As the year comes to a close, I’m reflecting on the past summer and one of the initiatives Healthcare Ready supported that aimed to promote equity in local emergency management policy. We worked with the Baltimore Office of Sustainability on the 2018 update of their Disaster Preparedness and Planning Project (DP3), a comprehensive plan that fulfills a federal requirement that cities must have an All-Hazards Mitigation Plan.
Employer-sponsored group health insurance plans first emerged in the 1940s as a way for employers to attract employees when wartime legislation mandated flattened wages. This was a popular tax-free benefit which employers continued to offer after the war’s end, but it failed to address the needs of retirees and other non-working adults. Federal efforts to provide coverage to those groups led to the Social Security Amendments of 1965, which laid the foundation for Medicare and Medicaid. These government-sponsored health plans continue to provide care to those left out of employer-sponsored group health insurance plans. As national health expenditures have climbed past 15 percent of gross domestic product (GDP), the Affordable Care Act of 2010 substituted a nationwide mandate that each taxpayer join a group plan for the sort of single-payer solution that has faced stiff opposition since the 1930s.
Sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. While standardized treatment protocols have been implemented, a wide variability in clinical outcomes persists across racial groups. Specifically, black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the white population. While this is often attributed to systemic bias against minority groups, a growing body of literature has found patient, community, and hospital-based factors to be driving racial differences. In this article, we provide a focused review on some of the factors driving racial disparities in sepsis. We also suggest potential interventions aimed at reducing health disparities in the prevention, early identification, and clinical management of sepsis. Full article
Sure enough, in the spring and early summer of 2018, when insurers began filing their proposed rates for 2019, the elimination of the individual mandate was almost universally listed as a factor driving up premiums. Even in cases where the insurer had proposed an overall rate decrease, they generally noted that rates would be decreasing even more if the mandate penalty wasn't being eliminated.
In the fall of 2017, just before open enrollment for 2018 coverage, the Trump Administration announced drastic funding cuts for exchange marketing and enrollment assistance. And in 2018, the Administration again slashed funding for Navigator programs, down to just $10 million (it had already been reduced to $36 million in 2017). The lower funding levels are likely to remain in place for the duration of the Trump Administration, and the Administration is likely to once again promote Medicare open enrollment but not individual market open enrollment.
“Humana” is the brand name for plans, products, and services provided by one or more of the subsidiaries and affiliate companies of Humana Inc. (“Humana Entities”). Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state.
Then the choice is clear: You need an ACA plan. ACA plans are the only option that will cover all pre-existing conditions on day 1 without waiting periods. Same with prescriptions. If you have lots of prescriptions you need coverage for then an ACA plan is your best option. Most alternative healthcare options will give you discounts on prescriptions but will not give you a “copay” structure like ACA plans—although many ACA plans do subject you to your plan deductible first. Some ACA alternatives will cover pre-existing conditions after a 12-24 month waiting period.
100 percent of qualified expenses (including pharmacy prescriptions) are paid by the employee until the employee deductible is met. Once the deductible is met, the employee will pay 20 percent co-insurance until the employee out-of-pocket maximum is reached. At that point, the Choice CDHP plan pays 100 percent of qualified expenses for the remainder of the plan year.
A high deductible health insurance plan has higher deductibles and lower premiums than most other health insurance plans. This means you pay a smaller fixed amount every month, but it will take a longer time for insurance to kick in and begin cost-sharing (meaning you will pay your percentage of coinsurance for every bill). You might benefit from this plan if you don’t require many doctor’s visits or other healthcare benefits. Look at quotes for high deductible health insurance plans to figure out if this plan is right for you.
Humana individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc.CompBenefits of Georgia, Inc ., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. For Arizona residents: Insured by Humana Insurance Company . For Texas residents: Insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits).
The effectiveness of regenerated chicken bone char (CBC) in fluoride removal was investigated in the present study. Heat treatment was studied as the regeneration method. Results revealed that the CBC regenerated at 673 K yielded the highest fluoride adsorption capacity, hence, 673 K was the best regenerating temperature. The study continued up to five regeneration cycles at the best regenerating temperature; 673 K. The CBC accounted to 16.1 mg F/g CBC as the total adsorption capacity after five regeneration cycles. The recovery percentage of CBC reduced from 79% at the first regeneration to 4% after five regeneration cycles. The hydroxyapatite structure of CBC was not changed during the fluoride adsorption by five regeneration cycles. The ion exchange incorporated with the chemical precipitation occurred during the fluoride adsorption. The repeated regeneration of CBC is possible and it could be used as a low cost defluoridation technique to minimize the wastage of bone char. Full article
Since 1974, New Zealand has had a system of universal no-fault health insurance for personal injuries through the Accident Compensation Corporation (ACC). The ACC scheme covers most of the costs of related to treatment of injuries acquired in New Zealand (including overseas visitors) regardless of how the injury occurred, and also covers lost income (at 80 percent of the employee's pre-injury income) and costs related to long-term rehabilitation, such as home and vehicle modifications for those seriously injured. Funding from the scheme comes from a combination of levies on employers' payroll (for work injuries), levies on an employee's taxable income (for non-work injuries to salary earners), levies on vehicle licensing fees and petrol (for motor vehicle accidents), and funds from the general taxation pool (for non-work injuries to children, senior citizens, unemployed people, overseas visitors, etc.)
The remaining 45% of health care funding comes from insurance premiums paid by the public, for which companies compete on price, though the variation between the various competing insurers is only about 5%. However, insurance companies are free to sell additional policies to provide coverage beyond the national minimum. These policies do not receive funding from the equalization pool, but cover additional treatments, such as dental procedures and physiotherapy, which are not paid for by the mandatory policy.
^ Bump, Jesse B. (19 October 2010). "The long road to universal health coverage. A century of lessons for development strategy" (PDF). Seattle: PATH. Retrieved 10 March 2013. Carrin and James have identified 1988—105 years after Bismarck's first sickness fund laws—as the date Germany achieved universal health coverage through this series of extensions to minimum benefit packages and expansions of the enrolled population. Bärnighausen and Sauerborn have quantified this long-term progressive increase in the proportion of the German population covered by public and private insurance. Their graph is reproduced below as Figure 1: German Population Enrolled in Health Insurance (%) 1885–1995.
Under Obamacare, these plans were non-compliant which meant they didn’t offer the “essential health benefits” and other qualifications and, therefore, you’d have to pay the mandate tax just like if you didn’t have insurance at all. However, if catastrophic plans fit your needs, some folks have been known to buy them for coverage, elect to pay the tax, and it still being cheaper overall than buying compliant plans on the exchanges.
Health services research can lead to greater efficiency and equitable delivery of health care interventions, as advanced through the social model of health and disability, which emphasizes the societal changes that can be made to make populations healthier. Results from health services research often form the basis of evidence-based policy in health care systems. Health services research is also aided by initiatives in the field of artificial intelligence for the development of systems of health assessment that are clinically useful, timely, sensitive to change, culturally sensitive, low burden, low cost, built into standard procedures, and involve the patient.
Through the 1990s, managed care insurance schemes including health maintenance organizations (HMO), preferred provider organizations, or point of service plans grew from about 25% US employees with employer-sponsored coverage to the vast majority. With managed care, insurers use various techniques to address costs and improve quality, including negotiation of prices ("in-network" providers), utilization management, and requirements for quality assurance such as being accredited by accreditation schemes such as the Joint Commission and the American Accreditation Healthcare Commission.
Below are key highlights of the different types of plans. Click on each plan name to learn more. If you or your eligible dependent is Medicare eligible, be sure you understand what you need to do. Also, see different prescription drug costs on high deductible and standard plans. This may be a factor in your choosing a health plan. Find out if you are eligible for these benefits.
Primary care refers to the work of health professionals who act as a first point of consultation for all patients within the health care system. Such a professional would usually be a primary care physician, such as a general practitioner or family physician. Another professional would be a licensed independent practitioner such as a physiotherapist, or a non-physician primary care provider such as a physician assistant or nurse practitioner. Depending on the locality, health system organization the patient may see another health care professional first, such as a pharmacist or nurse. Depending on the nature of the health condition, patients may be referred for secondary or tertiary care.
Well, the mandate stuck because the Supreme Court ruled the government isn’t forcing people to buy health insurance, just that they are levying a tax (the “penalty”…) if they don’t buy it and the government has the right to pass new taxes. So the mandate stuck…because it is a tax, not a penalty, and therefore the government isn’t “forcing” you to buy something. And here we are now with that tax being repealed as part of the Republican tax reform.
HSA funds are considered to be “triple-tax advantaged.” This means any money put into the HSA account is contributed on a pre-tax basis, any earnings on the investments are not taxed, and any funds withdrawn for qualified medical expenses are not taxed. The HSA is an account owned by the employee, and the employee may choose to use HSA funds in the current plan year or roll the account balance forward to let it grow – even into retirement. And if an employee leaves Vanderbilt, the HSA goes with them.
Medicare Levy Surcharge: People whose taxable income is greater than a specified amount (in the 2011/12 financial year $80,000 for singles and $168,000 for couples) and who do not have an adequate level of private hospital cover must pay a 1% surcharge on top of the standard 1.5% Medicare Levy. The rationale is that if the people in this income group are forced to pay more money one way or another, most would choose to purchase hospital insurance with it, with the possibility of a benefit in the event that they need private hospital treatment – rather than pay it in the form of extra tax as well as having to meet their own private hospital costs.
While improved mealtime practices can reduce agitation, improve quality of life, and increase food intake for people in aged care, the degree of implementation of these strategies is unknown. This study describes food service practices in residential aged care facilities, focusing on units caring for people with dementia. An online survey was distributed to residential aged care facilities for completion by the food service manager (n = 2057). Of the 204 responses to the survey, 63 (31%) contained a dementia-specific unit. Most facilities used adaptive equipment (90.2%) and commercial oral nutritional supplements (87.3%). A higher proportion of facilities with a dementia-specific service used high-contrast plates (39.7%) than those without (18.4%). The majority of facilities had residents make their choice for the meal more than 24 h prior to the meal (30.9%). Use of high contrast plates (n = 51, 25%) and molds to reform texture-modified meals (n = 41, 20.1%) were used by one-quarter or less of surveyed facilities. There is a relatively low use of environmental and social strategies to promote food intake and wellbeing in residents, with a focus instead on clinical interventions. Research should focus on strategies to support implementation of interventions to improve the mealtime experience for residents. Full article
Probably not a surprise since we’re talking health insurance, but there really isn’t a great one-stop-shop. Insurance is regulated at the State level so insurers and plans will vary. I’d start with checking the major health insurers directly (Aetna, UnitedHealthcare, Anthem and Cigna) as they operate in many states. But there could be small insurers that offer CAT plans in your state as well so Google searching might be a good resort to find specific plans in your State (and buying them direct from the insurer). Wish I could be more helpful here.
Access to health care may vary across countries, communities, and individuals, largely influenced by social and economic conditions as well as the health policies in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Healthcare systems are organizations established to meet the health needs of targeted populations. Their exact configuration varies between national and subnational entities. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others, planning occurs more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization (WHO), a well-functioning healthcare system requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; and well maintained health facilities and logistics to deliver quality medicines and technologies.
If you are looking for individual or family health insurance, it helps to get advice and ask questions. Licensed insurance agents at eHealth are here to help you make the right decisions for you and your family. They can give personalized opinions on what plans will work best for you based on budget and medical needs. Enrolling in a health insurance plan with the help of an agent comes at no extra cost to you.