Med-Vision Advisory Council

Corporations, healthcare facilities, municipalities, and school districts are reducing risk, reversing trends, and decreasing healthcare costs while increasing quality of care for their employees. Through our advisory council and webinars, YOU can also leverage expert solutions and ask pertinent questions for moving forward with health planning under the ACA. Start by contacting Med-Vision and letting us know what topics you need covered.

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Nov. 2014, Healthcare Alert: Don't Fear the Power of Big Data

Don't Fear the Power of Big Data

Uncertainty can be scary, and lately there's been a great deal of uncertainty in healthcare. One thing there's nothing to be afraid of is the advent of Big Data. Powerful, internet-based technologies can create a crystal-clear view of healthcare spending, thus, providing insight into money-saving solutions for employers and employees.

In recent years, data-mining services have expanded in efficiency and affordability. Analytics tools are empowering employers with reports for mitigating health risks and lowering employee healthcare costs. Imagine the blending of health claims, biometric, pharmacy, and health-risk-assessment data into HIPPA-compliant reports that concisely identify cost-drivers.

True "Big Data" technologies can rapidly and frequently scrub data, allowing users to select and summarize groups with specified attributes from millions of records as quickly as searching Amazon or Google. For example, Med-Vision's proprietary analytics program, Med-View LLC, uses Amazon Cloud and Milliman's Risk Model to rapidly translate healthcare data into strategies for lowering costs and boosting employee productivity. A simple dashboard also makes it easy to create customized reports, which place cost-saving solutions in the hands of CFOs, HR managers, and care managers.

Importantly, these customized reports aren't duplicating what you receive from consultants or insurers; rather, the reports can provide to-the-point summaries with actionable solutions in plain English. Med-Vision's experts, however, do warn that many vendors out there are claiming to offer "Big Data" solutions, but few are actually delivering results by simultaneously processing large data sets. You'll save a great deal of time and money by doing research upfront before signing with a less qualified provider.

Med-Vision has helped employers significantly reduce costs through Internet-based tools instead of costly database licenses and hardware. All client data is safely stored in Amazon Cloud, which means clients only pay for the secured space they use, as opposed to fixed-service space costs found on other vendors' rate sheets. We're experienced in helping employers analyze health-plan data to implement solutions for successfully saving millions of dollars.

If you need help analyzing health-plan data and determining actionable solutions for saving money through employee wellness, contact our experts today.

Oct. 2014, Women's Healthcare Alert: Cervical Cancer vs. Ovarian Cancer

Women's Cancer Awareness
Cervical Cancer vs. Ovarian Cancer
By Connie Gee, MBA, VP, Med-Vision Healthcare Analytics

This article offers a special alert on women's cancer, including cervical cancer and ovarian. It's important to know the causes, risk factors, and symptoms. The CDC reports that in 2011, a total of 12,109 women in the U.S. were diagnosed with cervical cancer and 4,092 died. It was once the leading cause of cancer deaths, but national rates of incidence have decreased over the past 40 years because of one simple preventative screening, the pap test. The American Cancer Society reports that 22,280 women will be diagnosed with ovarian cancer in the U.S. this year, and about 15,500 women will die from this cancer. Early detection of ovarian cancer is challenging since the symptoms are the same as some other conditions including ovarian cysts. Request this article for actionable tips for screenings and prevention.

Contact to get a full PDF of this article for your workforce.

Sept. 2014, Men's Healthcare Alert: Prostate Cancer & Prostatitis

Protecting Your Prostate
Prostatitis vs. Prostate Cancer
By Connie Gee, MBA, VP, Med-Vision Healthcare Analytics

This article offers a special alert on prostate health for men. It's important to know the causes, risk factors, and symptoms of prostate issues, including prostatitis and prostate cancer. In 2013, there were over 233,000 new cases of prostate cancer and over 29,000 deaths. Prostate cancer is the 2nd most common cancer in men (behind skin cancer), and it is the 2nd leading cause of cancer death for men (behind lung cancer). One in seven men will develop prostate cancer in their lifetime. Requests this article for the facts about prostate health and tips for prevention. Requests this article for the facts about prostate health and tips for prevention.

Contact to get a full PDF of this article for your workforce.

July/Aug 2014, Healthcare Alert: E-Cigarettes: The Next Great Costly Health Hazard

E-Cigarettes: The Next Great Costly Health Hazard
By Connie Gee, MBA, VP, Med-Vision Healthcare Analytics

Many people are worried about electronic cigarettes, also referred to as "e-cigs." The FDA warns that these battery-operated devices have cartridges filled with varying amounts of nicotine (an addictive drug) and other chemicals that are heated to create a vapor that burns the tissue in the throat. The contents include diethylene glycol (a toxic compound found in anti-freeze), nitrosamines (the same carcinogens found in tobacco and marijuana), and many other chemicals that are poisonous to humans.

Harvard Research has advised that e-cigarettes can reactivate the smoking habit in ex-smokers and increase the tobacco abuse for young people who are not yet addicted. Some e-cigarettes have gummy bear, cotton candy, or bubble gum flavorings to attract users of all ages, but results of this attraction has included accidental poisonings amongst children, most five years of age and under.

Contact to get a full PDF of this article on E-Cigs, which includes: Adverse Effects, FDA Safety Information, False Claims for Cessation, Teen Smoking, and Laws & Regulations.

While the controversy with e-cigarettes continues, some states have taken their rightful authority to restrict the use in public areas and banning the sale to minors. In 2013, California state senate implemented laws that make all e-cigarettes "subject to the same regulations and restrictions as traditional cigarettes and tobacco products." Check with your local Health Department for local programs and the Centers for Disease Control (CDC) for educational materials on smoking cessation. For customized employee-wellness programs pertaining to smoking cessation, contact Med-Vision's experts for assistance.

June 2014, Employee Benefits: New Rules on Wellness

New Rules on Wellness

Employers are scurrying to find the best benefit-plan designs for the upcoming enrollment season. While attention is always on costs, there also is a pressing need to focus on the ACA and IRS rules that will dramatically affect your plans and policies for January 2015.

The new regulations allow a greater amount of financial incentives that employers can offer to plan members participating in wellness programming, but remember the IRS is taxing certain incentives and can impose costly excise taxes on any employer who violates the new rules. Reviewing these rules and regulations with an expert is vital for protecting both your employees' health and your bottom line.

Incentive-based wellness-programs offering rewards for participants, specifically, come with complex implications, including income taxes, employment taxes, and employment laws. The ACA added an employer self-reporting obligation in connection with all applicable excise taxes, which is filed on IRS Form 8928. Consulting with a benefits design strategist, wellness expert, and accountant is recommended for meeting any tax deadlines and avoiding penalties.

In an effort to comply with these rules and requirements, you must start with an understanding of wellness programs. According to HIPAA regulations, a wellness program is any program of health promotion or disease prevention. Wellness-program types include programs with rewards that are based on meeting health benchmarks, and programs based solely on participation. Rewards may include prizes or gift cards exchanged between employee and employer or third-party, for which taxation guidelines do apply.

There are also different types of health-contingent programs. For example, there are "activity-only" wellness programs, for which a participant must undertake a form of physical activity or diet in order to obtain a wellness reward. "Outcome-based" wellness programs base rewards on achieving specified health outcomes with test or screenings showing health improvements, such as smoking cessation, lowering cholesterol, or losing weight. Notably, ACA regulations require that outcome-based wellness programs must offer a "reasonable alternative standard" for participants who don't meet the program standards. Additionally, in the event of offering rewards and perks, such as lower copays or deductibles for participants, the program must maintain compliance with the HIPPAA nondiscrimination requirements.

In sum, several rules and requirements apply for new plans and policies, which is why many employers have enlisted the help of wellness consultants during the benefits planning phase.

Resources & Links

"No Good Deed; While Easy to Implement in Theory, Outcomes-Based Wellness Programs in Practice Present Legal and Regulatory Challenges for Employers," by Andrea Davis, Employee Benefit News, June 15, 2014.

"ACA Final Regulations Impose New Burdens on Wellness Programs," by Russell Chapman, August 8, 2013.

Employment Tax, Fringe Benefits, Information Reporting, and ACA Update, Dallas, Ft. Worth Tax School, Tax Executives Institute, April 22, 2014.

"Will Your Wellness Program Be Compliant in 2014?," by Mark Bailey, 2014.

2014 Reporting & Disclosure Calendar for Benefits Plans

**Do you have questions? Take 10 minutes to discuss this topic with an employee wellness strategist, contact for your free initial 10-minute consult.

May 2014, Employee Benefits: Major Risks in Your Benefit Plans

Major Risks in Your Benefit Plans

Today's challenges in healthcare makes the measurement of benefit plans and wellness programs even more important than ever before. Healthcare costs continue to rise and many employer groups are converting to self-funding to reduce costs by gaining more control of the plan design. But it also takes a comprehensive analysis to understand what is driving the costs and to determine what actionable steps are required to lower costs. It is essential to know the risks and to focus on relevant data and meaningful metrics that will make the most significant impact to reduce benefit plan risks.

Risks to Benefit Plans:
1. 20% of processed claims are incorrect
2. Incomplete or inaccurate data information
3. Individuals have errors in their health records
4. Pricing disparities for the same services
5. Medical and prescription drug costs continue to escalate
6. Members not getting the care they need, leading to major medical events
7. Emergency room visits due to badly managed chronic conditions
8. Expensive prescription drugs used for behavior-based conditions
9. Expectations of ICD10 coding to create a higher percentage of mistakes
10. Benefits and Wellness professionals without the tools to know if programs are working
11. Insufficient healthcare data-analysis training
12. Insufficient training in data-based strategic planning
13. Insufficient training in skills needed for Healthcare Reform
14. Wellness not seen as a risk-management strategy
15. Health not considered a vital business strategy

**Take 15 minutes to see what you can do to mitigate the risks of your benefit plan. Contact Med-Vision for your complimentary WebEx.

May 2014, Employee Benefits: Implications of Dropping Coverage

Implications of Dropping Coverage

Since 2010 to the current state of the ACA, employers have deliberated the idea of dropping the long-standing benefit of employee health coverage. From a business perspective, healthcare benefits usually absorb 62% to 67% of profits, in spite of increasing the employees' premiums and cost share. Self-funded employers have an additional liability to cover the high-cost spike claims, such as complicated pregnancies and heart attacks. It's tempting for decision makers to change the company's healthcare costs from a variable to a fixed expense by writing a check to the employees and then having them shop for their own coverage. The company would also see additional savings through workforce reduction of the HR staff who manage the benefit plan. But is this the right strategy?

Employee healthcare benefits have always been considered part of the compensation package, and most job seekers also seek the best benefit-plan packages when considering job acceptance. Top talent looks for companies that offer top benefits. If a company loses their recruitment advantage because of elimination of the healthcare benefit, they may also see an increase in turnover, poor morale, and a changing company image. Long-term value of the company's brand may become perceived as a new "corporate greed" while lost motivation may mean lost innovation and quite possible customer loyalty.

Surveys have shown that employees want their employers to do the work of plan design, negotiating the best plan for the money. Employees also want to pay for their benefits at work through payroll deduction. It is a convenience for employees to stay focused on their jobs without the worry of having to navigate and negotiate their own healthcare benefits.

In spite of ACA, it is still all about the costs. They continue to rise and there are many unknowns. Employers today must take a hard look at their long-term business goals and take actionable steps for reducing costs while protecting their greatest asset, their workforce. What actionable steps will you take to reduce costs?

**Take 15 minutes to learn what you can do to keep your benefits for your employees, yet bend the cost curve in your favor. Contact Med-Vision for a Free WebEx to learn more.

April 2014, ACA Alert: Transitional Reinsurance Program/Tax

ACA Tips

Transitional Reinsurance Program/Tax

The Healthcare Reform Law created the Transitional Reinsurance Program to reimburse commercial insurers for writing policies for individuals with high-cost claims that have coverage through the Exchanges. This program is also known as "stop-loss" coverage. In 2014, public and private employers will pay $63.00 per healthcare-plan participant (employees, spouses, dependent children) to fund the 2014 HHS projected amount of $12 billion. A benefit plan with 10,000 participants would pay $630,000 for their 2014 TRP tax. HHS has recently proposed that the tax be paid in two installments. Using the 10,000 participants, the employers would pay $525,000 by January 2015, and the remaining $105,000 in the fourth quarter 0f 2015. Employers are to submit their plan participant numbers by November 2014, will be given their payment due by December 2014, and the first installment would be due by January 2015. The tax for 2015 is expected to drop to $44 per plan participant, and the 2016 tax has not yet been established. The projected amount needed to fund this program over three years is $25 billion, with $20 billion going to the reinsurance program, and $5 billion going to the U.S. Treasury. Certain employer groups have recently been exempted from paying this tax.


April 2014, ACA Alert: The Tobacco Surcharges

ACA Tips

The Tobacco Surcharges.

The Healthcare Reform Law allows tobacco users to be surcharged up to an additional 50% more for their insurance premiums. If a smoker has an annual premium value of $6,000, paid by employer and employee, an additional $3,000 can be added as a surcharge, payable by the tobacco user. The law requires a tobacco cessation program be made available to the individuals being surcharged and is the only way a tobacco user can avoid paying the surcharge.


April 2014, ACA Alert: Cadillac Tax

ACA Tips

Cadillac Tax

In 2018, the 40% Cadillac Tax will go into effect. This is a tax on what is now considered to be high-cost plans that exceed the annual premium values of $10,200 for individual coverage and $27,500 for family coverage. The annual premium values are determined by the total paid by the employer and the employee and includes any contributions to Flexible Spending Accounts (FSAs), Health Reimbursement Accounts (HRAs), and Health Savings Accounts (HSAs). Some employer sponsored plans are already at the thresholds, and some employer sponsored plans will reach the thresholds before or by the 2018 implementation. For example, an individual annual premium value of $8,000 in 2014 ($667 per month), with 8% annual increases in healthcare costs, would reach an annual premium value of $10,883 by 2018. The 40% tax per premium would be $273. If this same individual uses tobacco and a 50% surcharge is added to their premium, they would reach the threshold in 2014, the annual premium value by 2018 would be $16,326, and the 40% tax would be $2450. To avoid this taxation, some employers are changing their benefit plan strategies by increasing deductibles and/or ending employer contributions to FSAs and HSAs.


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