Horizon BCBSNJ launches AskBlue and AskBlue Medicare

Horizon Blue Cross Blue Shield of New Jersey is making available AskBlue ® and AskBlue Medicare, the Blue Cross and Blue Shield Association’s interactive online tools. If your clients and their employees are experiencing layoffs or a loss of group coverage, your clients can direct their employees to AskBlue and AskBlue Medicare. These tools can help lead your clients and their employees to information about the individual health coverage that best matches their needs.

How AskBlue works

Users have an interactive conversation with AskBlue, answering high-level questions about their health care needs. Then, AskBlue makes a personalized recommendation based on available products from Horizon BCBSNJ.

AskBlue will help your clients provide their employees with:

• Support as they transition from employer-based to individual coverage.

• An introduction to local coverage options.

• A valuable service at no extra cost; AskBlue requires no employer investment.

To begin the AskBlue conversation, visit http://www.bcbs.com/askblue/

 

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New Healthcare Cost Estimator Now Available to Members

Members can receive personalized provider- and facility-specific medical cost estimates for high-cost, common procedures and treatments based on their specific health plan benefits.

Enhanced capabilities include provider- and facility-specific medical cost estimates, quality information, personalized benefits information and a user-friendly user interface.

This first release of myHealthcare Cost Estimator (myHCE) exemplifies the UnitedHealthcare mission of helping people live healthier lives and reflects our continued commitment to consumer price transparency in health care treatment quality and cost. And while myHCE offers significant advantages over our current treatment cost estimator (TCE) tool, the recent March launch in 47 markets represents the foundation for what will be planned continuous improvement in product capabilities and steady expansion into additional markets.

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US spends most on health care, gets less.

Though America spends more on health care than 12 other industrialized countries, the quality isn’t  better, a new study from The Commonwealth Fund finds.

The U.S. spent nearly $8,000 per person for health care services in 2009 while Norway and Switzerland were a distant second and third on medical spending, respectively, at a little more than $5,000 per person.

U.S. health care spending amounted to more than 17 percent of gross domestic product in 2009, compared with 12 percent or less in other study countries. Japan was the lowest spender at less than 9 percent of GDP.

What’s causing the high cost? The study points to higher prices and greater use of technology as the main factors driving the high rates of U.S. spending, rather than greater use of physician and hospital services.

Relative to the other countries in the study, the U.S had few hospital beds, short lengths of stay for acute care and few hospital discharges, study author David Squires found, who is a senior research associate at The Commonwealth Fund.

But U.S. hospital stays were far more expensive than those in other countries at more than $18,000 per discharge. By comparison, the cost per discharge in Canada was about $13,000, while in Sweden, Australia, New Zealand, France, and Germany it was less than $10,000.

“It is a common assumption that Americans get more health care services than people in other countries, but in fact we do not go to the doctor or the hospital as often,” Squires said in a news release. “The higher prices we pay for health care and perhaps our greater use of expensive technology are the more likely explanations for high health spending in the U.S. Unfortunately, we do not seem to get better quality for this higher spending.”

Prescription drug costs were also significantly higher comparatively, as well as the prices of MRI and CT scans.

Additionally, despite their country’s spending, Americans can expect poorer access to physicians than people in other industrialized nations, with just 2.4 doctors for every 100,000 citizens. On that score, only Japan fared worse, according to the report.

The U.S. did have some good No. 1 rankings: survival rates among breast cancer patients and colorectal cancer patients (the latter shared with Norway). But still, it has among the highest rates of potentially preventable deaths from asthma and amputations due to diabetes, and rates that are no better than average for in-hospital deaths from heart attack and stroke.

Squires also said the high spending in the U.S. might be explained, in part, by the nation’s high rates of obesity and the associated medical costs.

Released on Thursday, the report analyzed health spending in the U.S., Sweden, Australia, New Zealand, France, Canada, Germany, Norway, Japan, Switzerland, Denmark, the Netherlands and the United Kingdom.

As America’s waistline expands, costs soar.

(Reuters) – U.S. hospitals are ripping out wall-mounted toilets and replacing them with floor models to better support obese patients. The Federal Transit Administration wants buses to be tested for the impact of heavier riders on steering and braking. Cars are burning nearly a billion gallons of gasoline more a year than if passengers weighed what they did in 1960.  Read more.

Ten Mistakes Small Businesses Make When They Buy Health Benefits

Need we say more?  Click here for the article from Forbes.

Healthcare Reform. Preventive Care Slashed?

The House approved the Sequester Replacement Reconciliation Act of 2012 last week, combining the two bills that were approved earlier in the week by the House Budget Committee.  The bill contains deficit reduction proposals that the Congressional Budget Office (CBO) says would achieve $315 billion in deficit reduction over 10 years.  A significant portion of the savings would be achieved by slashing money for preventive services under the ACA, reducing the federal Medicaid match to states and imposing stricter Medicaid eligibility standards, and implementing medical liability reform.  The bill also would devote $72 billion of the budget savings to exempting defense spending and certain nondefense appropriations in fiscal year 2013 from the sequestration, or automatic cuts, triggered under the Budget Control Act.  The Democrat-controlled Senate is not expected to take action on the House measure, although the debates on deficit reduction and sequester replacement will continue in the coming months. The Obama Administration issued a statement indicating that the President’s senior advisors recommend vetoing the bill if it reaches his desk.

Health Care Exchange Act Vetoed

Gov. Christie has vetoed the state Health Care Exchange Act bill that stems from the national Affordable Care Act, a source said.

Christie, despite pleas earlier this week from Exchange advocates that the bill is needed to provide coverage for the underinsured residents ofNew Jerseyas well as make it easier for small-employers to provide benefits, struck down the bill.

One of the bill’s provisions is that it would have made New Jersey one of only two states with such exchanges who would have paid the members who sat on the board. They would have received $50,000 a year.

Sponsor Herb Conaway, (D-7), Delanco, who is a physician, had defended the payments as necessary since the board members would have been prevented from working in the insurance fields for some time after leaving.

Breaking News. Aflac Pays for FMLA Violation.

Given its experience with time-off issues, Aflac is not the type of employer you would guess to settle with the DOL for a violation of FMLA.

That’s exactly what happened in April, to the tune of almost $17,000.

The DOL Wage and Hour Division (WHD) settlement was based on Aflac’s termination of an employee who took intermittent leave because of a serious health condition. Aflac contended that the leave was not FMLA-protected because the employee did not provide requested documents on a timely basis. The WHD investigation showed otherwise.

Under FMLA, employers can require employees to provide a medical certification that proves they have a serious health condition. FMLA Regulations state that employees must return this certification within 15 days of receiving it “unless it is not practicable under the particular circumstances to do so despite the employee’s diligent, good faith efforts or the employer provides more than 15 calendar days to return the requested certification.

WHD emphasized the importance of the settlement. “Workers’ jobs should be protected while they are dealing with serious medical problems,” said Janet Campbell, director of the Wage and Hour Division’s Atlanta District Office. “The Labor Department is committed to protecting the rights of employees eligible under the FMLA to take up to 12 weeks of unpaid, job-protected leave each year.”

Do you strictly enforce the 15-day requirement? In what situations might you allow more time? Please comment below.

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Horizon BCBSNJ Launches Tu Seguro Azul

Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ)  is proud to announce the launch of Tu Seguro Azul (Your Blue Insurance). Tu Seguro Azul is a program developed to serve Hispanic members enrolled in one of the products listed below.

Individual products:

  • All Individual products (excluding Medicare Advantage). For a complete      listing, visit www.HorizonAzul.com.

Small Group products:

  • Horizon HMO Access 100/80 Plus.
  • Horizon HMO Access – Basic $25/$50.
  • Horizon Advantage Direct Access 100/80/60.
  • Horizon Advantage EPO 100/50 $30/$50.

Tu Seguro Azul includes a dedicated Member Services team, staffed with representatives who can provide support to Hispanic members in English or Spanish. Horizon BCBSNJ’s Member Services Representatives have received cultural competency training to help address the needs of Hispanic members. The representatives will provide valuable plan information to help members take advantage of their health care benefits to optimize their health. Eligible members can take advantage of this service by calling 1-855-477-AZUL (2985).

The program is designed to:

  • Improve the end-to-end Hispanic member experience.
  • Enhance the carrier’s services and empower members with valuable plan and health information.
  • Establish a strong presence in the Hispanic community by developing key partnerships with Hispanic community leaders and sponsoring local community events.

Horizon BCBSNJ has created www.HorizonAzul.com, an informational website dedicated to its Spanish-speaking members. The website is written in Spanish and can also be viewed in English by selecting English once on the website. Members and prospects can access www.HorizonAzul.com for valuable plan information, including plan comparisons and Individual product rate sheets. The website is designed to offer consumer-focused solutions to meet Spanish-speaking members’ everyday health care needs, making it easier for Spanish-speaking members to find the health care information they need.

The website includes:

  • Horizon BCBSNJ’s Provider Directory, highlighting comprehensive network of  physicians, hospitals and other health care professionals.
  • A local community events section, highlighting various free events (i.e., health      screenings) targeting the Hispanic community in Hudson County.
  • Materials in Spanish:
    • Plan overview section with easy-to-read plan details.
    • Downloadable member marketing materials and resources.
    • Health articles and external links relevant to the Hispanic population.
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Will Health Law Result in Employers Dropping Coverage?

The House Ways and Means Committee released a report last week that says employers would save $28 billion in 2014 by paying penalties for dropping coverage rather than continue to pay for health benefits. The Congressional Budget Office has a different take on the issue.

We are hoping for a good old fashioned fist fight.

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