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Tuesday, April 29, 2008

Reducing Employer and Employee Health Plan Expenses

Johnson and Johnson recently introduced a health care plan to most of its employees replacing a POS plan with an HRA (Health Reimbursement Plan). It is a special plan design and administrated by three insurance carriers. As a leader in the health care field this is again showing how a major company can introduce a plan which educates employees and gives them choice which are based on developing consumer awarness of medical cost and an opportunity to help reduce those costs.

'This is a major change "It's a whole new way for [employees] to think about the delivery of health services." In January, J&J replaced the point-of-service plan it had offered for the past 10 years to its 43,000 white-collar workers in the U.S., mainly located in New Jersey, Pennsylvania, Florida and California. Under the old plan, employees were responsible for a flat $15 copayment for physician office visits.

All of the other health benefit programs were eliminated by J&J, although employees in some parts of the country have the option of enrolling in an HMO. Sexton says that about 70% of the company's entire work force is enrolled in the new account-based plan. To ease the transition toward the new plan, J&J relied on a technique used to market its products to the public — brand extension. Since the company's health and wellness program is known as Healthy People, the new health plan is called Healthy People HRA — folding it into an already recognized entity.

Small employers can also avail themselves of these plans and offer them as an option to standard plans. One way of doing this is through employer contributions and incentives. Employees who become more aware of health maintance programs and develope an awarance of provider cost to help reduce eventual claims expense can achieve savings for both themselves and their employer.

As more and more larger companies develope HRA and HSA programs so smaller employer groups will follow suit as they see the opportunity to better provide benefits and control costs.

Monday, April 28, 2008

Preventing Health Issues and Advocating Healthy Life Styles

The first step in understanding how prevention affects health care costs is to define exactly what is meant by "prevention." Its broadest definition includes anything that prevents disease, including healthy lifestyle habits and programs that usually fall under the "wellness" umbrella. Its narrowest definition is preventive care such as screenings for various types of cancer and other health risks.

Ideally, a health benefits program should include both clinical screenings and healthy lifestyle programs. Over the past several decades, the focus has shifted toward providing more preventive care benefits, but a stronger focus on preventing disease is still needed.


Preventive care in the United States
Prevention takes many forms: vaccines that prevent disease completely; medications that reduce the risk of developing disease; screening tests that detect disease at an early stage when treatment is more effective; and lifestyle changes - smoking cessation, exercise, diet - that keep people healthy longer.


Through a combination of public education and the growth of managed care, the use and coverage of many preventive care strategies has become more common. But preventive health care statistics in the United States still fall short of expectations. For example:
An estimated 30 percent of the more than 20 million Americans with diabetes remain undiagnosed.


The lifetime risk of developing hypertension is approximately 90 percent for adults between the ages of 55 and 65, but one-third of those affected don't know they have it. Americans receive appropriate preventive, short-term and long-term health care as recommended by professional guidelines only about 55 percent of the time. Approximately 45 percent of the U.S. population has a chronic medical condition, and about half (60 million people) have multiple chronic conditions.


Preventable causes of death, such as tobacco smoking, poor diet and physical inactivity, and misuse of alcohol have been estimated to be responsible for 900,000 deaths annually - nearly 40 percent of total yearly mortality in the United States. One reason why the use of preventive care is not as high as it should be is the large number of uninsured.People without health insurance are much less likely to receive recommended preventive services and medications or have access to regular care by a doctor than those who are insured. But simply having health insurance isn't the solution - it's important to have a plan that encourages the use of preventive care. In one study, screening rates dropped 5.5 percent in insurance plans that introduced cost sharing during the study period, yet increased by 3.4 percent in plans that maintained full coverage.5 By reducing or eliminating cost-sharing in health plans, plan sponsors can increase the use of key preventive services such as adult immunizations and tobacco cessation programs.


Another is lack of education. People often don't consider themselves to be at risk, don't know what preventive services they should receive based on their age, gender and risk factors, or are unsure about their effectiveness.7 It took a concerted effort by doctors, parents, government agencies, health insurers, employers and advocacy groups to achieve higher vaccination rates for children.


Saving lives and money with preventive care.
While immediate costs may be higher in some cases, preventive care can provide significant savings in both short- and long-term health-related costs. Preventable illness and chronic disease are major causes of employee absenteeism and presenteeism (decreased on-the-job effectiveness), causing a financial drain on businesses. A recent study found that increasing the use of just 5 clinical services to 90 percent of the target population would prevent 113,000 premature deaths each year. At least half of the deaths from cancers could be prevented by greater use of established screening tests and existing knowledge. Chronic conditions account for 70 percent of all deaths in the United States and the costs associated with them account for more than 60 percent of national medical care costs.


Studies indicate that prevention, early detection and chronic disease management would reduce the economic impact of disease by 27 percent, or $1.1 trillion annually by 2023 and the number of cases of chronic disease by 40 million. Flu vaccination reduced absenteeism by as much as 45 percent. Based on these numbers, you would expect that most plan sponsors would include coverage for preventive care in their health benefits plans. Unfortunately, that's not the case.


One study found that:
Only 57 percent of employers covered the flu vaccine. Less than 25 percent offered any kind of smoking cessation program. Colorectal cancer screening is offered by just over 70 percent of employers. Cost is the primary reason cited by plan sponsors for not providing more comprehensive health benefits that include preventive care. But some employers are beginning to realize that they can reduce absenteeism and presenteeism by investing in a healthy, productive workforce.2 In your role as a consultant, you can help your clients decide which preventive care services and programs will be most beneficial to their employee population.


Consumerism is also helping to increase the use of preventive care services. As consumers assume greater financial responsibility for their health care and become more informed about their risks, they're more likely to demand additional tests and procedures to protect their health.


Ask about the many Insurance Company special programs and benefits to help maintain health, healthy life styles and screenings for early detection of health issues. Contact, info@amsinsure.com or call 800-334-7875 or you can go online at http://www.amsinsure.com/ .

Sunday, April 20, 2008

What can be the most agonizinag decission with Seniors?



Ask anyone with an older parent who is suffering from Alzheimer's, Physical limitations or just needs more care or around the clock assistance. When it comes to a parent or loved one we can agonize over so many thoughts; aside from economics there are many guilt producing barriers to arriving at the best decision. What that decision is can obviously be different for many, however the person most affected and may be better off with proper care in a day care setting, or home setting or perhaps senior care facility. Who is most affected, it is generally agreed by most professionals that the patient is the one whom needs to be considered. For the person making care decision, usually a close relative, they must put there feelings aside to assure that the person needing care receives the most appropriate care.

Where can a person go for assistance in a professional environment. There are community, religious and private organization which provide these services in reviewing a case to help get proper care. Today there are many books on the subject which are available to help get a good picture of issues and solutions, along with references that can be used to help plan and solve a situation which could bring about family crisis.

A good friend whose mother is 91 came to a sudden decision about two months ago. He was a full time care giver to his mother who had undergone open heart surgery. Prior to the surgery she exhibited no real signs of memory loss or disorientation, and after that surgery it became evident that she had. He sought out professional help with senior consultants and is preparing to arrange for his mother to enter a home which can best help her now and in the future by providing a safe enviorment with 24 care.

Another friend also in a similar situation found a community service organization and they are helping him to plan out the proper care and living arrangements for there mother including financial assistance.

Some family issues which a need for senior care can bring about are division among family members, unnecessary financial difficulties and other problems. A friend of mine recently related that his sister removed the mother from the home leaving the father helpless, and created a divorce of the parents, while the father ultimately was able to get into full time care these wounds may never heal.

Preplaning when you or a parent can best make decision's about future care is always something to seriously consider even if uncomfortable. Long Term Care can also be something which you can arrange for prior to need.

Consider the possibilities and if you are looking for resources, contact us at http://www.amsinsure.com/ for assistance. You can also email info@amsinsure.com .

Sunday, April 13, 2008

How to legally terminate employee under California at-will employment laws.


Our clients receive HR as a value added benefit!


Give him 3 days to give you his own performance improvement plan and to rebut this warning. For transportation personnel, this also means disclosing recorded drug and alcohol abuse. One of the most trying parts about being a owner or Hr boss is dealing with problem employees. Decide whether you'll do voluntary or involuntary dismissals. Explanation of severance benefits in the lay off meeting. Because it is awkward for everyone, the dismissal of workers is not a common event. A difficult employee can easily be a safety hazard for your other employees as well as for him or herself. Will the company suspend the worker, will it dock pay, or will it fire the worker? Eventually, management will ask most supervisors to sack or layoff someone. If your small business doesn't have a conference room available, then use another manager's office, or use your own in a pinch.

In step two, you should discuss the issue with the at will worker. For example, a discontinuance package will reduce the sting of termination, sacking on Friday will reduce the humiliation, and having a witness in the meeting gives you extra physical protection. Don't sack workforce without evidence and before taking the time to seriously consider the ramifications. Are you a timid owner or Human resource person? 9) How To Fire an employee For Off-Duty Behavior And Lifestyle. The information you collect for the employee during this meeting will help you set the tone for the next actions in which you will take.

Saturday, April 12, 2008

AMS Newsletters RECORED MESSAGE

This Just In

The IRS has added three types of expenses to the list of medical expenses approved for deductions and reimbursement under a Health FSA, Health Reimbursement Arrangement or a Health Savings Account. The first expense is an annual physical exam. The second is full-body electronic scans. Although often performed without a doctor’s recommendation, the IRS considers such scans reimbursable because they serve "no non-medical purpose." (It matters not that this procedure is typically expensive and that cheaper and possibly more effective alternatives exist, such as X-rays.) The third is pregnancy tests, including over-the-counter tests. Anxious mothers-to-be can take comfort that the IRS did not limit the quantity of tests that can be reimbursed.

For details, see
Internal Revenue Bulletin
2007-50, Page 1154:
www.irs.gov/pub/irs-irbs/
irb07-50.

Friday, April 11, 2008


Free Samples Are Expensive click here for more information!


People who get free prescription samples actually spend more on prescriptions in the long run. One reason is that patients continue the medicines even when there are less expensive alternatives. The study was supported by the Robert Wood Johnson Foundation. Additional authors are from Virginia Commonwealth University and the University of Chicago. Younger patients and those not on Medicaid received more samples. Out-of-pocket expenditures were $166 during periods before patients received samples; $244 during periods while patients were receiving samples, and $212 during periods after patients no longer received samples.

Thursday, April 10, 2008

AMS Favorite Links:










Medical Assistance, Evaluation for Companies and IndividualsBusiness

Business Development, Marketing and Financial

Personal Interest Areas and Government Programs




Reputation is what health professionals rely on most when seeking medical care, so it pays to ask around. Check with your physician, friends and family to learn about there experiences and get referrals. A little known secret, at least today and perhaps not tomorrow is to ask the people who work at a hospital what they think, you'll be surprised at the candid answer you get.


You will want to consider the size of the institution depending on the procedure and whether they have the latest techniques and equipment to get the best results. Public resources that survey and rate institutions can be helpful as well as web sites that discuss hospitals and medical topics.


Look to professional forums regarding the experience and expertize of the professional you choose, as well as there education, background and training. Once again rely on those you know or other professionals for references regarding who will be providing your treatment.


When choosing a Hospital check into there patient to nurse ratio and general staffing as well as the level of the staff as there experience in assisting with procedures which you will be undergoing.


You can check with news publications, periodicals which rate and evaluate hospitals as well as government resource. The more informed you are will help to assure the best outcome for good results and recovery.