iLoveBenefits: Industry News Blog

Reimbursement is beginning to change in important ways

Effective January 1st, the Centers for Medicare and Medicaid Services (CMS) began reimbursing providers who actively manage care delivery for Medicare patients who have two or more chronic conditions. According to a recent health care provider survey, 76% of respondents planned to organize and structure to meet Medicare’s chronic care management program requirements within the next six months.



BEA: Breakdown of Healthcare Spending By Disease Type

The Bureau of Economic Analysis analyzed healthcare spending by disease from 2000 to 2010. Here’s the percentage of total spending for each disease category:

Disease Type Percentage Spent
Circulatory conditions 13.6%
Prevention, colds, basic care 12.0%
Musculoskeletal 9.9%
Respiratory 8.4%
Endocrine 7.3%
Nervous 7.0%
Cancers 6.7%
Genitourinary 6.4%
Injury 6.4%
Digestive 5.9%
Mental Health 4.6%
Infectious Disease 3.4%
Skin conditions 2.2%
Pregnancy/birth 2.2%
Other 4.1%

Source: Bureau of Economic Analysis, March 3, 2015

Worried about not sleeping . . . rest a bit easier

Study examines correlation between sleep hours, stroke risk A study in Neurology found that sleeping longer than eight hours a night was associated with a 46% increased risk of stroke. The study included 9,700 people. An 18% increased risk was seen among people who slept less than six hours, but the sample of people sleeping less than six hours was small enough that the association wasn’t considered significant. HealthDay News (2/25)

Employees are looking for integration they can rely on

53% of Employees say it’s difficult to understand how to improve their health

According to recent data from HealthMine, over half of employees say that it’s difficult to understand or know what they need to do in order to maintain or improve their health. Some specific areas that came up include:

·         85% want to know if they have health risks for developing chronic conditions.

·         55% want help from their health care plan in setting personal health goals.

·         65% want their health plan to send them reminders about critical health actions such as prescription refills and annual health exams.

Source: Employee Benefit News

Listening to the patient about their chronic pain

An independent panel convened by the National Institutes of Health concluded that individualized, patient-centered care is needed to treat and monitor the estimated 100 million Americans living with chronic pain. “Persons living with chronic pain have often been grouped into a single category, and treatment approaches have been generalized with little evidence to support this practice,” said Dr. David B. Reuben, panel chair and professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles. “Chronic pain spans a multitude of conditions, presents in different ways, and requires an individualized, multifaceted approach.”

Everyone’s destiny is health care . . . we need to improve this . . . for ourselves

Survey: 68% of older U.S. adults have multiple chronic conditions A survey from The Commonwealth Fund of 15,617 older adults in the U.S. and 10 other countries showed 68% of Americans had two or more chronic conditions and 53% were taking four or more medications, which were higher rates than reported in some other countries. Other countries had better rates of same-day care than the U.S., but Americans had faster access to specialist care. The findings were published in Health Affairs. Health Affairs Blog

How Pharmacists Can Improve Our Nation’s Health

On Tuesday, October 27th CDC announced that the video and presentation slides including Beyond the Data from the October session of CDC’s Public Health Grand Rounds, “How Pharmacists Can Improve Our Nation’s Health,” held on Tuesday, October 21 are now available here.  According to the CDC, “The expanded role of 21st century pharmacists will position them to have greater impact in the shifting landscape of health care and public health.  Beyond the dispensing of medications, pharmacists also provide a spectrum of prevention services to help improve health outcomes.  In the United States, people with chronic conditions account for 91% of all prescriptions filled. By 2020, it is estimated that 157 million Americans will have at least 1 chronic non-infectious or infectious medical condition.  By understanding and maximizing the role of pharmacists, opportunities exist to better use their knowledge and skills to improve our nation’s health.”

Most adjusted death rates continue to fall

From 2011 to 2012, the age-adjusted death rate fell 1.8% for heart disease, 1.5% for cancer, 2.4% for chronic lower respiratory diseases, 2.6% for stroke, 3.6% for Alzheimer’s disease, 1.9% for diabetes, 8.3% for influenza and pneumonia, and 2.2% for kidney disease; but the rate for suicide rose 2.4%; and the rate for unintentional injuries remained the same. Source: “Mortality in the United States, 2012,” Centers for Disease Control and Prevention, NCHS Data Brief #168, October 2014,

What are the benefits and challenges of long term drug utilization

While these studies demonstrate that there are benefits and challenges for statin users, it points out something that may be a very important finding. That is, that this drug (and can we extrapolate for other drugs as well) there is the potential that a drug, or combination of drugs, can advance the expression of other chronic diseases?

Statins’ heart benefits greatly exceed risks, analysis showsA review of data from studies published over the past 20 years found that the cardiovascular benefits of long-term statin use significantly outweigh the risks. Long-term use of the drugs, however, may slightly increase the risk of developing type 2 diabetes among those with existing risk factors. The findings appear in the British Medical Journal. HealthDay News (8/5)

Changing the paradigm and reach of the traditional office practice

Nurse-led protocol tied to better chronic disease managementAn analysis found nurse-led outpatient disease management protocols were associated with significant improvements in HbA1C, systolic blood pressure and lipid levels in patients with diabetes, hypertension and hyperlipidemia. The nurses followed a protocol for medication titration, according to the study reported in the Annals of Internal Medicine. Renal and Urology News (7/18)

Doctors agree that PAs, NPs improve care, productivityA Jackson Healthcare survey revealed about 75% of doctors who employed advance-practice professionals such as physician assistants and nurse practitioners said doing so helped improve patient care and practice efficiency, while two-thirds reported that PAs and NPs are handling tasks that formerly were handled by doctors. Sixty percent of respondents perceived the increasing role of PAs and NPs positively, researchers said. (7/17)

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