Patients, will your deductible be met?

When you buy insurance, what coverage do you expect to get from it?  Are you looking to get an inexpensive plan and expect full coverage or are you willing to pay a little more and know that your covered.  If you've chosen the inexpensive plan, such as a "bronze" plan, you may begin to find that it wasn't the best option in the long run once you're surprised with an expensive copay after your next visit.  Also, besides the copay charge you may have to pay full price for your visit as well.  Since these issues have been quickly emerging, experts are afraid that patients may be discouraged from following up with their doctors after getting charged full price for their previous visit.  Carl McDonald, senior analyst with Citi Investment Research said, "This could be the next shoe to drop, as people don't realize that if they're buying a bronze plan, they may have to pay $5,000 out of pocket before it contributes a penny." When McDonald said this at a Washington D.C conference last month he was arguing that if you try to save money on healthcare in the moment, it may catch up to you in the long run and cost you more.

What about a plan that is a little more expensive?  Plans such as "Silver" plans, generally have a higher monthly deductible but they do cover 3/4 of doctor visits before the deductible is met.  With this plan, you won't have to worry about being covered when you see the doctor or being surprised by a hefty bill.  Of course, the coverage may still vary if you go to see a specialist for an extreme reason and not an ordinary doctor visit.

However, all new insurance plans are required by the government to cover some preventative services without a copayment as well as not having met the patients deductible first.  Such plans include: "vaccinations, mammograms, other cancer screenings, contraception, birth control pills, and physicals." But charges may be applied if treatment is needed for an illness such as the Flu, a medical condition, or a minor injury.  Also, there is only limited coverage for prescription drugs.  After hearing this which plan do you think is best to get in the long run?  Will you choose to save money in the beginning with a cheaper deductible but have copayments and full bills, OR go with a plan that offers better coverage off the bat even though it has a higher deductible? The next time you look for a new plan, think about your long term coverage so you know you'll be covered.

EVERA. Everyone should feel this good about healthcare.



Source: http://www.kaiserhealthnews.org/stories/2013/december/23/consumers-with-less-expensive-plans-spend-thousands-before-coverage-begins.aspx


  

Ebola, can we stop it?

Lately all we've seen on the news is updates on the enormous Ebola Virus outbreak in West Africa, but have you heard about the new potential cure?  Since the virus seems to be spreading like wildfire infecting many healthcare workers and natives in West Africa and Liberia, Sierra Leone, and Nigeria after starting in December;  scientists have begun to develop a cure that is slowly starting to be tested on patients.  Today numbers have risen tremendously since the initial outbreak in December to approximately 2,600 people infected and 1,500 fatalities.  Will this cure work? or will the outbreak continue spread.  The healthcare workers have been setting up many quarantine stations and health centers to treat newly infected patients, this may be good enough to slow down the virus from spreading even further but it will still take some time to fully implement this newly developed antidote.

EVERA.  Everyone should feel this good about healthcare.

Source: http://www.cnn.com/2014/08/27/health/ebola-outbreak

Obamacare, for better or worse?

When you hear "Obamacare" what comes to mind? Helpful or hurtful?  Since Obamacare was implemented in March of 2010 there has been many disagreements between individuals on whether it was good or bad.  A recent investigation has shown that the cause of the HealthCare.gov website to crash last fall was due to management errors in the Obama Administration.  Failures such as these are what is providing americans with a doubtful opinion of the whole healthcare system as well as the Obama Administration in its entirety.   Some confusion was caused by the Government Accountability Office (GAO) when they continuously changed the marching orders for contractors who built the computerized sign-up system that is used in HealthCare.gov.  This miscommunication ended up causing millions of dollars in additional costs and americans to lose access to the healthcare website.  This investigation heavily exposed major flaws in the Obama Administration from how these mistakes were made when they could have been avoided.


EVERA.  Everyone should feel this good about healthcare.

Source: http://www.huffingtonpost.com/2014/07/30/obamacare-website_n_5634590.html?utm_hp_ref=obamacare

The ACA could still TANK!

It seems that as of late there hasn't been much talk about the ACA.  People got sick of hearing about it, it wasn't really working or not working, and there was nothing that could really affect the future of the ACA to talk about.  Well, apparently one the most important mechanisms of the ACA is illegal.  The law does not permit subsidies on a Federal Exchange.  Personally, I believe this will get tossed out of court within the next few days. However, in the rare occurrence that this is taken seriously it could have a detrimental effect on the ACA and basically diminish the law all together.  It would wreak havoc in the health care industry, millions of people would be without coverage overwhelming the state insurance exchanges. I have been totally against the ACA for a long time, I wanted to see it fail simply because I believed that the republican party had a much more realistic and obtainable goals for the industry. They were more focused on increasing accessibility and decreasing cost rather than just subsidizing and charging people based on income. But at this point, it would do way more harm than good after all the majority of us just want to see as many people with coverage as possible.

EVERA. Everyone should feel this good about healthcare.

Source:
http://finance.yahoo.com/news/conservatives-hoping-10-words-finally-182100171.html

Tele Medicine Friend or Foe?

The thought of being able to call, text, or skype with a doctor to get diagnosed and receive prescriptions sounds marvelous. It's inexpensive, an efficient use of time, and has proven to be effective.  Like all new discoveries and concepts people have their doubts, but with a model like this that has the potential to lower healthcare costs tremendously across the board as well as increase accessibility we need to explore every possible option to make this work.

Tele medicine is not a particularly new concept, it has been around since the 1960's.  There have been many laws restricting its use and occurrences that have slowed its progress over time. However, timing is everything. I believe the time is now! With the technology and data we have at our fingertips on a everyday basis there is no reason that we need to driving to sit in a doctors office full of sick people to get a prescription for strep throat when we've gotten it once a year for 10 years straight.

The problems that have previously occurred and many critics think will continue include fraud, privacy, and abuse.  An understandable conclusion based on the past but as we all know, times change.  We need to innovate and make sure these services are used for the right reasons.  

How do we do that?

-Data
 Knowledge is power, and that knowledge is more accessible than ever before. All the data is there it just needs to be unified and readily available for a doctor who is servicing a patient remotely.

-Restriction
Like anything else, there are always going to be people that abuse privilege. If a person has a history of prescription drug abuse or has been found guilty in committing fraud using a service such as this justice needs to be served. I am by no means a lawmaker but I would not be upset if fines were associated with crimes like this, but at the very least placing the offender on some sort of blacklist disabling them from having the PRIVILEGE of using telemedicine would suffice.

-Scope of Work
There needs to be strict limitation on the assortment of treatments and the types of prescriptions that can be written using telemedicine. We can't be prescribing pain meds to everyone that calls saying their back hurts. However someone who has high-blood pressure or another chronic disease should not have to visit a doc in order to get the medicine they need.

-Privacy
Medical documentation is extremely personal and with it flying back and fourth across the Internet it's very easy for it to end up in the wrong hands.  It's currently the biggest setback for telehealth right now and steps need to be made to solve this issue before we see any real progress.

-No Shortcuts
Providers of telemedicine need to be monitored. Proper protocol needs to be observed. Ethics and proper patient care needs to be on top of any telehealth providers priorities.

If we work to fix these bugs with the currently flawed system we will be well on our way to decreasing cost, increasing accessibility, and saving patients and doctors valuable time.  Anyone that follows the healthcare industry can see that it needs changing and this is a region that has serious potential.

EVERA. Everyone should feel this good about healthcare.

Source:
http://thehealthcareblog.com/blog/2014/07/07/how-telehealth-may-be-promoting-fraud-and-abuse/#more-74645

Theranos. Simply Amazing

Do you remember when smart-phones were car-phones and they were the size of a brick? Or how about when TV's were GIGANTIC and took up half a room. Now we have computers in our pockets and giants screens taking up only space on the wall. In a few years we will be looking back and saying "remember when we had to give big tubes of blood for each test and it was so expensive".

Thanks to Theranos we now only need a single drop of blood for up to 30 tests! The company has recently raised $400 million and has been valued at about 9 billion dollars. Elizabeth Holmes founder and leading shareholder at 50% has been building this company since she was 19 years old. She dropped out of Stanford in an attempt make actionable healthcare available to everyone. She is well on her way, the cost of all of the tests that Theranos covers are all published on their website and other marketing materials. They are less than half of what the standard medicare and medicaid reimbursement rates are. If ALL blood testing were done through Theranos it would save Medicare and Medicaid over 200 Billion over the next decade! I think the actual number will be considerably less because Theranos is still a relatively new company and needs time to grow and implement their testing facilities into the market. Eventually it they should be doing all testing.

I have no doubt in my mind this company is going to continue to grow exponentially. This is EXACTLY what we need to see more of in the healthcare industry. People working and being creative to decrease cost and increase accessibility. This is going to help so many people and it will most likely eventually save you a few dollars a month on your healthcare bill whether or not you actually get blood work or not.

EVERA. Everyone should feel this good about healthcare.  

Sources:
http://www.wired.com/2014/02/elizabeth-holmes-theranos/

http://www.theranos.com

Urgent Care is Exploding!

Urgent care clinics have been around in the United States since the 1970's. For the most part they have been successful and now, they are becoming the preferred choice for patients across the country.  The reasons behind this are plentiful, these facilities accept walk-ins, they treat a broad spectrum of illnesses and injuries, are equipped with licensed physicians, they are open long hours, and are typically conveniently located.

Two of the most prominent flaws with the United States healthcare industry are COST and ACCESSIBILITY. Below are a list of some of the more common treatments that would previously be performed in an ER. You can see that visiting an urgent care will save a patient on average of about 75%!

So not only will you save money by going to an urgent care, you will also receive quality treatment in a more timely fashion.

Have you ever loved a musician or a band for years and they finally make it big and get some real recognition? This is what is happening to the urgent care sector of the healthcare industry. One reason the urgent care sector is gaining so much traction is because investor owned companies, private equity, and other financiers are putting their money into immediate care because lawmakers are pressuring hospitals to treat out-patients more inexpensively. This is making urgent care companies a hot commodity. Humana the health insurance powerhouse purchased Concentra an urgent care company with more than 300 clinics nationwide for a whopping 790 Mil in cash. Dignity Health bought US Healthworks acquiring 172 clinics for 450 Mil back in 2012. Since then USHW's has grown to more than 200 clinics with no sign of slowing down. Below are some other notable urgent care companies that have been purchased by big players in the industry.

It shouldn't come as a surprise that these companies are continuing to grow and prosper. It's capitalism, when you can offer something people NEED with the same or better quality at a more inexpensive price you win. These facilities will continue to grow until a better more efficient model is achieved. For the time being this is EXACTLY what people need ACCESSIBLE, AFFORDABLE, CONVENIENT, care right around the corner from their home or office.

EVERA. Everyone should feel this good about healthcare!

Source:

http://www.forbes.com/sites/brucejapsen/2013/03/11/a-boom-in-urgent-care-centers-as-entitlement-cuts-loom/