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karla Jepsen

New York Regulators Slash Health Insurance Rates For 2015 - 1 views

The average health insurance rate increase next year will be about 6 percent in New York State. State regulators today set the rates for 2015 after reviewing proposals from insurers, which re...

Westhill Healthcare Consulting Review new york regulators slash health insurance rates for 2015

started by karla Jepsen on 11 Sep 14 no follow-up yet
Rose McGowan

Study: More exercise, less sitting reduces heart failure risk for men - Westhill Consul... - 1 views

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    Study: More exercise, less sitting reduces heart failure risk for men More exercise, less sitting reduces heart failure risk for men By American Heart Association DALLAS - sitting for long period's increases heart failure risk in men, even for those who exercise regularly, according to new research published in the American Heart Association journal Circulation: Heart Failure. Preventing heart failure, researchers found, requires a two-part behavioral approach: high levels of physical activity plus low levels of sedentary time. The study is the first to examine the link between heart failure risk and sedentary time, said Deborah Rohm Young, Ph.D., lead researcher and a senior scientist at Kaiser Permanente in Pasadena, Calif. "Be more active and sit less. That's the message here," Young said. Researchers followed a racially diverse group of 84,170 men ages 45 to 69 without heart failure. Exercise levels were calculated in METs, or metabolic equivalent of task, a measure of the body's energy use. Sedentary levels were measured in hours. After an average of nearly eight years of follow-up, researchers found: Men with low levels of physical activity were 52 percent more likely to develop heart failure than men with high physical activity levels, even after adjusting for differences in sedentary time. Outside of work, men who spent five or more hours a day sitting were 34 percent more likely to develop heart failure than men who spent no more than two hours a day sitting, regardless of how much they exercised. Heart failure risk more than doubled in men who sat for at least five hours a day and got little exercise compared to men who were very physically active and sat for two hours or less a day. Study limitations included: Since
Rose McGowan

IRS Offers Health Care Tax Tips to Help Individuals Understand Tax Provisions in the Af... - 1 views

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    February 25, 2014 - The Internal Revenue Service is offering educational Health Care Tax Tips to help individuals understand how the Affordable Care Act may affect their taxes. The IRS has designed the Health Care Tax Tips to help people understand what they need to know for the federal individual income tax returns they are filing this year, as well as for future tax returns. This includes information on the Premium Tax Credit and making health care coverage choices. Although many of the tax provisions included in the law went into effect on Jan. 1, 2014, most do not affect the 2013 tax returns. The Health Care Tax Tips, which are now available at IRS.gov/aca, include: * IRS Reminds Individuals of Health Care Choices for 2014? Find out what you need to know about how health care choices you make for 2014 may affect your taxes. * The Health Insurance Marketplace - Learn about Your Health Insurance Coverage Options - Find out about getting health care coverage through the Health Insurance Marketplace. * The Premium Tax Credit? Learn the basics of the Premium Tax Credit, including who might be eligible and how to get the credit. * The Individual Shared Responsibility Payment - An Overview? Provides information about types of qualifying coverage, exemptions from having coverage, and making a payment if you do not have qualifying coverage or an exemption. * Three Timely Tips about Taxes and the Health Care Law? Provides tips that help with filing the 2013 tax return, including information about employment status, tax favored health plans and itemized deductions. * Four Tax Facts about the Health Care Law for Individuals? Offers basic tips to help people determine if the Affordable Care Act affects them and their families, and where to find more information. * Changes in Circumstances can Affect your Premium Tax Credit? Learn the importance of reporting any changes in circumstances that inv
Rose McGowan

A Health Insurer Calls, With Questions - 1 views

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    Not long after she signed up for health insurance under the Affordable Care Act, Judy Shoemaker received a phone call that puzzled her. The caller said she was welcoming new members to the insurance network and then asked Ms. Shoemaker to take a survey about health care issues, so information could be provided to her physician. Ms. Shoemaker declined, saying she didn't understand why her insurer would be seeking medical information to give to her doctor. "I thought it was strange," said Ms. Shoemaker, a consultant to nonprofits in Indiana. "I can talk to my doctor myself." James Tuck, who runs a dog care business in Chicago, got a similar call after signing up for insurance through the Affordable Care Act in March. The caller said he was contacting Mr. Tuck on behalf of his new insurer, Blue Cross Blue Shield of Illinois, to go over his benefits and ask him some questions. Mr. Tuck hadn't yet received his insurance card and was hesitant to answer questions, especially after he consulted a private health advocate, who had helped him evaluate insurance options. She advised him not to answer the queries. "She said their goal is to find a reason to get you booted off your insurance." Insurers say they are doing nothing of the sort. Lauren Perlstein, a spokeswoman for the Health Care Service Corporation, parent of Blue Cross Blue Shield of Illinois and plans in four other states, said in an email that the company contacted new policy holders to help "new members get the proper coverage and medical assistance they need, by helping guide them through the health care system." The company's "experts" contact new members to explain benefits and answer any questions, she said, as well as to "identify members who can benefit from our personalized medical management program so they can best manage their health."
Rose McGowan

Practical Saver : Tips for saving money on healthcare - Westhill Consulting Insurance - 1 views

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    Practical Saver: Tips for saving money on healthcare By KARA ROZENDAAL Courier Columnist Changes in the health insurance arena have many consumers scrambling for affordable options. Don't despair; there are still ways to save significant money on healthcare. Below are a few medical resources that Prescott has to offer, as well as tips on how to pay less at the doctor's office, and an alternative to health insurance. To save money on premiums, many families opt for higher-deductible health insurance policies. High deductibles generally equate to lower monthly insurance premiums. However, in exchange, the majority of the medical expenses are paid out of pocket. In the case where doctor's visits and medical treatment are paid out-of-pocket, you can save money by asking the medical office if there is a cash pay discount. When a patient pays cash and the business doesn't need to submit the claim to the insurance company, it saves the office time.
Rose McGowan

Stateline Health Insurance Death Rates - 1 views

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    Does health insurance increase your lifespan? Felue Chang, who is newly insured under an insurance plan through the Affordable Care Act, receives a checkup from Dr. Peria Del Pino-White at the South Broward Community Health Services clinic on April 15 in Hollywood, Fla. The mortality rate in Massachusetts declined substantially in the four years after the state enacted a law in 2006 mandating universal health care coverage, providing the model for the Affordable Care Act. In a study released last week, Harvard School of Public Health professors Benjamin Sommers, Sharon Long and Katherine Baicker conclude that "health reform in Massachusetts was associated with a significant decrease in all-cause mortality." The authors caution that their conclusions, published in Annals of Internal Medicine, may not apply to all states, and other studies have shown little correlation between having insurance and living longer. Nevertheless, the Harvard study adds to a growing body of evidence that having health insurance increases a person's life expectancy.
Rose McGowan

Obamacare costs to taxpayers rise further as HHS reveals more costly fraud - 1 views

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    On May 17, 2014, The Fiscal Times reported that the government is: "paying incorrect subsidies to more than 1 million Americans for their health plans in the new federal insurance marketplace and has been unable so far to fix the errors, according to internal documents and three people familiar with the situation." A 7-page slide presentation created by HHS confirms that one-in-four people who have signed up for Obamacare have "data discrepancies." Reports are that some two million people's health care coverage may be at risk. Out of some 8.8 million persons who have signed up for coverage, about 5.5 million are in the federal insurance exchange receiving reduced rates, or benefits, to pay for their health insurance policies. The sliding scale subsidized policies are priced based on income, family size, and geographical location of the individual. Under the law, only citizens and legal immigrants are entitled to subsidized coverage. The presentation shows that the data errors involve information concerning details on income, citizenship and immigration status.
Rose McGowan

The Medicaid Black Hole That Costs Taxpayers Billions - 1 views

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    Here's some cheerful news: States and the federal government are doing little to stop a costly form of Medicaid fraud, according to a government report released last week. Medicaid, the federal-state health insurance program for poor Americans, now covers more than half its members through what's known as Medicaid managed care. States pay private companies a fixed rate to insure Medicaid patients. It has become more popular in recent years than the traditional "fee for service" arrangement, in which Medicaid programs reimburse doctors and hospitals directly for each service they provide. Despite the growth of managed care in recent decades, officials responsible for policing Medicaid "did not closely examine Medicaid managed-care payments, but instead primarily focused their program integrity efforts on [fee-for-service] claims," according to the Government Accountability Office, the investigative arm of Congress. The managed-care programs made up about 27 percent of federal spending on Medicaid, according to the GAO. The nonpartisan investigators interviewed authorities in California, Florida, Maryland, New Jersey, New York, Ohio, and Texas over the past 12 months. STORY: No Background Checks Needed for Home Health Workers in 10 States Funded jointly by the federal government and the states, Medicaid provided health insurance to about 72 million low-income Americans at a cost of $431 billion last year, according to the report. By the Medicaid agency's own reckoning, $14.4 billion of federal spending on Medicaid constituted "improper payments," which include both overpayments and underpayments. That's 5.8 percent of what the federal government spends on the program. The $14 billion figure doesn't tally what states lose to bad payments. The fraud risk for managed care is twofold. Doctors or other health-care providers could be bilking the managed-care companies, which pass on those fraudulent costs to the government.
Rose McGowan

Health insurance coverage now costs $23,215 for a typical family - 1 views

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    The typical cost of health care for a family of four with employer-based insurance this year is $23,215, according to a new report from the Milliman actuarial firm. The bad news first: That amount has more than doubled in the past 10 years. The goodish news: That cost grew just 5.4 percent between 2013 and 2014, the slowest growth rate since Milliman started keeping track in 2002. That $23,215 figure isn't what the employee pays, though. Employers pay about 60 percent of those costs ($13,520), while workers pay the rest through payroll deductions ($5,908) and out-of-pocket costs ($3,787). The employee share of the costs have been rising faster - increasing 73 percent since 2007 - than the employer contribution, which has grown 52 percent over the same period. The Milliman numbers are for family coverage under preferred provider plans, so it excludes the increasing prevalence of consumer-driven health plans, in which employees handle a higher share of the costs. Don't blame the four-year-old Affordable Care Act for these changes, though. Milliman says Obamacare has barely had any impact so far on these large employer plans, but that's about to change. The actuarial firm cites Obamacare's impending excise tax on "Cadillac" plans - valued at at least $27,500 for family coverage starting in 2018 - as a factor that will force employers to scale back health plans. Milliman points to other factors that will push down cost increases. Higher out-of-pocket costs are fueling efforts around health-care price transparency, and that's making consumers become better health-care shoppers. Conversely, an improving economy and an increase in expensive specialty drugs will pressure costs to rise.
Rose McGowan

4 Tips for Navigating Open Enrollment for Insurance - 1 views

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    When shopping for a plan, start with the basics of what you're looking for and what you're willing to pay for, says Michael McMillan,Executive Director of Market and Network Services at Cleveland Clinic. Then make your selection carefully so you get what you're paying for, he adds. To help you navigate enrollment - either on health insurance exchanges or elsewhere - McMillan offers the following helpful tips: 1. Know what services are covered under a selected plan Start by reviewing what each particular plan offers. For example, what does the network of care providers look like? What services are most important to you based on your particular health needs or conditions, and are they available within a plan's coverage? "This will be a period of great change, and consumers will have a lot of options they haven't had before on the exchanges," McMillan says. "It's important to be clear on what's available and what isn't." 2. Make sure your providers are part of the network When choosing plans, this is a major factor. Look at any given plan to see if your doctors and hospitals you use regularly are listed as network providers. One evolving trend has been for health plans to create narrow networks - smaller versions of their standard network that help them achieve a lower price. The bottom line: Not all providers are included in these limited networks, so it's worth your effort to check first and make sure your new plan includes the doctors and other practitioners you see regularly, McMillan says. 3. Know your out-of-pocket costs These are costs associated with the care received. They include things such as deductibles - the amount you pay before coverage kicks in - as well as copays and coinsurance on services. Out-of-pocket costs vary by the "metal" level of plan you choose on a health insurance exchange. So, for example, you would pay 40 percent of costs of coinsurance in a bronze plan, and 30 percent for silver. In some high
Rose McGowan

Woman found dead in shooting at Sanford insurance offices - 2 views

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    According to her friends, Cynthia McGee Bryant was a religious woman who owned her own insurance agency, worked hard and didn't have enemies. But on Monday, someone shot McGee Bryant, 53, to death inside her office at 400 W. 25th St., police said. Few details were released by the investigators however they did not mention if the motive was robbery. Officers received a 911 call about 12:15 p.m. and found Bryant's body a couple of minutes later at McGee Insurance and Financial Services, Police Department spokeswoman Shannon Cordingly said. Detectives were hesitant in revealing where in the office Bryant's body was found or what part of the body she was shot in and whether anyone witnessed the crime. They would not even say who was responsible in calling 911. McGee Bryant's former husband, Reginald Bryant, said his ex-wife was focused on her job and on evangelical work. She was a longtime member of Livingston Street Church of God in Orlando. "She was a God-fearing woman," Bryant said. McGee Bryant, who lived near Lake Mary, was from a small town in Georgia and also lived in upstate New York before moving to Central Florida to be near extended family, her ex-husband said. She was named Allstate agent of the year in her territory in 2005 and started her own Allstate agency in Sanford in 2007, according to her website. She started her current business in 2009. Her business is selling personal and business insurance. Her motto was "Integrity. Commitment. Dedication. Loyalty. Respect. Responsive." Bishop Antonio Richardson, whom Bryant recruited a few months ago to be spiritual leader at Livingston Street Church of God, described McGee Bryant as "a very soft-spoken, giving person" who sometimes paid clients' premiums when they could not afford to, ministered to the homeless and handed out money on the street if she saw a needy person. She as well was a licensed minister who was about to become outreach director for her congregation. "It's a shock," Richa
Rose McGowan

'Fraud' and 'cover-up' exposed in failing semi-privatised Irish healthcare - Westhill C... - 1 views

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      Image: Pharmaceuticals. Flickr/Waleed Alzuhair. Some rights reserved.   Commerce has corrupted healthcare in the Irish semi-privatized insurance-based system.   Late last year Senator John Crown revealed under parliamentary privilege in Ireland's Senead that his own hospital, St. Vincent's University Hospital in Dublin, had in 2002 billed the country's largest private health insurer €1 million for the drug trastuzumab (Herceptin). But the drug had in fact been supplied to the hospital free by pharmaceutical giant Roche, as part of clinical trials for women with breast cancer.   This was not an inadvertent error as the hospital claimed, said Senator Crown, but deliberate financial fraud, which the hospital board had spent perhaps tens of thousands trying to cover up, employing 'substantial intimidation' to bury the matter.   Senator Crown is also Professor Crown, arguably Ireland's most distinguished oncologist. He had been told of the fraud in 2002 and at once notified all relevant health authorities.   An investigation started, and then stopped in its tracks. The hospital argued it had not known about this major research program me taking place on its premises.   The debacle had ended with the suspension of the drugs trial for a year, jeopardising the lives of women with breast cancer who might otherwise have participated in this important trial
Rose McGowan

Steer clear of health insurance scams - 1 views

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    How to spot and stop health insurance scams Medical and health insurance scams are rampant. Both government and private initiatives have renewed their focus on preventing health insurance fraud and abuse. Michael Williams, director of communications and membership of the National Health Care Anti-Fraud Association, says new and better technology, improved awareness, and more widely available information combine to combat fraud. Williams adds that while the majority of physicians run honest practices, consumers must also step up to the plate to prevent fraud. "Pay attention, do your research, read your EOBs (explanations of benefits) and beware of free offers," he says. Read on to discover some of the most common health insurance scams making the rounds and ways experts like Williams say you can guard against becoming another victim. Fake insurance policies Like counterfeit money, bogus health insurance is not only circulating, but it's becoming increasingly common. James Quiggle, communications director of the Coalition Against Insurance Fraud, says fake policies are particularly virulent. "These crooks come out of the woodwork and promise affordable premiums, no medical exams and guaranteed acceptance," Quiggle says, adding that the criminals who offer worthless policies often operate through sophisticated networks with strong marketing arms and money-laundering components. Many times they can be tied to organized crime. Often, these con artists target small businesses, unions and associations. It's only when a policyholder needs the insurance that the game's up.
Rose McGowan

PROTECT YOURSELF FROM HEALTH INSURANCE SCAMS - 1 views

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    The U.S. health care system has changed significantly since the passage of the Affordable Care Act. The federal law introduced many changes to the insurance space and health care market and helped change the way that people shop for health insurance coverage. With the launch of insurance exchanges, new marketplaces were opened up to consumers, but these exchanges also represented a promising opportunity for scammers that are looking to exploit a person's private information. The U.S. Federal Trade Commission recently issued a warning about the growing prevalence of insurance scams, and there are some things that people can do to protect themselves and their information when shopping for insurance coverage. Be Careful About What You Share Online Many insurance scams seek to collect personal information through fraudulent websites. These sites can be designed to look official, but are merely fronts for criminal activity. Many fraudulent sites attempt to show that they represent an insurance or government agency, offering policies at discounted rates, but the policies that these sites offer are not real and exist only to collect information, such as medical records. Beware of Unsolicited Calls Sometimes, scammers prefer to take a more direct approach and will disguise themselves as insurance agents representing a reputable company or exchange. These people often attempt to call consumers and offer inexpensive insurance policies based on the information that they provide. Insurance exchanges do not randomly contact consumers and organizations promoting coverage through exchanges will never ask for personal information to be shared over the phone. Document Everything Keeping records of all salespeople you may come in contact with, as well as the names of their representative companies, could be valuable if your information is ever compromised. Information can be used for or against you, and collecting information from the agents or organizations trying to sell you
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