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Impact Health: Tax Unhealthy Foods and Subsidize Fruits and Vegetables (Jan. 2013)

Posted By National Wellness Institute, Friday, December 28, 2012
Updated: Monday, January 7, 2013

Could taxing unhealthy foods and beverages while subsidizing fruits and vegetables lead to improved health? Researchers from University of Aukland, NewZealand, and University of Otago, New Zealand, believe improved health outcomes are possible.

Researchers reviewed 32 studies that discussed food pricing and consumption in association with chronic diseases. Socioeconomic groups were alsotaken into consideration when determining if adding taxes and subsidies would be beneficial to society. When fruits and vegetables received a 10% pricedecrease, consumption increased up to 8%. Individuals from lower income groups benefitted the most, as subsidizing fruits and vegetables decreased the gap between the differing income levels.

The 32 studies done showed possible improvements in health outcomes if unhealthy foods such as those high in saturated fat were taxed combined with a subsidy forfruits and vegetables. However, adding a food tax would differ for each country so further planning would be necessary to guaranteefood-pricing strategies mesh with differing cultures and socioeconomic groups.

A healthy diet consisting of whole grains, fruits, and vegetables is necessary for maintaining a healthy weight, receiving proper nutrients, and for one's overall well-being. Due to food pricing, many people consume unhealthy foods and beverages that are high in calories and saturated fat, and low in nutritional content. If healthy foods are subsidized, individuals from different socioeconomic statuses would have more opportunities for healthier food options while improving health and well-being.

Article by Kelli Oligney, Associate Editor

Reference: Eyles, H., Mhurchu, C., Nghiem, N., & Blakely, T. Food Pricing Strategies, Population Diets, and Non-Communicable Disease: A Systematic Review of Simulation Studies. PLOS ONE. Retrieved on December 11, 2012, from http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001353

Tags:  Diet  Intellectual  January 2013  Nutrition  Physical  Policy 

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The New Standard in Stopping Obesity (Nov. 2011)

Posted By National Wellness Institute, Tuesday, November 1, 2011
Updated: Wednesday, December 19, 2012

The Strategies to Overcome and Prevent (STOP) Obesity Alliance, a conglomeration of consumer, provider, government, labor, business, health insurer and quality-of-care organizations, made recommendations for policy makers last month.

The Alliance's core principles are as follows:

  • Reducing overweight and obesity is about improved health, not appearance.
  • The work to end obesity cannot end with personal responsibility. Individuals need support and environments that facilitate healthy decisions to accomplish their goals. The Alliance sees roles for employers, schools and educators, health care professionals, community leaders, families, and the government in creating an environment that will help overcome and prevent overweight and obesity.
  • Prevention and intervention go hand in hand.

The Alliance's core recommendations are as as follows:

  • Redefine Success: Explore the use of a 5 to 10 percent sustained reduction of current weight as the appropriate measure of success for the purpose of determining whether treatment interventions and innovations are effective. Current standards of success vary greatly but a growing body of evidence suggests losing between 5 to 10 percent of current weight leads to major improvements in key health areas, including diabetes, lipid blood levels, and even mortality.

  • Encourage Innovation and Multifactorial Interventions to Strengthen the System of Care for Overweight and Obesity: There is a need to develop, test, and evaluate interventions that include multiple components (surgery + behavioral treatment + diet, for instance, or personal trainer + diet + drugs, diet and exercise plan) among diverse populations at lower levels of overweight and obesity, before co-morbidities develop. Eventually, this effort may lead to the creation of screening tools that could help match an individual patient's characteristics and needs with appropriate interventions.

  • Address and Reduce Stigma as a Barrier to Improving Health Outcomes: Cultivate a positive environment by promoting awareness and open discussion among health professionals, opinion leaders, role models (e.g., parents, teachers, coaches) and the public of the harmful impact of stigmatizing people with overweight and obesity and promote interventions that provide support for sustained weight loss and that go beyond recognizing the role of personal responsibility.

  • Broaden, Intensify and Coordinate the Research Agenda for Obesity: Encourage an interdisciplinary research environment that addresses the obesity epidemic as a result of a complex interplay of biological, genetic, behavioral, cultural, environmental, social, policy, and economic factors.

  • Encouraging Physical Activity for Improved Health: Encouraging interventions and creating environments that support physical activity will improve health, independent of weight or weight loss, resulting in a healthier population. Interventions and environments (such as the workplace, community, home, parks and public recreation areas, etc.) and systems aimed at promoting and increasing physical activity to improve fitness can have wide-ranging benefits.

For more information on the Alliance and its recommendations, click here.

Tags:  November 2011  Obesity  Physical  Policy  Weight Loss 

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CommonWealth Fund Grades U.S. Health System 64 out of a possible 100 on National and International Health Benchmarks (Nov. 2011)

Posted By National Wellness Institute, Tuesday, November 1, 2011
Updated: Wednesday, December 19, 2012

The National Scorecard on U.S. Health System Performance, 2011, updates a series of comprehensive assessments of U.S. population health and health care quality, access, efficiency, and equity. It finds substantial improvement on quality-of-care indicators that have been the focus of public reporting and collaborative initiatives. However, U.S. health system performance continues to fall far short of what is attainable, especially given the enormity of public and private resources devoted nationally to health. Across 42 performance indicators, the United States achieves a total score of 64 out of a possible 100, when comparing national rates with domestic and international benchmarks. (That's a "D" people!). Overall, the U.S. failed to improve relative to these benchmarks, which in many cases rose. Costs were up sharply, access to care deteriorated, health system efficiency remained low, disparities persisted, and health outcomes failed to keep pace with benchmarks. The Affordable Care Act targets many of the gaps identified by the Scorecard.

According to the report, variations in health care delivery persist throughout the United States, and opportunities to prevent disease are often missed. At the same time, the Scorecard finds notable gains in quality of care in those areas where the nation has made a commitment to accountability and undertaken targeted improvement efforts. Although the Scorecard draws on the latest available data, primarily from the period 2007 to 2009, the results do not fully reflect the effects of the recent economic recession on access to and use of care.

Some good news can be found in an exception to the overall pattern of U.S. performance: rapid progress on quality metrics that have been the focus of national initiatives and public reporting efforts. Hospitals, nursing homes, and home health care agencies are showing marked improvement in patient treatment and outcomes for which data are collected and reported nationally on federal websites and as part of improvement campaigns. There has also been significant improvement in the control of high blood pressure, a measure that is publicly reported by health plans; increasingly, physician groups are being rewarded for improving their treatment of this and other chronic conditions. Better management of chronic diseases also has likely contributed to reductions in rates of avoidable hospitalizations for certain conditions, though rates continue to vary substantially across the country.

Of great concern, access to health care significantly eroded since 2006. As of 2010, more than 81 million working-age adults—44 percent of those ages 19 to 64—were uninsured during the year or underinsured, up from 61 million (35%) in 2003. Further, the United States failed to keep pace with gains in health outcomes achieved by the leading countries. The United States ranks last out of 16 industrialized countries on a measure of mortality amenable to medical care (deaths that might have been prevented with timely and effective care), with premature death rates that are 68 percent higher than in the best-performing countries. As many as 91,000 fewer people would die prematurely if the United States could achieve the leading country rate.

Sharply rising costs are putting both access and budgets at risk. Health care spending per person in the United States is double that in several other major industrialized countries, and costs in the United States continue to rise faster than income. We are headed toward spending $1 of every $5 of national income on health care. We should expect a better return on this investment.

Of particular concern from a wellness standpoint, the following areas saw declining improvement:

  • Primary and preventive care: In 2008, more than 2 of 5 (44%) non-elderly adults lacked a regular primary care provider who is easy to get to and consult with by phone during office hours, and only half received a set of basic preventive services— representing little change from 2002. The vaccination rate for young children recovered in 2010 following a sharp decline caused by a vaccine shortage in 2009, yet one-quarter of children still lacked full protection against communicable diseases.
  • Childhood obesity: Nearly one-third (32%) of children ages 10 to 17 were overweight or obese as of 2007, with rates ranging from 24 percent to 39 percent among the top and bottom five states. Unless there is an improvement in healthy eating and weight control, obesity and related health problems are likely to rise—and could wipe out recent health gains from declining smoking rates.
  • Disparities: Minorities and low-income or uninsured adults and children were generally more likely than their white, higher-income, or insured counterparts to wait to see a doctor when sick, to encounter delays and experience poorly coordinated care, and to have untreated dental caries, uncontrolled chronic disease, avoidable hospitalizations, and worse outcomes. And they were less likely to receive preventive care or have an accessible source of primary care.

THE NATIONAL SCORECARD

The 2011 National Scorecard comprises an expanded set of 42 indicators within five dimensions of health system performance: healthy lives, quality, access, efficiency, and equity. The Scorecard compares U.S. average performance with benchmarks drawn from the top 10 percent of U.S. states, regions, health plans, and hospitals or other providers, as well as from the top-performing countries. If average U.S. performance came close to the top rates achieved here at home or abroad, then average scores would approach the maximum of 100.

For more information: The Commonwealth Fund Commission on a High Performance Health System, Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011, The Commonwealth Fund, October 2011.

Tags:  Health  November 2011  Physical  Policy  Social  Spiritual  Wellness 

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Emerging Public Health Crisis Linked to Mortgage Default and Foreclosure (Nov. 2011)

Posted By National Wellness Institute, Tuesday, November 1, 2011
Updated: Wednesday, December 19, 2012

University of Maryland School of Medicine researchers find mortgage default associated with substantially increased risk of depression.

Researchers warn of a looming health crisis in the wake of rising mortgage delinquencies and home foreclosures. The study, released October 2011 in the American Journal of Public Health, is the first long-term survey of the impact the current housing crisis is having on older Americans. The study focused on adults over 50 and found high rates of depression among those behind in their mortgage payments and a higher likelihood of making unhealthy financial tradeoffs regarding food and needed prescription medications.

"More than a quarter of people in mortgage default or foreclosure are over 50," says the study's principal investigator, Dawn E. Alley, PhD, assistant professor of epidemiology and public health at the University of Maryland School of Medicine. "For an older person with chronic conditions like diabetes or hypertension, the types of health problems we saw are short-term consequences of falling behind on a mortgage that could have long-run implications for that person's health."

The study was prompted in part by the rapid rise in foreclosure rates that began in 2007 following a dramatic increase in subprime lending. By 2009, 2.21 percent of all homes in the United States, a total of more than 2.8 million properties, were in some stage of foreclosure. Previous research had shown that home ownership is associated with better health while financial strain is associated with worse health and higher death rates.

"This study has pinpointed an issue that until now has been somewhat under the radar, but which threatens to become a major public health crisis if not addressed," says E. Albert Reece, MD, PhD, MBA, vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine. "Through research such as this, faculty epidemiologists and public health specialists provide valuable information and perspectives that are useful for government and private policy makers as they work to meet the health and economic needs of Americans."

The researchers examined data from the Health and Retirement Study, a nationally representative panel study of Americans older than age 50. In 2008, 2,474 participants were asked if they had fallen more than two months behind on mortgage payments since 2006. The survey included questions designed to measure psychological impairment, general health status, and access to important health-relevant resources. In predicting these health outcomes, researchers controlled for demographic factors, health behaviors, chronic diseases, sources of debt and annual household income.

Among participants who were mortgage delinquent, 22 percent developed elevated depressive symptoms over the two-year period compared to only 3 percent of non-delinquent respondents. Twenty-eight percent of mortgage-delinquent participants reported food insecurity compared to 4 percent in the non-delinquent group. In addition, the delinquent group reported much higher levels of cost-related medication non-adherence (32 percent compared to 5 percent).

The study also found that lower-income and minority homeowners were at higher risk for mortgage default. "Our results suggest that the housing crisis may be making health disparities worse," says Dr. Alley, "because these groups had poorer health, lower incomes and higher levels of debt even before the current mortgage crisis." The researchers note that it will likely take decades for African American and Hispanic communities to recover the wealth lost during the housing crisis and that minority communities are disproportionately affected by declining home values and lost tax revenue.

The study began just as mortgage delinquencies and subsequent home foreclosures began to rise in the United States, driven mainly by increases in mortgage payments related to adjustable rate loans. Dr. Alley says the health picture is much worse today because rising mortgage defaults are compounded by unemployment. "Recent data from the Centers for Disease Control and Prevention show that the number of Americans with depression has been increasing along with rising unemployment."

Dr. Alley adds that mortgage counselors are seeing a rising tide of health issues. "We did a separate nationwide survey of mortgage counselors and found that almost 70 percent of them said many of the clients they worked with were depressed or hopeless. About a third of [the mortgage counselors] said they had worked with someone in the last month who expressed intent for self harm or suicide. These are very serious and clearly ongoing issues."

This study was supported by the National Institutes of Health. It was conducted with support, resources and use of facilities from the Philadelphia Veterans Affairs Medical Center in conjunction with the Organized Research Center on Aging at the University of Maryland School of Medicine.

Alley DE, Lloyd J, Pagan JA, Pollack CE, Shardell M, Cannuscio C. "Mortgage delinquency and changes in access to health resources and depressive symptoms in a nationally representative cohort of Americans older than 50 years. "American Journal of Public Health. Published online October 20, 2011. doi: 10.2105/AJPH.2011. 300245

Tags:  Emotional  Health  November 2011  Physical  Policy  Social  Wellness 

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Changing the IRS Codes to Account for Workplace Employee Wellness Incentives (April 2011)

Posted By National Wellness Institute, Friday, April 1, 2011
Updated: Thursday, December 27, 2012

Incentive Legislation Campaign (ILC), of Falls Church, VA, representatives held another round of meetings with targeted members of Congress and their advisors during a recent visit to Capitol Hill conducted as part of the ongoing campaign to promote wellness incentives that would encourage a healthier American work force and reduce health care costs.

The group advocates adding a new section 274 (p) to the Internal Revenue Code that would extend employer deductions and employee tax exemptions for wellness incentives in much the same way that the current section 274(j) does for service and safety awards that have saved as much as $10 for every dollar invested.

Led by Incentive Federation Executive Director George Delta, 10 industry representatives met with the staffs of Senate Finance Committee members: Orrin Hatch (R-UT), Jay Rockefeller (D-WV), Robert Menendez (D-NJ), John Thune (R-SD), Ronald Wyden (D-OR) and Benjamin Cardin (D-MD). The group also met with Rep. Patrick Tiberi (R-OH), who sits on the House Ways & Means Committee.

About The Incentive Federation

Founded in 1984, the Incentive Federation is the umbrella legislative organization for the incentive field representing national trade associations, trade publications, and national trade shows. It is the only organization whose membership includes all of the industry's national trade associations and individual companies. The Incentive Marketing Association, the Promotional Products Association International, Recognition Professionals International, The Incentive Research Foundation, and SITE International Foundation are active members. More information can be found at: http://www.incentivefederation.org/

Tags:  April 2011  Incentives  Physical  Policy  Wellness  Work 

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What You Need to Know About Health Insurance from an Insider (March 2011)

Posted By National Wellness Institute, Tuesday, March 1, 2011
Updated: Thursday, December 27, 2012

A recent interview published in the New York Times conducted by Walecia Konrad with a 20-year health insurance veteran, Wendell Potter, left readers with the following advice:

  • Ignore marketing materials when looking for affordable insurance. Don’t be persuaded by slick messages; instead, make sure you understand the coverage.
  • Read everything carefully, even if you are covered by your employer.
  • Be wary of mini-med or limited benefits plans. Many have very low-lifetime caps and others do not pay for hospitalization. The health law eliminates these plans in 2014, when no lifetime or annual caps on coverage will be allowed, but in the meantime these policies trouble me a great deal. And the insurance industry will lobby heavily for more flexibility to offer limited benefits even after 2014. So, be on guard.
  • Visit healthcare.gov to get straightforward information on plans. The industry must comply by supplying accurate information for this site.
  • High deductible plans have good and bad points. Consumers should do their best to know exactly what they can afford. If the out-of-pocket costs are going to be impossible for you, it may well make sense to pay more in premiums for more extensive coverage. For the most part, high deductibles make sense only for the young and healthy or wealthy.
  • Consumers have a right to appeal when coverage is denied. With the new law, all consumers will have access to two layers of review. That’s a significant victory.Most important, if you feel you have been denied something you should have and that your doctor has prescribed and approved, don’t accept the denial as the last word. Insurers count on people just giving up.

Source: http://www.nytimes.com/2011/02/19/health/19patient.html?pagewanted=2&_r=1&ref=health

Tags:  Emotional  Healthcare  Insurance  March 2011  Physical  Policy  Work 

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Fun Facts: How does the government hope to increase your health? (February 2011)

Posted By Temporary Temporary, Tuesday, February 1, 2011
Updated: Thursday, December 27, 2012

The U.S. Government's Healthy People program provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to:

  • Encourage collaborations across sectors.
  • Guide individuals toward making informed health decisions.
  • Measure the impact of prevention activities.

Key Objectives include:

  • Increase the proportion of adolescents who have had a wellness checkup in the past 12 months
  • Reduce the overall cancer death rate
  • Increase the proportion of persons at high risk for diabetes with pre-diabetes who report increasing their levels of physical activity
  • Increase the number of Tribes, States, and the District of Columbia that have public health surveillance and health promotion programs for people with disabilities and caregivers
  • Increase the proportion of elementary, middle, and senior high schools that have health education goals or objectives that address the knowledge and skills articulated in the National Health Education Standards (high school, middle, elementary)
  • (Developmental) Increase the proportion of worksites that offer an employee health promotion program to their employees
  • Increase use of alternative modes of transportation for work
  • Increase the proportion of pregnancies that are intended
  • Increase the proportion of women with a family history of breast and/or ovarian cancer who receive genetic counseling
  • (Developmental) Improve the health literacy of the population
  • Increase the proportion of persons who have had a hearing examination on schedule
  • (Developmental) Increase overall cardiovascular health in the U.S. population
  • (Developmental) Increase the proportion of adults with prehypertension who meet the recommended guidelines for (Developmental) Body mass index (BMI), (Developmental) Saturated fat consumption, (Developmental) Sodium intake, (Developmental) Physical activity, (Developmental) Moderate alcohol consumption
  • Reduce the suicide rate
  • Increase the proportion of primary care physicians who regularly measure the body mass index of their patients
  • Reduce the proportion of adults who are obese
  • Increase the contribution of total vegetables to the diets of the population aged 2 years and older
  • Increase the contribution of dark green vegetables, orange vegetables, and legumes to the diets of the population aged 2 years and older
  • Reduce Injuries in private sector industries resulting in medical treatment, lost time from work, or restricted work activity, as reported by employers
  • Increase the proportion of older adults who are up to date on a core set of clinical preventive services
  • Increase the proportion of low-income children and adolescents who received any preventive dental service during the past year
  • Reduce the proportion of adults who engage in no leisure-time physical activity
  • Increase the proportion of 4-year colleges and universities that offer public health or related majors and/or minors
  • (Developmental) Increase the proportion of 4-year colleges and universities that offer public health or related majors and/or minors which are consistent with the core competencies of undergraduate public health education
  • Increase the proportion of 2-year colleges that offer public health or related associate degrees and/or certificate programs
  • Increase the proportion of adults who get sufficient sleep
  • Reduce average annual alcohol consumption
  • Reduce tobacco use by adults

    For a complete outline of what Healthy People 2020 includes visit: http://www.healthypeople.gov/hp2020/

Tags:  Emotional  February 2011  Physical  Policy  Social  Wellness 

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The Affordable Healthcare Act timeline and changes of note (January 2011)

Posted By National Wellness Institute, Saturday, January 1, 2011
Updated: Thursday, December 27, 2012

For more information on any of the below 'Changes of Note' visit www. http://www.healthcare.gov/law/timeline/index.html

  • March 23, 2010, bill becomes law. Changes of note: $250 Medicare drug cost rebate, Expanded coverage for young adults, Small business tax credits, Pre-Existing Condition Insurance Plans
    • Effective Jan. 1, 2010: Up to 4 million small businesses are eligible for tax credits to help them provide insurance benefits to their workers. The first phase of this provision provides a credit worth up to 35% of the employer's contribution to the employees' health insurance. Small non-profit organizations may receive up to a 25% credit.
    • Effective April 1, 2010: States will be able to receive federal matching funds for covering some additional low-income individuals and families under Medicaid for whom federal funds were not previously available. This will make it easier for states that choose to do so to cover more of their residents.
    • First checks mailed in June, 2010, and will continue monthly throughout 2010 as seniors hit the coverage gap. An estimated 4 million seniors will reach the gap in Medicare prescription drug coverage known as the "donut hole" this year. Each such senior will receive a $250 rebate. Expanding Coverage for Early Retirees. Applications for employers to participate in the program available June 1, 2010. Learn more about the Early Retiree Reinsurance Program.Too often, Americans who retire without employer-sponsored insurance and before they are eligible for Medicare see their life savings disappear because of high rates in the individual market. To preserve employer coverage for early retirees until more affordable coverage is available through the new Exchanges by 2014, the new law creates a $5 billion program to provide needed financial help for employment-based plans to continue to provide valuable coverage to people who retire between the ages of 55 and 65, as well as their spouses and dependents. For more information on the Early Retiree Reinsurance Program, visit www.ERRP.gov
    • Providing Access to Insurance for Uninsured Americans with Pre-Existing Conditions. National program established July 1, 2010—A Pre-Existing Condition Insurance Plan will provide new coverage options to individuals who have been uninsured for at least six months because of a pre-existing condition. States have the option of running this new program in their state. If a state chooses not to do so, a plan will be established by the Department of Health and Human Services in that state. This program serves as a bridge to 2014, when all discrimination against pre-existing conditions will be prohibited. Learn more about the Pre-Existing Condition Insurance Plan.
    • Extending Coverage for Young Adults. Effective for health plan years beginning on or after September 23, 2010—Under the new law, young adults will be allowed to stay on their parent's plan until they turn 26 years old. (In the case of existing group health plans, this right does not apply if the young adult is offered insurance at work.) Some insurers began implementing this practice early. Check with your insurance company or employer to see if you qualify. Learn more about the young adults insurance policy.
    • Providing Free Preventive Care. Effective for health plan years beginning on or after September 23, 2010—All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.
    • Prohibiting Insurance Companies from Rescinding Coverage . Effective for health plan years beginning on or after September 23, 2010—In the past, insurance companies could search for an error, or other technical mistake, on a customer's application and use this error to deny payment for services when he or she got sick. The new law makes this illegal. After media reports cited incidents of breast cancer patients losing coverage, insurance companies agreed to end this practice immediately.
    • Appealing Insurance Company Decisions . Effective for new plans beginning on or after September 23, 2010—The law provides consumers with a way to appeal coverage determinations or claims to their insurance company, and establishes an external review process.
    • Eliminating Lifetime Limits on Insurance Coverage. Effective for health plan years beginning on or after September 23, 2010—Under the new law, insurance companies will be prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays.
    • Regulating Annual Limits on Insurance Coverage. Effective for health plan years beginning on or after September 23, 2010—Under the new law, insurance companies' use of annual dollar limits on the amount of insurance coverage a patient may receive will be restricted for new plans in the individual market and all group plans. In 2014, the use of annual dollar limits on essential benefits like hospital stays will be banned for new plans in the individual market and all group plans.
    • Prohibiting Denying Coverage of Children Based on Pre-Existing Conditions. Effective for health plan years beginning on or after September 23, 2010 for new plans and existing group plans—The new law includes new rules to prevent insurance companies from denying coverage to children under the age of 19 due to a pre-existing condition.
    • Holding Insurance Companies Accountable for Unreasonable Rate Hikes. Grants will be awarded beginning in 2010—The law allows states that have, or plan to implement, measures that require insurance companies to justify their premium increases to be eligible for $250 million in new grants. Insurance companies with excessive or unjustified premium increases may not be able to participate in the new health insurance Exchanges in 2014.
    • Rebuilding the Primary Care Workforce. Effective 2010—To strengthen the availability of primary care, there are new incentives in the law to expand the number of primary care doctors, nurses and physician assistants, including funding for scholarships and loan repayments for primary care doctors and nurses working in underserved areas. Doctors and nurses receiving payments made under any State loan repayment or loan forgiveness program intended to increase the availability of health care services in underserved or health professional shortage areas will not have to pay taxes on those payments.
    • Establishing Consumer Assistance Programs in the States. Grants Awarded October 2010—Under the new law, states that apply receive federal grants to help set up or expand independent offices to help consumers navigate the private health insurance system. These programs help consumers file complaints and appeals; enroll in health coverage; and get educated about their rights and responsibilities in group health plans or individual health insurance policies. The programs will also collect data on the types of problems consumers have, and file reports with the U.S. Department of Health and Human Services to identify trouble spots that need further oversight.
    • Preventing Disease and Illness. Funding begins in 2010—A new $15 billion Prevention and Public Health Fund will invest in proven prevention and public health programs that can help keep Americans healthy—from smoking cessation to combating obesity.
    • Strengthening Community Health Centers. Effective 2010—The law includes new funding to support the construction and expansion of services at community health centers, allowing these centers to serve some 20 million new patients across the country.
    • Payments for Rural Health Care Providers. Effective 2010—Today, 68% of medically underserved communities across the nation are in rural areas, and these communities often have trouble attracting and retaining medical professionals. The law provides increased payment to rural health care providers to help them continue to serve their communities.
  • Prescription Drug Discounts. Effective January 1, 2011—Seniors who reach the coverage gap will receive a 50 percent discount when buying Medicare Part D covered brand-name prescription drugs. Over the next ten years, seniors will receive additional savings on brand-name and generic drugs until the coverage gap is closed in 2020.
  • Free Preventive Care for Seniors. Effective January 1, 2011—The law provides certain free preventive services, such as annual wellness visits and personalized prevention plans, for seniors on Medicare.
  • Bringing Down Health Care Premiums. Effective January 1, 2011 —To ensure premium dollars are spent primarily on health care, the new law generally requires that at least 85% of all premium dollars collected by insurance companies for large employer plans are spent on health care services and health care quality improvement. For plans sold to individuals and small employers, at least 80% of the premium must be spent on benefits and quality improvement. If insurance companies do not meet these goals because their administrative costs or profits are too high, they must provide rebates to consumers.
  • Addressing Overpayments to Big Insurance Companies and Strengthening Medicare Advantage. Effective January 1, 2011—Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than is spent per person in Original Medicare. This results in increased premiums for all Medicare beneficiaries, including the 77 percent of beneficiaries who are not currently enrolled in a Medicare Advantage plan. The new law levels the playing field by gradually eliminating this discrepancy. People enrolled in a Medicare Advantage plan will still receive all guaranteed Medicare benefits, and the law provides bonus payments to Medicare Advantage plans that provide high quality care. Learn more about improvements to Medicare.
  • Improving Health Care Quality and Efficiency. Effective no later than January 1, 2011—The law establishes a new Center for Medicare & Medicaid Innovation that will begin testing new ways of delivering care to patients. These new methods are expected to improve the quality of care and reduce the rate of growth in costs for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). By January 1, 2011, HHS will submit a national strategy for quality improvement in health care, including these programs.
  • Improving Care for Seniors after They Leave the Hospital.Effective January 1, 2011—The Community Care Transitions Program will help high-risk Medicare beneficiaries who are hospitalized avoid unnecessary readmissions by coordinating care and connecting patients to services in their communities.
  • New Innovations to Bring Down Costs. Administrative funding becomes available October 1, 2011—The Independent Payment Advisory Board will begin operations to develop and submit proposals to Congress and the President aimed at extending the life of the Medicare Trust Fund. The Board is expected to focus on ways to target waste in the system, and recommend ways to reduce costs, improve health outcomes for patients, and expand access to high-quality care.
  • Increasing Access to Services at Home and in the Community. Effective beginning October 1, 2011—The new Community First Choice Option allows States to offer home and community based services to disabled individuals through Medicaid rather than institutional care in nursing homes.
  • Encouraging Integrated Health Systems. Effective January 1, 2012—The new law provides incentives for physicians to join together to form "Accountable Care Organizations." In these groups, doctors can better coordinate patient care and improve the quality, help prevent disease and illness, and reduce unnecessary hospital admissions. If Accountable Care Organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped save.
  • Understanding and Fighting Health Disparities. Effective March, 2012—To help understand and reduce persistent health disparities, the law requires any ongoing or new Federal health program to collect and report racial, ethnic and language data. The Secretary of Health and Human Services will use this data to help identify and reduce disparities.
  • Providing New, Voluntary Options for Long-Term Care Insurance. Benefit plan no later than October 1, 2012—The law creates a voluntary long-term care insurance program—called CLASS— to provide cash benefits to adults who become disabled.
  • Reducing Paperwork and Administrative Costs. First regulation effective October 1, 2012—Health care remains one of the few industries that relies on paper records. The new law will institute a series of changes to standardize billing and requires health plans to begin adopting and implementing rules for the secure, confidential, electronic exchange of health information. Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors and, most importantly, improve the quality of care.
  • Linking Payment to Quality Outcomes. Effective for payments for discharges occurring on or after October 1, 2012—The law establishes a hospital Value-Based Purchasing program (VBP) in Original Medicare. This program offers financial incentives to hospitals to improve the quality of care. Hospital performance is required to be publicly reported, beginning with measures relating to heart attacks, heart failure, pneumonia, surgical care, health-care associated infections, and patients' perception of care.
  • Improving Preventive Health Coverage. Effective January 1, 2013—To expand the number of Americans receiving preventive care, the law provides new funding to state Medicaid programs that choose to cover preventive services for patients at little or no cost.
  • Increasing Medicaid Payments for Primary Care Doctors. Effective January 1, 2013—As Medicaid programs and providers prepare to cover more patients in 2014, the Act requires states to pay primary care physicians no less than 100 percent of Medicare payment rates in 2013 and 2014 for primary care services. The increase is fully funded by the federal government.
  • Expanded Authority to Bundle Payments. Effective no later than January 1, 2013. —The law establishes a national pilot program to encourage hospitals, doctors, and other providers to work together to improve the coordination and quality of patient care. Under payment "bundling," hospitals, doctors, and providers are paid a flat rate for an episode of care rather than the current fragmented system where each service or test or bundles of items or services are billed separately to Medicare. For example, instead of a surgical procedure generating multiple claims from multiple providers, the entire team is compensated with a "bundled" payment that provides incentives to deliver health care services more efficiently while maintaining or improving quality of care. It aligns the incentives of those delivering care, and savings are shared between providers and the Medicare program.
  • Additional Funding for the Children's Health Insurance Program (CHIP). Effective October 1, 2013—Under the new law, states will receive two more years of funding to continue coverage for children not eligible for Medicaid.
  • Establishing Health Insurance Exchanges. Effective January 1, 2014—Starting in 2014 if your employer doesn't offer insurance, you will be able to buy insurance directly in an Exchange -- a new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans. Exchanges will offer you a choice of health plans that meet certain benefits and cost standards. Starting in 2014, Members of Congress will be getting their health care insurance through Exchanges, and you will be able buy your insurance through Exchanges too.
  • Promoting Individual Responsibility. Effective January 1, 2014—Under the new law, most individuals who can afford it will be required to obtain basic health insurance coverage or pay a fee to help offset the costs of caring for uninsured Americans. If affordable coverage is not available to an individual, he or she will be eligible for an exemption.
  • Ensuring Free Choice. Effective January 1, 2014—Workers meeting certain requirements who cannot afford the coverage provided by their employer may take whatever funds their employer might have contributed to their insurance and use these resources to help purchase a more affordable plan in the new health insurance Exchanges. These new competitive marketplaces will allow individuals and small businesses to buy qualified health benefit plans. Starting in 2014, Members of Congress will be getting their health care insurance through Exchanges and all Americans will have the choice of buying insurance through them, too.
  • Increasing Access to Medicaid. Effective January 1, 2014—Americans who earn less than 133 percent of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in Medicaid. States will receive 100 percent federal funding for the first three years to support this expanded coverage, phasing to 90 percent federal funding in subsequent years.
  • Makes Care More Affordable. Effective January 1, 2014—Tax credits to help the middle class afford insurance will become available for those with income between 100 percent and 400 percent of the poverty line who are not eligible for other affordable coverage. (In 2010, 400 percent of the poverty line comes out to about $43,000 for an individual or $88,000 for a family of four.) The tax credit is advanceable, so it can lower your premium payments each month, rather than making you wait for tax time. It's also refundable, so even moderate income families can receive the full benefit of the credit. These individuals may also qualify for reduced cost-sharing (copayments, co-insurance, and deductibles).
  • Ensuring Coverage for Individuals Participating in Clinical Trials. Effective January 1, 2014—Insurers will be prohibited from dropping or limiting coverage because an individual chooses to participate in a clinical trial. This applies to all clinical trials that treat cancer or other life-threatening diseases.
  • Eliminating Annual Limits on Insurance Coverage. Effective January 1, 2014—The law prohibits new plans and existing group plans from imposing annual dollar limits on the amount of coverage an individual may receive.
  • No Discrimination Due to Pre-Existing Conditions or Gender. Effective January 1, 2014—The law implements strong reforms that prohibit insurance companies from refusing to sell coverage or renew policies because of an individual's pre-existing conditions. Also, in the individual and small group market, it eliminates the ability of insurance companies to charge higher rates due to gender or health status.
  • Increasing Small Business Health Insurance Tax Credit. Effective January 1, 2014—The law implements the second phase of the small business tax credit for qualified small businesses and small non-profit organizations. In this phase, the credit is up to 50 percent of the employer's contribution to provide health insurance for employees. There is also up to a 35 percent credit for small non-profit organizations.
  • Paying Physicians Based on Value Not Volume. Effective January 1, 2015—A new provision will tie physician payments to the quality of care they provide. Physicians will see their payments modified so that those who provide higher value care will receive higher payments than those who provide lower quality care.

Tags:  January 2011  Occupational  Physical  Policy  Wellness 

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New tips and helpful information from health.gov (January 2011)

Posted By National Wellness Institute, Saturday, January 1, 2011
Updated: Thursday, December 27, 2012

If the litany of health facts, information, to-do lists, and meant-to-be helpful suggestions seem overwhelming to you, Wellness News You Can Use would like to offer a simple way to start. The website health.gov has a handy tool on the right hand side of its landing page that provides a customized health guide just for you!

To use the guide, simply enter in your age and sex. The site will generate a checklist of preventative services you should take advantage of to maintain your health. In addition, each service has quick and easy links with further explanations. What's more, you can use the check list provided as a guide when you visit your doctor and for suggestions on not only maintaining your health, but also improving it.

The site also has useful information on activity guidelines, health news, health literacy, dietary guidelines, and toll-free hotlines you can use related to your health!

To give it a try, visit www.health.gov today!

Tags:  January 2011  Physical  Policy  Social  Wellness 

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Are you "left" politically? It might be in your genes! (November 2010)

Posted By National Wellness Institute, Monday, November 1, 2010
Updated: Friday, December 28, 2012

Researchers f from the University of California, San Diego and Harvard University have found evidence that our political leanings might be connected to our genetic make-ups. Published in the Journal of Politics, the scientists found that ideology is affected by both social factors and a dopamine receptor gene called DRD4.

The research focused on 2,000 subjects from The National Longitudinal Study of Adolescent Health. By matching genetic information with maps of the subjects' social networks, the researchers were able to show that people with a specific variant of the DRD4 gene were more likely to be liberal as adults, but only if they had an active social life in adolescence.

Dopamine is a neurotransmitter affecting brain processes that control movement, emotional response, and ability to experience pleasure and pain. Previous research has identified a connection between a variant of this gene and novelty-seeking behavior, and this behavior has previously been associated with personality traits related to political liberalism.

Lead researcher James H. Fowler of UC San Diego and his colleagues hypothesized that people with the novelty-seeking gene variant would be more interested in learning about their friends' points of view. As a consequence, people with this genetic predisposition who have a greater-than-average number of friends would be exposed to a wider variety of social norms and lifestyles, which might make them more liberal than average. They reported that "it is the crucial interaction of two factors—the genetic predisposition and the environmental condition of having many friends in adolescence—that is associated with being more liberal." The research team also showed that this held true independent of ethnicity, culture, sex or age.

Source: www.ucsd.edu

Tags:  Intellectual  November 2010  Policy 

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