Groupons have been in the medical news lately (for example “Groupons For Medical Treatment? Welcome To Today’s U.S. Health Care” and “Groupons for medical care are helping patients save money“) with stories of deeply discounted rates for some medical tests in several local markets across the country.
Here’s the net of the good and bad from a smattering of the news reports.
Good because the lower rates may make the tests affordable for some who need them and who may otherwise pass because they simply can’t afford. In other words, if you have to have a test and don’t have coverage or if you have coverage but your plan’s deductible coupled with your network’s contracted rate for the test are out of reach, the Groupon rate may make it affordable.
Bad because the discounted rates sometimes prompt people to undergo testing unnecessarily and often without their doctor’s input or supervision. In some respects, it could be a cousin to a practice known as “predatory testing” (offering free initial tests designed to encourage more not so free tests and/or costly treatments…….when they may not be necessary or advisable in the first place.)
And, bad because the quality is sometimes not up to par leading to a retest which usually ends up being performed somewhere else at an additional cost. Essentially, patients end up having to pay multiple times to have the test done right.
According to one of the reports “Groupon dictates the price for its deals based on the competition in the area — and then takes a substantial cut”…
‘They take about half. It’s kind of brutal. It’s a tough place to market,’ said a provider that signed on with Groupon to market for his testing facility.”
Makes me think we could do just as well or even better fending for ourselves with a qualified provider of our choosing without Groupon as the middleman. If a test is needed, first talk to your doc and ask for a list of multiple qualified providers. And/or, check your insurance carrier’s online provider network directory for participating providers. Most insurance carriers now have online cost comparison tools that you can access by logging into your account. They are simple to use and allow you to shop for where you receive your healthcare. Once you have your lists of providers, check for quality ratings and pricing information.
After you do a little homework, select a few qualified providers. Ask each of the providers for their best rates; and, what kind of break they’ll give you for pre-payment or paying in cash.
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- Tom Barrett
- September 23, 2019
- affordable, cost, costs, coverage, employees, employers, health plans, healthcare, high deductible, insurance, kaiser, medical
- 0 Comments
Medicare can be daunting and confusing and quite difficult to grasp.
This is true in the case of existing Medicare beneficiaries as well as their care givers. And, it’s especially true for those prospective new enrollees who are about to turn 65 and have to deal with trying to understand their Medicare options for the very first time.
The Medicare Minute was created and sponsored by the Medicare Rights Center to help address and alleviate some of the confusion surrounding Medicare. The program consists of an ongoing series of free monthly educational programs designed to equip people with the knowledge to more clearly understand their Medicare options, to make more informed decisions, and to ultimately utilize their Medicare coverage more effectively.
Volunteers from across the country with experience in how health benefits work serve as facilitators for the Medicare Minute educational programs. And, bbg65Plus is now certified and appointed to serve as a Facilitator of the Medicare Minute program.
The Medicare Minute educational program is available free of charge to employers, organizations, and community groups interested in educating members on the ABC’s (and Part D) of Medicare. And now readers of our blog will be able to read a summary of some of highlights and key tips from those programs in this space each month.
To learn more about the Medicare Minute educational programs and how you can schedule Medicare Minute presentations for your organization, contact Tom Barrett, Medicare Minute Facilitator for bbg65Plus at 866.845.8600 x130 or email@example.com.
For more information — go here 1 Medicare Minute Overview and here 2 Medicare Minute FAQ
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- Tom Barrett
- August 29, 2019
- confusion, employees, employers, enrollment, federal, health plans, healthcare, insurance, medical, medicare, open enrollment
- 0 Comments
A dog’s sense of smell can be 10,000+ times more powerful than humans. It’s no surprise that we ingenious humans have figured out how to train these loving creatures with their amazing sniffing abilities.
We’ve all seen dogs at the airport and/or in cop cars. These dogs are particularly trained to sniff out illegal drugs. However, dogs can also be an effective solution in some healthcare situations.
Disclaimer: All dogs featured in this post belong to (or previously belonged) a BBG team member. The theme photo may just happen to be the president’s dog…or should I say the dog who owns the president may just happen to be featured in the theme. 😉
Life is good!
Wait, you want me to work??
Did you know there are seizure alert dogs? That’s right if you have a loved one who is challenged with epilepsy, there are organizations who can pair them with a trained seizure alert dog.
Here are several such organizations that we’ve come across in our research on the internet:
Ready to please!
According to Canine Partners for Life these dogs can do the following:
- Alert its partner of an oncoming seizure
- Stay close to its partner in the event of a seizure to prevent injury
- Alert a caretaker
- Fetch an alert device
- Open a door and/or turn on a light
The Epilepsy Foundation states that “dogs can be trained as service animals for people with seizures, just like they can be trained to serve people with other disabilities. The law protects a person’s right to use a service animal in any public place.”
It’s quite amazing that these fuzzy, friendly creatures can not only be our best friend but also provide a valuable service.
Everyone needs a best friend.
Diabetes is another health condition for which dogs can be trained to detect. The key with many medical conditions is early detection. Blood sugar levels which go too low (hypoglycemia) or too high (hyperglycemia) pose serious health risks.
Diabetic alert dogs are trained to alert their partner in advance of levels becoming dangerous.
According to the American Kennel Club, “diabetic alert dogs can function as blood sugar level detectors.” While dogs cannot give exact measurements of blood sugar levels, like a blood glucose meter, they can preemptively alert their partners when levels are out of range.
If you are looking for organizations to pair you or your loved one with a diabetic alert dog, here are several organizations and resources:
Early Cancer Detection
Did you know I have 220 million smell receptors?
So if a dog’s sniffing ability is so phenomenal at early detection of certain health conditions, what about cancer? If so, wouldn’t it seem like a grand solution to have dogs in our primary care physicians waiting room? Well, we are probably a long way from that ever happening but there are dogs being trained.
However, no one can deny that some dogs are already being credited with life-saving abilities. This article from American Veterinarian has some great stories of normal dogs alerting their owners in creative ways about cancer. Many of the owners have good reason to believe their dogs saved their lives!
According to Medical News Today, dogs can detect certain cancers in a person’s:
This seems like a no brainer, right? It’s a low-risk, noninvasive method; however, there are still many inconsistencies.
Who me? I’d never present a challenge.
The first double-blinded studies were published in 2006. Dr. Klaus Hackner, a pulmonary physician at Krems University Hospital in Austria reports in this article on Scientific American.
First, let’s look at why/how dogs can detect cancers. Cells give off volatile organic compounds, also known as VOCs. According to Hackner, each type of cancer would have a distinct smell and it would be different from a normal cell.
“Given that dogs have more than 220 million smell receptors in their noses, they’re excellent animals for sniffing out disease,” Hackner said. “In comparison, humans have a ‘mere’ 5 million smell receptors in their noses,” he said.
Most dogs can be trained, in about 6 months, to detect the odors associated with certain cancers. However, the study failed due to the lab environment being set up in a way that neither dog nor handler knew if samples selected by the dogs were actually cancerous. Dogs will lose interest without positive reinforcement.
In this same article from Scientific American, Dr. Hilary Brodie, a professor in the Department of Otolaryngology at the University of California, expounds on some arguments of why dog detection of cancer is not ideal even if the lab situation was different:
- It would take an immense amount of time and energy to train dogs on the many types of cancer.
- Dogs can have a bad day and misdiagnose.
- No test is perfect but doctors know the accuracy of certain tests such as mammograms while rates would vary from dog to dog.
Both Hackner and Brodie believe it may be more feasible to think that dogs will be aiding researchers in the creation of biochemical “nose” machines, known as e-noses.
The nose knows.
Dogs make wonderful companions and very apparently aid in improving our lives in various ways and especially with those who are challenged with health conditions. Dogs are already making a positive impact in the world of healthcare in regards to seizure and diabetic alert.
There is more research needed before dogs can be of assistance in the detection of certain cancers. However, the good news is that they possess a valuable key component (amazing sniffing abilities) and now it’s up to us to figure out how to best train and utilize them.
We are capable of more than just looking cute.
We have some very exciting news to share with you. Earlier this year, with great encouragement from our clients, we launched bbg65Plus.
Thinking about Medicare can be truly daunting. For years our clients have leaned on our knowledge, experience, and hallmark customer service for guidance on what to do and where to start when it comes to all things Medicare.
Now you can also turn to us to find the right coverage. We provide the full range of:
- Medicare Advantage Plans,
- Medicare Supplemental or Medigap Plans, and
- Prescription Drug Plans
We match each person with the plan that’s right for them. And, we simplify the enrollment process making the transition to Medicare smooth and pain-free.
The age 65 and over demographic represents the fastest-growing segment of the U.S. workforce. Today, Medicare plays a much more significant role in the workplace.
Successfully transitioning to Medicare is a big deal that can also be a big cost and coverage win when done the right way. We can help.
Our goal centers on providing Medicare Peace of Mind. We remove the mystery and help you make the right decision about your Medicare coverage.
In launching bbg65Plus, we’re excited to serve the needs of our business clients as well as the Medicare needs of our families, friends, colleagues, and neighbors in the communities where we live and work.
So, for anyone needing assistance and hoping to experience Medicare Peace of Mind, please contact us. We’d love to help.
And, of course, we’d be very grateful if you’d help us spread the word.
(e) 65Plus@bbginc.net; (p) 866.845.8600 x130
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- Tom Barrett
- July 18, 2019
- confusion, cost, coverage, employees, employers, federal, health plans, healthcare, HHS, insurance, medical, medicare, open enrollment
- 0 Comments
The value of SharedFunding is that it creates a gap between what you were paying for traditional insurance and what you pay with SharedFunding.
Unfortunately it’s typical for insurance costs to increase annually. However, we’ve found that by creating a gap with SharedFunding, that increase can be on less premium.
You’ll be glad you brought it! Photo by Ricardo Resende on Unsplash
When you have traditional insurance, you need to buy the plan that you want to offer your employees. Makes sense, yes? The problem is that you are paying for this plan for every employee regardless if they use it or not.
The real benefit of insurance can be compared to an umbrella. You’ll be glad you have it with you when it downpours. Additionally, you’ll never mind when the sun comes out and you are carrying your umbrella.
At BBG, Inc., we’ve come up with a way to provide the protection of an umbrella at a fraction of the cost of traditional insurance.
With SharedFunding, you can reduce the high premiums you are paying to the insurance company by buying catastrophic coverage. You are still buying an umbrella but just with a little more gap between you & the umbrella.
Typically we recommend purchasing the highest deductible available ($5,000, $6,350, $6,650). However, BBG will work with you to determine the appropriate amount of risk.
Then we’ll build out the plan that you want to promise your employees and deliver it to them. This is called SharedFunding:
- You buy catastrophic coverage from the insurance company
- Your annual premium costs go down ↓
- We deliver the plan you want to your employees
- It’s a promise to pay rather than buying from the insurance company
But won’t we fund the difference back in claims?
Healthcare is used unevenly and in the 14 years we’ve been doing ShareFunding, no client has ever funded back the entire premiums savings in claims.
Here is a simple example:
Things are starting to look up. Photo by Jude Beck on Unsplash
Let’s say that traditional insurance costs you $1.00 (haha, I know what world do I live in?? Just trying to keep it simple).
BBG comes in and recommends you buy the highest deductible possible for $0.60. Right now things are looking up as you’ve reduced your healthcare costs by 40%.
The next step involves building the SharedFunding plan you would like to promise to your employees. BBG can build any type of ShareFunding plan you’d like. Most employers choose to mimic their former traditional plan. This way employees still get the same benefit they are used to receiving.
Most likely you’ll end up funding approximately $0.20 in claims for employees who utilize the SharedFunding plan.
That brings your final cost up to $0.80 for a 20% savings. Not too bad, eh?
The Compound Savings of ShareFunding
Saving 20% on your healthcare costs when you initially set up SharedFunding is lovely, yes? But what makes it even lovelier is what happens in the years to come.
Since pictures speak 1,000 words, let me explain with a graph:
Here at BBG we tend to look at the average cost per employee per year as a benchmark. The reason is that your enrollment fluctuates each year. You can calculate your average cost per employee per year by taking your total costs divided by your current enrollment.
The above graph includes numbers from a real client who has been SharedFunding since 2012.
As you can see their average cost per employee per year were at $15,197 with traditional insurance in 2012/2013. By switching to SharedFunding that year, we were able to reduce that number by 39%. Whoa!! Then in 2014/2015 they embraced a more robust form of SharedFunding and reduced their cost another 21%.
While we are pretty good, we are not magical. Unfortunately, you’ll notice their healthcare costs did rise through the years with SharedFunding. However, the true value of SharedFunding is that your increases are on a smaller premium amount; hence, the compound savings of SharedFunding.
To show this we assumed they would have received a trend increase of 5% each year if they had stayed on the traditional route. Based on past renewal trends, this was an appropriate average increase to assume.
Firstly, they are not even close to what their average cost per employee was in 2011/2012. Secondly, while both graphs go up the gap between them grows!
Healthcare is likely one of your biggest expenses as an employer. The math of self-funding may not work for small employers, but the math of SharedFunding most likely will. Here are BBG, we have fun delivering strong benefits to your employees while reducing the amount of premium you pay to the insurance company.
Your employees will still have access to the network that the insurance carriers provide. Additionally, you will be protected from catastrophic claims with a mini stop loss in purchasing a high deductible plan from the carrier. Furthermore you can deliver the same benefits to your employees by promising to fund. Lastly, with a promise to fund, you, the employer, will be able to retain more dollars in your business.
If you are interested in seeing if SharedFunding might be a good fit for your company, don’t hesitate to reach out to us for a no obligation analysis.
Lastly, we will be running a series on SharedFunding and in this series we plan to get into the details on a more granular level.
A study of spending on 12.5 million diagnostics tests by UnitedHealthcare once again revealed substantial variation in the prices patients pay for common diagnostic tests. The seven groups of common diagnostic tests included echocardiograms, mammograms and ultrasounds.
The price range for an echocardiogram — $210 to $1,830 – typifies and illustrates the wide variation in the price for common diagnostic tests. And, according to the report, the higher prices did not correspond to improved patient outcomes or to the quality of the provider.
So Why Do We Pay More?
“A more likely reason is that health care providers generally are incentivized to use their market power to increase prices, often resulting in overpriced services,” per the report.
A copy of the report can be found here.
We’ll write more in upcoming Two Minute Drill articles about what you can do to avoid the higher prices. You’ll learn how BBG paves the way for our clients via our SharedFunding program. They consistently experience lower costs without sacrificing quality of care.
“A more likely reason is that health care providers generally are incentivized to use their market power to increase prices, often resulting in overpriced services,”
Don’t get me wrong, I completely support the notion of promoting positive health behaviors and healthier lifestyles. Encouraging such things as regular exercise, good and balanced nutrition, the proper amounts of sleep, and all the things associated with taking better care of ourselves is all good. No question about that.
It’s just that for the most part you could color me the doubting Thomas when it came to believing the narrative that wellness programs definitively lead to lower insurance premiums and other healthcare-related cost savings.
And, it seems that most often that’s how wellness programs have been sold to employers. “Implement a wellness program and you will lower your company’s insurance premiums and other employee health-related costs” has commonly comprised a major part of the wellness sales pitch made to employers.
And many employers, especially large employers, have been buying this cost savings aspect of it. (80% of large employers in the U.S. offer wellness programs*).
I’ve long wondered if these corporate wellness programs provided any direct return on an employer’s investment (Workplace wellness is an $8 billion industry*). We sure haven’t witnessed it either in the way of lower insurance premiums or a decrease in the consumption of medical services and medical claims.
Harvard provides an answer via a major study on the Health and Economic Outcomes of Workplace Wellness Programs.
Results of the Harvard study were recently published in The Journal of the American Medical Association (JAMA). In a nutshell the Harvard study concluded that while there were significantly greater rates of some positive health behaviors among participating employees, there were no significant effects on health care spending.
In other words, when it comes to wellness programs and savings, the Harvard study verdict is in. Under-deliver.
For more on the Harvard study click here.
Buried far below the most recent headlines related to eliminating the ACA, The Centers for Medicare and Medicaid (CMS) once again announced that employers in the small group market still enrolled in Transitional Relief Plans (pre-ACA) may keep their existing policies and plans for another year. CMS stipulates that ultimately the discretion for granting an extension again rests with state regulators and the respective participating insurance carriers who continue to make those plans available. As we learned last year a few insurance carriers (e.g. Aetna) elected not to extend the Transitional Relief Plans beyond 2018. They instead chose to eliminate the option of renewing the old plans thus requiring impacted employers to move to ACA plans or one of the market compliant alternatives (e.g. level funding, MEWA, etc).
For more info click on the link below:
Extended Non-Enforcement of Affordable Care Act-Compliance With Respect to Certain Policies
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- Tom Barrett
- March 28, 2019
- ACA, affordable, affordable care act, cost, costs, coverage, DOL, employees, employers, federal, health plans, healthcare, healthcare reform, HHS, insurance, IRS, medical, Obamacare, ruling, states
- 0 Comments