Archive for the ‘Healthcare Reform’ Category
Healthcare Reform is a Winner for Wellness. Really?
It’s official. President Obama signed “our” new health care bill last week, and now it’s law. It’s supposed to “explore” how wellness concepts can be integrated into federal policy for agriculture, transportation, education and other areas announced that provisions in the health care reform bill will address the underlying causes of poor health habits. The new bill is also supposed to increase the number of businesses that offer wellness programs, increase the number of employees who participate, more effectively track programs, and improve overall program effectiveness.
In addition, there a six specific provisions in the bill that “directly relate” to worksite wellness programs:
- Development of a national health promotion plan
- Enhance health promotion research
- Technical assistance to enhance evaluation of workplace health promotion programs
- Regular, periodic surveys on workplace health promotion relevance and components
- Grants to pay a portion of the cost of comprehensive workplace health promotion programs for small employers
- Allowing employers to offer employees a premium discount of up to 30% for positive lifestyle practices or participation in health promotion programs
There are many “leading experts” in my field that think these provisions are the best thing to happen to the field of health promotion since the invention of “sliced whole wheat multigrain bread.” Well, I personally wouldn’t go that far. Forget making sense of the new 2,400-page health care law. Try interpreting just these new provisions, how they will be implemented and when they will begin.
We’ll let’s start with the easy part first. The Kaiser Family Foundation has a pretty good summary on their website. Its broken down the bill in an easy-to-read time-line format. In a nut-shell, here it is:
- Small businesses will be able to receive federal grants to start wellness programs. The grants will be available for up to five years. (Starting in 2011)
- A new National Prevention, Health Promotion, and Public Health Council will be formed to develop a national health improvement strategy. (Starting in 2011)
- Chain restaurants and vending machines that sell food must disclose nutritional information. (Starting in 2011)
- Employers will be able to offer employees who participate in wellness programs up to a 30% discount on the cost of insurance coverage. (Starting in 2014)
- A 10-state pilot program will allow participating states test the efficacy of offering similar rewards in the individual insurance market. (Starting in 2014)
Now, here’s where it gets confusing. As you can see, out of the six, only three of the provisions have actually been mentioned. Let’s see how easy it will be to sign-up for those grants next year. While I am at it, why only keep the availability of the grants for 5 years? How about keep them indefinitely? I’ll keep you updated on the grant-process.
Next, there are so many companies, including us, that already provide wellness programs that include strategies for implementing, maintaining and evaluating the success of those wellness programs.
I understand that having information on the “foods” we eat makes us “more informed” – I say that grinning – but how much “nutrition” info can you put on a bag of Cheetos or on a Triple-meat-with-cheese? I’m just saying…
HIPAA already allows for a 20% discount on those who are participating in a “bonafide” wellness program. You can read more about how the HIPAA rules affect your small biz wellness program. Finally, we’ll have to wait and see how successful this new “pilot-program” will be.
As I wrote about earlier, it would have been great if they would have included the Healthy Workforce Act or at least specific provisions from these bill. In the next coming weeks, I’m going to do my best to better explain what these 6 provisions actually mean.
Employee Wellness Likely to Survive Battle Over Health Care Reform
Okay, the current healthcare reform legislation may have slowed down, but it’s not over yet. Whether its tort reform, the ability to buy your insurance from another state, or an over-haul on medicare, one definite area that is being looked at by employers is employee - wellness and prevention. This issue is one that will be more on everyone’s radar because it consistently draws bipartisan support.
As we covered in an earlier post, the Healthy Workforce Act, written by Sen. Tom Harkin, D-Iowa, would give you an annual $200 tax credit for each of the first 200 employees participating in your small biz wellness program and $100 for each additional employee.
In addition, the Partnership for Prevention found that worksite wellness produced an average savings-to-cost ratio of $5.81 to $1. The programs also reduced annual health costs by an average of 26 percent, reduced absenteeism by 27 percent, and reduced workers compensation and disability claim costs by 32 percent.
Comprehensive wellness programs usually end up being cost neutral in year one. Year two is when you start seeing return on investment, and by the time you get to three years, things really start kicking in and you really do see ROI.
We are still waiting to hear whether or not this proposed billed makes its way to the President’s desk, but in the mean while think about this:
- An estimated 142 million Americans are overweight or obese, this represents 66 percent of the adult population.
- Health care costs in the United States doubled from 1990 to 2001 and are expected to double again by 2012.
- Chronic illnesses affect more than a third of working-age Americans and the costs associated with chronic diseases account for approximately 75 percent of the nation’s annual health care costs.
- Obesity costs American companies $225.8 billion per year in health related productivity losses. An obese employee costs the employer an additional $460-$2,500 in medical expenditures and absenteeism annually.
- The workplace environment is a significant target for obesity prevention efforts. Over 130 million Americans are employed across the United States and spend a significant part of their day at work. Sedentary jobs have increased 83 percent since 1950.
- The Healthy Workforce Act provides employers with the means to implement evidence-based strategies for improving the health of workers by addressing causes of chronic disease including obesity, physical inactivity and tobacco use.
Senate Upset Foils Democrats’ Health Reform Agenda
House and Senate Democrats’ ambitious plans to revamp the nation’s health-care system were torpedoed Tuesday night in the wake of a Massachusetts special election that delivered the seat long held by the late Sen. Edward Kennedy to a Republican.
State Sen. Scott Brown, who won the crucial seat by more than 100,000 votes, has vowed to vote against the health-care legislation that Congress is considering. Without 60 Democrats in the Senate to hold off a Republican filibuster, health reform legislation — at least in its current form — seems much less likely to advance, pundits say.
Carol Pryor, a health policy analyst based in Boston, said Brown’s message resonated with voters in part because of the complexity of the legislation — detailed in voluminous House and Senate bills passed in 2009.
“People really had lost sight of what’s in it, or didn’t have a good sense of what was in it, and there was a lot of misinformation spread around about it,” she explained.
“I do think that the dragged-out negotiations and all of the deals that people had to make in order to get this through Congress, especially with the need for 60 votes in the Senate, after a while made it seem like there was just a lot of deal-making going on behind the scenes,” Pryor added.
Appearing on Fox News Sunday this week, Senate Minority Leader Mitch McConnell (R-Ky.) characterized the election as a “referendum” on the national health reform initiative, which he claimed Democrats were trying to work out in secret.
“They have arrogantly ignored American public opinion all the way to this point,” he said. “And they’re trying to get their members to continue to ignore public opinion one more time.”
Robert Restuccia, executive director of Community Catalyst, a national consumer health advocacy organization, disagreed. “I don’t think it was a referendum,” he said. “I think fundamentally this came down to two campaigns: one that was pretty effective and one that wasn’t, in an environment that was probably not as good as when Obama ran.”
And while the vote fundamentally changes the calculus in the Senate, it doesn’t alter the need for specific reforms, Restuccia stressed.
“I think there’s still an urgency to pass something,” he said.
In the wake of the Senate shakeup, Democratic leaders in both chambers were pondering ways to move the legislation forward. The House could pass the Senate version of the bill, avoiding another Senate vote, although that scenario seemed unlikely given the many concessions House members would have to make.
In remarks to MSNBC, Rep. Anthony Weiner (D-N.Y.), a progressive Democrat, conceded it may be time for his party to take a new tact on health care.
“I think we’ve made some crucial mistakes along the way by making this more complicated than it needs to be,” he said. Weiner said he supports a “much simpler approach” to health care as part of a jobs bill.
Pryor said she hopes that whatever Congress decides to do will ultimately salvage some key elements of the legislation, including an expansion of Medicaid and health insurance market reforms.
While public support for “health reform” may be lagging, Restuccia said the public remains strongly in favor of specific elements of health reform.
“What the package is, how to move forward, is going to be the question now,” he said. “I still think it’s very high on the agenda, and I would be surprised if it disappears between now and the next election.”
Curbing Obesity Epidemic Key to Health Care Reform
A diverse alliance of payer, provider and consumer organizations, girded by two former U.S. Surgeons General, on Wednesday urged policymakers to address the nation’s obesity epidemic as part of federal health care reform legislation.
“At this critical juncture where we’re dealing with health-care transformation, we want to make sure that the federal government and our elected leaders recognize the importance of including approaches to obesity that are evidence-based and proven within their legislative strategy,” former Surgeon General Dr. Richard Carmona told reporters during a media briefing.
Carmona serves as the health and wellness chairperson of the Strategies to Overcome and Prevent (STOP) Obesity Alliance, whose steering committee includes the American Diabetes Association, American Heart Association and the U.S. Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity and Obesity, among other public and private organizations.
The alliance is funded by drug makers Sanofi-Aventis U.S. L.L.C. and Amylin Pharmaceuticals.
Former Surgeon General Dr. David Satcher, whose 2001 report on obesity recognized the problem as an “epidemic,” emphasized the need to invest in health promotion and disease prevention, particularly for the health of the nation’s youth.
“We are in essence addicting our children to sedentary lifestyles; we’re addicting them to high-salt, high-sweet, high-fat diets,” he said, “and then we pay for it later on when they come to us with cancer, heart disease, [and] diabetes.”
America’s weight problem is pervasive. Two-thirds of the population is now overweight and obese, according to the CDC, and as many as 72 million adults are considered obese. In fact, obesity rates have doubled for adults and tripled for children since 1980.
People often see obesity as a personal failure, explained Christine C. Ferguson, director of the alliance and a research professor at George Washington University School of Public Health and Health Services, in Washington, D.C. “The result is the problem has gotten worse and worse, and more and more expensive.”
Obesity accounts for 9.1 percent of annual health-care spending in the United States, or nearly $150 billion annually, according to a study in a recent issue of Health Affairs.
To help arrest the epidemic, the alliance urges policymakers to include four specific elements in health reform:
- Recognize proven clinical interventions. Studies demonstrate, for example, that shedding just 5 percent to 10 percent of body weight can lower the risk of heart disease and other chronic conditions.
- Enhance the use of preventive services. The U.S. Preventive Services Task Force recommends obesity screening for all adults, yet studies show height and weight data often is not recorded during an office visit.
- Foster community programs and polices that encourage and support healthy lifestyles. A community might design public spaces that accommodate walkers and bikers, for example, or sponsor a farmer’s market to make fresh produce available to local residents.
- Coordinate research efforts to improve the quality of care, show which interventions work in various settings and translate science into practice.
Morgan Downey, the alliance’s policy adviser, noted one positive aspect of health reform proposals from the House of Representatives and Senate Health, Education, Labor and Pensions Committee: They eliminate the worry that overweight Americans might not be able to obtain health insurance coverage because of preexisting health conditions.
“Just the removal of that language really frees up individuals who are overweight or obese to have access to health insurance,” he said.
Another Reason for Small Biz Wellness
Wellness Tax Credits for Small Biz May Be Coming
Okay, if you’re still on the fence as to whether or not to start a worksite wellness program at your small business, this may help you make a decision. We already know that when your employees’ health-risks increase your costs increase. When your employees’ health-risks decrease, your costs, decrease. Period!
What ever comes out of the current healthcare reform debate, you can bet that wellness and prevention will play a big part of that reform. Implementing a small business wellness program can not only help you control costs, it may even earn you a tax credit in the near future. Let me explain.
Currently, if you already have a wellness program in place, all you get is to deduct it as a regular business expense. Now, the government has issued a proposal that would give businesses a tax credit would be allow for 50 percent of the costs paid by an employer for providing a “qualified wellness program” during a taxable year. View the video.
Under the Healthy Workforce Act, the amount of the credit would be limited to an amount not exceeding $200 for each employee not exceeding 200 employees, plus $100 for each additional employee in excess of 200 employees. Only employees generally working more than 25 hours per week are taken into account.
For purposes of this credit, any amount paid for food or health insurance could not be included as a cost of the wellness program. The credit would not be refundable and would not be paid in advance and would be available for a maximum of five years.
To claim the tax credit for eligible expenditures, an employer would be required to obtain a certification by the Secretary of HHS (in coordination with the Director of the CDC and the Secretary of the Treasury) that its program meets the definition of a qualified wellness program.
In order for a program to be a qualified wellness program under the proposal, all employees would be required to be eligible to participate in the program. Further, under the proposal, a qualified wellness program includes four components:
- health awareness (such as health education, preventive screenings and health risk assessment);
- employee engagement (such as mechanisms to encourage employee participation);
- behavioral change (elements proven to help alter unhealthy lifestyles such as counseling, seminars, on-line programs, self help materials); and a
- supportive environment (such as creating on-site polices encourage healthy lifestyles, eating, physical activity and mental health). For an employer with 500 or more employees, to be a qualified wellness program, a program would be required to include all four components. For an employer with less than 500 employees, to be qualified wellness program, a program would only required to include at least three of the four components.
In addition, to be a qualified wellness program under the proposal, the program would be required to be consistent with evidence-based research and best practices, as determine by the Secretary, such as research and practices described in the Guide to Community Preventive Services and Guide to Clinical Preventive Services and the National Registry for Effective Programs.
Finally, another option would apply all of the criteria described above as well as provide employers with 50 or fewer employees with a credit limited to $400 per employee. This credit option would not have a sunset requirement for those employers, meaning it would be indefinitely.
We will be staying on top of this legislation, so we’ll let you know what happens!