Longer hospital stay linked to low health literacy

The article below was published on October 11, 2017 by Clinical Advisor, written by Madeline Morr.

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Photo source: Clinical Advisor

Low health literacy is associated with a longer hospital length of stay among general medicine patients, according to a study published in the Journal of Hospital Medicine.

Ethan G. Jaffee, MD, from Massachusetts General Hospital in Boston, and colleagues conducted an in-hospital cohort study of patients who were admitted or transferred to the general medicine service at the University of Chicago between October 2012 and November 2015. Those who died during hospitalization or whose discharge status was missing were excluded.

Health literacy was screened using the Brief Health Literacy Screen (BHLS), which included 3 questions: 1) How confident are you in filling out medical forms on your own?; 2) How often do you have someone help you read hospital materials?; and 3) How often do you have problems learning about your medical condition because of difficulty understanding written information?

Responses to the questions were scored on a 5-point Likert scale, in which higher scores corresponded with higher health literacy. Length of hospital stay was counted from the date of admission to the hospital, with patients being discharged on the same day as admission counted with a hospital stay of 1.

A total of 5,983 participants met inclusion criteria and completed the hospital length assessment. Of these participants, 75 (1%) died during hospitalization, 9 (0.2%) had missing discharge status, 79 (1%) had a length of stay greater than 30 days, and 280 (5%) were missing data on sociodemographic variables. A total of 5,540 patients remained, with a median age of 57 years. The sample was divided into those with private insurance (25%), those with Medicare (46%), and those with Medicaid (26%).

Using the BHLS screen, 20% (1104/5540) had inadequate health literacy. Patients with low health literacy had an 11% longer average length of stay (6.0 vs 5.4 days). Among men, low health literacy was associated with a 17.8% longer length of stay, and among women, low health literacy was associated with a 7.7% longer length of stay.

“We found that low health literacy was associated with a longer hospital length of stay, a result which remained significant when controlling for severity of illness and sociodemographic variables and when testing the model for sensitivity to the highest values of length of stay and illness severity,” the authors said. “Additionally, the association of health literacy with length of stay appeared concentrated among participants with shorter length of stay.”

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Rapid Growth for HSAs

HSAHealth savings accounts are hot, with nearly two-thirds of respondents to a Plan Sponsor Council of America survey saying they believe that even those without a high deductible health plan should qualify. A benefit often cited by employers and employees alike is that HSAs can be a valuable part of one’s retirement strategy, since healthcare expenses are viewed as one of the largest people face in retirement.

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Amid Uncertainty in Health Care, the Forecast for Self-Funding with an Independent TPA Remains Very Positive

The 2018 Forecast for TPAs & Self-Funding, recently released by the Society of Professional Benefit Administrators (SPBA), expects factors to fuel continued growth and expansion by TPAs and self-funded health benefit plans in the coming year. The most significant of these factors is a growing demand by today’s workforce for more personalized benefit offerings that help enhance the well-being of younger workers. Fred Hunt, past President of SPBA, describes independent TPAs as creative, flexible and well positioned to respond to rapidly changing needs of plan sponsors and their employees.

A Trusted Authority on Self-Funding

“As an independent TPA with 40 years of experience, Diversified Group has helped thousands of companies enjoy the flexibility and financial control that a partially self-funded health plan can provide,” stated Brooks Goodison, President of Diversified Group. “Our firm is a long-standing member of SPBA because of Fred Hunt’s experience and the unique vantage point the organization provides to the self-funded marketplace.”

As the need for customization and relevant plan data continues to grow, the Diversified Group of companies are uniquely qualified to help employer groups avoid the limitations and rising costs common to off-the-shelf, fully-insured plans. Let our experience in self-funding provide your solution to health benefits.

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Doctors Go Retail

doctorIf you live near a large shopping mall, chances are you’ve noticed vacant stores, thanks to the rapid growth of online shopping. Many retail vacancies are being filled by doctors, dentists, physical therapists and other healthcare professionals looking for ways to become more accessible to their communities. To generate more foot traffic, one dental network will open clinics in 36 retail centers this year.

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What are your clients’ most-pressing issues?

The article below was published on October 17, 2017 by BenefitsPRO, written by Alan Goforth.

Benefits professionals have been on a roller-coaster ride since the 2016 presidential election. That ride includes the highs of lofty rhetoric, the lows of as-yet unfulfilled promises, and uncertainty about what may lie around the next curve.

Every now and then, it helps to step off the ride, catch your breath and collect your thoughts. That’s why BenefitsPRO takes time each year to ask employers to share their insights on the most important issues they face. Their responses provide a valuable roadmap for brokers as they plan ahead for this fall’s abbreviated open enrollment period.

Not surprisingly, the economy is top of mind for the 125 decision-makers who participated this year (see box on last slide). Overall, employers give the Trump administration low marks for its economic policies. Thirty-seven percent said these policies have had a moderately or extremely negative effect on their business outlook, with 20 percent reporting a moderately or extremely positive impact.

Perhaps the most important takeaway message for brokers is that most employers adjust their benefits spending to economic conditions. Sixty-four percent said their benefits spending is influenced by the economy.

Coping with costs

The rising cost of health care benefits tops the list of concerns, with most citing increased expenses over the previous year:

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However, there is good news for brokers among the economic concerns. The overwhelming majority of employers (85 percent) use a benefits broker or agent. Compensation is divided somewhat evenly between commission-based (54 percent) and fee-based (46 percent). Seventy percent of employers said their broker either conducts enrollment or helps them conduct it.

The even better news is that more than 91 percent of respondents have no thoughts of dropping their broker and going it alone. Still, it would be smart to pay attention to the factors that they say would cause them to consider such a bold move:

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Communication is critical

Timely, actionable communication is more important than ever in today’s fast-changing benefits environment. Nine employers in 10 said they are satisfied with the frequency of communication with their broker. How often do they connect?

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One potential topic of conversation is the new Department of Labor fiduciary rule and its potential impact. Eighty-three percent of employers said they understand it extremely or moderately well, and the rest said not very well or not at all.

Although many conversations take place about benefits products, technology is an increasingly hot topic. Thirty-six percent of employers consult with their broker multiple times each year about such topics as enrollment, administration and compliance platforms. Another 25 percent do so once a month or more frequently. More than 80 percent of employers are satisfied with the frequency of technology communications with their broker.

Speaking of technology, nearly every employer said it is essential to his or her business:

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Employers seek out a variety of print and online sources for information about health-care reform, led by electronic newsletters from an insurance magazine (66 percent). Not to blow our own horn, but BenefitsPRO.com is the most popular information site, mentioned by 81 percent of employers.

Expanded product offerings

Although many employers are expanding the menu of voluntary benefits, health insurance (including HMOs and PPOs) remains the overwhelming favorite. Eighty percent said their employees consider health insurance their most important benefit. Sixteen percent cited consumer-driven health care options, such as HSAs and HRAs. A majority—60 percent—now offer health savings accounts. About half of employers surveyed said they are used by between 1 percent and 25 percent of their employees.

Not many employers are open to the idea of health insurance exchanges. Forty-four percent have consulted with their broker about an exchange. However, only 13 percent have considered moving their employees onto a public exchange, while 21 percent have considered a private exchange option.

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Positive outlook

The bottom line for this year’s survey is that the vast majority of employers look to their broker as a valued business partner. Brokers who listen to what they have to say, communicate clearly, and deliver practical solutions will be well positioned to build strong relationships during enrollment and look forward to a mutually prosperous 2018.

Meet the respondents

The 125 survey respondents represent a broad cross-section of the benefits industry (although not every participant answered every question). Three-fourths of them are involved in making benefits decisions for their company.

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BenefitsPRO takes time each year to ask employers to share their insights on the most important issues they face. Their responses provide a valuable roadmap for brokers as they plan ahead for this fall’s abbreviated open enrollment period.

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National Prescription Drug Take-Back Day is October 28th

PrescriptionBecause of their focus on substance abuse issues and the national awareness of the opioid epidemic, Magellan Rx Management is calling your attention to the Drug Enforcement Administration’s (DEA) scheduled event – National Prescription Drug Take-Back Day. This event will take place on Saturday, October 28th, from 10 a.m. to 2 p.m. and is a great opportunity for those who missed the previous events, or who have subsequently accumulated unwanted, unused prescription drugs, especially medications including opioids such as codeine, hydrocodone, oxycodone, morphine or fentanyl, to safely dispose of those medications.

Since the first Take-Back day in 2010, over 4,000 tons of unwanted or expired medications have been surrendered for safe and proper disposal at over 9,000 sites. Click here to find a collection site near you.

In an environment where cost containment and quality care are constantly challenged, Magellan Rx Management is the smart solution.

SIIA Stop-Loss Legislation Becomes Law in New York State

The article below was published on October 24, 2017 by Self-Insurance Institute of America, Inc., written by Wrenne Bartlett.

dg-news-article-nyThe Self-Insurance Institute of America, Inc. (SIIA) is pleased to announce that Governor Andrew Cuomo has signed A.8264 into law, allowing grandfathered stop-loss contracts for groups of 51-100 to renew until January 1, 2019.

As background, in late 2015 and early 2016, the New York legislature passed and the governor signed three laws allowing existing stop-loss contracts of 51-100 to be renewed for a period of up to three years. Without these changes, New York State law would have prohibited stop-loss contacts to be issued to any employer classified as a “small employer,” which increased to 100 employees on January 1, 2016.

As part of the series of laws, the New York State Department of Financial Services has contracted with an independent consulting firm to study the employer use of stop-loss in the state and will be issuing a report in March 2018. In speaking to legislators and regulators, it was clear that they wanted to see the report before re-opening the 51-100 stop-loss market. To protect plan sponsors with grandfathered stop-loss policies, we suggested that the legislature extended grandfathering protection for an additional year and allow stakeholders to review the comprehensive report.

SIIA is confident that the report will conclude that smaller employers need continued access to stop-loss insurance as the most cost effective way to provide high-quality self-insured health care benefits. While the report remains ongoing, SIIA continues to press the legislature to pass a permanent fix for smaller employer stop-loss access in 2018.

If you have any questions, please contact Adam Brackemyre, vice president of state government relations at abrackemyre@siia.org or (202) 595-0641.

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