by Admin. | Jan 22, 2013 | healthcare
Physician’s Poem
Physician’s Poem: The Good Physician
Jay Jackson, MDYork, Pa. jackson@cyberia.com
Has a brain that works
Can tell a joke tastefully
Listens as much as talks
Conveys as much with a gaze as with expostulation
Avoids the counsel of scalawags and pontificators
Watches, with pride, the accomplishments of others
Adds to the value of every encounter
Welcomes newness in all its forms
and oldness when it turns newness inside out
Knows that the cerebellum is for dancing
Is not annoyed by mediocrity
Never underestimates the intelligence or ability of others
Realizes that when the procedure has ended, someone still has to clean up
Notes that being wrong and glib is tactless
Thoughtfully navigates divisions of cultural diversity
Is haunted by the difference between accomplishment and aspiration
Can touch
Accumulates a trove of magical ideas for sharing
Is well remembered for those things given away without a second’s hesitation
Understands the weight of oceans in a tear
Bumps into life with boldness and civility
Can use sotto voce
Asks for help when needed
Knows the names of everyone in the room and remembers
to thank them all
Is comfortable with silence
by Admin. | Jan 20, 2013 | Health Care Reform, MEDICARE
The Doctor is not in
A great infograph by Good and Column Five that tells the story posted Aug 2012- Doctor Shortages-Covered but Less Access
The Association of American Medical Colleges projects a shortage of 60,000 physicians by 2015 and 90,000 physicians by 2020, roughly a 10-15% shortfall. Although the shortage preceded ObamaCare, the new law will make matters worse. The Physicians Foundation predicts a “silent exodus“ of physicians retiring early or reducing work hours in response to ObamaCare.
Many primary care physicians are overloaded and closing their practices to new patients. If you don’t have a doctor yet, get one before it’s too late.
The Doctor is Not Infograph by Association of American Medical Colleges Kaiser Health
Similarly, if you’re approaching Medicare age (65) and your current doctor will retire in a few years, consider switching to a younger doctor now. Many doctors no longer accept new Medicare patients, and this problem will worsen with anticipated Medicare payment cuts. However, most doctors will continue seeing their current patients even after they turn 65. But if you wait until after age 65 to look for a new doctor, you may have a hard time finding one.
- https://medicalsolutionscorp.com/p/doctor-shortages-covered-but-less-access
by Admin. | Jan 1, 2013 | Health Care Reform, Health Care Refrom, PPACA
Fiscal Cliff Deal: Doc Cuts Spared. Happy 2013 Fiscal Cliff averted! At least for another year the dreaded 27% Medicare reimbursement have been spared. The so-called “doc fix” would boost the deficit by $31 billion. The President stood firm against any proposed Republican cuts to the Affordable Care Act.
The fear in provider cuts is grounded. According to The Lewin Report Patient Protection and Affordable Care Act (PPACA): Long Term Costs for Governments, Employers, Families and Providers “About half of program costs will be funded with reductions in payments to providers and health plans under the Medicare and Medicaid programs, which the CBO estimates will amount to $498 billion over the ten year period“. The new cost estimate has been updated to $1.4445 trillion from original estimate $938 billion over 10 years.
With millions of new uninsured patients slated to enter the system this would help providers recover reimbursement losses. Additionally, the President was firmly against any Provider cuts in 2013.
The Lewin Report predicts in fact that Provider Reimbursement will recover losses long term and in fact increase gross payments to $129.8 billion under the Act.
“..estimate that utilization of physician services will increase by about $102.7
billion under the Act. This estimate reflects Medicaid the payment levels for the portion of
newly insured people covered under that program and commercial payment levels for those
who become covered under private insurance. As discussed above, our key assumption is that
utilization of services for newly insured people adjusts to the levels reported by insured
individuals with similar age, gender, health status and income characteristics.
Physicians also will be paid for services formerly provided free to uninsured people resulting in
revenues of $8.4 billion. There will be an increase in reimbursement for people who shift from
Medicaid to private coverage, and payment rates for Medicare primary care services will be
increased for a three year period under the Act. These factors will add 18.7 billion in revenues
for physicians.
While there was large Senate consensus 89-8 approval for the American Taxpayer Relief Act the health care debate is far from over. With rising health care costs, combined with the aging of the baby boomers, means the entitlement programs will remain at the heart of the tax-and-spending battles to come.
by Admin. | Dec 23, 2012 | family health insurance, Health Care Reform, healthcare, latest health insurance news, Obamacare, PPACA, Wellness
New Proposed Rules for Wellness Programs In another step forward to ncentivize wellness new proposal can give discounts for managing good health much like good drivers with auto insurance.New proposed rules issued under Health Care Reform address certain amendments to the nondiscrimination requirements for group health plans offering a wellness program to comply with the federal Health Insurance Portability and Accountability Act (HIPAA).Specifically, the proposed rules would increase the maximum permissible reward under a wellness program that requires an individual to satisfy a standard based on a health factor in order to obtain a reward, from 20% to 30% of the cost of coverage (and to 50% for programs designed to prevent or reduce tobacco use). The rules also include other proposed clarifications regarding the requirements for such wellness programs to avoid prohibited discrimination, including reasonable design and reasonable alternatives that must be offered for individuals to obtain the reward.Other Proposed Rules Released Under Health Care Reform
Separately, new proposed rules have been issued for health insurance companies regarding the law’s requirements related to guaranteed availability of coverage and essential health benefits.
- Under one set of proposed rules, issuers offering non-grandfathered health insurance coverage in the individual or group market would be required to accept every individual and employer that applies for coverage, with limited exceptions. Issuers in the individual and small group markets would be allowed to vary premiums within limits, only based on age, tobacco use, family size, and geography.
- Another set of proposed rules outline issuer standards related to coverage of “essential health benefits.” Essential health benefits are a core set of items and services that must be covered by non-grandfathered plans in the individual and small group markets beginning in 2014.
While its always been known a healthy living for employees makes a productive employee. Large businesses have benefited from a healthy work force as they can better afford programs and have a direct rate reduction in rates.
Although employers continue to use cost shifting to control health insurance expenses, many companies are also making wellness programs part of the overall strategy to keep costs down by keeping staff members healthy.“Our entire health care system is organized around treating diseases after they occur, not preventing them before they occur. We need a paradigm shift that places prevention at the center of our health priorities.” – Lynn C. Swann, Chairman, President’s Council on Physical Fitness and Sports
The new proposed rules would apply for plan years beginning on or after January 1, 2014. An overview of the proposed rules is available on Healthcare.gov. Our Summary by Year offers updates on other requirements related to Health Care Reform. |
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by Admin. | Dec 11, 2012 | Health Care Reform, Health Exchanges, Obamacare, State Exchanges
Governor Christie vetoes Health Insurance Exchange – Washington Post “Christie Vetoes Obamacare”.
“New Jersey and all other states still await substantial federal guidance on the functioning of all three types of exchanges,” Mr. Christie said in his veto message. “To be sure, the decision of whether to move forward with a state-based exchange can only be fully understood when competitively compared to the overall value of the other options.”
States have until Dec. 14 to decide whether to establish a state-based exchange. They have more time to decide whether to partner with the federal government or let federal bureaucrats design and run the state exchange. Many states with Republican governors have said they would not participate in the process, citing their opposition to the law and its potential costs. This is the current Map of State Exchange Status.
What is an Exchange? One of the centerpieces of the recently passed Patient Protection and Affordable Care Act (PPACA) is the establishment of state based health insurance exchanges by the year 2014.
An “Exchange” is a mechanism for organizing the health insurance marketplace to help consumers and small businesses shop for coverage in a way that permits easy comparison of
available plan options based on price, benefits, service and quality. By pooling individuals and small groups together, transaction costs can be reduced and transparency can be increased.
Exchanges can create more efficient and competitive markets for individuals and small employers.
States have until Dec. 14 to decide whether to establish a state-based exchange. They have more time to decide whether to partner with the federal government or let federal bureaucrats design and run the state exchange. Many states with Republican governors have said they would not participate in the process, citing their opposition to the law and its potential costs.
Many Republican governors were saying before the Court ruling that the Medicaid expansion was yet another unfunded federal mandate they could not afford. Yes the Supreme Court ruling has given the Republican governors enormous leverage. Republican governors have long argued that state control and flexibility can save lots of Medicaid money. If they put a reasonable plan on the table to expand their Medicaid programs to 133% of poverty–one that saves at least as much as their state match–it could be a win for everyone. The Republican governors get their flexibility and the Obama administration gets their expansion.
by Admin. | Dec 9, 2012 | Health, Wellness
Top 10 Holiday Stress Free Tips
Surviving the holidays with one’s waistline, bank account and sanity intact can be challenging for everyone, but the season affords specific pitfalls—and opportunities—for those who are mindful of staying physically and mentally healthy throughout the season and beyond.—try these tips:
1. Protecting Big-Ticket Items: Big-ticket electronics, such as televisions, computers and gaming consoles, are at the top of many holiday wish lists but who can afford to break the bank? How about a Discount Dental PPO/Vision Card for less than $10? With eroding benefits you would be amazed how many loved ones need coverage!
2. Never arrive to your social function feeling overly hungry. Avoid skipping meals or snacks to save up your calories- this will encourage over eating. Have a snack ahead of time to take off the edge such as goodness knows snack squares- a four-square serving has 150 calories and is made from slow-roasted whole almonds, fruits, toasted oats and extraordinary deep chocolate. They come in three delicious flavors: Nutty Apple, Very Cranberry and Peachy Cherry.
3. Take care of yourself. Be active and eat well – these help maintain a healthy body. Physical and mental health are closely linked; it’s easier to feel good about life if your body feels good. You don’t have to go to the gym to exercise – gardening, vacuuming, dancing and bushwalking all count. Combine physical activity with a balanced diet to nourish your body and mind and keep you feeling good, inside and out.
4. Deal with stress. Be aware of what triggers your stress and how you react. You may be able to avoid some of the triggers and learn to prepare for or manage others. Stress is a part of life and affects people in different ways. It only becomes a problem when it makes you feel uncomfortable or distressed. A balanced lifestyle can help you manage stress better. If you have trouble winding down, you may find that relaxation breathing, yoga or meditation can help.
5. Incorporate daily, moderate, physical activity. Even doing 2 -15 minute walks each day can make a difference. This is especially easy to do when holiday shopping! If you can’t get to a gym, try wearing a pedometer and increase your steps each day- (10,000 steps/day = 5 miles)
6. Watch the Liquid Calories: A martini contains about 275 calories, and 1 glass of wine has about 130 calories. Also watch out for all of the calories you might consume while you drink. Try substituting with a glass of sparkling water in between alcoholic beverages. Moderation for men is no more than 2 drinks per day and no more than 1 drink per day for women (wine: 5 oz, beer: 12 oz, liquor: 1.5 oz)
7. Plan ahead! It’s no so much of a lack of will power but a lack of preplanning. A great quote related to this is “failure to plan is planning to fail.” Think ahead and set realistic daily goals for yourself. Start thinking about making healthy food choices before you even walk into the party.
8. Portions, Portions, Portions– practice portion control: enjoy your favorite holiday foods but be mindful of your portions. Try eating slower or using smaller plates. Fill up ½ your plate with lower calorie items such as raw veggies or shrimp cocktail.
9. Office Parties, leave the work talk in the office This is a chance to let your hair down, to meet coworkers’ spouses and significant others and children. Make the rounds and mingle with as many different people as you can. And whatever you do, don’t be that guy who brings up work stuff. No matter how fun your light-up Frosty tie is, you will be hated for this. Sales numbers and conference calls and brainstorming sessions can wait. People have lives outside of the office. You should too. Or you should fake it.
10. Rest and refresh. Get plenty of sleep. Go to bed at a regular time each day and practice good habits to get better sleep. Sleep restores both your mind and body. However, feelings of fatigue can still set in if you feel constantly rushed and overwhelmed when you are awake. Allow yourself some unfocussed time each day to refresh; for example, let your mind wander, daydream orsimply watch the clouds go by for a while. It’s OK to add ‘do nothing’ to your to-do list!
Do you have another healthy holiday eating tip we haven’t talked about yet? If so, leave us a comment or a question.
by Admin. | Dec 7, 2012 | Health Care Reform, Hospitals
Interfaith Hospital Files Bankruptcy
To no one’s surprise the Interfaith Hospital in Brooklyn Files for Bankruptcy Protection – Dec3, 2012 NYT . In addition to the $130 Million in debt “…hospital estimates its cash spending will exceed its 
cash receipts by nearly $2 million, and it will have $7 million in unpaid obligations and $26 million in unpaid receivables, other than professional fees.”
The long time beleaguered hospital has been a stepchild of the State with multiple bail outs in the past decades. “Interfaith officials have said that they need $20 million from the state just to continue operating during the bankruptcy reorganization, and otherwise face the possibility that the hospital will close.” The State promised some financial support last year to accomplish an integrating Wyckoff Hospital, Brooklyn Hospital and Interfaith Hospital by a Cuomo Pane Administration. Interfaith Hospital, located in Bedford Stuyvesant, took extreme steps to save cash by foregoing malpractice insurance – NYT “Troubled NY Hospital Forgo Coverage for Malpractice”.
Since health care is viewed as a right, the government has been subsidizing and encouraging its growth for decades, helping it to evolve into the juggernaut of 17% of the GNP that it is. Now, as Margaret Thatcher so famously said of all socialist experiments, “they have run out of other peoples’ money”. The law and the courts compel them to give everyone 21st century technology which costs more than many patients make in their whole life ! Now the medical industry is up against the limits of what they can pry out of the taxpayer and the private citizens but they are still compelled to offer insanely expensive health care to everyone. Very bright people try to wiggle around this dynamic but they are finding that they cant. We need to strike at the source, and accept : Health care is not a right, you don’t get it because you exist, you have to buy it. Only by accepting this truth can we begin to save a reasonable health care industry.
Unlike St Vincent’s Hospital Bankruptcy Closure in 2010 was a complete shock to NYC Health Community. For more than 150 years the hospital was a mainstay of Downtown Manhattan. It remains to be seen if this Administration will step in and save Interfaith Hospital again.
by Admin. | Nov 12, 2012 | Health Care Reform, Health Exchanges, Individual Exchanges, PPACA, SHOP Exchanges, Small Business Group Health, State Exchanges
Crains Brokers’ Commissions Face Uncertain Future. A quick comment on our quote in Crains “Crains Brokers’ Commissions Face Uncertain Future” today. Insurers are indeed cutting back on services resulting in cost containement measures such as layoffs, outsourcing and significant broker commissions cuts.
A significant negative development is the NYS decision to not allow licensed Agents/Brokers in the Individual Exchange. Many States such as Massachusettes, the inspiration for Health Care Reform, use a Connector which is an Exchange or an independent state agency that helps Massachusetts residents find health insurance coverage and avoid tax penalties. Instead NYS will allow Agents/Brokers to only work in the Commercial Exchange known as SHOP. HealthPass is a good pre-cursor of the SHOP Exchange offering Small Businesses a Defined Contribution Health Plan of full options form Health Insurance, Dental, Vision to Term Life Insurance and Disability.
The Individual Exchange will work with an “Assitor” or “Navigator”. In NYS Government and Non-Profit Agencies will comprise the “Navigator” which will only be allowed to operate in the Individual Exchange. By design an income subsidy will only pass through this Individual Exchange an not on the SHOP Exchange. Example: a $50,000 Family Household of 4 can get approximately 80% credited.
The Federal Gov has already spent $2.2 Billion on State Exchanges. And this figures does not include remaining States as there are only 19 States working on an Exchange for 2014. The Exchanges will be built up for 2 years and then must be fully independent by 2016. If 88% of small groups coverage purchased by Brokers acc. to Bostons Wakely Report in research study- Role of Producers and Other Third Party Assisters in New York’s Individual and SHOP Exchanges the distribution infrastructure is already there. Access to care is not the difficulty in finding a plan its the very cost of the plan! Why then does NYS decide to spend on building up new infrastructures? AgentsBrokers can easily outreach and council to uninsured as well. In fact many small businesses such as construction, consulting services and dining have many uninsured that an Agent/Broker already has a relationship with.
Despite all this and the rapid changes in reshaping health care we remain optimistic and look forward to taking on a greater role in health care reform.
With more choice, our groups and their employees will need more direction, allowing brokers to take on more of a consultative role. Healthcare plans are not a simple purchase and one plan doesn’t fit all. By delivering the latest cutting-edge benefits technologies, continued consumer focus approach and leveraging our long time relationships with Benefits/HR/Payroll partners our role will be pivotal in being part of the solution.
Pulse Nov 2012 Quote MMS
by Admin. | Nov 6, 2012 | NY News
Hurricane Sandy Recovery Assistance Resources. Department of Small Business Services (SBS) and the New York City Economic Development Corporation (NYCEDC), is coordinating a set of services to assist small businesses in recovering from Hurricane Sandy.
Below is an outline of available programs & relevant contact information:
For small- to mid-sized businesses that have experienced business interruption
An emergency loan for businesses will be available, patterned after similar programs deployed in past emergencies. Loans will be capped at $10,000. Please click this link to contact an NYC Business Solutions Account Manager or call 311 and ask for NYC Business Emergency Loan.
Federal Aid Programs for State of New York Disaster Recovery Loans are available up to $2 million for business property losses not fully compensated by insurance, and for small businesses, small agricultural cooperatives and most private, non-profit organizations of all sizes that have suffered disaster-related cash flow problems and need funds for working capital to recover from the disaster. More information can be found at www.DisasterAssistance.gov, or 1-800-621-FEMA (3362). Information from the Federal Small Business Administration on disaster recovery assistance is also available at www.sba.gov.
For mid- to large-sized businesses that need to undertake rebuilding
An emergency sales tax letter from New York City Industrial Development Authority (IDA) will be available allowing businesses to avoid payment of New York City and New York State sales taxes on materials purchased for rebuilding. IDA will also waive all fees and, while following State law, look to streamline its normal procedure. This program is expected to offer economic benefits to reconstruction projects costing $500,000 or more. Please contact Shin Mitsugi at smitsugi@nycedc.com for further information on this program.
For any business that is temporarily displaced from its space
Short-term “swing” office space at Brooklyn Army Terminal available free of charge for the next 30 days. NYCEDC has approximately 40,000 square feet of warehouse space at the Terminal that can be used for this purpose. Please click this link to contact an NYC Business Solutions Account Manager or call 311 and ask for NYC Business Solutions.
For any business in need of other emergency assistance
The SBS Business Outreach Team and Emergency Response Unit’s Large Scale Response Team will be deployed after the storm to help all impacted small businesses. This team is currently on-call for any storm-related business inquiries and is closely coordinating with the NYC Office of Emergency Management. Please click this link to contact an NYC Business Solutions Account Manager or call 311 and ask for NYC Business Solutions.
Federal Aid Programs for Disaster Recovery
Click here for information from the Federal Small Business Administration on disaster recovery assistance.
State resources
- State of New Jersey – The state website has a Hurricane Sandy resource center with emergency hotlines, updates from the power companies and how you can volunteer.
If you would like to help those hurt by this storm, here are a few ways:
Visit www.redcross.org, call 1-800-RED CROSS (1-800-733-2767), text the word REDCROSS to 90999 to make a $10 donation, or mail a contribution to a local Red Cross chapter or the American Red Cross, P.O. Box 37243, Washington, D.C. 20013. The Red Cross is providing food and shelter to storm victims.
Visit salvationarmyusa.org, text the word STORM to 80888 to make a $10 donation, confirming the donation with the word, “Yes.” The Salvation Army is providing food and shelter to storm victims.
Visit www.humanesociety.org to support the group’s pet rescue team.
Visit www.redcrossblood.org to find the nearest blood drive site. The Red Cross said more than 360 Red Cross blood drives were canceled due to the storm.
by Admin. | Nov 2, 2012 | Liability
Filling a Liability Claim after Storm Sandy
The most effective way to file a claim is to contact your carrier directly. We have compiled a list of our companies and their respective claim department numbers that you can conveniently reference below.
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Claim Department Contact Numbers (By Insurance Carrier)
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ACE Ins. Co.: 1-800-778-1629
Adirondack: 1-877-365-8693
Chartis Private Client Group: 1-888-760-9195
Chubb Ins. Co.: 1-800-252-4670
CNA Commercial Ins.: 1-877-262-2727
Encompass Ins.: 1-800-340-3016
Farmer’s Group: 1-800-435-7764
Foremost: 1-800-527-3907
Foremost Auto Claims: 1-800-274-7865
GMAC Ins. Co.: 1-800-325-1088
Guard Ins. Group: 1-888-639-2567
Hanover Ins. Co.: 1-800-628-0250
Harleysville Flood: 1-800-421-3535 |
Harleysville Ins. Co.: 1-800-892-8877
Hartford Flood: 1-800-759-8656
Hartford Ins. Co.: 1-800-243-5860
Kemper Ins. Co.: 1-866-536-7376
Lancaster Ins. Co.: 1-800-521-6155
Main Street America Group: 1-877-425-2467
Metropolitan Ins. Co.: 1-800-854-6011
New York Central Mutual Ins. Co.: 1-800-234-6926
One Beacon: 1-877-248-3455
Peerless Ins. Co.: 1-800-522-7152
Penn Millers Ins. Co.: 800-233-8347
Progressive Ins. Co.: 1-800-274-4499
QBE Ins. Co.: 1-888-737-8256 |
Safeco Ins. Co.: 1-800-332-3226
Selective Ins. Co.: 1-866-455-9969
Seneca Ins. Co.: 212-277-3490
Sterling Ins. Co.: 1-800-462-4661
Tower Group Cos.: (Pers.) 1(888) 856-5522
Tower Group Cos.: (Comm.) 1-888-856-5522
Traveler’s Ins. Co.: (Pers.) 1-800-252-4633
Traveler’s Ins. Co.: (Comm.) 1-800-238-6225
USLI Ins. Co.: 1-888-875-5231
Utica First Ins. Co.: 1-800-456-4545
Utica National Ins. Co.: (Pers.) 1-800-216-1420
Utica National Ins. Co.: (Comm.) 1-800-216-1420
Zurich Ins. Co.: 1-800-987-3373 |
Once again, we hope you and your family are recovering from the storm in good health and safety!
