Politics May Change FL Health Insurance Rates

The Florida health insurance industry could undergo some massive changes in coming months. Last month, at the end of the state’s legislative session, lawmakers introduced a bill that could alter the way health care is paid for in the Sunshine state. Lawmakers and doctors insist it’s a way to improve and streamline Florida health insurance, insurers beg to differ.

Up to now, Florida health insurance provider Blue Cross Blue Shield has only made direct payments to those doctors inside their PPO networks. The state’s largest insurer claims negotiating payments with doctors in their networks assists them in keeping costs low. The bill at hand seeks to change that, allowing doctors outside of the PPO networks to receive direct payments.

Opponents of the bill claim this will cause Florida health insurance rates to rise as Blue Cross Blue Shield will lose its negotiation powers with providers. BCBS representatives claim the measure will create an exodus of providers from their PPO network. Supporters claim the bill will address a number of issues related to the current system of payments.

Currently those on Blue Cross Blue Shield Florida health insurance are paid directly if they use an out-of-network provider. The patient is then responsible themselves to use this payment for reimbursing the provider. Concerns stem from allegations that some patients use these direct payments for other expenses, even illicit drug purchases. Doctors in Florida support the bill saying it will cut down on administrative costs for them, thus reducing costs for the patient.

Doctors and other providers lobbied hard during this Spring to bring this bill to fruition. Some argue their attempts are so they can gain negotiating power over Blue Cross Blue Shield and Florida health insurance rates. Others claim this bill will save millions in administrative costs across the state, simply by changing the address on the reimbursement check.

With a growing elderly population, due namely to incoming Snowbirds and other out-of-state retirees of the Baby-Boomer generation, controlling Florida health insurance rates has become a top priority for state officials. It is still unclear as to what Florida Governor Charlie Crist (R) will do with the bill. Crist has until near the end of June to sign the bill. With both a father and a sister who are doctors, it is anyone’s guess as to whether or not Crist will sign the proposed legislation into law. These changes to Florida health insurance also comes amidst massive changes proposed at the federal level by those in the House and Senate.

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Affordable Health Insurance Plans Employees’ Most Popular

As employees speak out in regard to health insurance programs NC survey shows that less costly and more affordable health insurance programs are the most popular with employees. Workers are slow to adopt most popular programs; financial incentives motivate behavior changes.

In today’s stressful economic environment, starting a workplace wellness program may be the furthest thing from employers’ minds, but creating a healthier workforce is more important than ever to contain rising health care costs and reduce the health impact employees are facing in these uncertain times.

According to a statewide poll commissioned by Blue Cross and Blue Shield of North Carolina (BCBSNC), employers are still slow to adopt jobsite wellness programs even though they help improve employees’ health, increase loyalty, and the most popular ones aren’t costly to implement.

“With the economy the way it is, employers might be tempted to cut back on wellness programs,” said Bob Greczyn, president and CEO of BCBSNC. “But now’s not the time to cut back, because we’ll all be paying the price in the long run.”

In June, more than 500 employees from around the state were surveyed about workplace wellness programs and the results were compiled into the Healthy on the Job report which was presented today in Raleigh at the 2008 State of Preventive Health Summit.

The results showed the most popular workplace wellness programs with employees are:

* Paid time off for doctor’s visits or health care needs: 78 percent
* Purchasing healthy café or vending options: 67 percent
* Participating in physical activity during work hours: 67 percent
* Completing a health risk assessment (HRA): 66 percent

However, the survey showed that most employers aren’t offering these popular programs. Only 35 percent of employers offer physical activity during the workday, 29 percent offer healthy café or vending options and 31 percent offer health risk assessments. Just 61 percent of employers are offering paid time off for doctor’s visits according to the survey.

Financial incentives are effective in changing worker behavior, according to the survey. Discounts on health insurance premiums have the highest motivational impact on being physically active, losing weight and receiving preventive care. It ranks second among smokers for motivating them to quit smoking. Proof that employers recognize incentives as good motivators: Nearly half of employers offering health risk assessments offer rewards for completing them.

Workplace wellness programs also contribute to employee loyalty. Employees who participated in at least one wellness program more often say they like working for their employer and are more likely to recommend their company to others. What’s more, employees who took paid time off for doctor’s visits and engaged in physical activity at their worksite had higher loyalty scores than those who didn’t participate or whose employers didn’t offer it.

“Too many of our employees are making bad choices about physical activity and nutrition – add stress on top of that and the impact of our health is going to hit the bottom line,” said Greczyn. “Lifestyle and behavior changes are harder to come by. It’s going to take a concerted effort on the part of employers to set the standard so that employees can become healthier on the job.”

Three North Carolina employers have done their part to set the standard. These organizations are highlighted in the Healthy on the Job report for their best practices:

o Durham County has created a culture of wellness through providing an on-site clinic for its employees and giving employees an extra half-hour at lunch to exercise.

o Progress Energy established its wellness program, Healthy Progress in 2007, by establishing a core wellness team and identifying wellness coordinators and champions.

o Inmar in Winston-Salem has built meaningful financial incentives for its employees to participate in a chronic disease management program, tobacco cessation classes and track their physical activity.

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Beware of Health Insurance Scams

It was bound to happen: health care reform triggered a flood of health insurance scams across the nation, fueled by consumers’ fears and confusion over what impact the new laws will have on them and their families. Bogus health insurance policies are being peddled via every media possible, so buyers beware.

In an April 6 letter to state officials, Secretary of Health and Human Services, Kathleen Sebelius urged them to be on the alert for scammers who are looking to lure people into buying worthless health insurance policies. Her agency had noted a recent increase in the number of health care-related crimes, and the numbers are likely to continue to rise.

The letter noted that “Media accounts indicate that fraudsters have gone door to door selling phony insurance policies. Some have attempted to make dishonest profits by urging consumers to obtain coverage in a non-existent ‘limited enrollment’ period that they falsely claim was made possible by the new legislation.”

Among those most often victimized are seniors. Sebelius said that her department was contacting seniors groups to alert them of possible fraudulent sales pitches for health insurance policies and health care related issues. Such sales pitches often come via a telephone call or door-to-door salesperson who uses high-pressure scare tactics.

Consumers should be wary of tactics that scammers often employ to lure in their victims. Here are some red flags:

  • High-pressure scare tactics: If a salesperson tells you that a health insurance policy is only available at a special price or with special options for a limited time because of the new federal health care laws and that you should buy now, don’t.
  • “Urgent” Internet and TV ads: Beware of advertisements that urge you to call a toll-free number to take advantage of special insurance coverage because of the new health care laws.
  • Door-to-door sales: Legitimate health insurance companies do not use this sales approach any more. Do not fall for it.
  • Too good to be true: If someone offers you a health insurance policy at a very low cost with great comprehensive coverage, it’s too good to be true. Health insurance is not inexpensive.
  • Verify: If you are considering a policy with a company, verify that the company is licensed to conduct business in your state. Contact your state insurance office, or you can visit the website for the National Association of Insurance Commissioners, which provides detailed information and access to commissioners in all 50 states.
  • Examine all documents carefully: Make sure you read all the documents the insurance agent gives you, that all the blanks are filled in, and that you keep a copy of anything you sign.
  • Review your policy: After you get a copy of your health insurance policy, compare its contents with the paperwork that you signed to make sure you got what you agreed to buy, nothing more and nothing less. If there is any discrepancy, contact the insurance company immediately.

The search for affordable health insurance can be a challenge. Don’t be frightened into becoming a victim of a health insurance scam. If the individual who is trying to sell you a health insurance policy is offended because you ask lots of questions or you try to verify their credentials, that is an instant indication that something is not right. Protect yourself and your family.

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MO Health Insurance Goes Social with Healthychat.com

Missouri health insurance provider, Anthem BlueCross BlueShield, has created an online forum, Healthchat.com, to address concerns from Americans over the impact of health care reform. The health insurance provider is also taking advantage of social media to get the job done.

With the use of the website, Twitter, Facebook, and YouTube, Anthem BCBS hopes to reach those who have questions about how the health insurance reform will impact them personally. The text of the law is long and complicated, making it challenging for citizens to learn how each will be individually affected. Kate Quinn, of Anthem, says, “By offering a forum on healthchat.com, we are providing an interactive place where consumers can participate in an open discussion about health benefits and the impact of health care reform.”

Healthychat.com has two main areas: Learn and Stay Informed. On the Learn page is where the “interactive” discussion board is located. Also given are blog posts with information such as “Is it safe to get immunized when pregnant” and others.

Users create a profile, similar to those found on Facebook, Twitter, and other social media sites in order to register. They can keep track of conversations, create favorites and make connections with others. And users can “Stay Informed” with a blog at healthychat.com which offers information on upcoming features and related news stories.

Right now, there does not seem to be an interactive quality as reported, upon use of the site. There is a lot of information there but it is not easily clear how one can interact with the site beyond reading the information. Users can comment upon the articles and topics that are there but there does not appear to be a way to start a conversation. Users can “suggest” a topic, however. They can also add the topic discussions to favorites and share it on other social media sites. It causes one to wonder how this website is any different than any other health insurance news website.

The difference may just be that Anthem is listening. The company has created a Twitter account, a Facebook page, and a YouTube channel to complement the healthychat.com website. Employees from the company monitor the conversations and use that to provide feedback to the general public and to incorporate suggestions into the website as well as its own policies. At the very least, it is an informative website.

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Hearing colors, seeing sounds: New research explores sensory overlap in the brain

New research indicates that the integration of senses and functions in the brain is common. About two percent of the population has a condition called synesthesia, in which two different sensations, like color and sound, are experienced at once. Although this condition is rare, the new findings suggest the brain is wired in complex and sometimes overlapping ways to help people interpret and understand their environments. The research was presented at Neuroscience 2010, the annual meeting of the Society for Neuroscience and the world’s largest source of emerging news on brain science and health. Today’s new findings show that:

  • Researchers have pinpointed the brain region responsible for the McGurk Effect, an auditory phenomenon in which viewing lips moving out of sync with words creates the perception of other words. A brain area known to play a role in language and eye gaze processing is the hub of the sensory overlap (Michael Beauchamp, PhD, abstract 400.2, see attached summary).
  • People adjust the perceived location of sensory stimuli faster than previously thought. Results show that exposure to light for only a fraction of a second alters the perceived source of a subsequent sound. The findings have implications for the development of hearing aids and rehabilitation from brain injury (Ladan Shams, PhD, abstract 125.1, see attached summary).

Other recent findings discussed show that:

  • Synesthetes who describe colors as either inside their minds or outside in the world have distinct brain structures and processes (Romke Rouw, PhD, see attached speaker’s summary).
  • People who share one type of synesthesia, in which letters and numbers create the experience of color, describe drastically different sensations from one another. This indicates that synesthetic experiences are more idiosyncratic than is commonly realized (Avinash Vaidya, see attached speaker’s summary).
  • In people with synesthesia, scientists found the brain’s color-processing area was active five to 10 milliseconds after the visual processing areas, suggesting synesthesia occurs through direct communication between the senses (David Brang, see attached speaker’s summary).

“While synesthesia reflects an extreme manner in which the senses communicate, there’s evidence that synesthesia operates through mechanisms present in all individuals,” said press conference moderator Vilayanur Ramachandran, MD, PhD, of the University of California, San Diego, an expert on visual perception and behavioral neurology. “Understanding these mechanisms can help us answer fundamental questions about how the brain works.”

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