• Archives

  • Aug31

    The Business Case for Prevention

    Posted in: Aging and Costs of Aging, Wellness and Health

    There is a great business case for prevention.  And the government is making the argument, and putting our money, towards it.

    Starting 2011, small companies—those with 100 employees or fewer, and no existing wellness program in place–will be able to get grants for up to five years to establish employee wellness programs. With a 30% credit.

    Companies also can establish employee rewards programs, with an up to 50% credit by the government.

    But what are the criteria? How to apply? Where is the grant application? Not posted, yet.

    Many studies say corporate wellness programs show a positive return on investment (ROI). A study of 56 worksite health promotion programs showed, on average, 32 percent less workers’ comp/disability claims costs.

    A 2010 Harvard Study of wellness programs found
    *$2.73:1 savings-to-cost ratio for absenteeism
    *$3.27:1 savings-to-cost ratio for health costs

    All from the Patient Protection and Affordable Care Act. Here is a timeline summary through 2015, courtesy of the Kaiser Foundation, about what to expect. Fasten your seat belt!

     

  • Aug27

    The Coming of Prevention: What’s Covered

    Posted in: Aging and Costs of Aging, High Cholesterol, Wellness and Health

    Get ready for a boom in prevention. Many benefits will be covered. But which?

    Health plans established on or after Sept. 23, 2010 will need to cover preventive services rated “A” or “B” by the U.S. Preventive Services Task Force. Ditto Medicare/Medicaid by January 1, 2011.

    Which services are those for You? Fill in the quick blanks below: it shows “A” and “B”.

    No copays, deductibles and coinsurance amounts will be due. That’s for

    • Mammograms, colonoscopies and other cancer screenings.
    • Blood pressure, diabetes and cholesterol screening.
    • Lifestyle counseling (quitting smoking, losing weight, eating better, treating depression and reducing alcohol use).
    • Counseling and screening for healthy pregnancies.
    • Flu and pneumonia vaccines
    • Regular well baby and well child visits

    Older private employer plans are exempt or grandfathered, if they don’t change their plans. But most will. 70 percent will probably lose their exemption or grandfather status by 2013.

    Next: grants for employee wellness.

     

  • Aug24

    Short Trip to Sacto: Obesity Testimony

    Posted in: Child Obesity, Obesity and Weight Loss, Wellness and Health

    Jamie Oliver illustrating policy change in West Virginia...next stop SacramentoTomorrow I’m testifying at a Legislative Informational Hearing on Diabetes and Obesity at the California State Capitol in Sacramento on what works in practice.

    It’s not unfamiliar, but still a challenge. I did testify before the U.S. Senate Subcommittee on Aging about the care near the end of life in the 1990s.

    Now the time seems right to be part of change about obesity and public policy.

    You can read the press release about my appearance, and sneak a quick look at my prepared statement.

    I think this will be fun, and hope you’ll find ways to advocate for change not just in school lunches (which California is leading in, within the U.S.), but also in “seat-belt-equivalents” (my term).

    Seat belts save more lives than any doctor ever will. We need something like them in obesity and diabetes prevention. What would it be?

    Here’s a 90 second viewer success story in diabetes: a viewer of my Chef MD segment on Lifetime TV followed my plan, wrote to me, I encouraged her, and she transformed her life. Gotta love how powerful Susan is.

     

  • Jul16

    Prevention Will Be Cheap. But Fun?

    Posted in: Child Obesity, High Cholesterol, Wellness and Health

    For 43 million Americans on September 23 and probably the rest of the U.S sometime in 2011, preventive services just got cheaper.

    No co-pays, no deductibles, no direct charges for stuff that works.

    Now, we must figure out how to make it fun, sexy and easy. For kids and adults.  But doctors getting paid to do it? Way fun.

    Which services?

    Blood pressure, diabetes and cholesterol tests; many cancer screenings; routine vaccinations; prenatal care; and regular wellness visits for infants and children; screening and counseling for obesity; and tests for HIV. Kathleen Doheny at WebMD has a comprehensible short list; healthcare.gov has a long one.

    These are mostly to diagnose disease, but the vaccines and obesity counseling are to prevent it. What about obesity?

    “The USPSTF recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults….and screen children aged 6 years and older for obesity and offer them or refer them to comprehensive, intensive behavioral interventions to promote improvement in weight status.”

    Does this mean that the intensive Ornish program, designed for heart disease treatment and on the verge of approval by Medicare would qualify, but something milder, like Diet Plan of the Month, might not?

    If insurers cover weight loss counseling, there will be a lot more clinicians interested. And that will start the change in obesity treatment in health care.

     

  • May11

    Marching Orders for Docs, Hospitals: The White House Child Obesity Report

    Posted in: Wellness and Health

    Today, the White House Task Force on Childhood Obesity has released its recommendations and report. Of course, it needs a roadmap: recommendations without funding or teeth just set the agenda. But for doctors, hospitals and insurers, the assignments are clear.

    *Doctors should
    a. calculate BMI, beginning at age 2
    b. tell parents how to keep kids slim (this is worth a lot, as most MDs are frustrated and feel ineffective)
    c. prescribe, on a Rx pad, healthy active living

    *Insurance should cover assessing, preventing and treating overweight and obese kids.

    *Medical schools, associations and health care systems should train and teach pediatric obesity prevention and treatment.

    How will this work? The NCQA, which monitors quality for health care plans using a tool called HEDIS, will track rates of BMI assessment, nutrition and physical activity counseling. And payment dollars *may* follow. What a big If!

    Childhood obesity increased by 10% between 2003 and 2007. 16.4% of U.S. kids are obese and 31.6% overweight.

    The incentives have been not to write recipes on prescription slips, or prescribe free play. That takes training and time which most health providers don’t have and don’t get paid for.

    But physicians and hospitals are no different than other workers: they do more of what they are paid and trained to do. Let’s move!

     
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