The Business Case for Providing Health Insurance to Low-Income Employees

Low income employees without health insurance could be detrimental for a business. This study explains why providing health insurance for low income employees is crucial for successful performance in the workplace.


After the failed negotiations over the repeal of Obamacare earlier in March, the Trump administration appears to be on the brink of proposing a new health care bill. While the details are still sketchy, it seems likely that the new bill will leave many lower-income Americans without access to health insurance.

I believe there is a case to be made that, should this take effect, the private sector has a strong incentive to step in. The provision of health insurance by organizations is a sensible business decision—especially for low-income individuals. In fact, a number of studies—including one that I co-authored—highlight that health insurance coverage can be beneficial to the bottom line of businesses, and should be endorsed by managers as good corporate strategy if they seek to increase their productivity.

Health insurance for low-income employees is good business for at least three reasons: it is linked with reduced levels of stress, more long-term decision-making, and increased cognitive ability, as well as (perhaps somewhat obviously) increased physical health — all of which are crucial components of higher organizational performance.

Health Insurance Can Reduce Stress

Among other positive outcomes, health insurance significantly decreases the level of stress employees experience, as a study described in a recent working paper shows. Johannes Haushofer of Princeton University and several colleagues worked with an organization in Nairobi, Kenya — the metalworkers of the Kamukunji Jua Kali Association (JKA) — and randomly allocated some employees to receive health insurance free of cost for one year. In other words, the researchers sponsored a health care plan for a proportion of JKAs’ employees, whereas others continued working for JKA as usual.

In addition to collecting data through surveys — for example on the employees’ self-reported health and well-being, and their household characteristics — the researchers did something rather unusual: they collected saliva samples from all respondents, which were later tested for the stress hormone cortisol. These measurements occurred at two time points, at the start of the study and at the end.

The researcher’s results were striking. Not only did employees who received free health insurance report feeling less stressed, but this decline correlated with a reduction in the cortisol measured in the saliva sample. The decrease in cortisol was comparable to roughly 60% of the difference between people who are depressed, and people who are not.

This is important for organizations because employees who experience higher levels of stress are more prone to burning out, and less likely to attain high levels of performance. Stressed employees hurt the bottom-line — and interventions that reduce stress benefit it.

Health Insurance Can Lead to More Long-Term Decision-Making

But health insurance can do more, too. A paper I co-authored with Elke Weber of Princeton University and Jaideep Prabhu of Cambridge University that was recently published in the Proceedings of the National Academy of Sciencesfocuses on one reason why low-income individuals have difficulties escaping their destitute situation. As research has found, we show that poor people are more likely to make decisions that favor the short term, even when these decisions involve smaller payoffs than larger payouts they might receive in the future.

In our study, we find that this is partially the case because low-income individuals experience more pressing financial needs than their richer counterparts. Because they are so pre-occupied with making ends meet, they are unable to even consider a possible larger payout in the future. This way, they remain captured in what Johannes Haushofer and Ernst Fehr of the University of Zurich so aptly call the “vicious cycle of poverty.”

However, we also find that interventions that serve to reduce levels of financial need that low-income individuals experience can make them more likely to make more long-term-oriented decisions. One such intervention may be the provision of health insurance. With a safety net they can draw on when health problems arise, poor people may be less likely to experience their financial needs as pressing — and as a result, make more long-term-oriented decisions.

This can lead to significant improvements for organizations as well. Companies require their employees to make many long-term decisions. In many cases, a more long-term orientation is necessary for companies to thrive.

Not Having Health Insurance Can Hinder Cognitive Ability

Finally, health insurance can give low-income individuals peace of mind. A seminal study led by Anandi Mani of the University of Warwick investigated the cognitive consequences of poverty. The researchers found — in concordance with an increasing body of evidence — that lack of money saps people’s attention. While they did not specifically study health insurance, it is easy to extrapolate their research to this question. Given that everyone’s attention is limited, the more people’s concerns weigh on their mind, the less attention they can pay to any one concern.

To illustrate this finding, imagine a case where a low-income employee uses her car to come to work every day. She lives paycheck to paycheck and depends on her steady stream of income. Every day, even when she isn’t driving, she worries about what she would do if her car broke down. Such thoughts circle in her mind incessantly — they are always there, no matter what else she tries to focus her attention on.

Obviously, such worrying thoughts have detrimental consequences for her performance. Constant ruminations make it more difficult to focus on tasks that matter in the moment. Now replace the car in the above scenario with her health; let’s assume she has a chronic condition that requires medical attention when it breaks out. This is not an uncommon case: over 34% of employees have chronic medical conditions, which are even more widespread amongst low-income individuals.

Although many of these physical ailments cannot be cured, their accompanying cognitive detriments can be. Thoughts such as, “How will I pay for the doctor? How can I afford my medication?” could be eradicated with the provision of health insurance. This is especially important for low-income individuals who are more likely to have such worries. And with an increased ability to focus on their work, employees are also more likely to be productive members of the organization. 

It is unclear what will happen in Washington D.C. in the next few months. Will Obamacare be repealed? Will millions of low-income individuals lose their health insurance? In the absence of a resolution, managers may have to step up. There is a business case to be made for providing employees with health insurance, which may make them less stressed, improve their long-term decisions, and lead to increased attention on the task at hand — and the case is especially strong for low-income employees.

SOURCE:

Jachimowicz J (29 May 2018). [Web Blog Post]. Retrieved from address https://hbr.org/2017/04/the-business-case-for-providing-health-insurance-to-low-income-employees


How to get the most out of a day off

Time off is necessary but planning an extended vacation may be stressful. These pointers will help show you how micro-vacations can positively benefit your lifestyle.


The idea of “vacation” often conjures up thoughts of trips to faraway lands. While it’s true that big trips can be fun and even refreshing, they can also take a lot of time, energy, and money. A lot of people feel exhausted just thinking about planning a vacation—not just navigating personal commitments and school breaks, but deciding how to delegate major projects or put work on hold, just so they can have a stress-free holiday. Because of this, some might put off their time away, figuring they’ll get to it when their schedule isn’t so demanding, only to discover at the end of the year that they haven’t used up their paid time off.

In my experience as a time management coach and as a business owner, I’ve found that vacations don’t have to be big to be significant to your health and happiness. In fact, I’ve been experimenting with the idea of taking “micro-vacations” on a frequent basis, usually every other week. These small bits of time off can increase my sense of happiness and the feeling of having “room to breathe.”

From my point of view, micro-vacations are times off that require you to use a day or less of vacation time. Because of their shorter duration, they typically require less effort to plan. And micro-vacations usually don’t require you to coordinate others taking care of your work while you’re gone. Because of these benefits, micro-vacations can happen more frequently throughout the year, which allows you to recharge before you’re feeling burnt out.

If you’re feeling like you need a break from the day-to-day but can’t find the time for an extended vacation, here are four ways to add micro-vacations to your life.

Weekend trips.Instead of limiting vacations to week-long adventures, consider a two- to three-day trip to someplace local. I’m blessed to live in Michigan, and one of my favorite weekend trips is to drive to Lake Michigan for some time in a little rented cottage on the shore or to drive up north to a state park. Especially if you live in an urban area, traveling even a few hours can make you feel like you’re in a different world.

To make the trip as refreshing as possible, consider taking time off on Friday so you can wrap up packing, get to your destination, and do a few things before calling it a night. That still leaves you with two days to explore the area. If you get home by dinnertime on Sunday, you can unpack and get the house in order before your workweek starts again.

There may be a few more e-mails than normal to process on Monday, but other than that, your micro-vacation shouldn’t create any big work pileups.

Margin for personal to-do items.Sometimes getting the smallest things done can make you feel fantastic. Consider taking an afternoon—or even a full day—to take an unrushed approach to all of the nonwork tasks that you really want to do but struggle to find time to do. For example, think of those appointments like getting your hair cut, nails done, oil changed, or doctor visits. You know that you should get these taken care of but finding the time is difficult with your normal schedule.

Or perhaps you want to take the time to do items that you never seem to get to, like picking out patio furniture, unpacking the remaining boxes in the guest room, or setting up your retirement account. You technically could get these kinds of items done on a weeknight or over the weekend. But if you’re consistently finding that you’re not and you have the vacation time, use it to lift some of the weight from the nagging undone items list.

Shorter days for socialization.As individuals get older and particularly after they get married, there tends to be a reduction in how much time they spend with friends. One way to find time for friends without feeling like you’re sacrificing your family time is to take an hour or two off in a day to meet a friend for lunch or to get together with friends before heading home. If you’re allowed to split up your vacation time in these small increments, a single vacation day could easily give you four opportunities to connect with friends who you otherwise might not see at all.

If you struggle to have an uninterrupted conversation with your spouse because your kids are always around, a similar strategy can be helpful. Find days when one or both of you can take a little time off to be together. An extra hour or two will barely make a difference at work but could make a massive impact on the quality of your relationship.

Remote days for decompression. Many offices offer remote working options for some or all of the week. If that’s offered and working remotely is conducive to your work style and your tasks, take advantage of that option.

Working remotely is not technically a micro-vacation, but it can often feel like one. (Please still do your work—I don’t want to get in trouble here!) If you have a commute of an hour or more each way, not having to commute can add back in two or more hours to your life that can be used for those personal tasks or social times mentioned above.

Also, for individuals who work in offices that are loud, lack windows, or where drive-by meetings are common, working remotely can feel like a welcome respite. Plus, you’re likely to get more done. A picturesque location can also give you a new sense of calm as you approach stressful projects. I find that if I’m working in a beautiful setting, like by a lake, it almost feels as good as a vacation. My surroundings have a massive impact on how I feel.

Instead of seeing “vacation” as a large event once or twice a year, consider integrating in micro-vacations into your life on a regular basis. By giving yourself permission to take time for yourself, you can increase your sense of ease with your time.

SOURCE:
Saunders E (28 May 2018). [Web Blog Post]. Retrieved from address https://hbr.org/2018/05/how-to-get-the-most-out-of-a-day-off


Eat to Live Well: Health Benefits of the Mediterranean Diet

Promoting workforce wellness never tasted so good. For heart-healthy living, it turns out a great dietary option for many dates back centuries.

Based on the traditional cuisine of communities along the coasts of Italy and Greece, the Mediterranean diet is gaining increasing popularity among nutrition experts in this hemisphere.

In the ‘50s, researchers noticed the poor villagers along the Mediterranean coasts tended to live longer than the wealthiest New Yorkers. Further study revealed that, in addition to their vigorous lifestyle, a big contributor to their longevity was their cuisine of basic ingredients, rich in local produce, fish harvested daily from the bountiful ocean waters and a splash or two of red wine from neighboring vineyards.

According to the Mayo Clinic, research involving more than 1.5 million healthy adults following a Mediterranean diet showed a strong association with reduced risk of heart disease, far and away this country’s leading killer. It’s much lower in fat and complex carbohydrates than typical North American fare. As a result, this diet promotes lower levels of “bad” LDL cholesterol, which can build up on artery walls and eventually cause total blockage.

The Mediterranean diet is also associated with reduced risk of a range of other afflictions, including cancer. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may reduce their risk of breast cancer. It also fights cognitive diseases such as Parkinson's and Alzheimer’s. Some studies have shown that the diet even enhances one’s memory and ability to focus.

Key components:

Plant-based foods — fruits and vegetables, whole grains, nuts and legumes
Replaces butter and saturated fats with olive and canola oils
Uses herbs and spices instead of salt and artificial flavorings
Fish and poultry predominate over red meats
Red wine in moderation

Source:
Olson B. (24 April 2018). "Eat to Live Well: Health Benefits of the Mediterranean Diet" [blog post]. Retrieved from address http://bit.ly/2JOqjEF


Is Ergonomics A "Must-Have" For Your Workplace Wellness Plan?

 

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Workplace wellness in most organizations centres around health promotion activity or policy development to support healthy behaviour and improve health outcomes in the workplace. A "workplace wellness" Google search reveals a range of programs focused on fitness, weight management, smoking cessation, stress management, work-life balance and occasionally flexible work scheduling. These are legitimately important aspects targeted at improving specific health outcomes.

It is important to realize that the average office worker spends over 65 per cent of their time at work in a sedentary seated position. No doubt you have seen the media campaigns touting the health concerns related to sedentary behaviour, some going as far as labelling sitting as the new smoking. Prolonged sitting has been associated with cardiovascular problems, increases in musculoskeletal discomfort, and decreases in concentration and productivity. Improper sitting and work station setup has been associated with an increase in musculoskeletal pain and injury (MSI) in the neck, shoulders, arms, wrists, legs and lower back. MSI are associated with the wear and tear on the muscles, tissues, ligaments and joints of the body.

It is for these reasons that office ergonomics should be on the workplace wellness program menu. Ergonomics is the science of matching the work to the worker. In an office environment, a major focus would be insuring that employee workstations fit the worker – not the employee made to fit the workstation. To design a healthy employee work station properly requires an understanding of the limitations of the human body, especially in terms of muscle and soft tissue fatigue. Again, a Google search on "office ergonomics" leads you to resources on the proper configuration of computer workstations to promote a neutral sitting posture aimed at reducing muscle and soft tissue pain.

This is a great place to start, but does not replace the knowledge of an experienced ergonomist to ensure that individual limitations and pre-existing health conditions are accommodated for properly. Here are some examples of the most common office ergonomic challenges I encounter when consulting with organizations. The first is the desk. The working height of a standard desk is 30 inches, for which we expect it be comfortable for both the 5-foot-2-inch and a 6-foot-2-inch employee. But the reality is that this standard desk height is appropriate for the 6-foot-2-inch employee. The average female is 5-foot-4-inches, which would suggest that the standard 30-inch working height is too high for the majority of female workers in the office. When the working height is too high, the employee will adopt a posture where the wrists are extended when keyboarding, the neck is extended, shoulders are hunched and back is flexed forward off the chair.

—theglobeandmail.com


No mat needed: Yoga at your desk

A sticky mat seems de rigueur for modern-day yogis, but that doesn’t mean a long piece of rubber is required to take part in the ancient practice.

Yoga first and foremost is about being present, and it starts with attentive breathing. You can do that anywhere and without props.

Once you’ve got the hang of steady breathing, matching inhales and exhales to movements helps your body relieve tension and your muscles wake up. In fact, the key to the physical practice of yoga is matching conscious breath to movement. It’s also a big part of what makes yoga feel great. Without it, you’d be doing calisthenics.

We’ve rounded up a few yoga exercises you can do easily and safely at work. All require standing – good news, given sitting is pretty bad for us. It’s best to do them with your feet flat on the ground.

 

Stand with your feet hip-distance apart. Inhale as you bring your arms overhead. Keep your chin level with the ground. Exhale as you soften your knees and twist your torso to the right, letting your head follow and dropping your arms to shoulder-height. Inhale as you turn back to center, lifting your arms overhead. Do the twist to the left. Repeat this pattern several times.

Benefits: Strengthens abdominal muscles, shoulders and upper arms. Stretches back and chest. Lubricates joints of the spine, including in the neck, and shoulders.

Chair

Stand with your feet hip-distance apart, arms at your sides. Inhale as you lift the crown of your head. Exhale as you bend your knees (typically you want to track each knee over the middle of its corresponding foot), like you’re sitting back in a chair. Hinge at your hips, tilting your torso forward up to 45 degrees. Lift your arms to a comfortable height. Inhale as you return to standing, crown lifted, arms lengthening down. Repeat several times.

Benefits: Strengthens front thighs, buttocks, core, upper back and upper arms. Stretches calves and side torso. Lengthens spine. Lubricates joints of the ankles, knees, hips and shoulders.

Triangle

Stand with your feet slightly wider than hip-distance apart, toes pointing same direction as your chest, then turn your right foot 90 degrees to the right, and your left foot about 15 degrees to the right, making sure your left toes point the same direction as your left knee. Inhale as you extend your arms out from the shoulders and lengthen your spine. Exhale as you tilt your torso to the right, releasing your right arm toward your right leg and your left arm up to a comfortable height. Don’t turn your chest toward your right leg. Drop your gaze to the ground if you feel tension in your neck. Hold for several breaths, and repeat with the left leg.

Benefits: Strengthens front thighs, buttocks, side torso and neck. Stretches calves, back thighs and side torso. Lubricates joints of the hips and shoulders.

 

 

You can read the original article here.

Source:
Malek M. (2 May 2017). "No mat needed: Yoga at your desk" [Web blog post]. Retrieved from address http://worklife.coloniallife.com/2017/05/no-mat-needed-yoga-desk/?utm_sq=flegx3i374&utm_source=Twitter&utm_medium=social&utm_campaign=WorkLifeTweets&utm_content=Articles


Workout - Girl - Stretching - Pixabay

Apple, Fitbit to join FDA program to speed health tech

Wondering how technology can speed the process of developing health tech? In this article from BenefitsPro written by Anna Edney, gain a close insight on how Apple and Fitbit are working together with the FDA to make your health of vital importance.

You can read the original article here.


A federal agency that regulates apples wants to make regulations on Apple Inc. a little easier.

The Food and Drug Administration, which oversees new drugs, medical devices and much of the U.S. food supply, said Tuesday that it had selected nine major tech companies for a pilot program that may let them avoid some regulations that have tied up developers working on health software and products.

“We need to modernize our regulatory framework so that it matches the kind of innovation we’re being asked to evaluate,” FDA Commissioner Scott Gottlieb said in a statement.

The program is meant to let the companies get products pre-cleared rather than going through the agency’s standard application and approval process that can take months. Along with Apple, Fitbit Inc., Samsung Electronics Co., Verily Life Sciences, Johnson & Johnson and Roche Holding AG will participate.

 

A new report and video from the Health Enhancement Research Organization (HERO) identifies six promising practices for effectively integrating wearables...
The FDA program is meant to help the companies more rapidly develop new products while maintaining some government oversight of technology that may be used by patients or their doctors to prevent, diagnose and treat conditions.

Apple is studying whether its watch can detect heart abnormalities. The process it will go through to make sure it’s using sound quality metrics and other measures won’t be as costly and time-consuming as when the government clears a new pacemaker, for example. Verily, the life sciences arm of Google parent Alphabet Inc., is working with Novartis AG to develop a contact lens that could continuously monitor the body’s blood sugar.

Faster Pace

“Historically, health care has been slow to implement disruptive technology tools that have transformed other areas of commerce and daily life,” Gottlieb said in July when he announced that digital health manufacturers could apply for the pilot program.

Officially dubbed the Pre-Cert for Software Pilot, Gottlieb at the time called it “a new and pragmatic approach to digital health technology.”

The other companies included in the pilot are Pear Therapeutics Inc., Phosphorus Inc. and Tidepool.

The program is part of a broader move at the FDA, particularly since Gottlieb took over in May, to streamline regulation and get medical products to patients faster. The commissioner said last week the agency will clarify how drugmakers might use data from treatments already approved in some disease to gain approvals for more conditions. In July, he delayed oversight of electronic cigarettes while the agency decides what information it will need from makers of the products.

Rules Uncertainty

As Silicon Valley developers have pushed into health care, the industry has been at times uncertain about when it needed the FDA’s approval. In 2013, the consumer gene-testing company 23andMe Inc. was ordered by the agency to temporarily stop selling its health analysis product until it was cleared by regulators, for example.

Under the pilot, the FDA will scrutinize digital health companies’ software and will inspect their facilities to ensure they meet quality standards and can adequately track their products once they’re on the market. If they pass the agency’s audits, the companies would be pre-certified and may face a less stringent approval process or not have to go through FDA approval at all.

More than 100 companies were interested in the pilot, according to the FDA. The agency plans to hold a public workshop on the program in January to help developers not in the pilot understand the process and four months of initial findings.

You can read the original article here.

Source:

Edeny A. (27 September 2017). "Apple, Fitbit to join FDA program to speed health tech" [Web Blog Post]. Retrieved from address http://www.benefitspro.com/2017/09/27/apple-fitbit-to-join-fda-program-to-speed-health-t

Wondering how technology can speed the process of developing health tech? In this article from BenefitsPro written by Anna Edney, gain a close insight on how Apple and Fitbit are working together with the FDA to make your health of vital importance.

You can read the original article here.


A federal agency that regulates apples wants to make regulations on Apple Inc. a little easier.

The Food and Drug Administration, which oversees new drugs, medical devices and much of the U.S. food supply, said Tuesday that it had selected nine major tech companies for a pilot program that may let them avoid some regulations that have tied up developers working on health software and products.

“We need to modernize our regulatory framework so that it matches the kind of innovation we’re being asked to evaluate,” FDA Commissioner Scott Gottlieb said in a statement.

The program is meant to let the companies get products pre-cleared rather than going through the agency’s standard application and approval process that can take months. Along with Apple, Fitbit Inc., Samsung Electronics Co., Verily Life Sciences, Johnson & Johnson and Roche Holding AG will participate.

 

A new report and video from the Health Enhancement Research Organization (HERO) identifies six promising practices for effectively integrating wearables...
The FDA program is meant to help the companies more rapidly develop new products while maintaining some government oversight of technology that may be used by patients or their doctors to prevent, diagnose and treat conditions.

Apple is studying whether its watch can detect heart abnormalities. The process it will go through to make sure it’s using sound quality metrics and other measures won’t be as costly and time-consuming as when the government clears a new pacemaker, for example. Verily, the life sciences arm of Google parent Alphabet Inc., is working with Novartis AG to develop a contact lens that could continuously monitor the body’s blood sugar.

Faster Pace

“Historically, health care has been slow to implement disruptive technology tools that have transformed other areas of commerce and daily life,” Gottlieb said in July when he announced that digital health manufacturers could apply for the pilot program.

Officially dubbed the Pre-Cert for Software Pilot, Gottlieb at the time called it “a new and pragmatic approach to digital health technology.”

The other companies included in the pilot are Pear Therapeutics Inc., Phosphorus Inc. and Tidepool.

The program is part of a broader move at the FDA, particularly since Gottlieb took over in May, to streamline regulation and get medical products to patients faster. The commissioner said last week the agency will clarify how drugmakers might use data from treatments already approved in some disease to gain approvals for more conditions. In July, he delayed oversight of electronic cigarettes while the agency decides what information it will need from makers of the products.

Rules Uncertainty

As Silicon Valley developers have pushed into health care, the industry has been at times uncertain about when it needed the FDA’s approval. In 2013, the consumer gene-testing company 23andMe Inc. was ordered by the agency to temporarily stop selling its health analysis product until it was cleared by regulators, for example.

Under the pilot, the FDA will scrutinize digital health companies’ software and will inspect their facilities to ensure they meet quality standards and can adequately track their products once they’re on the market. If they pass the agency’s audits, the companies would be pre-certified and may face a less stringent approval process or not have to go through FDA approval at all.

More than 100 companies were interested in the pilot, according to the FDA. The agency plans to hold a public workshop on the program in January to help developers not in the pilot understand the process and four months of initial findings.

You can read the original article here.

Source:

Edeny A. (27 September 2017). "Apple, Fitbit to join FDA program to speed health tech" [Web Blog Post]. Retrieved from address http://www.benefitspro.com/2017/09/27/apple-fitbit-to-join-fda-program-to-speed-health-t


Absent federal action, states take the lead on curbing drug costs

What's your state's stance on the cost of prescription drugs? See how Maryland has moved forward in their decision making for drug prices, giving themselves the ability to say "no" in this article from Benefits Pro written by Shefali Luthra.

You can read the original article here.


Lawmakers in Maryland are daring to legislate where their federal counterparts have not: As of Oct. 1, the state will be able to say “no” to some pharmaceutical price spikes.

A new law, which focuses on generic and off-patent drugs, empowers the state’s attorney general to step in if a drug’s price climbs 50 percent or more in a single year. The company must justify the hike. If the attorney general still finds the increase unwarranted, he or she can file suit in state court. Manufacturers face a fine of up to $10,000 for price gouging.

As Congress stalls on what voters say is a top health concern — high pharmaceutical costs — states increasingly are tackling the issue. Despite often-fierce industry opposition, a variety of bills are working their way through state governments. California, Nevada and New York are among those joining Maryland in passing legislation meant to undercut skyrocketing drug prices.

Maryland, though, is the first to penalize drugmakers for price hikes. Its law passed May 26 without the governor’s signature.

The state-level momentum raises the possibility that — as happened with hot-button issues such as gay marriage and smoke-free buildings — a patchwork of bills across the country could pave the way for more comprehensive national action. States feel the squeeze of these steep price tags in Medicaid and state employee benefit programs, and that applies pressure to find solutions.

“There is a noticeable uptick among state legislatures and state governments in terms of what kind of role states can play in addressing the cost of prescription drugs and access,” said Richard Cauchi, health program director at the National Conference of State Legislatures.

Many experts frame Maryland’s law as a test case that could help define what powers states have and what limits they face in doing battle with the pharmaceutical industry.

The generic-drug industry has already filed a lawsuit to block the law, arguing it’s unconstitutionally vague and an overreach of state powers. A district court is expected to rule soon.

The state-level actions focus on a variety of tactics:

“Transparency bills” would require pharmaceutical companies to detail a drug’s production and advertising costs when they raise prices over certain thresholds. Cost-limit measures would cap drug prices charged by drugmakers to Medicaid or other state-run programs, or limit what the state will pay for drugs. Supply-chain restrictions include regulating the roles of pharmacy benefit managers or limiting a consumer’s out-of-pocket costs.

A New York law on the books since spring allows officials to cap what its Medicaid program will pay for medications. If companies don’t sufficiently discount a drug, a state review will assess whether the price is out of step with medical value.

Maryland’s measure goes further — treating price gouging as a civil offense and taking alleged violators to court.

“It’s a really innovative approach. States are looking at how to replicate it, and how to expand on it,” said Ellen Albritton, a senior policy analyst at the left-leaning Families USA, which has consulted with states including Maryland on such policies.

Lawmakers have introduced similar legislation in states such as Massachusetts, Rhode Island, Tennessee and Montana. And in Ohio voters are weighing a ballot initiative in November that would limit what the state pays for prescription drugs in its Medicaid program and other state health plans.

Meanwhile, the California legislature passed a bill earlier in September that would require drugmakers to disclose when they are about to raise a price more than 16 percent over two years and justify the hike. It awaits Democratic Gov. Jerry Brown’s signature.

In June, Nevada lawmakers approved a law similar to California’s but limited to insulin prices. Vermont passed a transparency law in 2016 that would scrutinize up to 15 drugs for which the state spends “significant health care dollars” and prices had climbed by set amounts in recent years.

But states face a steep uphill climb in passing pricing legislation given the deep-pocketed pharmaceutical industry, which can finance strong opposition, whether through lobbying, legal action or advertising campaigns.

Last fall, voters rejected a California initiative that would have capped what the state pays for drugs — much like the Ohio measure under consideration. Industry groups spent more than $100 million to defeat it, putting it among California’s all-time most expensive ballot fights. Ohio’s measure is attracting similar heat, with drug companies outspending opponents about 5-to-1.

States also face policy challenges and limits to their statutory authority, which is why several have focused their efforts on specific parts of the drug-pricing pipeline.

Critics see these tailored initiatives as falling short or opening other loopholes. Requiring companies to report prices past a certain threshold, for example, might encourage them to consistently set prices just below that level.

Maryland’s law is noteworthy because it includes a fine for drugmakers if price increases are deemed excessive — though in the industry that $10,000 fine is likely nominal, suggested Rachel Sachs, an associate law professor at Washington University in St. Louis who researches drug regulations.

This law also doesn’t address the trickier policy question: a drug’s initial price tag, noted Rena Conti, an assistant professor in the University of Chicago who studies pharmaceutical economics.

And its focus on generics means that branded drugs, such as Mylan’s Epi-Pen or Kaleo’s overdose-reversing Evzio, wouldn’t be affected.

Yet there’s a good reason for this, noted Jeremy Greene, a professor of medicine and the history of medicine at Johns Hopkins University who is in favor of Maryland’s law.

Current interpretation of federal patent law suggests that the issues related to the development and affordability of on-patent drugs are under federal jurisdiction, outside the purview of states, he explained.

In Maryland, “the law was drafted narrowly to address specifically a problem we’ve only become aware of in recent years,” he said. That’s the high cost of older, off-patent drugs that face little market competition. “Here’s where the state of Maryland is trying to do something,” he said.

Still, a ruling against the state in the pending court case could have a chilling effect for other states, Sachs said, although it would be unlikely to quash their efforts.

“This is continuing to be a topic of discussion, and a problem for consumers,” said Sachs.

“At some point, some of these laws are going to go into effect — or the federal government is going to do something,” she added.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation. KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Source:

Luther S. (29 September 2017). "Absent federal action, states take the lead on curbing drug costs" [Web Blog Post]. Retrieved from address http://www.benefitspro.com/2017/09/29/absent-federal-action-states-take-the-lead-on-curb?page=2


Center Stage...Do You Have an Employer Return to Work Program?

A proven strategy to reduce workers compensation cost and shorten the length of a worker’s compensation time is a return to work (RTW) program.

Loss reduction overall can be greatly improved by an effective RTW program.

 

“Before RTW programs evolved, the role of an employee was a passive one. If an employee was injured and was unable to work, they ended up sitting at home and it became the doctor’s responsibility to decide when they were cleared for work. Hierl takes a proactive approach to getting these workers back on the job.” -Cathleen Christenson

Today, most disability or worker’s compensation insurers enact RTW programs to help facilitate injured workers return to work in a timely manner. Hierl recommends a policy where employers are more actively involved with the doctor and employee throughout the worker’s compensation claim. These policies clarify the employee’s late duty work, alternative job duties to keep workers engaged when they are on a leave, and any other expectations up front.

A study by the Department of Labor and Industry, produced that the chances of returning to any type of work drastically reduced the longer they are away from work. At just six months away from work, the employee only stands a fifty percent chance of getting back to any type of work. At twenty-four months, the study found the worker will most likely never return to productive work.

Key Points to a Successful Return to Work Program

  1. Have a dedicated person responsible

Having a dedicated return to work coordinator or specialist to facilitate the return to work process and provide individualized planning that adapts to the worker’s initial and ongoing needs shows that you care as an employer. This role will also be in charge of assigning modified work duties for the employee. Be sure to make sure the employee knows who they can contact if they have any questions or need help through the return to work process.

 

  1. Maintain active communication

An essential requirement for a successful early return to work program is good communication between the employer, the employee and the medical care provider. It can be very beneficial for employers to be able to develop a relationship with medical providers in their community to allow the medical provider to understand what the company does and accurately determine when an employee can return to their workplace.

  1. Actively engage employee in the return to work program

Often employees are injured and left to stay at home without work and they suffer a serious change to their normal routine. By spending time away from the office, it causes a disconnect from the human element that exists in the office. In order to ensure employees stay involved and return to work, it is crucial to keep them engaged usually through late duty work. Ensure that all employees know the company return to work policy and that they understand the company is committed to keeping them engaged in late duty work.

The key in successful return to work programs is making sure that any of your efforts aren’t perceived as punitive but instead convey to your employees that you care about them. Make sure that all levels of employees recognize that early return to work after an injury speeds up the recovery process and reduces the likelihood of a permanent disability. Studies clearly demonstrate that employees who are off work because of an injury for more than 16 weeks seldom return to the workforce, costing companies hundreds of thousands of dollars each year. Overall, workplace return to work policies have positive impacts on duration and costs of worker compensation.

Contact Hierl for guidance in enacting a return to work program or general employee safety practices. A good return to work program should be set up before it is needed.


Survey: Small Businesses Keeping Pace with Health Benefits Offered by Employers Nationwide

Find out how small businesses compare to major corporations when it comes to their healthcare benefits in this informative article from our partner, United Benefit Advisors (UBA) by Bill Olson.

Small employers, those with fewer than 100 employees, have a reputation for not offering health insurance benefits that are competitive with larger employers, but new survey data from UBA’s Health Plan Survey reveals they are keeping pace with the average employer and, in fact, doing a better job of containing costs.

According to our new special report: “Small Businesses Keeping Pace with Nationwide Health Trends,” employees across all plan types pay an average of $3,378 toward annual health insurance benefits, with their employer picking up the rest of the total cost of $9,727. Among small groups, employees pay $3,557, with their employer picking up the balance of $9,474 – only a 5.3 percent difference.

When looking at total average annual cost per employees for PPO plans, small businesses actually cut a better deal even compared to their largest counterparts—their costs are generally below average—and the same holds true for small businesses offering HMO and CDHP plans. (Keep in mind that relief such as grandmothering and the PACE Act helped many of these small groups stay in pre-ACA plans at better rates, unlike their larger counterparts.)

PPO Plan Average Annual Cost per Employee

Think small businesses are cutting coverage to drive these bargains? Compared to the nations very largest groups, that may be true, but compared to average employers, small groups are highly competitive

See the original article Here.

Source:

Olson B. (2017 August 24). Survey: small business keeping pace with health benefits offered by employers nationwide [Web blog post]. Retrieved from address http://blog.ubabenefits.com/survey-small-businesses-keeping-pace-with-health-benefits-offered-by-employers-nationwide


The COBRA Payment Process

Great article from our partner, United Benefit Advisors (UBA) by Danielle Capilla.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. The COBRA payment process is subject to various rules in terms of grace periods, notification, premium payment methods, and treatment of insignificant shortfalls.

Grace Periods

The initial premium payment is due 45 days after the qualified beneficiary elects COBRA. Premium payments must be made on time; otherwise, a plan may terminate COBRA coverage. Generally, subsequent premium payments are due on the first day of the month. However, under the COBRA grace period rules, premiums will still be considered timely if made within 30 days after the due date. The statutory grace period is a minimum 30-day period, but plans may allow qualified beneficiaries a longer grace period.

A COBRA premium payment is made when it is sent to the plan. Thus, if the qualified beneficiary mails a check, then the payment is made on the date the check was mailed. The plan administrators should look at the postmark date on the envelope to determine whether the payment was made on time. Qualified beneficiaries may use certified mail as evidence that the payment was made on time.

The 30-day grace period applies to subsequent premium payments and not to the initial premium payment. After the initial payment is made, the first 30-day grace period runs from the payment due date and not from the last day of the 45-day initial payment period.

If a COBRA payment has not been paid on its due date and a follow-up billing statement is sent with a new due date, then the plan risks establishing a new 30-day grace period that would begin from the new due date.

Notification

The plan administrator must notify the qualified beneficiary of the COBRA premium payment obligations in terms of how much to pay and when payments are due; however, the plan does not have to renotify the qualified beneficiary to make timely payments. Even though plans are not required to send billing statements each month, many plans send reminder statements to the qualified beneficiaries.

While the only requirement for plan administrators is to send an election notice detailing the plan's premium deadlines, there are three circumstances under which written notices about COBRA premiums are necessary. First, if the COBRA premium changes, the plan administrator must notify the qualified beneficiary of the change. Second, if the qualified beneficiary made an insignificant shortfall premium payment, the plan administrator must provide notice of the insignificant shortfall unless the plan administrator chooses to ignore it. Last, if a plan administrator terminates a qualified beneficiary's COBRA coverage for nonpayment or late payment, the plan administrator must provide a termination notice to the qualified beneficiary.

The plan administrator is not required to inform the qualified beneficiary when the premium payment is late. Thus, if a plan administrator does not receive a premium payment by the end of the grace period, then COBRA coverage may be terminated. The plan administrator is not required to send a notice of termination in that case because the COBRA coverage was not in effect. On the other hand, if the qualified beneficiary makes the initial COBRA premium payment and coverage is lost for failure to pay within the 30-day grace period, then the plan administrator must provide a notice of termination due to early termination of COBRA coverage.

See the original article Here.

Source:

Capilla D. (2017 August 23). The COBRA payment process [Web blog post]. Retrieved from address http://blog.ubabenefits.com/the-cobra-payment-process-1