TDF investors, one at age 25 and one at age 60.

The pandemic has exposed more than just the importance of risk exposures within a TDF for people nearing retirement. It has also revealed how important human emotion is as a factor in glide path design.

Too often, glide paths are developed quantitatively in the lab and can ignore or underappreciate the fact that these are products that will ultimately be used by real people with real needs and emotions.

Theres an important takeaway for advisors and plan sponsors here. When evaluating funds, keep participants in mind, and remember theyre human just like you. Ask your provider if their funds factor in participants emotions and behavioral biases into the investment process.

The range of threats to retirement savings include things such as market risk, longevity risk, sequence risk, inflation risk, tail risk, and interest rate risk. But human decision-making concerning those risks differs depending on the persons stage of life. Those behavioral patterns can and should be factored into a TDFs design to help drive toward successful outcomes for retirement savers.

We encourage advisors and their plan sponsor clients to consider the COVID-19 pandemic as a prompt to re-examine the TDFs theyre offering in their retirement plans.

To help evaluate portfolios, advisors and plan sponsors should:

Questioning TDF equity exposures for near-retirees may not have been the most popular message even a few months ago. But just like so many other parts of our lives, were in a whole new world now.

Omar Aguilar is Chief Investment Officer for Passive Equity and Multi-Asset Strategies andJake Gilliam is Head of Multi-Asset Portfolio Solutions with Charles Schwab Investment Management, Inc.

Read the rest here:
What the Pandemic is Revealing About Target Date Funds - The 401(k) Specialist

Building a culture of trust is a composite of many things, there is no unified field theory of trust. There are many individual components both within a culture, and environmental conditions without that will determine the longevity of success after a culture of trust is created.

For businesses, society, or even for personal development trust begins with awareness. Awareness of ones own abilities without comparison to those around them. To build a culture of trust, you first have to know who you are and what your strengths and weaknesses are. This is part that is not very comfortable if a change is going to happen. Its not comfortable for individuals, companies, cities, or countries.

Why? Because, part of instituting real, valuable, and lasting change that breeds success and growth means shedding old skin. It means giving up things that once felt safe and comfortable. It means allowing space to mourn what we once thought was good for us (and it very well could have been) is now no longer serving us or our need to grow. We can move on. Life, growth, and change happen in cycles.

What does this look in real-time? What are practical steps to building a culture of trust with ourselves, in society and in business?

PERSONAL: Know who you are. Take time to get real with yourself.-Write down your strengths. Write down your weaknesses. Write down your passions. Then take a hard long look at where you are, how you got there, and where you want to be. Then map out where you want to be for the next 5 years, the changes you need to make to get there. Create a supportive community of people around who will keep you accountable. Create a joy ritual. If you have a goal. Enjoy it. Reward yourself for hitting milestones.

SOCIETY:

BUSINESS:

These are not all-inclusive lists. But these are all areas we need to take seriously. This is beyond the fad of having a growth mindset its seeing that whatever our context is, the long game is the way to succeed. To choose positivity and chase the outcomes wholeheartedly. To do it with tenacity, joy, and creativity. Be willing to challenge the status quo (this is the true seat of growth).

Once these lists are executed, true incremental change can begin. Perspective and how to phrase growth has to be filtered in and through the context. This is key. It has to speak the language of the person, brand, or society. Culture is about incarnation. This means every step toward building a culture of growth and success has to be intentional if it is not then that is a direct sign of something that either should not be taken on or something that should be jettisoned.

Read the original:
A Quick Primer On Creating A Culture of Trust - PsychCentral.com

Leon MacDonald understands better than anyone the value of having a Dan Carter in your squad when youre about to undergo what might be the toughest 10-week schedule in rugby history.

Its why he made the call he did to his one-time Crusaders and All Blacks team-mate whom he labels our Tom Brady in reference to the 40-year-old quarterback legend still throwing pinpoint passes as he enters his third decade in the NFL.

Brady played in nine Superbowls in 20 seasons with the New England Patriots, winning six of them. And now, even at 40, the competitive fire still burns within as the ageless American football wonder gets set for a first campaign with the Tampa Bay Buccaneers.

Like Brady, Carter still thirsts to contribute at the top echelons of his game at a time when most of his peers have long hung up their boots. Its why when MacDonald had a hole to fill in his squad (in-form fullback Stephen Perofeta suffered a foot fracture in training), he thought of the two-time World Cup winner and one of the finest No 10s to have ever laced em up for the All Blacks.

READ MORE:* Dan Carter's Kiwi comeback a great story, but fairytale ending might be far-fetched* How Blues got their man: Dan Carter answers Leon MacDonald's call* From millions to thousands: How Dan Carter's rugby salary has plunged * Blues ready to ride the Beauden Barrett express when Super Rugby resumes

Luckily for all concerned including the Super Rugby Aotearoa competition which has received a massive injection of interest just over a week out from its post-Covid shutdown resumption the circumstances lined up.

Carter was off contract after his final season in Japan ended prematurely thanks to the virus.

He is not yet ready to hang up the boots just yet. He and his family are living in Auckland and linking up with the Blues presented the least disruption there. As rugby options go, this is as good as it gets right now. And, of course, in the Blues, and his old mate MacDonald, he had a willing suitor.

This time money was no sort of a factor either, with Carter evidently happy to come on board for the prescribed replacement player rate of around $1800 a week.

It definitely wasnt the money. Hes not getting rich doing it, said MacDonald when asked about Carters motivations for re-entering the Super Rugby arena five years since his last appearance there. His heart is in the right place. You know why hes playing hes doing it because hes giving back.

I think I got the timing right, got him maybe coming out of lockdown and not quite thinking straight and hes a man of his word, so couldnt go back on it. I think we might have hit the jackpot there. Sometimes it is about timing, but the motives are really good and I bought into that.

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Dan Carter will be invaluable to Blues coach Leon MacDonald on and off the field.

Neither Carter nor MacDonald are under any illusions about the challenges that await the veteran as he re-enters the pointy end of the game. At 38, he is clearly not the player he was, say, in 2015 when he majestically piloted the All Blacks to that second straight World Cup triumph.

He has also not played a lot of rugby (six games over the last 18 months by Carters estimation) in recent times and is coming back from major neck surgery last year. He looks fit and says his body feels in good condition, but he comes into the Blues on the back of three months without contact.

What cannot be questioned, though, is Carters innate ability, his sharp rugby mind and his competitive desire which still fans the flames within. Also his ability to influence those around him, which, depending on how things pan out in this rejigged Super Rugby competition, might be his greatest influence on these Blues.

Its a good story for rugby, noted MacDonald. Dan has earned respect around the world as a world-class player through his longevity and being a high performer for a long period. For him to give back this way is testament to his character.

Our job with the Blues is to try produce All Blacks. We get a lot of pride in promoting All Blacks to the pinnacle of the game and Dan is helping us on that trek. Weve got some young talent in this team and theyre going to thrive on having him around.

Thats where this Carter addition to the Blues is so intriguing. As it stands now they dont need to throw him into the fray. They have Beauden Barrett, Otere Black and Harry Plummer who cover 10, as well as one or two other spots, very well indeed. Right now theyre all fit and jumping out of their skin.

But in Carter they have possibly the worlds best backup plan. If Barrett or Black falls over, they have a general to slot in at No 10. Plus, as Barrett finds his feet with his new franchise, he has in fellow former world player of the year Carter, the ideal mentor.

Hell be great for us, added MacDonald. Hes already a great sounding board. Hes got a level head, hes selfless, a no-ego type person the younger guys feel very comfortable to come have a chat with. One of the big values of our team this year is we talk about loving the game.

I think Dan really epitomises that. Hes our Tom Brady. He just doesnt stop. Hes still a great athlete and still got a lot to give.

But MacDonald is no rush with his new addition, noting he is three weeks behind his team-mates in terms of building into contact. We need to progress him safely so dont expect to see DC on a rugby field in the early weeks. Well take our time and when he is ready to go it will be on a needs basis.

MacDonald wouldnt be drawn on where he might play Carter, noting the veterans utility ability, but said he would contribute from the off round the training field and in the meeting rooms.

Were lucky. The young guys are almost pinching themselves. They dont know whether to shake his hand or get an autograph. Its surreal for some of our players and a strength of New Zealand rugby, this willingness to give back and commit.

The Blues will be patient with their Tom Brady. Ageless wonders have earned their careful handling.

Read the rest here:
'He's our Tom Brady': Blues playing long game with Dan Carter for Super Rugby return - Stuff.co.nz